Birth Matters Podcast, Ep 32 - Trying to Change OBs for Vaginal Breech

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In today’s episode, Christine learns in her 33rd week of pregnancy that her baby has flipped to breech, or heads up, position. She scrambles to change care providers in hopes of having closer to the kind of birth she and her husband, Omri, wanted. While she wasn’t able to have the vaginal, unmedicated birth she had hoped for -- because it’s nearly impossible to find any care providers who are trained to safely deliver breech babies vaginally -- she opts out of the recommended scheduled cesarean and waits for labor to start spontaneously before having a surgical birth at Metropolitan Hospital (NYC). She and Omri advocate for specific things in the surgery that mattered to them, and their doula helps them know the smart questions to ask along the way. This is a story of strong self-advocacy and making informed choices, as well as building in support, to have as positive and healthy a birth as possible.

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Episode Topics:

  • Christine finds out baby is breech (heads up) and searches for a care provider who knows how to deliver a breech baby vaginally and explains all the things she tried to encourage baby to flip, even trying ECV (external cephalic version), to no avail.

  • water breaks at 40 weeks, 4 days; calls doctor, who advises them to come in. They take their time prepping to head to hospital

  • head to hospital & get pulled over by a cop(!) as they arrive, having doula meet them at hospital, ways doula supported even through cesarean, helping them advocate for themselves for the best cesarean birth possible

  • arrival at hospital, confirmation baby still breech, prep for surgery, talking through surgery and special requests they made such as 1 minute of delayed cord clamping

  • recovery room, beginning breastfeeding and painful latch

  • coming home and recovering from cesarean

  • clarification on how ended up deciding to give birth at Metropolitan; last minute unofficial transfer of care

  • breastfeeding challenges - tongue tie, lip tie, & cheek tie diagnoses for her son and getting IBCLC support and then getting the frenectomy (surgical procedure to loosen frenulum), baby losing weight, milk supply issues and trying to remedy the issue with pumping, discussion about donor milk and milk banks

  • La Leche League meetings as a great resource

  • final thoughts for expectant parents: pursue the kind of birth you want and switch care providers if you need to (and get a birth pro’s help in finding good care, especially in a large city where there are so many options), and hire a doula!

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Resources:

Transcript

Lisa (00:00): You're listening to the Birth Matters Podcast, Episode 32.

Christine (00:03): We got pulled over by a cop. It's like something out of a movie, you know, right? You're like about to get to the hospital and you're in labor and a policeman pulls you over and we pulled into the hospital and a cop pulled up behind us. My husband's like, "What did I do?" He's just like, "License and registration." My husband gets out of the car which kind of freaked him out a little bit, and my husband just was kind of like, you know, a little frantic, and he's like, "My wife's in labor. I just want to see if I can park over there." And then he, like, hands the cop his license. He's like, "Here's my license, just mail it back to me. Give me a ticket, whatever you need to do. My wife is in labor, though. We got to go. Like, I gotta park, whatever." And the cop just like–at that point the cop is just like, "Here you go, just...nevermind."

Lisa (00:58): Hey there! And welcome to the Birth Matters Show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC Childbirth Education and Labor Support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence info and soulful interviews with parents and birth pros. Please keep in mind the information on this show is not intended as medical advice or to diagnose or treat any medical conditions. Did you know you can sign up to receive email updates whenever a new episode goes live? Visit birthmattersshow.com to join our podcast community.

Lisa (01:36): Hey, everyone. If you’re listening to this anytime near the time that this goes live, I hope you’re hanging in there and staying safe and healthy at home. I’m recording this a week before it airs and about 2 and a half weeks into New York’s social distancing and homeboundness due to COVID-19.

Lisa (01:51): I want to make sure you’re aware that, throughout this pandemic, Birth Matters has a page on our website with constantly updated COVID-19 resources for expectant parents. One of the most recent updates at the time of this recording is that, on March 28th, Governor Cuomo issued an executive order in effect for the next 30 days telling hospitals they must allow 1 labor support partner who is both symptom-free and screened upon arrival into the hospital with the laboring person through the immediate postpartum. Read more details, tips, and stress management strategies over at our website at birthmattersnyc.com/covid-19 and know that we are constantly updating it anytime there are new resources that we think might be helpful for you. Also, Birth Matters has partnered with The Root Therapy NYC to provide an ongoing, weekly support group for expectant parents. The Root Therapy is also offering a new parents support group as well as other group options. For more information, email contact@theroottherapynyc.com Throughout the COVID-19 pandemic, Birth Matters is offering a HUGE discount on our online, on-demand course because it’s more important than ever to get equipped for the best birth possible. Our heart goes out to the families whose hospitals have canceled birth classes across the country OR who are experiencing severe financial hits right now, and we don’t want cost to be a barrier. You can find the promo code and sign up over at birthmattersnyc.com. Also, our regularly scheduled live, group classes that are normally in person are temporarily being held on Zoom, and we’re also doing virtual private sessions. So, please know you can prep for birth and parenthood in whatever format works best for you and wherever you are. Again, you can register for any of these class formats over at birthmattersnyc.com. I wanted to give a couple of quick tips for this time before I discuss this month’s theme and today’s episode. If you’re giving birth in a hospital anytime soon during the COVID-19 pandemic and if your hospital doesn’t have ample protective gear, please add some to your hospital packing list. Birth professionals, expectant parents, and concerned citizens have worked hard to get partners who are not symptomatic and who are screened allowed back in hospitals to support laboring folks, so it’s incredibly important to in turn help them out by bringing in as much of your own protective gear as possible if they don't have ample supply -- a mask, gloves, a gown if possible, disinfectant wipes at a minimum. Not just for partners but also for the laboring person. Also, partners need to pack and be prepared to stay at the hospital until at least a couple of hours after birth, knowing that you likely will not be allowed to leave the Labor & Delivery room once you are admitted with your partner. Also consider, as you’re packing, if you can throw away as many of the items that you took out of your bag and used as possible to minimize the germs you’ll be bringing home. So there are just a few tips; I’ll likely have more in future episodes. Moving on now to the theme for the next few weeks. April is Cesarean Awareness Month, so we’ll be sharing cesarean birth stories in the next few episodes. Be sure to follow us over on Instagram or Facebook (both @birthmattersnyc) for some educational content on this topic this month. Today, Christine will share her birth story. You’ll also hear her singing parakeets in the background and you might hear her husband, Omri, making an occasional clarification in the background. Her son flipped into breech position in the last few weeks of her pregnancy, and when she learned that her doctor would automatically schedule a cesarean due to baby’s position, and given she was already less than satisfied with the care she was receiving, she tries her very best (unsuccessfully, unfortunately) to find a care provider who will support her desire to have a vaginal breech birth. She also shares some about her breastfeeding journey, her baby’s diagnosis with something called tongue tie, lip tie, and cheek tie, and struggling with low milk supply. Learn how it’s never too late to switch care providers if, at ANY point, you’re feeling like you might be misaligned. Without further ado, here we go!

