Birth Matters Podcast, Ep 33 - Virtual Doula Support in the Covid-19 Pandemic

When the Covid-19 pandemic starts getting real in March, Jackie & Michael try everything they can near their due date to help labor to start when their doctor wouldn't agree to induce until after her due date. A few days before her due date, Jackie's surprised when her water breaks. Because she sees meconium in the fluid and she was Group B Strep positive, they head to the hospital. They describe how both the induction and the pushing stage surprise them when it progresses more quickly than most. You'll hear the different ways that, in mid-March when Jackie gave birth, hospital precautions were ramping up moment-by-moment in one specific way that affected them. They also share the ways their pediatrician office's protocols changed across their first 3 visits. Jackie & Michael also talk about how valuable hiring doulas was through this journey into parenthood, even when it had to be virtual support for the actual labor.

Episode Topics:

• Taking both prenatal hospital & consumer-based childbirth classes

• Hiring doulas and how much they valued their doula duo’s non-judgmental attitude and the resources they provided

• Trying to get labor started due to the rapidly escalating Covid-19 pandemic in NYC - requesting induction, trying lots of things like acupuncture, castor oil (“midwives brew”), etc.

• Water breaks, there’s meconium in the fluid

• They call doulas first and then hospital/care provider

• 2:30am - Head to hospital (due to the meconium and testing GBS+)

• Arrival at hospital, admitted into a shared induction room, separated only by hanging curtains

• Induction brings on strong contractions almost immediately

• They get moved to a private L&D room

• Getting epidural

• Surprise to progress much more quickly than anticipated

• Find out their favorite doctor will catch the baby (Dr. Mercer)

• 12:40pm - start pushing, he’s born in only 23 minutes

• Pediatrics takes baby over to warmer in the room for a few minutes to give him some oxygen, as he had a little trouble due to the meconium, but then comes to mom’s chest

• They’re sent home earlier than usual due to Covid

• Changes across 3 weeks of pediatrician visits due to escalating pandemic

• Postpartum virtual visits with doulas

• Final reflections and tips for expectant parents - get doula support, everything will be okay

Resources:

• Birth Matters Covid-19/pandemic resources

• The Root Therapy NYC (support groups for new & expectant parents)

• Birth Matters Group Classes (Astoria / virtual through the pandemic)

• Birth Matters online, on-demand comprehensive childbirth prep course

• NYC Doula Collective

• Raychel Franze & Kori Krysh, doulas

*Disclosure: Links on this page to products are affiliate links; I will receive a small commission on any products you purchase at no additional cost to you.

Transcript

Lisa: You're listening to the Birth Matters Podcast, Episode 33.

Jackie: We did also have a follow up with the doula, so the original contract that we had with them was that they would, you know, come to our house two times for postpartum follow-up visits. Which, of course, you know, wasn't possible now. So we did another ZOOM meeting with them. And that felt, you know—of course, it would have been nicer to have them here in person. But it still felt really nice and kind of celebratory to do that because we have had this, you know, sort of months-long relationship with them where we were gearing up for the birth. And so it was really nice to then have that meeting where, you know, they met the baby over over ZOOM, and we just kind of debriefed about everything. And, you know, I asked some questions just about my own postpartum care, and they gave some advice about that. It kind of felt like a little bit of a party, you know, a celebratory party just getting to meet with them over ZOOM.

Lisa: 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.

Lisa: 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.

Lisa: Welcome to the Birth Matters Podcast. Today I have with me Jackie and Michael. Welcome, you guys.

Jackie: Hi! Thanks for having us.

Lisa: So would you like to share with the listeners, maybe, what you do for a living and maybe even before that, when did you give birth? It was recently.

Jackie: Sure. So Tara was born March 17th, so his three week birthday will be this coming Tuesday, so he's about 2 1/2 weeks. And we are both lecturers. We both teach writing to college students, and we're also writers, Want to add anything to that?

Michael: No, that's good.

Jackie: That's who we are.

Lisa: Great. And we're recording this, what, like three weeks into people starting to do social distancing and staying at home amidst this pandemic. So my heart goes out to you guys and all the expectant parents and new parents out there, particularly in this challenging time.

Jackie: It's definitely affected us. So we'll talk about that.

Lisa: Sure. Well, so first, why don't you share a little bit about the different—how did your pregnancy go, and the different ways that you might have prepared for birth and your entry into parenthood.

