Today Ellen shares the birth stories of her two daughters, who were both born prematurely. We discuss the benefits of midwifery care and why Ellen chose midwives for both of her births, as well as some of the insurance challenges that we face when attempting to choose midwives. She details how both of her daughters were not only preemies but also how her bag of waters broke as the first sign of labor both times.
You'll hear Ellen describe a difficult 2nd pregnancy and how seeing a chiropractor who was expert in this phase of life helped eliminate all of the severe pain she had experienced. She also shares coping strategies for her second (induced) birth that really helped her cope in a way that enabled her to opt out of the epidural. She discusses the various ways that her midwives advocated for her in both births to avoid a cesarean in the first birth and to push the way she wanted to her in her second.
Ellen tells how her husband, Lo, almost missed the 2nd birth when he ran out briefly to grab food. She also shares details on having both babies in the NICU for jaundice and ways she advocated for her daughters, along with the nuances of being a pediatric nurse as a new parent and how that dynamic played into the advocacy.
Ellen describes specific ways she coped with the challenges of labor and how her training as a prenatal yoga teacher and meditation habits as a couple informed her strategies. Finally, she shares about early breastfeeding challenges and both of her daughters’ diagnoses with and treatment for tongue tie.
Episode Topics:
Midwifery model of care & insurance coverage challenges with working with a midwife
FIRST BIRTH STORY (Evie):
Conception via IVF after only one try
Water breaking several weeks before estimated due date with first baby
Blood pressure too high and baby being in distress causing cesarean to be brought up a real possibility
Induction with foley balloon
Epidural administered “just in case” a cesarean becomes necessary due to constant decels in baby’s heartbeat
Just as they’re about to take her for a cesarean, baby is crowning so midwife tells them to back off so she can push the baby out
Baby has one extra day of stay for treatment for jaundice under bililights
2ND BIRTH STORY (Sierra):
2nd pregnancy challenges - symphysis pubis dysfunction, threw back out and could barely walk -- seeing chiropractor completely healed it all
water breaking as first sign of labor again while she’s at her sister’s house even earlier (33 weeks, 6 days), the anxiety that causes based on her 1st experience
Upon hospital admission, they stopped her labor for 24 hrs and administered steroids to help baby’s lungs mature
She meets with a NICU intensivist to ask for all the details about her daughters impending stay
How Ellen’s husband, Lo, almost missed the birth when he went out to grab food
Midwife’s tip to, “breath to the base of her spine” is golden for Ellen
Nurse telling her to make no noise in pushing, Ellen obeys briefly until midwife tells the nurse not to tell Ellen what to do with her body
Baby stays in NICU for 6 days and had jaundice
Description of early breastfeeding & advocating for her baby when being pressured to do a feeding tube in the NICU
Diagnosis & treatment of tongue/lip tie in the hospital before discharge (Ellen asks because her 1st daughter had it), getting conflicting info from nurse and pediatrician
Pain coping strategies - reflexology, counterpressure techniques, meditating together as a couple
How being a yoga teacher informed her pregnancies/labors
Ellen’s favorite labor playlist songs
Ellen’s tips: surround yourself with lots of support, so that you can take it easy for the first 40 days, postpartum nutrition
Resources:
Birth Matters NYC Childbirth Education Classes (Astoria, Queens)
Dr. Lauren Macaluso (M.D. with breastfeeding expertise)
Music mentioned:
Transcript:
Lisa (00:00): You're listening to the Birth Matters Podcast, Episode 26.
Ellen (00:03): But as a yoga teacher I know how to drop into what it feels like when I'm in Shavasana, that same feeling. The night before Sierra came out, my husband and I—my husband is trained in meditation and we meditated the night before she came out, because neither of us could sleep. So we just, I said, "Just, you know, like, lead a sit, like, just lead me through a meditation." And he did, and it was—the nurse walked in and we're both, like, barely touching palms, and they know what we're doing was meditating and it helped us through just the emotional roller coaster of giving birth.
Lisa (00:47): Hey there! And welcome to the Birth Matters Show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC Childbirth Education and Labor Support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence info and soulful interviews with parents and birth pros. Please keep in mind the information on this show is not intended as medical advice or to diagnose or treat any medical conditions. If you like the show, we'd be so grateful if you'd write a review. Wherever you're listening to this, you might just get a shout out on social media or on the podcast if you do.
Lisa (01:24): In fact, let’s share one of those reviews right now. Here’s a shoutout to Cesia Falcon, who wrote the following very kind 5-star review. She says, "Lisa provides all listeners with different birth stories that are amazing! Love listening to her and share her wisdom of the birth process as well.”
Lisa (01:42): Cesia just happens to be the host of the Parenting in Queens podcast. If you check out her show, she has a great interview with Ellen and her husband, Lo, the family who share their birth story on this podcast today. The episode is called “Unconventional Parenting and Growing Closer Through IVF.” You can also hear yours truly interviewed on the show 3 episodes later. So, check out the Parenting in Queens podcast, and thanks so much for the kind review, Cesia.
Lisa (02:08): Today Ellen shares the birth stories of her two daughters, who were both born prematurely. We discuss the benefits of midwifery care and why Ellen chose midwives for both of her births, as well as some of the insurance challenges that we face when attempting to choose midwives. She details how both of her daughters were not only preemies but also how her bag of waters broke as the first sign of labor both times. You'll hear Ellen describe a difficult 2nd pregnancy and how seeing a chiropractor who was expert in this phase of life helped eliminate all of the severe pain she had experienced. She also shares coping strategies for her second (induced) birth that really helped her cope in a way that enabled her to opt out of the epidural. She discusses the various ways that her midwives advocated for her in both births to avoid a cesarean in the first birth and to push the way she wanted to her in her second. Ellen tells how her husband, Lo, almost missed the 2nd birth when he ran out briefly to grab food. She also shares details on having both babies in the NICU for jaundice and ways she advocated for her daughters, along with the nuances of being a pediatric nurse as a new parent and how that dynamic played into the advocacy. Ellen describes specific ways she coped with the challenges of labor and how her training as a prenatal yoga teacher and meditation habits as a couple informed her strategies. Finally, she shares about early breastfeeding challenges and both of her daughters’ diagnoses with and treatment for tongue tie.