Lisa (06:12): Welcome Christine. Thanks so much for joining us today. I'm looking forward to hearing your birth story. You want to introduce yourself and then just go on into your birth story?

Christine (06:19): Yes. Hi, I'm Christine. I have a baby boy, Maayan, and my husband's name is Omri, and I gave birth seven–almost eight weeks ago.

Lisa (06:31): Not long ago.

Christine (06:34): Yeah, my birth story...I'll start when I was 33 weeks, because that's when I found out my baby was breech, and before that he was head down. And he flipped to breech in a matter of, like, two weeks. I never felt it happen. At some point it happened and the next seven weeks of my pregnancy were just, like, me obsessively focused on trying to get him to flip head down, because I really wanted to have a vaginal birth and I wanted to have a natural birth. I didn't want to have surgery and that's the option that was offered to me with a breech baby. The only option I was given from the current doctor that I had. So I started looking into how to flip the baby, but also where could I possibly give birth to a vaginal breech baby.

Lisa (07:27): It's hard, it's like a needle in a haystack, right, to find that in our area. And really in the country in general, it's hard to find.

Christine (07:34): Yeah, I mean I did everything to flip him. Like, you name it, I tried it. Like, I had an inversion table in my living room, I was seeing a chiropractor, I was doing acupuncture. I did headstands in a pool, homeopathic medicine. I did, like, everything.

Lisa (08:00): And where did you get your tips on what things to try? Was it Spinning Babies or was it something else?

Christine (08:04): Yes, Spinning Babies, but also my doula. And other than that, like, kind of just the internet, I guess, in general. Just doing research on what I could do and none of it worked. Then I tried ECV. I did–what is it, external...

Lisa (08:20): Cephalic version...

Christine (08:20): Yeah, I did that, too. They wanted to do it for me at 37 weeks and I still wanted to try to flip him on my own. I just like didn't feel like the procedure was right for me. And then I found a doctor I really liked in New Jersey and ended up trying it with him, and it was kind of scary.

Lisa (08:39): Do you mind my asking who that was in New Jersey?

Christine (08:41): Doctor Haddad.

Lisa (08:43): Yes. He's a favorite for sure.

Christine (08:46): Yeah, he's really great. We really liked him. Both of us. And he was a doctor I went to actually with the idea that he might deliver a vaginal breech. I went to him and he was basically like, "I don't do that anymore. Not since 2001." Which is when, I learned, I guess everything changed with breech births with the new guidelines that came out from ACOG and he's like, "I used to do it, I used to deliver them all the time in the 90s, I'd get it all the time," and he was, like, so apologetic, but he was like, "The hospital, like, won't let me do it. And the only time I've done it in the past few years was like, was a twin, one of the twins in a twin birth was breech." Or I think another woman came in and the baby like slipped to breech last minute. So they just delivered the baby that way. And that's basically the answers that I got from all the exploring I was doing of, "Can I somehow somewhere have a vaginal breech birth?"

Lisa (09:47): Have you heard of the documentary "Heads Up"?

Christine (09:50): Yeah.

Lisa (09:51): It's sad that vaginal breech delivery is a dying art.

Christine (09:57): Yeah. It's a nice documentary. I wish they had delved into it more. Like, I felt like they kind of just skimmed the surface of the subject.

Lisa (10:03): Yeah, I agree. It was short. Maybe they just didn't have enough budget to...I don't know.

Christine (10:08): Yeah. But there is definitely, you know, enough interest to create something more like that. And I dropped my care provider at 38 weeks. I left him. And part of the reason was once the baby was breech, it was kind of like, "Okay, C-section. Done deal. I'm going to schedule it."

Lisa (10:28): But this was at New York Presbyterian, Lower Manhattan. Right? Because you had originally been with midwives there, but you risked out due to a medical thing that happened, right?

Christine (10:38): Yeah. I had an infection in December. It was sepsis and it was, like, really serious and it didn't affect the rest of my pregnancy other than I was put on a little just antibiotic and I was told I couldn't see the midwives anymore. And yeah, so I ended up with a doctor that I hadn't even chosen to begin with. He did an ultrasound where I was asking what breech position the baby was in and he told me, like, "Oh, it's complete breech." But I think he, like, doesn't even know, didn't even know, like, the breech positions. Because like he's like, "It doesn't matter because it's a C-section, like, no matter what." And I was going, "Okay..." And he was like, "There's no benefit and there's only disadvantages to you not scheduling a C-section." Because he wanted me to schedule a C-section at 39 weeks. And he told me that there was an increased risk of cord prolapse. Yeah. And I did a little bit of reading about that, but I was like, "I see no reason not to wait till I go into labor. No matter what." And I did. And I'm still so happy that I did that, because just—to me it just makes sense, it just made more sense to wait until, like, the baby's ready. And I thought it would make it easier with breastfeeding and just my recovery in general, like, just to let the body take its natural course.

Lisa (12:03): Yeah. I think that there's so much wisdom in that, because the hormones of labor are there for reasons more than just giving birth. But, like, they help with birth, even if you're having a C-section and then, like you just said, it can help with breastfeeding. And so good for you, for making that choice for yourself and advocating for yourself.