Jackie: Okay. Yeah. So I guess one of the main things that we did to prepare—you know, as teachers, we are always believers in education. So we signed up for a lot of classes and did a lot of research. The first thing that we did—I mean, I guess, just to back up for a second, we, at least I came to pregnancy with a lot of fear. I was really afraid of the labor and the birth process and being a new parent, and even the pregnancy to some extent. So there was a lot of, you know, researching, just googling things and and all that from the beginning. But I think a turning point was when we made the decision to hire doulas. And so we did some research about that, of course. And we interviewed a few different people and people from different agencies and organizations. But what ended up happening is that we signed a contract with Raychel Franzen & Kori Krysh. They are with the New York City Doula Collective, and when we met with them, it just was—like, we just clicked. It was just a moment when it suddenly felt like, "OK, we can do this. We're gonna be able to get through the pregnancy and the labor and everything." So they just were so warm and knowledgeable and nonjudgmental. I think part of my fear was just about people having their own agendas, that they would force onto us as parents and, you know, deciding what we should do, without thinking about what we might want, or what might be best for us. And I think when we met with Rachel and Kori, they just—there was no judgment. There was just knowledge and compassion that they shared with us. Like, whenever we had a question or something that we were unsure about, they gave us their opinion. But more importantly, I think, they directed us toward resources, like the circumcision thing. Do you want to...?

Michael: So, I mean, I think one aspect about choosing the doula is that they were highly experienced. They each had a couple 100 births under the belt. So whatever sort of factor that we were interested in discussing, they had had experience with that kind of pregnancy, that kind of birth. You know, so it was very reassuring to sort of have that kind of knowledge on your side. As Jackie said they gave us, you know, whenever we had questions, rather than saying, "OK, this is what you should do or shouldn't do," they would give us resources for us to, you know, read and decide for ourselves and, you know, discuss with them, but ultimately decide for ourselves. For example, circumcision was a question that we had, and they, you know, provided us a resource that was very thorough talking about the sort of why it's been done historically. And that really helped us make our decision to not get Tara circumcised.

Lisa: Do you mind my asking, was that "Evidence Based Birth?"

Jackie: Yeah.

Lisa: And that just came out over the summer. I've been so thankful to have that resource to give to my clients.

Michael: That is a great page.

Jackie: Yeah, I think that's just one example. They just knew about resources that obviously we didn't, that they were able to point us to.

Michael: There was only one thing that they had an opinion on, that they said you definitely should do, which is not to have him bathed in the hospital.

Jackie: Immediately after birth, yeah, don't bathe the baby. We took that advice and...

Michael: He actually hasn't been bathed yet. Today is the big day.

Jackie: Yeah. The pediatrician said today he should be bathed, so we'll see. So anyway, hiring the doulas, I think was a turning point now. So I guess another thing...

Michael: And they recommended your class.

Jackie: Yeah. So one good thing—there's a lot of things—but they work as a team. So that was reassuring to me. Originally, the idea was that—so we met with them three times during the pregnancy, and they both came to each of those three meetings. And then the idea was that one of them would be present for the birth. So we had this idea that, you know, we would know very well the person who was there for the labor and the birth, you know, as opposed to a doula who maybe works by themselves. If they had another client that ended up having labor at the same time, you might get a backup that you've never met. But we felt close to both of them and knew them really well. So that was really nice. And we signed up for a class at the hospital.

Michael: Yeah, at Long Island Jewish Katz.

Jackie: Yeah, we gave birth at Katz at Long Island Jewish. So we took a class there that was a one day class. But Raychel and Kori had suggested that sometimes the classes at the hospital are a little bit more about sort of educating you about how to be a good patient, rather than educating you about what your options are, or, you know, what, maybe, you can ask for or expect during birth. So they recommended your class, Lisa. And so, obviously, we took that. And it worked out really well, because I think the hospital class was good because we did learn about the hospital procedures and sort of what they expected from the hospital class. And that was probably about a month before we took Lisa's class.

Michael: Yeah, Yeah, we were—when we took the hospital class, which was a very institutional, sort of formal, you know, one day class, we were the farthest from the due date in the class. But then when we took your class we were the closest to the due date. So, like, I think that, you know, that worked out for the best.