Lisa (03:37): Before we jump into the story, I want to let you know that this episode is brought to you by Birth Matters NYC's Childbirth Education Classes. If you live in the New York City area, the best way to build your confidence and prep for an amazing birth and entry into parenthood and to connect with other expectant parents to build your very important support system is to attend group childbirth education classes. You'll spend quality time with your labor support partner in our comfy Astoria living room classroom as you prepare for not only birth but also for your best possible postpartum recovery and wellness, as well as early parenting with classes on breastfeeding and newborn care techniques. Classes often book up about 1 to 2 months in advance, so be sure to grab your spot on the early side. For more information and to sign up, visit birthmattersnyc.com. Okay, let's jump in.
Lisa (04:28): Welcome to the Birth Matters Podcast. Today I have Ellen with me, a mom of two little ones, and welcome, Ellen, how are you?
Ellen (04:35): Hi Lisa. I'm good. How are you?
Lisa (04:37): I'm great, thanks. You want to share with the listeners where you are in your parenting journey?
Ellen (04:42): Sure. Currently, I have a two-and-a-half-year-old and I just had—she just turned two months two days ago, so two and a half and two months. Pretty busy.
Lisa (04:55): Yeah, it's already been two months. I can't believe that. Time flies.
Ellen (05:00): Well, she wasn't due until last month, but she's now two months.
Lisa (05:04): Great. Well, can you just share a little bit about your journey toward discovering the midwifery model of care and why you chose midwives for each of your pregnancies?
Ellen (05:15): Sure. Well, I'm also a nurse. That's pretty much my identity before becoming a mom. And so I'm very pro nursing and I feel very connected to the core of our profession, which is to care, and healing touch, and all that loving stuff. So I wanted something like that for myself. I've been a patient before in hospital. I don't like it even though I'm a nurse. But I love the aspect of the humanistic approach with nursing. So I really believe that I wanted the least medical intervention. I wanted somebody or a practice that will honor my belief in what I want in a birth. Like, I don't want to be pressured into doing something. I want to be listened to. I want my desires to be acknowledged. I want my birth plan to be followed as much as possible, and I want somebody to advocate for me when I'm under distress.
Ellen (06:08): And I've met with a high risk maternal—fetal maternal doctor for both of my pregnancies, just as a consult. But I really wanted somebody who was very closely connected to my practice at home and as a nurse. And the only practice I really connected to was a midwifery. The ones that we found, which is Central Park Midwifery is—we just absolutely love them, we're in love with them. We've had two of their midwives deliver each baby. The first was Elaine and she just set the standard for what it is like to give birth within the care of a midwife. And even moving after that, moving far away from their practice logistically, we still seek them because we couldn't imagine giving birth again without that support. So, yeah, we just love what their mission is, what they stand by, what—they're, you know, just very closely connected to us.
Lisa (07:09): I love that. I was just recommending Central Park to a student last night in class. They're just so wonderful. I've gone to them for well woman care, and love, love their practice.
Ellen (07:18): They are. And they are just, I mean, I can't even imagine not being with them, because I—they can easily, they're so open to you and they're so, you know, like, they, they still text me, they still keep up with me. They still ask me questions at a time where I'm, like, I'm two months out, I should be out of your radar. And they still do, they still check up on me and make sure I'm okay. And I think that's the connection that we want to feel, like, that we're just not, we're not just a number, we're not just a, you know, a woman giving birth. We're actually human beings that they care about.
Lisa (07:53): Oh, I love that so much. That is exactly how we can improve—one way that we can improve our maternal outcomes in our country that are so terrible. So thank you.
Ellen (08:05): With that said, it does suck that New York seems to be a very hard place to be cared for by midwives, with health insurance—and we've gone through so much of this, you know, that's, like, one of the things that we had to struggle with this last one—but not just health insurance, practice itself. Midwives themselves feel like we're in a state that's not really very welcoming to the practice, and it's so hard to find one. It's so hard to find—not a good one—I feel like every midwife that I've talked to or seen, they're all good. It's just hard to, like, find a practice that's still open.
Lisa (08:46): Yeah. It's so unfortunate that it's so hard to find midwifery practices that that are covered by insurance and I think then it makes it hard for them be a viable practice—for them to stay in business—because so many people really want that insurance coverage, maybe can't afford the out-of-pocket. But there is, I think it's important to know that a lot of the midwifery practices do have good billers who are very good at kind of, like, knowing how to work the system and try to get as much coverage as possible. What was your experience with that?
Ellen (09:19): The first time? The first time went really well. I don't know what happened—and this goes into, like, healthcare and insurance—and it's just.... My second pregnancy and labor, for some reason, I don't know if my insurance changed without me reading the fine print or something. And I do have out-of-pocket out of network benefits, but it was not covered. It was mainly denied and, and I've called the insurance company and this is—it has nothing to do with my midwives at all. They have no control over this. But with healthcare I called the insurance company just giving birth, like, two weeks after, and asked them, like, why it was denied, and they couldn't give me the answer and my, the person on the other line was so empathetic and she felt so bad and she just said, "I'm so sorry. I don't know why it's denied, but it is."
Ellen (10:16): And I said, can you give me an explanation? And she said, "They control how much is covered as an out-of-network, and they really don't tell you how much is covered beforehand. So they can't warn you." And I just feel like, are you listening to yourself? Because this doesn't make any sense and this puts a lot of women in a bad situation. We're lucky. We're fortunate that we're not there, but it's, like, I can't imagine anyone else going through this and being blindsided. You know, I totally felt blindsided and I said, "Is there anything I can do? Can I appeal this?" She said, "You can appeal it," but she made it seem like nothing will—it won't be solved anyway and it's kind of, like, you're stuck and you already gave birth, so it's like you don't really have a choice, and it, it just, like, the whole cumulative part of, like, choosing....
Ellen (11:07): And I spoke to my midwife and I said, "This really makes it—they make it so hard for us to—for women in New York to, you know, to be cared for by midwives." They really, I feel like they put a block into it. Like, they just make it so hard for you to, like, want to be with a midwife. They stop—they don't, you know, they don't cover insurance. Even if you have out-of- network benefits, they don't cover it as much. It's so weird that they can't tell you how much is covered. There's just so many things that makes it so hard and I just feel so terrible that we're, we're not taking care of the women. And it's, you know, New York is a big city and everyone says it's the greatest city in the world. But as a woman, it's hard to be a laboring women in New York or a pregnant women in New York.