Christine (12:22): Yeah. Yeah. I decided to just wait and I was ready to go up to 41 weeks and beyond. Even though, like, the doctors were like, "If you're still pregnant at 41 weeks, like, we want you to come in and talk about the scheduled C-section." Because at that point I was, like, going to...I went to Metropolitan Hospital also and saw doctors there. There was one doctor there that—rumor had it, he would deliver vaginal breech. Also just does it for twins, you know where one's breech and one whatever. Anyway, that was the story with that. And then at 40 weeks, on my due date, I found one practice in New Jersey that told me they would deliver, that I contacted on my due date, and then a few days later they told me they would deliver a vaginal breech, but it was, like, too late.

Lisa (13:13): According to them, it was too late? Or it felt too stressful for you?

Christine (13:17): They didn't have a phone number. It's like a midwife practice. They didn't even have a phone number. I, like, emailed them, but I was kind of like totally ready to hear the same answer I was getting from everyone else, which was, you know, "We don't do that anymore," or "No, you can't," or whatever. And by the time they got back to me, it was like the day, maybe the day before I went into labor.

Lisa (13:38): Okay. I see.

Christine (13:39): And it's kind of like, and I even considered, you know, a home birth experience, but you can't really plan that at the end of your pregnancy. Like, because there are home birth midwives, at least none that I talked to directly, but— that will deliver vaginal breech. You kind of have to plan for that. And I heard, like, some of them, they won't even take a transfer patient that had been previously planning, like, a hospital birth. And it's complicated.

Lisa (14:06): At least not that late in pregnancy.

Christine (14:07): Yeah, yeah. At least not that late in pregnancy. Yeah. So I just waited to go into labor and actually just was like, "Who knows, the baby could flip at the very last minute," which didn't happen, but I have heard of it happening. So, you know, I wouldn't tell anybody, like, not to hold out hope, or, you know, to like give up and just have a C-section. Because, I mean, Dr. Haddad told us about a woman whose baby flipped when she was 40 weeks, five days. So amazing things can happen.

Lisa (14:37): Yeah. Yeah, absolutely. I had a friend whose baby was actually doing somersaults in labor. It was, like, going breech-vertex, breech-vertex. That's not common, of course, but, you know, anything can happen. So you never know.

Christine (14:53): Totally. I've heard of that, too. So I went into labor at 40 weeks and four days. And my water broke. That happened in the middle of the night. And it was sort of like a common situation of—I didn't know if it was my water broke or if I just peed myself.

Lisa (15:14): Because there's so much pressure down there at that point, that could easily happen and you didn't realize it.

Christine (15:19): I had already had a bit of incontinence at the end, towards the end of pregnancy. And so, like, it seemed a totally logical idea that I could have just done that. And then, like, I just went back to bed and, like, the next morning I got up and, like, the fluid continued and it was like a river. Like, there was so much fluid throughout the whole day. Like, I did not know it was like that. I was like—I thought your water broke and it was just, you get one big gush and that was it. But no, no, no.

Lisa (15:54): Yeah, it can trickle a lot, right?

Christine (15:56): Yeah. There was so much fluid. By the afternoon it was like, I soaked through, like several pads, put, like, a towel down. Yeah. So then I, like, I called the doctor's office, just to confirm that it was, like, actually my water broke. And they're like, "Yeah, you should head into the hospital." And I called my husband home and we're like, "You know what? There's not really any rush. Like, we can just wait a little bit and like, you know, take our time, like packing the bag, and, you know, getting last minute things ready." So we did, and I thought, you know, eventually I was gonna start having contractions, but I didn't. But I did kind of get a bit antsy, like with all the fluid. I was like, "Is this normal? Like, you know, can something be wrong? I don't know."

Christine (16:47): It was all fine. It was all normal. So we went to the hospital—I think late afternoon we headed there. And I still had, we had a doula. And I still had her come to the hospital even though I knew I was probably having a C-section. And it still helped to have her there, because she helped me in general, with support. But she also helped me navigate the C-section with the doctors. Like, told me what I could ask for, you know, what I could push them on, and all of that.

Lisa (17:17): Do you remember what kinds of things she was encouraging you to think about or ask?

Christine (17:22): I'm trying to remember. Do you remember, Omri?

Lisa (17:23): Was it some gentle cesarean techniques? Maybe lowering the curtain when the baby's born?

Omri (17:29): [inaudible]

Christine (17:34): Yeah, it was gentle cesarean and things basically.

Lisa (17:39): And I forget, did you guys know you were having a boy? Yeah. You did.

Christine (17:43): Yeah, we did. Yeah. We knew we were having a boy.

Lisa (17:45): Because sometimes people want to identify that for themselves, if they don't know already, instead of the doctors. But you already knew.

Christine (17:52): Yeah. Yeah. It was, like, gentle cesarean stuff. She was, like, talking about what they were going to do—how the whole thing was going to go, basically. How long it usually takes and what happens afterward when they take the baby, what they do and she's like, "If they're taking too long, like, you can say, 'Hey, I want to hold the baby already. Like, maybe you can speed things up or hold off on, you know, doing things that can be done later.' Because they just take the baby. I think they—I couldn't even see what was happening.

Christine (18:20): So, so just to go in order of things more, I guess, like, I think an hour before—we came into the hospital and they just checked his position, he was still breech. And actually we were pushing them out. They were like, "Oh, you know, for the safety of the baby you need to have a C-section." I'm like, "No, know what? This is not for the best of the baby. This is, like, your hospital policy because of, like, liability. And, you know, it's—don't act like this is always, like, the safest way to give birth, because it's not." [inaudible] Oh yeah. My husband was like, "Don't lie. Don't lie. This is not, you know, this is not what you always do just for safety's sake and, like, what's best for the baby."

Lisa (19:11): At the same time, to be fair, if they don't train, if they don't know how to do it safely, then, you know, it is riskier. Which is unfortunate, that they're not teaching anybody to do it. Because it could be done safely.

Christine (19:23): Yeah. I would only want to give birth that way with a doctor who was trained to do it.

Lisa (19:31): Which is why you were trying to find one.