Jackie: Yeah, yeah. We couldn't remember a lot of the information that we learned with the hospital class afterwards. And then a lot of that was reviewed, but also enhanced, I think, in Lisa's class where, you know, it was spread out over three meetings, and it was personal, and, you know, it just gave us a good refresher of information, but also, we went more in depth and learned a lot more about options.

Michael: Possibilities rather than, "Okay. This is the way things are done in this institution. You know, this is what you can expect will happen when you come into this institution." Versus the possibilities. You know, these are things that could happen.

Jackie: Right. So, yeah. My three favorite things from Lisa's class, not in any particular order, but: the massage techniques, those were really, really helpful. Because especially at the end of the pregnancy, but really for a long part of the pregnancy my back was a constant issue. I always had back pain. So the massage techniques helped alleviate that. Yeah, so that was really good. Also the diapering session, when you taught us about how to change diapers, was really helpful. Our baby does not like having his diaper changed, but he's getting better.

Michael: Well, we're getting better.

Jackie: Yeah, we're getting better, too. But also, I think, you know, we had some, like, knowledge to be able to do it quickly because of the class. So that was good. And then the other thing: this was just something that you very briefly mentioned in the class, but it really helped me with the fear, and I didn't end up needing to use this, but you had said during your class that if at any point during labor or delivery a doctor or a nurse or anyone was doing something that you know, I didn't feel comfortable with or didn't want, you gave the suggestion of just kind of loudly stating, "I do not consent." And I just had this fear that they would perform an episiotomy on me. And so just knowing that I had that sort of option to just, you know, forcefully say "I do not consent" made me less fearful. And I didn't end up needing to say that at the hospital or, you know, at any time. But just knowing that just made me feel a lot better, that I could do that if I needed to. So that was really helpful.

Lisa: Thank you for that feedback, because that's actually a slide I just recently added. I did it with a lot of hesitation because I was concerned that it would scare people, you know. And maybe it does some, but I just know that in certain circumstances, it might be needed. So I just decided I needed to include it, so I appreciate that feedback. I'm glad it helped you feel more confident and peaceful.

Jackie: Yeah. Do you want to add anything else about the class?

Michael: Well, we got some of the items that you actually recommended. Like, we got a birthing ball. For the postpartum we got some of those items.

Jackie: The peribottle, yeah.

Jackie: Just there were—there's all these bits and pieces that just turned out to be, you know, like—it would have taken us much longer to figure out what to do on our own, so yeah. Yeah, thank you for, you know, expediting that knowledge.

Lisa: My pleasure. All right. So any other things you wanted to share about pregnancy and ways you're prepared? Or if not, you can launch into the birth story.

Jackie: Well, I think this is kind of related. So obviously, given the time that we're living in, the historical context, the Coronavirus became this thing.

Michael: So our due date was March 21st. And when did when did the city get shut down? Just a few days before then.

Jackie: Yeah, so I mean, throughout, of course, you know, earlier on in the pregnancy, we, you know, we just had expectations that we would have help if we needed it.

Michael: That our doulas would be present.

Jackie: And, you know, we just had no idea what, the world would become, you know, by the time that the delivery happened. So things changed really quickly. And during the time that we were sort of waiting for labor to begin was the time that the virus was really—seemed like every hour, if you checked the news, there was more alarming information, and it just became this really really frightening time, I think, in the world and New York City in general. But then, of course, adding the waiting to go into the hospital, too, it made it much worse.

Michael: Yeah. I mean, there was a moment, I mean, the doula sent an email saying that many of the hospitals were no longer allowing more than one support person. Some were actually starting to not allow any support person. So it sort of became important to us to try to get in and out of the hospital as soon as we could. We just didn't know what was going to happen.

Jackie: Yeah, I guess, like, one of the catchphrases, and it seems crazy that this was only three weeks ago. But one of the catchphrases at that time it was "It's going to get worse before it gets better." We kept on hearing that. So we really wanted to get into and out of the hospital as quickly as possible. I think it's—you know, any time you talk to anybody who's ever been pregnant and had a baby, at the end of pregnancy you're sort of just eager for it to be over and you want to meet the baby. But I think that was so heightened by our fear about, you know, "Are we gonna catch the virus? What's gonna be the protocol in the hospital?" All that. So we became really interested in trying to speed things up. So we did a couple of things to do that. So first of all...