Lisa (11:53): Absolutely it is. You're right. Yeah. And of course different insurance companies will cover different things. But you're right, you're so right that it's very hard to get from them, like, "Really tell me exactly how much you're going to cover beforehand," which is so unjust. It's just so wrong.
Ellen (12:11): I actually told the woman, I said, "I've never felt like a victim of health care before. Like, I know people talk about how awful health insurances are, but I've never felt that myself. And this has really given me a different, you know, experience. Like I've—I work on the other side of healthcare. I provide healthcare and, if anything, you know, I understand that insurance companies relatively pay for what I do as my job. But I would never wish that on anyone else to put them in that." I mean, this is kind of off-track to what we were going to talk about, but it does, it does, like—it is a part of it, because not everyone can afford a self-pay midwifery care.
Ellen (12:49): Besides that, we still wouldn't have chosen any other way. We were still happy with what we, you know, the practice that we went with.
Lisa (12:57): Yeah. If only insurance companies would wise up to the fact that they would spend a lot less money if they would just cover midwifery care. It's such a backwards thing.
Ellen (13:07): I look at the EOBs—explanation of benefits—and I'm like, "The hospital is billing you 10 times more than what my midwives billing you. Yet you'd rather cover that?"
Lisa (13:19): Bizarre.
Ellen (13:20): It's so bizarre. But, you know, it is what it is.
Lisa (13:25): Well, thank you so much for sharing that, because I think that's really just important stuff for people to think about as they're making their choices in birth, and, you know, to talk to your insurance, get as much information as you're able to, and hopefully you'll have some coverage for midwifery care if that's what you want, you know.
Ellen (13:40): Well, did you hear about—I just heard this about—from Cesia, who's the other lovely woman that did a podcast with me, and we were due around the same time, and she just gave birth, but she posted something about Haven.
Lisa (13:53): Yes. I'm so excited about that.
Ellen (13:55): I am so excited and...
Lisa (13:56): Her midwives and a couple of others.
Ellen (13:57): Yeah, this is exactly—it kind of offsets that women can't find health midwives in New York because of the cost and the availability of practice. I don't—I haven't really read much about it, but I thought just the idea is amazing.
Lisa (14:14): Yes. And I know most of the midwives behind it, and I just was jumping up and down in joy when I found out about it and I hope, I really hope that it goes well. It's a new birthing center, all midwifery-led and it's in the works. It's not here yet in New York city, but hopefully it will be here before long.
Ellen (14:32): Yeah. Something to look forward to, although I don't know if I'll be pregnant again, but rooting for all pregnant women to have that.
Lisa (14:41): Oh, and the podcast you mentioned is the Parenting in Queens podcast, right?
Ellen (14:45): Yes.
Lisa (14:45): Your episode was so wonderful. I loved it and I will be sure to link to that episode in the show notes for this episode.
Ellen (14:51): That was a great podcast. Thank you.
Lisa (14:54): All right, well do you want to jump into your birth stories?
Ellen (14:58): Yeah. So I have two girls, the two-and-a-half-year old, which is Evie. She was born—we conceived her via in vitro. Luckily she was, you know—we were successful the first time we tried in vitro. Luckily my insurance covered it. My job had IVF coverage, which is all amazing. It just felt like it was meant to be for, you know, it just, like, opened up this gateway for us to make it happen easily. And pregnancy went well, I loved every minute of being pregnant with her. She just, like, made me feel like such a woman. And I was teaching yoga, restorative and Vinyasa till I was about 34 weeks, and I just felt great. Went to Italy for our "babymoon."
Ellen (15:44): But she came out, she was born at 35 weeks and three days, and nothing out of the ordinary. I was lying in bed and my water broke and I wasn't sure what it was. And I called my midwife and she was like, "Let's see if it's your water. You know, try to move around and try to eat breakfast, take a shower." I did all that. And I said, "I think it's my water. It's, you know, it's still going." So we went to the hospital, she's, like, "Yeah, you know, just tell your husband to meet us at the hospital. He doesn't have to come back from work. Just meet us at the hospital. He has plenty of time. And I was like, "He's already at the door." He already made it back and you know, we went in, it was kind of, like, a conversation between me and my midwife and they brought in a high risk fetal maternal doctor because of my age, because I was—you know, my water broke prematurely, and just kind of another consult and another person to, you know, chime in on what the best solution for me is. I was induced. So this happened—I went in at 12:00 PM. At 10 o'clock was when I started to feel contractions. Before that I was, like, laughing. I was, like, eating Pad Thai, and, you know, just drinking and drinking and drinking. And at 10 o'clock I laid down, I was, like, "I'm going to take some rest."
Ellen (16:54): My two sisters are there with me, they're both nurses. Because my background is a pediatric ICU nurse. So I'm very—in my head, I need my sisters to—one, you can go, you can stay with me if something happens to me. And the other one stays with baby if something happens to the baby. I think as an ICU nurse you just want to plan everything ahead and make sure that all bases are covered. And sure enough, I had some situations where, you know, the baby decelled a few times to the point that they would barge in, turn on the lights, you know, turn my, tell my husband to, like, turn off your playlist that you've made with all these, like, amazing music or zen music. 15 people came in, internal monitor being placed, ephedrine being pushed in me, my blood pressure—it's, like, because of my blood pressure, and again as a nurse I was like, "What is going on? What are you giving me? What am I getting?" Like, I'm trying to control the situation. My midwife is like, "Listen, you're the patient right now. I will explain everything to you, but right now we need to take care of you." And after that I said "Okay, that's fine." But they basically controlled—my blood pressure went down, she decelled, put the monitor in, everything was fine after that. They left. And then another time—you know, two and half years, it's so far away that I feel like it's all a fog—but it happened again. And finally my midwife was, like, "You know, we're in a situation where we may need to consider a C-section because she is in distress and she keeps going into distress mode longer and longer periods of time. But you"—and she told me, "And you know I want to follow your birth plan and I wouldn't open up this conversation if it's not realistic."