Christine (19:33): Yeah, and I mean when I, when I talked to the doctors at the hospital before I went into labor, before I went there for the birth, they were like, "The only way that you can have a vaginal breech birth here is if you came in active labor, like you come in and you're, like, eight centimeters dilated or something, and you refuse surgery. And then at that point this is the only doctor who will touch you, because no one else knows how to do this." And, I mean, I was really just asking them, you know how I could do this with the doctor being on board with it, and they were, like, taking my questions to mean that this is something I was considering, which I was not. I just wasn't comfortable with doing that. Yeah, so in the hospital they're like, "This is your only option." And that's the hardest part about having a breech baby is, like, you just don't have a choice. I am totally supportive of moms who choose to have a C-section with a breech birth who like, would not be comfortable having a breech vaginal delivery. But just the fact that you can't have that all because—it goes back to that study, that breech birth study that they later said had so many flaws to it, and they shouldn't have made the guidelines based on that, and that whole thing.

Lisa (20:52): Wherever we post this interview, I'll be sure to post some of that information with the show notes.

Christine (20:57): Yeah, yeah. Post the link. I'm sorry, I'm not, like, saying the exact name of that.

Lisa (21:02): No, that's fine. I don't remember it off the top of my head, either, but I'll be sure to look it up.

Christine (21:07): The Term Breech Study, or something like that. And, you know, the international study, like the biggest study they'd ever done on breech birth, and then it was later discredited. But by then it was too late, from what I understand. Yeah. And they just aren't training the doctors in it anymore. And my baby was in the right quote-unquote right position for breech vaginal birth. Because, you know, if he had been footling breech, I don't know that I would've even been trying to attempt to do it, but he was frank. Frank breech is like the most common position. So, yeah, they saw that position in the hospital and then from then on it was like preparing me for the C-section to have that night. So before I went into surgery, like, it wasn't any rush to it. Because it wasn't like I was having an emergency C-section or anything like that. I could still talk to the doctors about my preferences. I'd actually asked them about a clear drape—like, before all this, when I had a doctor's appointment there—which they don't have, but the doctor was like, "Oh, you're the third person to, like, ask me about that in the past two months. He was used to having that..."

Lisa (22:19): Yay. See, that's how we have change happen in maternal healthcare is when people start making their wishes known. So I'm so happy to hear that they're hearing that request. Good.

Christine (22:29): Yeah. That's really important, to ask for things like that. Yeah. Then the doctor, like, started telling me stories of, like, people passing out in the surgery room looking over the curtain. I'm like, "Okay." Yeah. My husband still did it in the surgery room. He's not, I mean, he's not somebody who, you know, freaks out at seeing open wounds and things like that. And the doctors were still like, "Well, we've had people say that and still pass out."

Lisa (23:00): Makes them nervous.

Christine (23:00): He was fine. I mean, I think he was told to sit down when he did it. But no, he was fine. And I wanted to, you know, get the baby on me right away and have skin-to-skin and even trying to do, like, immediate breastfeeding. So I talked to the doctors about this. I mean, they did tell us we couldn't bring in our gigantic camera. I mean, it's not gigantic. But it's, like, a big digital camera. The anesthesiologist saw it and he was like, "Can you bring in a smaller camera?"

Lisa (23:31): Why does the size of the camera matter? That's odd.

Christine (23:36): I don't know. Maybe they're afraid you're gonna, like, knock something over with it.

Lisa (23:38): Yeah, maybe. Maybe so.

Christine (23:39): Yeah. I don't know. But we just took in a cell phone and actually my husband gave his phone to one of the nurses and they took pictures...

Omri (23:47): The anesthesiologist.

Christine (23:50): The anesthesiologist took pictures for us, actually in the delivery room. Yeah.

Lisa (23:58): So did they let—did Omri bring the baby over to your chest or to your cheek or what? How did that look?

Christine (24:06): Yeah, so they took him, you know, right away when he came out. I couldn't see anything. I had the curtain, I just heard the cry, he came out crying, and they took him, you know, to weigh him and whatnot and they wrapped him up. And then either Omri or one of the nurses...Did you bring him over to me?

Christine (24:28): So one of the nurses brought him over to me and put him right on my chest and my husband actually helped me, like, unwrap him, like, unswaddle him and so yeah. I tried to take the antibiotic ointment off the eyes and I got him on my chest just like that. And, like, in front of the curtain, there was enough space. I couldn't get breastfeeding going right away. It was just too awkward. Flat on my back.

Lisa (24:56): Sure.

Christine (24:58): It just didn't seem, like, very easy to do that at that point.

Lisa (25:02): But your arms were not restrained for the surgery, correct?

Christine (25:05): No, I was afraid of that. I was afraid they were going to, and I talked to them about it beforehand and...

Omri (25:11): And I told them I would unhook you if you were.

Lisa (25:15): Most hospitals don't do that locally anymore. Most hospitals in New York don't restrain the arms. Occasionally you might hear of it, but most of the time they don't anymore. They're just out to our sides.

Christine (25:28): Yeah. My husband was like, "I'm going to unhook you if they were restrain you." I think the anesthesiologist was like, we asked him and he was like, "No, we'll only do that if we need to." And he's like, "Weird things happen in surgery rooms, and, you know...'.

Lisa (25:44): Yeah, sometimes someone will start freaking out and if they start freaking out then the arms can get in the way of the surgery. That's part of the concern.

Christine (25:50): Yeah, yeah, yeah. I suppose, for a situation like that. But I was fine. I was really worried about getting the epidural injection in my back and just about the surgery in general. But, like, that went fine. I just, like, laid down right away and the whole thing took, you know, 10 minutes. After like 10 minutes, maybe, he was out, and the longest part of it is just them sewing you back up. And like they said, you—or maybe the doula said to me like, "You want them to take their time with that."

Lisa (26:25): Good point. Excellent point. And did you, did the epidural take really well, to where you only felt, like, tugging and pulling but no pain?

Christine (26:34): Right, exactly. Yeah. Yeah. It went really well. And, yeah. My husband, like, fought with the doctor for a while about delayed cord clamping.

Lisa (26:46): I was going to ask about that because I was remembering that you wanted to do that, I think.