Michael: We spoke to our doulas about possibly...well, first of all, we had read that, you know, a first pregnancy actually usually comes later, after the due date. And we were trying to get our doctors to, you know, do some induction techniques earlier to extradite the process. But they wouldn't. They said, "We will schedule an induction when you reach week 41." Right?

Jackie: Right. Yeah.

Michael: And so, I mean, that was really scary, given what was happening...

Jackie: With the virus.

Michael: Yeah with the virus. So we asked the doula about things we could do ourselves to try to...

Jackie: Right. And so there's all kinds of information about things you can do. And, you know, Lisa's class touched on that, too. But I guess there were two things that we pursued quite seriously. So the first one was acupuncture. So I had 4 or 5 acupuncture sessions. We went to Dr. Moon right here in Astoria, and I, you know, the purpose—I had acupuncture before, long before the pregnancy, but hadn't had it in a while—the purpose of these sessions was specifically to ready the body and, you know, try to bring about labor. So I was going, I guess I went twice a week for like 2 and a half weeks.

Michael: Starting week 37?

Jackie: Yeah, starting at the end of week—or the second half of week 37. And so I went, you know, I guess twice a week for two and a half weeks. The acupuncture—it was so funny that every time when I would leave acupuncture I would think, you know, "I can feel all these things happening inside of my body. The baby's moving a lot, you know, this is definitely going to work. Something's gonna happen." And then, you know, by the next day, I was like, "Oh, I don't think acupuncture works." But I kept going. I went for either four or five sessions. And then what ended up happening was Monday March 16 I had my 39 week appointment with the obstetrician and went in, and, you know, I was really concerned about the virus at that time and the doctor...

Michael: We had an appointment the week before at 38 weeks. And we were saying, "Oh, we're really concerned about the virus." The doctor had kind of dismissed our concerns.

Jackie: Yeah, during 38 weeks, and then 39 weeks, kind of the same thing happened. We asked about, you know, "Is there any way to schedule an induction because we want to get into and out of the hospital?" you know, and the doctor said no. And I also had a cervical check at that visit, which was again, Monday, March 16, and the doctor said, you know, "There's no progress. It doesn't seem like you're very close to labor." At which point I cried. We went home and I was crying in the car on the way home the whole time. Just, you know, feeling overwhelmed by fear and anxiety about the virus and the hospital and all that. And so what we decided to do then was try the "midwives brew," which is a concoction where, I think, the key ingredient is castor oil. So we watched the "Evidence Based Birth" video about this. And, you know, Lisa had talked about in her class, too, and a lot of people say, you know, castor oil does seem to be effective, but it has some terrible side effects. But at this point, I was just kind of really, you know, ready to just—however bad it was going to be, I just wanted to do it.

Jackie: So that was on Monday. I took the midwives brew, which you can find the recipe for online, but it was almond butter, lemon tea, some juice and castor oil. And you mix it in the blender. It's kind of a smoothie. And you're supposed to—the Internet says, you know, to drink it warm, that if it's cold, it's not as effective. So it's a warm smoothie. It's not very good at all. But it was drinkable. So I got it down. I finished drinking that at 1:46 in the afternoon on Monday.

Michael: March 16th. Yeah, after a surgical check that had no dilation, no progress.

Jackie: Right. And so then that night we had another emergency Zoom call with the doulas. I shouldn't say emergency. But an added Zoom, just because of everything that was going on, you know, Raychel and Kori had offered to, you know, just talk for some extra support. And so we took them up on that offer and, you know, kind of talked to them about the frustrations of, you know, "We don't know if the pregnancy is ever going to result in a birth." And all of that, so, you know, they were very supportive and we talked with them. And at that point, it had become clear that we were not going to be able to have the in-person support of one of them, because the hospital rules had changed that only one support person was allowed. So that was going to be you. So we just talked to them about the logistics of them supporting, you know, from a distance. So we had planned to, you know, I guess, Zoom...

Michael: Have Zoom, have a laptop in the delivery room.

Jackie: Yeah, right. So we just talked about the logistics of that, and that was sort of the plan. We hung up with them probably at, like, 9 p.m. Monday night.

Michael: Yeah. And at this point, you have had no side effects from the midwives brew.