Ellen (18:35): So I said, "I know. I trust you and I know that you know this is not what I want. So if you feel like this is the best thing for me, I will go through with it. You know, I will follow whatever you tell me to do." So she said, "I think we should get you an epidural just in case it happens." And at that point I was having a lot of contractions. So I said, "Yes, that's fine." Got the epidural. I think that also caused my blood pressure to drop. Had another intervention. I think she checked me once and she was like, "You're three centimeters." And then after she decelled again, a few minutes later, a while later, she checked me again. She said, "Let me just check you because I know they're waiting to see if the OR's open." And she was like, "She is right—she's right there. I feel her head right there."
Ellen (19:21): She said, "If you feel any pressure"—at this point I had a Foley catheter, an internal monitor, blood pressure, fluids, like, all the monitors. She's, like, "If you feel any pressure, just go for it." And I did. And I started going for it and I just, like, she was crowning. At the same time I was pushing, the OR team was coming in to take me to the OR for a C-section, and she was, like, she just pulled everything out. She's like, "Baby's coming out. Just keep pushing, just keep pushing." So she basically told them to hold off, the baby's already coming out, and she just encouraged me to keep pushing on my own and, like, really, like, she didn't tell me what was happening, that they were coming right at that point. She just said, "If you feel the pressure, go for it." Once the baby's crowning, she just, like, encouraged me to keep going, keep going. And she came out within, like, maybe 10 pushes. She kind of flew out, and she was only little, she was about five pounds, three ounces. Healthy, good lungs, Apgar scores probably 9 and 10. No NICU stay because she was 35 weeks. And we went home in three days. I think she went home in four days. She had to stay an extra night for the lights, but otherwise that was pretty—and it felt longer than it did and it felt more traumatizing. But again, my sisters were there, and my midwife controlled the situation as I wanted her to, and she didn't let anyone touch me. She put in the Foley, she put in the catheter, she did everything. And Evie was healthy, and now she's thriving. She's two and a half.
Ellen (20:49): My second one is Sierra. She came out at 34 weeks. She actually—same thing. My pregnancy with her was a little bit different. It was a lot more—it was pretty rough. I had, like, pubic symphysis dysfunction. I couldn't walk. I had to, like, stop working and then that resolved. Then my back—I threw my back out to the point that I really couldn't walk. I thought the pubic symphysis dysfunction was painful. The back was three times as painful, and I really couldn't walk. I would cry every time I moved. My friend recommended seeing Flower of Life Chiropractors and she said they, you know, specialize in pregnant women. I was hesitant because they were so far away. But at that point I was like, "I will just—I need something. I need somebody that knows, that has an expertise on this." And sure enough, they completely fixed me. And there was one appointment where I was dragging myself and crying, walking to the table and, you know, Dr. Erin felt so bad and she had to, like, make me turn over and, like, adjust me. But between Dr. Erin, Dr. James, they—I saw them twice every, like, every other day or a few times a week, and they saw my progression to the point that one day I walk in and I was smiling and I was walking and she was like, "Look at you smiling!" And I couldn't believe what they did, but they were able to just, like, fix my body into alignment.
Ellen (22:15): But after that it was—I was actually 33 weeks and six days, same exact thing, lying in bed in the morning on my phone and my water breaks. I'm in complete denial because I'm at 33 and nine—at 33 and six and I said, "Maybe I just have to pee." And I tried to go to the bathroom. This time I was at my sister's house and I just kept gushing and I just screamed at her, I said, "I think my water broke." And I just started sobbing because I knew—and I really didn't want to have another preterm baby just because I was scared. You know, so many things that can go wrong and just a lot of fear. I called my midwife and the first thing I did was just bawl out crying and I said, "My water broke!" And I lost it. And she tried. She calmed me down. She said, "You know, this is okay. We knew this was a possibility. We're here, we're gonna get through this." And she told me all the scenarios, she said, "We will try to see if we can keep you pregnant. So you're 34 weeks, we will advocate for you." She just led the way to, like, what I need, to the space that I needed to be in. And so we got our stuff. We were in Long Island, drove to the city. My midwife Christina came in and she was not the same midwife that I worked with before and I was actually a little bit sad because I knew Elaine and I was comfortable with her. So I was hoping that she would be the same one. But Christina came in and had just the same exact feeling. She just knew exactly what to do.
Ellen (23:45): She explained everything to me in the best way I could understand it and you know, eased all my discomfort, all my concerns, and walked me through everything. Surprisingly, this birth was much easier than Evie's because they kept me pregnant for 24 hours. They wanted me to get steroids for 24 hours just to help with her lung maturity. As soon as the 24 hours was reached, they started to induce me. I didn't feel anything from 12 o'clock to five o'clock then I started feeling contractions and they kept asking, you know, "Do you want an epidural?" And I said, "Yeah, because I've been here before. I will sign the consent. It doesn't mean I want it, I just, I will sign it and at a point if I need it, I don't have to be in pain signing it and it may be just, like, something to make sure it's in the back of my head that it's cleared off."
Ellen (24:34): I met with a NICU intensivist because I knew Sierra had to go to the NICU. I wanted to know what's going to happen to her. I wanted to know criteria for discharge. You know, like, thinking so far ahead, I wanted to know what I can do to get her out as soon as I can. And she laid it out to me and she said, you know, "She can be healthy but she's 34 weeks, she's going to have to be in the NICU. We have to monitor her and make her, you know, make sure her sugar is fine. She can eat, all this stuff." Explained to me their criteria for discharge, which I really appreciated. The intensivist spent maybe 30 minutes talking to me, which I would—it's a little unheard of and I'm a nurse and I know doctors come in and out and they don't spend that much time with you. So I was really comforted that she took her time to do that.
Lisa (25:20): I was curious if you told them that "I'm a pediatric nurse and I just need to get the lay of the land, coming from that profession."
Ellen (25:28): No. I didn't. I don't know if...
Lisa (25:28): No? Because I thought maybe they would give you more time if you said that. I don't know.