Christine (26:50): Yes. So C-section, they usually don't allow that at all. They just want to get the baby out and start closing you back up.

Lisa (27:00): Right. Yeah. It's more because of the mother having surgery.

Christine (27:04): They were like, "Well, we can't have an open wound being open for, you know, we can't just leave an open wound being open for 30 seconds or a few minutes or whatever." And my husband was like, "Well, I've seen open wounds." You know, he was in the army. He's like, "I've seen guts and open wounds open and everything was fine." Like, you know, "It was fine. Like, people got treated. Like, you know, nothing, nothing terrible happened just because of the wound being open." And he just, like, fought with the doctor on it. And at the end he let me have delayed cord clamping by...I think a minute I was allowed. And so, yeah, as soon as the baby came out, they started—the doctor started to count a countdown. And he said, "I'll give you 15 seconds." And he started counting down and then was like, "Wait, I lost count. I lost count. Start again."

Christine (28:16): Yeah. So it ended up being about a minute. So that was nice to have that. And it took a lot of, it took a lot of discussion, took a lot of pushing them about it, and argument. But, yeah. At least we had that. And then I was, you know, ready to be wheeled out. Like, we went to a recovery room for two hours, at least two hours, and I took the baby and tried to start breastfeeding right away, and that was difficult, too. Like, the latch was just like painful from the very beginning. And I was, I knew it wasn't supposed to be so painful, and it was hard in those few days in the hospital because there I did not get the support that I hoped to get with breastfeeding. And like they were like, "We have one IB CLC and she's on vacation."

Lisa (29:05): Aw, that's too bad.

Christine (29:07): Yeah.

Lisa (29:07): And you said this was at Metropolitan Hospital? Is that where you ended up?

Christine (29:10): Yeah. Metropolitan. Yeah, that's where I ended up. I almost did go to Dr. Haddad, but he happened to leave town the night that I went into labor, and I was just gonna have a C-section. So, you know, it wasn't like I was going to go have some, some other experience necessarily. Like, with him it was just going to be a C-section there, too. But yeah. So I just went to Metropolitan and yeah, like, so then after, we did have our own private room after I was taken out of the recovery room, which was...at least that was really beneficial and really important at the end because I don't know how I would have done that with—like recovered so well without my husband there.

Lisa (29:55): Yeah, I always say if you have a C-section, it's the good kind of debt to splurge on a private room. But at Metropolitan Hospital, that is, I think, the only hospital in Manhattan that has private, like, by default, that you don't have to pay the big bucks for.

Christine (30:14): Yeah. And I heard at Columbia—I think—Hospital, like, in Harlem or something like that.

Lisa (30:19): That's right, I was forgetting. Yes, you're right. You're absolutely right. Yep.

Christine (30:24): I did all kinds of reading about different hospitals and I almost like, because I was trying to figure out where to transfer care to, at different points, and I read about all the hospitals.

Lisa (30:34): You can tell. It's great.

Christine (30:35): I know, but you know, they're kind of all the same in many ways. And all the, all the major, like, private city hospitals. And then so at some point I was like, I should just choose like based on a doctor that I like, not based on the hospital. Though I will say that if I were choosing now I would probably, I think, I think I would go to NYU.

Lisa (30:57): Yeah?

Christine (30:58): Just because you don't get a private room, but you do, they do allow the partner to stay.

Lisa (31:05): Yes, they do. Yep.

Christine (31:05): They have, like, they do have a lot of breastfeeding support, and you can get donor milk, apparently, if you can't produce your own breast milk. But meanwhile I was in Metropolitan, like, trying to breastfeed. And it just wasn't going well. And by the time I went home, my nipples were, like, in bad shape. And I, like, from the hospital I was, like, texting IB CLCs, like, to arrange for someone to come to my home and help me. And I kind of wish I had even had them come to the hospital and help me, you know, while I was there. So, yeah, I had somebody come the next day. And she helped me a lot, I mean, even just to calm down. Because I was so stressed out in the hospital and, like, the nurses were not helping. They were just not sensitive in how they were, you know, dealing with my situation.

Christine (31:56): They were, like, upsetting me more so than anything. Just making me more stressed out, you know, making me feel like I was starving my baby, like, in trying to breastfeed. And, yeah, that just made it a difficult situation. And yeah, I went—one of the nurses, like the worst one, just, like, had me in tears on, like, the last day we were there. At least she, like, to her credit, she apologized to me, like, before we left. So that was nice. Yeah, my husband kind of went up against all the nurses, dealing with them. Yeah. And then, you know, the C-section recovery, like really wasn't too bad. Like, I think I only took one strong ibuprofen pill after I got home. I was prescribed, like, strong painkillers but didn't have to take them. And just getting in and out of bed was hard. And if I just moved a certain way where I would pull on the incision, or anything like that, that would be painful. It was just hard to move around for a while, for the first week or two. But yeah, it wasn't too bad as far as that, and breastfeeding became, you know, my main focus, like, after the birth.

Lisa (33:17): Sure. And did you find—in terms of your C-section recovery, did you find any specific things helpful for your physical wellbeing? For your mental wellbeing?

Christine (33:27): One thing. I took—what's it called...arnica.

Lisa (33:31): Arnica. Yeah, I thought that was maybe what you were going to say. Yeah. Homeopathic.

Christine (33:36): Yeah. I took that. I was wanting to take that for pain instead of taking prescription painkillers and I think it helped me. And I was happy to have that instead of taking drugs. There's always the concern about when you're trying to breastfeed and taking prescription drugs. So yeah, that's one thing I recommend getting. And I had these, like, high waist underwear that someone had given me from my neighborhood, another mom who had the hospital underwear that she got in the hospital, these white mesh panties, which people talk about and they're like, "Stock up on those panties!"

Lisa (34:14): Did you see just in the last week, Amy Schumer Instagrammed her walking down a country road with a stroller in those hospital underwear, those mesh underwear? Yeah. She's trying to normalize all this postpartum stuff and I'm like "Yay! That's great." We need to have more awareness of our postpartum, you know, bodies and everything.