Jackie: Yeah. Yeah, that's right. Yeah, I had finished the midwives brew just a little bit before 2 p.m. and felt like, "Okay, another thing that didn't really work." Nothing really came of it. Um, so we

Michael: No nausea.

Jackie: No nausea, no diarrhea. I had a a bowel movement, but I was having those very regularly at the end of the pregnancy anyway, so it just felt like nothing—you know, no results. So we'll see. And then we hung up with the doulas about nine and kind of went to bed just, you know, expecting nothing. And about 12. 30 that night, I woke up and my water had broken, which I was just in total disbelief about because we had, you know, heard and read, and everybody says, you know, it's not very often that that's how labor begins, is that your water breaks, and so I didn't expect it. But I woke up thinking I just had to go to the bathroom, and I went to the bathroom and I was all wet. And I just started shaking, because I was realizing "Oh, my God, the water broke. I can't believe this." And I was also thinking, "I'm actually really tired, and I'd kind of rather hope back to bed and sleep and not deal with this right now."

Michael: There was meconium in there.

Jackie: Yeah, right. Yeah. So I guess I came back to bed and told you "You have to wake up because the water broke." Yeah. And, yeah, there was meconium in it. It was sort of a grayish color, so that was a little bit concerning. So I guess the first thing that we did was contact Kori and Raychel, even before we called the doctor. So at that point, Raychel—we were text messaging and then Raychel called and, you know, I sort of describe the situation to her, and she was like, "Yes, your water definitely broke. There's definitely meconium in it." And she said, you know, "Call your doctor, and they're going to have you come to the hospital, but, you know, don't rush. Right? Like, that was really great advice that she gave. She was like, "You know, you can take a shower, eat something, you know, take your time, get to the hospital. But it's not, you know, like in the movies where you have to almost have a car accident getting to the hospital."

Jackie: So that's what we did, called the hospital. They said to come in.

Michael: The Strep B.

Jackie: Yeah.

Michael: Yeah. So we got to the hospital around—so we took our time. We had already had a bag packed, but we put it in more clothes, put in more things.

Jackie: I did eat. I did take a shower. And I was not having any contractions or anything at that point. So I think it was easy to take our time and sort of let it sink in, like, "OK, it's finally happening," you know, "Labor is going to begin," so we left the house about 2:30 in the morning, but

Michael: So, with the timing and with the social distancing that was already in place at that point, you know, there was no traffic. So, I mean, we had been a little worried about, like, "What's the drive to the hospital going to be like?" And it was, you know, I guess one of the benefits of having—of the time was that there was no problem.

Jackie: Yeah. One of the things that you were worried about was taking that left off our street. There's just a bad intersection where there's not a light or a stop sign. And you were always worried about taking that first left on the way to the hospital. But it was a non-issue, because it's the middle of the night. Nobody on the road. So that was good. But, yes, we got to the hospital about 3.

Michael: 3, 3:30, yeah.

Jackie: So, and at that point, I guess we were, like, texting and calling Raychel. And she was offering support, and saying, you know, just giving us ideas about, like, things to keep in mind and stuff like that. So we got to the hospital, and...

Michael: There was nobody there.

Jackie: There was nobody there. So we got—we were brought through triage. And they did another cervical exam, and they said that I was half a centimeter dilated. And what did they say about effacement, do you remember?

Michael: I don't remember. 60% or something.

Jackie: I don't know, but yeah, so it was still...contractions had not begun. And, you know, it still seemed like it could potentially be a long process.

Michael: This is around 5 in the morning.

Jackie: Maybe not that late, but, yeah it's like 3, 4, 5 in the morning. But they were—because the water had broken, there was meconium in it, and I was GBS positive, they, you know, said that they were going to induce, which was totally fine by me.

Lisa: You're like, "That's what I've been asking for!"

Jackie: Exactly. So they brought us to...

Michael: A horrible room. Oh, my goodness.

Jackie: This was the low point of the experience. They brought us to the induction room, which was—at this point, it's, yeah, like 5, 6, 7 in the morning, been there a couple of hours. So it was a very dark, small room where there was a curtain separating us from another couple and another woman who was, you know, going through the induction process. So that just felt like we were too close and...

Lisa: Oh, yeah, I've heard tales of this induction room. I haven't worked there as a doula in that part of the hospital. But I...ooh.

Jackie: You? We remember that was the room from hell.