Ellen (25:31): I don't know if the nurses told them. I try to not say that I'm a nurse until somebody asks, or if something I said gives it off, because I don't want to be that person. But usually if I say something, like, a term that, you know, only medical—healthcare workers know, then they know that's, like, a giveaway. In the conversation, my sisters were asking a bunch of questions so they were, like, "Are you guys in the medical field?" And that's when we had to tell her. But she had explained to us everything that we wanted to know before even telling her that we are. But after we told her, obviously everybody knew there in the NICU. So that's, you know, they could talk to us in a way that we can understand. It's a different language.
Ellen (26:13): But yeah, like, I started contracting at 5. 5:15 I could start to feel it getting stronger. So my two sisters were there again, my husband and my midwife. And at 5:20 my husband's like, "Okay, I'm going to go pick up dinner." I was, like, "Okay." I wasn't sure what he meant. I thought he called in dinner and he was picking it up in the lobby, but turns out he went to pick up Thai food, like, three blocks away while I was contracting. And I was wondering where he was and I thought he'd be back shortly. He literally almost missed the birth because when he came in I was fully, like, swaying side to side [moaning] hauling out over my bed and he was, like, just upset that he almost missed it. But he was great. My midwife was great and, like, giving directions.
Ellen (26:59): My sisters held my hand. I didn't have an epidural. My sisters were kind of, you know, like, skeptical. One told me, "You need to get it, you have to get it. You're going to be so tired. You're going to have to be ready," you know, all these things. And I said, "Okay." I just nodded my head. I nodded my head, but I didn't—my body just kind of knew how to, you know, like every woman, your body knows how to do this. My midwife gave me the best advice or best tip when I was laboring, when I was contracting, she said, "Breathe to the base of your spine." And as a yoga nurse, it almost, like, I knew exactly what she meant. I knew I had to open my mouth. I knew I had—there's a certain sound that I need to make to loosen everything up, and instead of screaming, I was able to, like, just really let it out and it helped exponentially.
Ellen (27:59): I think that's really what got me through my labor. Because every time I kind of consciously did that breath, it was much easier. My contractions were, like, just went by so much smoother. And so it was, like, 6:20, 6:25, you know, I was on my, I was on—I was hovered over the bed. She had me move around as much as I wanted. Finally got on the bed, got on my back, had my legs, like, you know, my knees in and all the other nurses came in. I was moaning. As I was, one of the nurses, funnily enough, said, "Don't make any noise." I was so confused. I was like, "What? What do you mean 'don't make any noise?'" Like, I just, like...and I did it. I obeyed her. I was, like, "Okay." So I just, like, kind closed my mouth. And my midwife was like, "Please don't tell her what to do with her body. Let her body do it herself."
Lisa (28:54): Yay.
Ellen (28:54): And I started moaning again.
Lisa (28:57): Good.
Ellen (28:57): And she came out in five minutes. And you know, that was it. She—again, healthy, Apgar was, like, 8 and 9, I think. Screaming her lungs out. She did have to stay in the NICU for six days. She was jaundiced. She didn't need any feeding tube or anything. We breastfed her the whole entire time we stayed in the hospital, you know, pumped like crazy, because they're very regimented. But we followed the rules to get her out and now she's amazingly thriving and pretty big for a preemie baby.
Lisa (29:30): Yeah. So you're saying she didn't have any sucking issues?
Ellen (29:33): She didn't. So that's what the concern was. That's what the intensivist told me. I felt she had a good latch. She had—her suck wasn't quite as great. Actually, let me take it back. She did—she was able to latch and suck, but it wasn't as efficient because we found out that she had a tongue tie, but in the NICU she was able to—I just... another detriment is I couldn't breastfeed her the whole time because they're so run by the numbers, so I couldn't—they wanted me to quantify everything and I, you know, they would just base her caloric intake on, like, what they can quantify. It was, like, hard for them to quantify the minutes that she was on my breast. It's almost, like, not in the calculation.
Lisa (30:24): Can they do a weighted feed?
Ellen (30:27): So that's a good question, because one of the nurses said she needed a feeding tube. And I said, "No, she doesn't. Why would you need a feeding tube? That's totally going backwards. For three days out she's been feeding well by mouth." And she said, "No, she needs a feeding tube because she's taking too long to feed." There was one feed that she took too long. I said, "That really doesn't make any sense." And again, you know, I didn't tell anyone that I'm a pediatric ICU nurse, because I didn't want any anything about that. And my momma bear instinct came out, and I was, like, you know, "I'm a pediatric ICU nurse. I know how this goes. I know what a feeding tube is. I just know that she doesn't need it. I think it's an aggressive conversation to have three days after she's been feeding well by mouth. You know, and just because that's an order in your system doesn't mean that you should do it without questioning it." And I spoke to the intensivist and, you know, they all agreed. They knew I was, like, kind of very upset about it. But they also—the intensivist understood that what they're asking from Sierra was not—she's not a machine. You know, she can't just, like, do all these things and fulfill all the numbers. They wanted her to feed, like, 30 mls every three hours at second day of life. And I said even—I didn't even fight it, but that's a lot, and I don't know, there's a lot of things, but...so we had—eventually I ended up just to get her out, I just pumped so they can quantify it, kind of make them happy, bring her home and breastfeed her every day till now. I just had to do it. I said, you know, "Let me abide by the rules, get her out, and then we'll breastfeed her for the rest of her life.
Lisa (32:05): Sometimes you have to pick the battles.
Ellen (32:07): Yeah. Because they kept wanting to—I can't think of the word—to add calories to the breast milk. Fortify it. "We have to keep fortifying it because she's not eating that much. She's not eating that much." Because they can't quantify the breastfeeding. Then they kept thinking that her numbers, the mls she's taking was not sufficient for her day of life or something.
Lisa (32:30): Well, it sounds like you did the advocacy for your baby that you could, you know.
Ellen (32:34): Yes. Yeah, exactly what I told...I mean, they were all lovely. The nurses are lovely. I think they were just following what their usual protocol is. And I said, "You know, I'm advocating for my daughter, she doesn't need a feeding tube." And the intensivist said, "You may not know what a feeding tube is." And I said, "I actually do, because I put them in, and I know this doesn't seem like a big invasive procedure for you guys, but it is when she doesn't need it." And I said, "I'm not going to go against your intervention if she medically needs it, and if I see a trend, if I see it. And I'm not just being a hard person with you guys, but I just don't see her needing a feeding tube when she's been feeding well." And, yeah, I mean just kept at it, and finally eventually got her tongue tie fixed a few, like, a week later.