Christine (34:34): I agree. That's amazing. I'll have to look up that picture. Yeah, I had those and, I mean, I had expected to have a vaginal birth but actually those still come in useful because they sat above my incision line, and that made it easier. So that helped. And there was still bleeding and I, like, stashed up on cloth pads, so I still got to use that and...

Lisa (34:59): Yeah, a lot of people are surprised that they will still bleed after a C-section.

Christine (35:03): Yeah. I had known what to expect with that, and I didn't have any issues with bleeding. It just, like, gradually let up after a few weeks. Yeah, I think that was it.

Christine (35:16): Oh, I'll tell you a story first before I forget, and you can maybe edit it back so it makes more sense, into the timeline of the story. But we got pulled over by a cop when we got to the hospital. Yeah. It's like something out of a movie, you know? Right. You're like about to get to the hospital and you're in labor and the policeman pulls you over. We made an illegal left turn. Knowingly. Yeah, no, we knew it was an illegal turn. We didn't, you know, not see the signs. We did it anyway. My husband also saw the cop. I didn't see the cop. And we pulled into the hospital because they have a little parking lot right there and we were going to try to park there. We pulled in and the cop pulled up behind us.

Christine (36:04): He came up to the window. "License and registration." My husband's like, "What did I do?" He's just like, "License and registration." My husband gets out of the car, which kind of freaked him out a little bit. And my husband just was kind of like, you know, a little frantic, and he's like, "My wife's in labor. I just want to see if I can park over there." And then he like, hands the cop his license. He's like, "Here's my license. Just mail it back to me. Give me a ticket, whatever you need to do. My wife's in labor, though. We got to go. Like, I gotta park, whatever." Like the cop just, like, at that point the cop is like, "Here you go. Just go. Nevermind."

Lisa (36:47): Rightly so. My goodness.

Christine (36:50): I know. I like, I said to my husband, "What a place to pull people over. Like, when you're just pulling into a hospital, I mean you clearly have something important happening." But my husband, yeah. My husband's like, "Yeah, I know I did a wrong thing here. You can give me a ticket. I know I did an illegal turn." He's like, "Just mail it to me." Yeah. He just, like, let us go. Like, yeah, uneventful after that. But it was funny.

Lisa (37:26): Can you clarify one thing? I'm just trying to figure out, did you just decide—had you seen a care provider at Metropolitan? Sorry if I missed something here.

Christine (37:36): I did for—maybe I just had one appointment there.

Lisa (37:42): I was trying to figure out if you had transferred your care officially, or if you just decided "I'm going to show up on their doorstep." Because sometimes people will do that.

Christine (37:49): Yeah. I kind of officially transferred, in that I told my, I called my doctor's office and told them to cancel the C-section and said, "I'm going somewhere else." And I did see one, do one appointment at Metropolitan, but...I guess I didn't officially, like, transfer there.

Lisa (38:09): Basically you just didn't go totally blindly.

Christine (38:12): Yeah, I hadn't made any, I hadn't made any commitment to giving birth there. And even, like, a week before I was due, my family was like, "So where are you giving birth now?" And I was like, "I dunno." Like, they were kind of amazed, you know, people were kind of amazed that I didn't have, like, a set place or already, you know, a whole plan of, like, where I was going. So yeah, at the last minute, like, I was just going to see when I went into labor and then see if Dr. Haddad would be around. And if not, then I would go to New Jersey, or if he wouldn't be around, I would go to the city hospital. So I really didn't decide until the day I went into labor. Yeah, I just, I just kind of flew by the seat of my pants.

Christine (39:01): I wasn't like a—some people really, I guess, want to plan a C-section more in advance. I mean the doula told me there were advantages to, like, having it scheduled, in that I could negotiate for what I wanted.

Lisa (39:15): True.

Christine (39:15): So there would be that benefit. But I really was kind of like—and I know, like, okay, there's some doctors, people say, "Oh, this doctor's amazing at C-sections." You know, "I had hardly any scarring." Or whatever. But to me, like, a C-section was a C-section. Like, you know, I trusted either place to, like, do it right. And to me it didn't matter as much, like, where I had the C-section.

Lisa (39:41): Well I'm glad to hear it sounds like your healing has gone pretty well from that.

Christine (39:45): Yeah, it really like, it really became the least of my worries after birth, because then I was just wrapped up in the breastfeeding thing. And there was so much I didn't know about breastfeeding. Like, I didn't even know that, like, so many women use formula in the beginning, just for whatever reason, just because there's so many things that can happen in the first few days. And, like, my son had a tongue tie and lip tie and cheek tie. I knew about that before I'd given birth, and I just knew it wasn't supposed to be really painful. So yeah, when the IB CLC came, like she told me, like, "He has tongue tie for sure." Like, "Go to this doctor or this doctor, and they can treat it." And I did that and I just, like, took a break from breastfeeding. I started pumping the day after I got home from the hospital.

Lisa (40:41): And for listeners who don't know what a tongue tie is, it's when the frenulum, the little string underneath the tongue, or sometimes it's a posterior tongue tie, so we have several different of those [frenula], and if it's too short or tight, it makes it impossible to get the breast into the mouth in a healthy way. It causes pain for the mom. The baby doesn't get enough. So it's an increasingly diagnosed problem or issue these days that, when it's addressed, when it's identified and addressed, can radically change the breastfeeding relationship. Not immediately but gradually. So I just wanted to clarify that because a lot of the listeners might not know what that is.

Christine (41:24): Yeah, yeah. I certainly never knew about it until I was, you know, pregnant, and going to have a baby and learning about breastfeeding. And yeah, we found out he had that, and he was not, for sure, like, getting enough milk by the time I left the hospital. And it was really hard to figure out in the first few days. Just...you don't know. I mean you're trying, I was trying to breastfeed him, especially, like, all the time in the hospital. And he was still, you know— the only way they can tell is like how many diapers, dirty diapers are they making?

Lisa (41:57): Unless you have an IB CLC who can then do the weighted scale. But the IB CLC was on vacation, right? You said? I think? Or gone for some reason.

Christine (42:05): Yeah. So he lost like 10% of his body weight by the time—like, the day after we got home from the hospital. Because the IB CLC then came and, like, weighed him, which is like, you know...