Michael: And so they were like, "Okay, we're going to give you Cytotec. We're gonna give you doses every two hours, nine doses over a period of every two hours. So it potentially could have been 18 hours in the induction room. They were like, "You could be here in this horrible room for 18 hours."

Jackie: Yeah. And, well, they said that hopefully labor would begin within 24 to 72 hours after, you know, starting the induction process. And so they suggested that we settle in. So psychologically, we were, like, trying to prepare for that. But I took the first dose, and I would say...

Michael: About seven in the morning.

Jackie: Yeah, and it seems like it was 15 minutes later that contractions began very, very strongly. So there, you know, had been a lot of thought and preparation leading up to the labor about, you know, laboring at home in the beginning and, you know, kind of using comfort techniques in the beginning, and breathing into the pain, and, you know, just being with it. But all of that sort of went out the window when the contractions began because they were just really strong really fast. And then everything started happening really, really quickly.

Jackie: So the nurse came and she was like, "Well, you know, you only just started taking the medication, so it's gonna be a long time before you are in active labor. So maybe you need some morphine to deal with the pain." And I was thinking, "Why am I dealing with this pain so horribly?" Because I could hear the other woman in the induction room on the other side of the curtain, and it became clear that she had been there for eight hours and, you know, she was not having, I guess, any progress. And, you know, she was fairly quiet. And I got to this point where I was just in such excruciating pain that I was, you know, not very quiet. And so then the nurse had suggested morphine and said that she was going to, you know, call the doctor to see what the doctor thought. And so a doctor came and they checked, and they said I was between four and five centimeters dilated already.

Michael: And it was time for the epidural.

Jackie: Yeah, so, I mean, in my experience, it seemed like only 20 minutes or so had passed. When it was longer than that, but only a very few hours.

Michael: The contractions went from no contractions to every five minutes, or quicker. There was no gradual building up.

Lisa: It's bizarre how differently different people's bodies take to these different medications and induction approaches. Some it, like, hits fast, and then others It can take a day or more to feel anything.

Jackie: Right. And we had definitely, I think, kind of tried to prepare for that long process, but it was so fast. So then I was, you know, I was in quite a bit of pain. They say that, you know, when you're induced that the contractions are stronger, so maybe that was part of it. But I had always been very open to having a medicated birth, so I was pretty eager to get the epidural at that point. And it seemed like it took forever for the anesthesiologist to come and do that. But then finally they came, and I was having a lot of trouble not moving. Like, the pain and the feeling of the contractions was just so intense that it was really difficult for me not to move and try to find some relief. And then they said, "Well, you know, really, at this point, you're so far dilated you should have had your epidural half an hour ago. And, you know, if you're not able to stay still, don't worry. We won't give you the epidural because, you know, we would never put you in danger. And you don't need the epidural. You'll be able to handle this without it." And at that point, I was like, "There is no way I'm going to move. Because I'm going to stay still and get this epidural." So I did. And what time was that?

Michael: So they were going to do it in the induction room because things were proceeding so quickly, but a room, a labor and delivery room opened up, so, you were whisked off.

Jackie: They moved me quickly. So what time was it when I got the epidural?

Michael: Maybe, like, 10 in the morning.

Jackie: Yeah, I think it was a little bit before that, maybe. Yeah, but I know we sort of settled into a labor and delivery room about 10. And at that point things became quite peaceful. So we we got our own room, and they kind of, you know, I got the epidural. So I was feeling a lot more comfortable and they settled us. And then we were alone in that room for a little while, and they had suggested, you know, "Try to rest now. You know, once the pushing phase begins, you're gonna need your energy, so, you know, try to take a nap." And again, I think mentally and psychologically, we were prepared to kind of settle in and take a long break.

Michael: When we first got to the room, there had been another cervical check. At that point, it was like, "OK, now you're at 6 to 7." So things are proceeding, you know, like, you know, a centimeter—centimeter and a half per hour. So we were like, "OK." We thought that there was gonna be a bit of a pause at this point.

Jackie: Right, and then I remember they came in at one point a little bit later and said...and I asked, you know, "So, do you think that the baby will be born today?" And they were like, "Definitely your baby will be born today." And so then, about 12...

Michael: We still hadn't seen our doctor yet.