Lisa (33:22): I was just about to ask about that. How was that diagnosed?
Ellen (33:26): The lactation specialist. Evie had it, too. The nursery nurse told me that she had it, and she said, "You should really consider having this fixed because it will affect breastfeeding." But the pediatricians didn't want me to, because they said that "She's just little and she'll grow out of it." And I was, like, "I'm really confused. What—who do I follow?" And I talked to a lot of moms, and, you know, and I just—my instinct kicked in and I felt that she wasn't doing what she should, was capable of doing. And after we had it fixed, it was, like, a literally a five second snip. She—before she even whimpered, she was on my boob and she didn't even cry at all. And it made a hell of a difference. We breastfed her for 21, so, I mean, it obviously worked. So I knew that we—so there was that concern.
Ellen (34:15): So with Sierra, I made sure I saw a lactation specialist before we left, and I asked her, "Can you please check if she had it?" She had a, you know, posterior one, but not that significant, but she said it would help breastfeeding if she had a frenotomy. Again, went to a pediatrician, they're like, "No, she doesn't need it. She doesn't have it. She is sucking." Again, conflicted. Again, went with my gut, and I said, you know, "One of my priorities is breastfeeding. It's one thing I can give her that I can't buy. And it's just, like, giving her a lot of, like, just the goodness from breastfeeding, antibodies, it's free. And if I can do it, why not?" I just needed some people to support me. If I had a question about it, which all the lactation specialists that I met with, I met with three, they all told me the same thing: that she has it, she should get it fixed. And I kept asking, like, "Why is it that, you know, there's, like, a different conversation when you're talking to somebody else in different profession?" And they said, you know, "It's just a different mindset..."
Lisa (35:20): And they also don't have the breastfeeding expertise—pediatricians don't—that we would assume that they have.
Ellen (35:27): Right. And they just keep saying she's tiny and she'll grow out of it. And I didn't want to buy into that. So I went to a doctor that specializes in breastfeeding. I didn't even know there was one.
Lisa (35:40): Nice.
Ellen (35:40): Yeah. And she told me that she should get a frenotomy. She said, "Yeah, she should get it." I think she by training is an internal medicine doctor that specializes in breastfeeding.
Lisa (35:51): Does it happen to be Dr. Ramona Gabay?
Ellen (35:54): No.
Lisa (35:54): No. Okay. That's the only doctor I know of in the area who specializes in that.
Ellen (35:58): No, she's, she's in New Hyde park, her name is...Mancuso? And she was great, too, because she confirmed—because I, you know, I just, I don't know what I was looking for. I just needed somebody to validate what I was feeling. And we already saw lactation specialists, so we wanted to see another one. We saw another pediatrician, she—Dr.—I think Mancuso is her name—but she did a pre- and post- weight on her after feeds and she said, you know, this was after she had her frenotomy, and she said, "Yeah, she's transferring well at this point." Because her frenotomy was only the tongue tie, and she didn't get her lip tie fixed for some reason. It was overlooked. So I was wondering if I needed to do that. If I did her an injustice by having her tongue tie fixed and not her lip tie, is it going to make an impact? Is it going to be, is it worth it? And both lactation specialists we saw after the frenotomy said she's transferring well based on the pre and post, you know, weights, and that it's really, it wouldn't make that much of an impact at this point because she's transferring well. So yeah, because we didn't have it done by Dr. Siegel. So I was, like, you know, did we do the right thing? But they said, you know, "Based on what she's doing, she seems to be doing it right, and just keep at it."
Ellen (37:22): And she's been doing well. She's gaining a ton of weight. So.
Lisa (37:26): Great. And was there aftercare that you did after the frenotomy to be sure it fused back together?
Ellen (37:31): Yeah, just the massage.
Lisa (37:34): Great. Yeah. Because a lot of people have that procedure done and aren't told to do aftercare, depending on who does it. And so that's so critical to be sure to do that massage.
Ellen (37:44): Right. Yeah, I remember that from Evie's. And, I mean, to me it just makes sense because there's so much, like, adhesion that can happen and you know, buildup of tissue and having to have another procedure done. So, yeah.
Lisa (37:58): I wanted to back up to both of your labors and just ask you if there were specific coping tools that you found instinctive or that were really effective. I know you said vocalization was one thing. Breathing into the spine.
Ellen (38:13): I feel, like, for the, for Evie's birth, not so much. I think I was such a new mom that I don't—I think breathing. I said, you know, "I'm a yoga teacher. I know how to breathe, I can do this." And you forget it. Like, my sister is like, "You were purple. I don't think you were breathing, you know, like, I was afraid you were just going to pass out." But I think I learned a lot from my first pregnancy going into my second during labor and postpartum. With Sierra's birth, my midwife told me that there's a reflexology, a point in between your thumb and your forefinger that you can press while you're contracting. So my sister was doing that while I was contracting. I would just give her, like, squeeze her hand, tell her I'm contracting. So she would do that. Lo was really active in doing counter pressure that he learned from your class that he loves doing. He's, like, he totally—if there's one thing—there's two things he remembers from taking your childbirth class, the counter pressure, which he was, everyone in the room was, like, "He was so into it." He really was, like, giving his all. And the second one is the diaper. When you—one of the points that you went through in diaper change is putting a diaper under it, and he was, like, "Lisa said...." He really took that to heart.
Ellen (39:34): So with the birth was, you know, the counter pressure, the reflexology, and the breathing that my midwife told me, like, breathe to the base of your spine, open up your mouth. That was, like, probably—it made a world of a difference. Also, like, hovered over the bed and just, like, moving my pelvis back and, like, sideways helped a lot too.
Lisa (39:53): Like kind of swaying?
Ellen (39:54): Yeah. So, like, during the contraction I'm swaying, I'm moaning, I'm growling, my sister's doing reflexology, Lo's doing counter pressure. Maybe that's why I didn't need an epidural because I was getting the full treatment.
Lisa (40:07): Absolutely. Yeah. And were there specific counter pressure techniques that worked for you better than others?