Lisa (42:17): That's within the range of normal. Up to 10.

Christine (42:20): Yeah. But she was like, "Baby's hungry. Like, you need to start formula now." And just, like, the night after we got home from the hospital, like, I was just like, you know, clenching my teeth through the pain, just breastfeeding him all night. And she was like, you know, "Listen, your problems are solvable. Like, this isn't, you know, this isn't gonna last. Like, you're going to put him on formula now, but we're going to work on this." And she developed a whole plan for me and, like, put me on a pumping schedule. So I started using my pump right away, but I just had a problem with, like, my supply. So, you know, I pumped a whole syringe of milk while I was at the hospital, but it went downhill from there. I was just, yeah, at some point I went a week pumping no milk at all. So it was just like my milk, like, never really came in quote-unquote. So yeah. Then I started looking into Donperidone, which is a medication that was not developed for breastfeeding, but, actually they were using it to treat, like, nausea or acid reflux and discovered that it makes people lactate. So yeah, I learned all about that and how women have been using it for breastfeeding and milk supply for a long time, which is not really possible to get in the United States. So that was kind of annoying, too, because I wanted to get it right away and I was like, I need to, like, figure all this out now, like with my breastfeeding problems. Which—I learned, too, you know, it was like, it's not so crazy to, like, figure out breastfeeding when the baby's like six weeks old or something, you know? And it was kind of like in the beginning, I felt like, "I need to, like, figure out everything, like, this week, like, I need to, you know, I need to get the baby breastfeeding or this is not going to work out and it's not going to happen."

Lisa (44:15): Sure. Yeah. You feel this urgency in you, right? Because you're like—they have to eat, they have to eat. Yeah. It can feel stressful.

Christine (44:21): He was on formula. I really didn't want to be on formula. I wanted to give him breast milk. I even looked into, like, getting breast milk from another mom, which my husband calls "off the street." But it's not like getting a street drug.

Lisa (44:39): No. There's actually a number of donor milk networks here in the city. Yeah, I always mention it in my classes. Or I usually try to remember to mention it, that, you know, that's an option, and just to reach out to me if anybody needs that, if they need to supplement.

Christine (44:59): Yeah. People do it, for sure. But my husband just wasn't comfortable with, you know, getting it from somebody we don't know.

Lisa (45:05): That makes sense. Yeah. You have to be comfortable with it. Of course.

Christine (45:09): Yeah. And you have to, I mean, some people surprisingly, like, don't ask too many questions before they take milk, but you obviously want to ask them if they have anything, any kind of disease or what their lifestyle's like, etc.

Lisa (45:24): Of course. Yeah, definitely.

Christine (45:26): But yeah, I had looked into that and we ended up like buying some donor milk from the New York Milk Bank, which is in Westchester.

Lisa (45:34): I guess I didn't realize you had to buy it from them.

Christine (45:37): Well, so you first of all, like, you need a prescription to get it from them.

Lisa (45:44): Yeah. That I knew.

Christine (45:44): So I got my doctor to write a prescription. And then either you get insurance coverage or you can pay out of pocket, and it's like $4 an ounce.

Lisa (45:53): Okay.

Christine (45:54): Which is crazy.

Lisa (45:54): Yeah.

Christine (45:54): A crazy amount of money if you're trying to exclusively give your baby donor milk. So, great for someone who's like, that's financially doable for them. But otherwise, you know, you try to get—so I'm trying get my insurance to cover it. And I think insurance companies should cover it for anyone who wants to give donor breast milk. I mean, you know, we have established that breast milk is, like, the best thing for babies. Has so many benefits. You know, it's a thousand times better than formula. But yeah, of course they don't want to cover it. I'm still, you know, trying to appeal and, like, get them to cover it for us. But yeah, I mean at least I am glad that we have the Milk Bank, because I think it's great. And definitely, you know, preterm babies need that milk, too.

Lisa (46:41): Absolutely.

Christine (46:42): Yeah. And they told me, I mean I knew already that they won't give it to, like, a full-term healthy baby, like what I have, unless they have enough of an inventory. They want to be able to give it to the preterm babies.

Lisa (46:54): Right.

Christine (46:54): So I learned all about that and I went to La Leche meetings before, while I was pregnant twice, and I've gone since I gave birth. And that's really been a great resource for me.

Lisa (47:09): Good.

Christine (47:09): I want to throw that out there because anybody who's pregnant should go to a meeting.

Lisa (47:13): Yay! I always say that in class. I'm so glad you're saying it too.

Christine (47:17): Yes, yes, absolutely. You learn so much just going to one of those meetings. I think you learn more than you would at any breastfeeding class, even. Just because you have, like, women who are breastfeeding and going through and talking about what they're dealing with. And not only that, but you have women coming in with everywhere—babies can range in age from like infancy to toddler. So, and you know, I learned quickly that you might have a great experience breastfeeding, it might be really easy, but then down the line there are things that come up, you know, the babies, every stage is different. So yeah, I mean they talk about what it's like to go back to work, and what happens when the baby is a toddler, and under-supply and over-supply, and all the different, all the different issues that come up. So yeah. And you get so much support in those meetings, too. And it's just a really great, great resource.

Lisa (48:14): Which location have you gone to?

Christine (48:17): I'm in Long Island City, so I went to my meeting in this neighborhood, my own neighborhood. Yeah.

Lisa (48:24): Nice. I don't know if I realized there was one happening in LIC. They change a lot, because it's volunteer led, they don't often stay in one place for a really long time. So it's hard for me to keep track of where all they are. But that's great that there's one in your neighborhood.

Christine (48:39): Yeah. Yeah. So it's been really convenient.

Lisa (48:42): Well. So do you have any last tips, or wisdom, or thoughts for expectant parents who might be listening, from your pregnancy-birth-parenting journey to date?

Christine (48:54): I mean, I'm sure anybody who has a breech baby will be interested in learning about my experience, and I hope that it helps them in some way. And...let me think if there's anything, like, I'd want to share about my whole experience.