Jackie: Yeah, we hadn't seen our doctor yet, but I guess about 12 they came in and checked and said, "Well, you are now fully dilated, and it's time to push, so we'll get your doctor." And I was just in complete disbelief because, you know, because of the epidural, I was feeling fairly comfortable. And I just felt like no time had passed. And I was like, "I need to take a nap before I can do this. It's not time." But they said it was.

Michael: Yeah, it went from 1/2 centimeter, I think, at the 7am exam, to fully dilated, in like...

Jackie: Just a few hours. By noon I was fully dilated.

Michael: It was so fast. And then our doctor—we still didn't know who the doctor was going to be, because our practice had seven doctors, and it was whoever was on call.

Jackie: Whoever was on call. Yeah, we had, you know, there were some doctors that we really liked more than others.

Michael: There was one we really liked.

Jackie: Yeah, there were several that were, you know, fine. But there was one doctor that we really, really liked. And then there were a few that we were really hoping it would not be. And at some point around noon or a little bit before that, we found out that it was gonna be the best doctor, our favorite doctor.

Michael: One of the best moments of the day.

Jackie: Yeah, we were like, "Yes! Dr. Mercer! We're so happy."

Michael: Yeah, Daphne Mercer. She was amazing.

Jackie: And then, you know, she came in and she was like, "Oh, I'm so glad that I get to be the doctor for you guys." And we were like, "We're so glad." So that was, like, a triumphant moment. So, yeah, that was about noon. And then, you know, they got set up and they got ready.

Michael: Did some practice pushes.

Jackie: Yeah, well, and but before that, one of the things that was really shocking for me, Dr. Mercer was like, "Oh, you know, I can see your baby's hair. Do you want to feel it?" And I just—that was really amazing. So, yeah, she you know, sort of like, guided me to be able to touch his hair that was poking out a little bit. And she was like, "Okay, now it's time to push." And so I started pushing at 12:40 and he was born at 1:03, which was another huge shock. I mean, obviously at that time, I wasn't watching the clock, and I didn't realize how fast it was, but yeah. So Dr. Mercer was like, this great coach. And, you know, it never would have been so fast if it had been a different doctor, but we just felt really good with her.

Michael: When she had first come in, she said, "Okay, it's going to be anywhere between half an hour and three hours, but since it's the first birth, it's gonna tend to be longer."

Jackie: Yeah, that was what the nurse had said yes. So we had asked about how long they thought that the pushing phase would last, and again, you know, for the last time, I guess, we sort of started preparing for, like, "Okay, this could be a while, you know, we've got to be patient here," that, you know, it might be closer to three hours because I had never given birth before. But it ended up being 23 minutes, which we found out after he was born. Yeah, I don't know how it was so fast. I guess he was really ready. And we were really ready. So, yeah, he was born at 1:03, and that...yeah, that was...

Michael: So there were, you know, there were a few things we had learned, like, try to delay the cord clamping, but because of the meconium...

Jackie: Well, yeah, so there was a lot of meconium in the fluid. And also when he did come out, you know, of course, they were monitoring his heart rate and everything, and his breathing was a little bit fast. So when he came out, they did place him on me, but only for a very short time. And, you know, during the—I guess before the pushing, they had said, you know, "Because of all the meconium we are going to have the pediatricians here in the room, so that when he's born, you know, in case of anything, they're right here and they can monitor him. So the pediatricians were there and when he came out, they, you know, you kind of cut the cord very quickly.

Michael: They were like, "You have to cut the cord immediately."

Jackie: They placed him on me for maybe a minute at most.

Michael: There was a sort of another—the pediatric team took him to the side, and began examining him immediately.

Jackie: Yeah, they gave him some oxygen. So, he wasn't taken out of the room, but he was sort of off to the side...

Michael: Under a heat lamp.

Jackie: With this team of doctors. And that that was really scary. So at that point, you had gone over and you were sort of with him and watching what was going on with him and with the doctors. And I was getting stitched up, because I had some tearing, and I just—that was really scary. So I was trying to, like, look over to the side and see what was going on with him, and there was talk that he might need to go to the NICU. And, you know, I was like, "Is he breathing okay? What's going on over there?" But it ended up being OK.

Michael: Yeah, they did a few checks in the next couple hours, and it was okay. He never had to go to the NICU.