Ellen (40:14): Yeah, when he pressed, like, he, I don't know how to explain it. He went from both sides of the pelvis and just kind of squeezed it.
Lisa (40:22): The double hip squeeze. The golden move.
Ellen (40:24): Yeah, it was, it was great. I mean it totally worked. My sisters were really impressed that I did it without an epidural. Just like, "You did it. I can't believe it. You did it." Because everybody was playing their role and helping me get this baby out without any intervention.
Lisa (40:42): Yeah. And the pressure point you mentioned, I'll just mention for listeners that it's the same pressure point that a lot of people use for headaches.
Ellen (40:49): Yes.
Lisa (40:49): The fleshy part in between the thumb and the pointer finger. And it can start or strengthen contractions, like, make them more effective. So, yeah, that's a good one.
Ellen (40:56): Yeah. I felt the difference with all of them. And I think, you know, the combination of all that was really key, too. Like, I could tell when my contractions started and ended, and kind of, you know, they would strengthen their acupressure and their counter pressure as my contraction was getting stronger. And it was kind of like a symphony when it was all happening. Like we all knew how to get into the position, and how I was coming out of it. They would lean back and yeah, it was great.
Lisa (41:28): Yeah. It sounds like you were finding the rituals that we talked about in class, the three r's: the rhythm and the ritual and the relaxation.
Ellen (41:34): Oh, yeah. Yes, exactly.
Lisa (41:35): Yeah. It's so instinctive, isn't it?
Ellen (41:37): It is. I mean, that's so funny that it is because you know, you kind of don't think—you hear these things, but you don't think that you'll be playing that same part and then you're, like, it's so instinctive. Like, the way you're breathing, the way you're coping, the way—everything, and your baby comes out, and they're, you know, it's amazing.
Lisa (41:58): And did your work as a yoga teacher inform any of how you're labored or any of your pregnancy?
Ellen (42:05): Yes, I think the practice itself made me aware of what I needed to focus on while I was pregnant. It also made me aware of what was happening with my body, and how to breathe through a lot of it, and also identify what's wrong. Because when I would go to the chiropractor and they're like, "Besides the fact that you can't walk, what are you feeling?" And I could say, you know, "I feel like my—it's my sciatica, if I do this, it relieves it." Like just, like, certain positions that relieve it. And I think just the overall mental state that Pranayama gives you, like, being able to breathe, and knowing that you need the space that you need during labor and delivery and postpartum.
Ellen (42:52): Knowing that that space is there and it's, it's open and it's something that you can reach into, like, that you can tap into with just consciousness. It allowed me to, you know, like, have ease in that, that it's something available to you that not all of us can tap into. But as a yoga teacher, I know how to drop into what it feels, like, when I'm in Shavasana. That same feeling. The night before Sierra came out, my husband and I—my husband is trained in meditation and we meditated the night before she came out because neither of us could sleep. So we just, I said just, you know, like, "Lead a sit, like, just lead me through a meditation." And he did and there was—the nurse walked in and we were both, like, barely touching palms, and they know what we're doing was meditating, and it helped us through just the emotional roller coaster of giving birth.
Lisa (43:45): I love that. It's such a great way for you to connect as a couple as well as just centered.
Ellen (43:51): And I think, you know, my husband was wonderful through the whole thing and he's always been wonderful and gives me the space that I need, makes sure that I have the, you know, even an hour to myself. Like he's the one that's telling me to do this. I'm, like, "No, I have to do this and that." And he's like, "You need a break, you need space, you need to make yourself okay. When you, you know, for us, for you to take care of us, you have to be okay first." And he's always been great at that. And I think the, just—the labor, it just strengthened our marriage because we became a team and we know what each other is capable of. And he knows my weakness. When he fills in his strength, you know, like, he knows where to put himself, to make me to do my best to be to, you know, get through the situation, get through the labor, get through the pain, and what I need as a mom postpartum to just heal, which is, you know, not—you know, I can't say that for everyone, but he's just very in tune to that stuff.
Lisa (44:54): Mm. So important to have that support. It sounds like the dynamic in your relationship really works well.
Ellen (45:00): Yeah. And I mean, because having the meditation background, he knows what your mental state, like, what you need to heal, and he knows where you need to be and that you can't, you can't do everything. He just knows, like, you need to ground yourself, you need to sit, and you need quiet, you need all these things for you to heal properly. And he provides that, so it's amazing. And I'm lucky.
Lisa (45:26): That is beautiful. Let's have all partners be just like that. That's sounds so great.
Ellen (45:30): He is a great guy.
Lisa (45:35): Nice. This is just sort of an aside, when you said you had music, I was just curious if you had, like, a favorite song or two for labor.
Ellen (45:43): Yes, so I had a lot of playlists as a restorative yoga teacher. A lot of it was, like, East Forest. A lot of it was, like, ambient sounds. Bon Iver was one of them. I don't know if it's Holocene, that just puts me in this, like, state of, like, as if I'm in a restorative pose, maybe because I associate it with being in class and it just, like, drops you into that mental space. Your brain waves drop down and you're just, like, cruising. And Morning Phase by Beck. It's kind of weird.
Lisa (46:20): Cool. I'll try to mention those maybe in the show notes and see if I can pull them up on Spotify or something.
Ellen (46:27): Yeah.
Lisa (46:27): Well, great. This has been wonderful. Do you have any specific tips for new parents or expectant parents across your journey, whether that's about labor or pregnancy or parenthood? Yes.
Ellen (46:39): Yes. I think you really need a team. It's almost like when they say "it takes a village to raise a child," it takes a village to be pregnant. You need a midwife in my opinion, you need a chiropractor that knows how to deal with pregnancy related issues. Myofascial release physical therapist that I was also seeing was, you know, a good adjunct to my therapies. Girlfriends that you can vent to who's been through the pregnancy and labor and motherhood stage. A good family. I mean, I shouldn't say "good family." A supportive family that will listen to you just because you need to vent. A mom that will cook for you for 40 days. Even though you're not nice to her a lot of the time. She will just, you know, treat you, like, you're a baby, you're back to being a baby. You need this whole, like, you need a village to really get through it successfully and you know, the healing part.