Lisa (49:14): One thing, as you're thinking about that, one thing I think is a big takeaway from your story is that it's never too late to change a care provider. You know, and don't stay with one if you're not happy with them. Not that you found the ideal care provider for you, but, you know, you did your best to navigate that and work with the circumstances that you had. So I commend you for that because I think that's really admirable.

Christine (49:37): Yeah, I would really encourage, people to, like, pursue the kind of birth experience that they want, and, like, don't let your doctor stop you, or think that you can't find a better care provider. Because it was—I had actually tried to transfer when I was 28 weeks. I, like, started looking for a different doctor, just because I wanted to see midwives and I wanted...like, I wasn't that enthusiastic about the doctor I was seeing, and I wanted someplace, like, closer to home, and all these different things, and I was, I found it so difficult. I think people need to know—at least in New York City—that if you're trying to transfer late, like, contact a doula to help you, or someone who...or ask around, because it's so hard to transfer. It is particularly difficult in New York City, but doulas do know who to call. Like, they do know what doctors will take a late transfer. I called so many practices who told me their cut off, that I was past their cutoff.

Lisa (50:46): It's usually 28 weeks. A lot of them.

Christine (50:49): Yeah. One was like 25. And I just did not know that until I was in that situation. And yeah. And I was like, "How does somebody even find a doctor if they, like, move here when they're like 29 weeks?" So crazy.

Lisa (51:04): I've helped a lot of my students switch, but it's always tricky. Yeah. Especially because, you know, I want to help somebody find the best fit for them, and that's not going to be right for the next person, you know? So it's a little tricky, but yeah, a doula or childbirth educator can definitely help with that.

Christine (51:22): Yeah. I encourage people to, because it was really discouraging when I was just, like, being told "no" from so many practices. And I just was happy to have a doula. I just realized, like, that doulas know so much more than anyone, I guess, about doctors and hospitals. It's like, they really see it all. Like who else, like, travels from hospital to hospital, sees different birth experiences, works with different doctors. They really know more than anyone, I think, about who to go to, and can tell you about the different doctors. It was only through my doula that I was able to even explore the option of having a vaginal breech birth, because she looked into her network, asked around and everything, and I would not have been able to find anybody to even consider that otherwise. So I encourage people to get a doula or at least talk to a doula.

Lisa (52:21): Yes. I agree. Thank you for saying that.

Christine (52:24): I contacted doulas just when I was looking for a doula. Like, I just wanted a doula to be present at my birth. And at that point they were—I even had doulas saying, like, "Oh no, I'm not available, but, like, did you try this...?" Like, they were suggesting practices to me before, you know, even ones that I had not hired or interviewed, they were just, you know, voluntarily telling me, giving me advice about who to go to. So yeah, that was just invaluable resource. Yeah, that's what I would say. And my doula really encouraged me. She was like, "If you're not happy with your doctor, like, transfer. Like, you can, like, I can help you," and yeah, at the end she was like, "I'm so happy you left that practice." "Me, too!" So yeah, I really wasn't happy there.

Lisa (53:12): Well, thank you so much for sharing this, all about your journey, Christine. It's been wonderful hearing about it all and I hope to see your family in person sometime so I can give your little one a kiss, or a hug, or a cuddle.

Christine (53:27): Yeah. Thanks for having me. Yeah, I hope you get to meet our little boy.

Lisa (53:31): All right. Thanks again.

Christine (53:34): Thank you. Thanks for having me.

Lisa (53:35): Take care.

Lisa (53:37): In observation of cesarean awareness month, I’m going to teach some basics about cesarean birth. First, I do want to say that we should be grateful we have the surgical birth option when a baby absolutely needs it. However, a common misconception is that cesarean birth is just as safe and healthy as vaginal birth. This is just not true. Vaginal birth, when it’s possible, is far safer and a healthier birth for both baby and mom and carries less risk in the healing process, too. We'll talk about the risks next week. About 1 in 3 births in the U.S. are C-sections. I recommend asking your care provider what their C-section rate is. You really don’t want to hear above 20% to be assured that they’re only doing C-sections when absolutely necessary -- even with high-risk OBs. If you hear a number higher than that, you may want to consider finding a different care provider, even it requires travelling farther for your care.

Lisa (54:32): Your choice of care provider and birth location are two of the top ways you can avoid an unnecessary surgical birth. Other things you can do to position yourself wisely to avoid a C-section are to let labor start on its own. Hire a doula (even if it has to be virtual support). Take birth class. Several examples of things you’ll learn in class that help reduce the chance of an unnecessary C-section are 1) you learn strategies to help labor progress efficiently and healthfully, 2) you learn how to advocate for yourself to avoid unnecessary interventions, 3) you learn how to discern between a necessary cesarean and an unnecessary one. Regarding this episode and the baby’s breech positioning being the reason for the cesarean, I hope you’ll check out the documentary HEADS UP to learn more about the history of vaginal vs cesarean birth for breech babies. It’s very unfortunate that U.S. medical schools don’t train doctors in how to safely catch breech babies, so that most women have no choice but to have a surgical birth if their baby is breech toward the end of pregnancy. I’ve linked to this film as well as a number of breech resources in this episode’s show notes over at birthmattersshow.com. Okay, here's what's up next week.

Speaker 3 (55:50): Yeah. Min was having a pretty tough time.

Speaker 4 (55:53): This is when the lessons of your class came in handy for Grant, because he was amazing and was just—the entire time, you know, just holding my hand and just sort of whispering these mantras. You know, things like—I can't remember what you said. Just, you know, "Breathe, relax your jaw." You know, "You can do this."

Speaker 3 (56:20): "Just breathe through this one."

Speaker 4 (56:20): Yeah, it was... you know, as uncomfortable as it was at times, it was really like...my memory of it is sweet because of that, because it was such a—it was an intense time and it had that bonding effect on us as a couple.

Speaker 3 (56:34): Yeah, I've never felt so close. It was amazing.

Lisa (56:45): Here's the affirmation I'll leave you with this week that might be helpful right about now. Tell yourself throughout this week, "I am calm and safe. My baby is calm and safe." Thanks so much for listening to the Birth Matters Podcast. We'll see you next week. And until then, stay safe, wash your hands, and be well.---END---




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