Ellen (47:42): And I would say postpartum was a big thing for me this time around. I really treated it as a sacred time and I didn't do that with my first pregnancy. My first pregnancy, my first, you know, after I gave birth, I think I just wanted to prove something to myself and to other people that I could just jump back into, like, doing all these things right after and, like,
Lisa (48:05): It's the American way, right? Shouldn't be, though.
Ellen (48:05): Right, like, don't show weakness or you know, don't be vulnerable. But the second time I was, like, I literally, the whole month we just breastfed. My mom wouldn't let me do anything and I stayed in, like, the same outfit. I would wear a black tank top and pajama pants, take a shower, wear another black tank top and pajamas and just be in bed and breastfeed. And I cherish that. It's so valuable to just bond and heal and recognize that you have—your whole body has been in trauma and you need to respect it and you know, treat it as is, that it needs time. But I also think that with that you need the same support system that will let you heal, allow you to—give you time to bond with your child and eat nourishing food. I really believe in eating all that, you know, like, dense nutrition, postpartum food that everybody tells you you need. I think a lot of it, like, you said, it's instinctual, because my body craved it. I didn't want anything cold, I didn't want anything, you know, like, a fast food. I just wanted, like, broth. I wanted soup, I wanted, like, heartwarming stuff that filled my belly. And it's very, like, if you just listen to your body, your body really knows what it wants and what it needs.
Lisa (49:26): Yeah. That's so true. Yeah. Because we lose a lot of body heat in giving birth. So those warming foods are really, really nourishing for you.
Ellen (49:33): Yeah. And it goes across. So, like, reading about, you know, going into Ayurveda or Chinese medicine. It's the same thing that they, everybody talks to, that warm, nourishing food. Yeah. That's what I would say. And I tell that to my pregnant friends right now, it's that, really treat postpartum as a time to heal. It's not just about learning how to take care of your baby. It's also, like, for you to sit down and enjoy breastfeeding and learn about it. It's not easy at all. And if it, if it's easy for you, you're lucky, but for me it was a priority, so we had to work hard at it because if, you know, if we didn't, then we wouldn't be where we are.
Lisa (50:16): Yep. Sometimes things worth the time, it takes some persevering.
Ellen (50:21): Yeah. Yeah.
Lisa (50:23): The same was true for both of my babies and breastfeeding journeys. 99% of us have that struggle, unfortunately. I wish it wasn't that way. But...
Ellen (50:32): Yeah, I think it's all about priorities. I'm not saying, you know, like, formula fed babies are any different. I think once you have your priorities, it could be breastfeeding, it could be healing. It could be whatever you need to do for yourself, your body will tell you where to go and how to get there. So really just listen to your body. I guess that would be the best thing.
Lisa (50:52): Listen to your body. Build your community of support. Those are golden tips. Thank you so much Ellen.
Ellen (50:59): You're welcome.
Lisa (50:59): Well it has been lovely talking with you. Thank you so much for taking the time to share your experiences today.
Ellen (51:08): You're welcome. My pleasure.
Lisa (51:08): Alright, have a good one.
Ellen (51:09): Thanks Lisa.
Lisa (51:10): Bye.
Ellen (51:11): Bye.
Lisa (51:12): Ellen mentioned a couple of things I wanted to briefly discuss. She mentioned having Symphysis Pubis Dysfunction (or SPD) in her 2nd pregnancy. SPD is often also called pelvic girdle pain, and is a condition that can develop in pregnancy whereby the front joint of the pelvis, or the symphysis pubis joint, loosens up too much to the point of causing instability and causes pelvic pain. With this condition, it’s usually not recommended to use laboring positions that could put too much pressure on the public symphysis, or open it too much, such as deep squatting or being all fours. Often a counterpressure technique called the double hip squeeze is not recommended with SPD, either, but it depends on the level of severity. I suspect that the fact that Ellen found this very popular move helpful might mean she didn't have a severe case. Also, tongue and lip tie came up in this story. You can listen to more information on this topic at the end of Episode 6, but somewhere around 10% of babies have an issue with their tongues or lips that can create issues with breastfeeding. Meaning, having too-tight connective tissue in the middle of the tongue or lips, which is called the frenulum, can cause the baby to not be able to express enough milk. This is because they can’t get positioned in an optimal way on the breast. It also causes the breastfeeding parent pain. One thing I’ll add to what I shared in Episode 6 is that lactation consultants tend to more readily acknowledge this anatomical challenge and diagnose it than pediatricians, for whatever reason. You’ll find a big range among pediatricians in their opinions on this topic; some don’t even think it’s a condition that can negatively impact breastfeeding while others very much acknowledge it and the need to have it addressed. I’ve had so many students say that having the minor surgical procedure of a frenotomy or frenectomy done totally saved their breastfeeding relationship. It’s unfortunate that there are differing opinions on this topic among the voices new parents are hearing, like, was the case for Ellen. Also go back and listen to Episode 6 for a gentler alternative that parents could try before resorting to the surgical procedure, as it’s not always necessary. Finally, I want to point out that seeing a chiropractor who specializes in this time of life can be a gamechanger, as it was for Ellen, toward minimizing or even eliminating the very common pain and discomfort that can often occur through and after our pregnancies. For those of you in NYC, we have a number of chiropractors in several boroughs who are expert in this, including the practice Ellen mentioned, Flower of Life Chiropractic in Park Slope, Brooklyn. I’ll link to them in the show notes. I'm also happy to provide other recommendations local to NYC if you reach out to me @birthmattersnyc on social. Okay, here’s a sneak peek of what’s up next week!
New Speaker (54:03): The nurses were amazing. Alexis, my last nurse was the best because other nurses kept coming in and they were, like, do you sure you don't want any pain medication? And then Alexis would look at me and she's, like, you don't need it. She's, like, you've gone through, like, crazy contractions and you don't need it. She's, like, you're going to deliver your baby the way you want to deliver your dog. It was great. It was fantastic. I was so thankful when she, when they switched to her, I was, like, I didn't know her and she was quiet at first, but she was amazing.
Lisa (54:35): The parting thought for today is to remember to “breathe to the base of your spine,” if that helps you now or in labor!---END---
the moment of birth with their beloved midwife