Jackie: Yeah. They said that he was okay at that time. And then they were like, "We're gonna come back in half an hour to check him again." And it ended up being that, you know, he didn't need to go to the NICU, and everything was okay, but that was scary.

Michael: He did pass his first standardized test with flying colors.

Jackie: His APGAR.

Michael: Yeah. Nine point nine out of ten. Yeah. That bodes well for his academic future.

Lisa: I love how you call it standardized test, that's great.

Jackie: He was good in that department.

Michael: Yeah, so we weren't—he never left us. Then after another couple hours a room opened up in the—a postpartum room, and we were, you know, moved to another room.

Jackie: Yeah. And then, you know...

Michael: At that point, we were like, "We need to try to get out of the hospital as soon as possible."

Jackie: Yes. Before Dr. Mercer left, after the delivery, you know, I asked her about that, and she said that she didn't think that that would be a problem, that, you know, we would both be monitored, but that she thought we would probably be able to get out of the hospital a day early because of, you know, the virus and everything. So, yeah, we went to a postpartum room, and then, you know, people were in and out of the room, nurses and doctors and stuff, but it was pretty much just the three of us. And we stayed overnight. And then...

Michael: The wards were a lot more empty because you could only have one person with you, so there weren't a lot of like, you know, just people milling around. Everyone, you always had to wear a mask.

Lisa: I was gonna ask about that. You guys gave birth early enough in this whole pandemic process that I was curious as to whether all the labor and delivery and postpartum hospital staff were wearing PPE? They were? They were, okay.

Jackie: Wearing masks, not face shields. They were wearing masks and gloves and...

Michael: Everybody had to wear masks.

Jackie: Yeah, as soon as we got to the hospital, you know, before labor began in the beginning, like, we walked to the security desk at the front of the hospital, and the first thing they did was, like, tell us to put on a mask. And so we were supposed to be wearing masks the entire time. But when I was having the contractions and then during the pushing, I just I felt like I could not wear a mask. Like, I needed as much air as I could get. So I kept ripping my mask off and they kept telling me to put my mask back on.

Lisa: Oh, I can't even imagine having to wear that during contractions. I keep thinking about that. I'm like, "Oh, that must just be the worst kind of torture."

Jackie: They kind of ...like, in the beginning, they kept telling me to put it back on. Then I think, you know, once it got to a certain point, they kind of understood, and so I was the only person not wearing a mask.

Lisa: I don't blame you one bit. Were you restricted to—well, at first you were in the induction room that was shared. Did you have to stay in there? Like, Michael, could you go grab something to drink or to eat? Or did you have to stay in the room? And then the same, once you moved to postpartum, as well as your labor and delivery room?

Michael: I don't know, like, what would have happened if we had left. But we didn't leave the room.

Jackie: Yeah, things were happening so quickly,

Michael: And also, like with, you know, things were happening so quickly that we were not actually able to set up like a Zoom feed with our doula.

Lisa: I was gonna ask about that.

Michael: We were texting with them. There was just not—like, things were happening so quickly that there was just not a time to, like, you know, settle down, "Let's set this up. Let's get a conversation going." It was just one thing happening right after the other.

Jackie: Yeah. Yeah, like, I remember at one point after I had the epidural, you asked, you know, "Do you want to Zoom with Rachel," and I was like, "Yeah, but, like, let me just rest for a minute before we do that." And that...

Michael: Two minutes later the pushing was starting.

Jackie: Yeah. And then that was the last time we talked about that. But you were texting with her and she was giving some pointers. Yeah, it was so funny how it ended up, you know, just having her availability and her support, even though she didn't end up being there, still made a world of difference. But I was sad after it was all over that she wasn't there, even on Zoom. But it just, you know, just worked out that things happened so fast that she wasn't.

Michael: Yes. So with the Coronavirus, so again, like, every person when we went in were only allowed one support person, and so the ward was actually quite empty. And then the next day—so we had to be there for 24 hours

Jackie: At least. Yeah, so normal, you know, standard procedure, I guess, for a vaginal birth is 48 hours, but because of the virus, I think a lot of people were trying to get early discharge

Michael: And they wanted—the hospital wanted to get people out, too.

Jackie: Yeah, so we had to wait 24 hours to get his newborn screen.

Michael: And they came in right...

Michael: At 1 p.m. the next day.

Michael: Right on the clock, just because they were trying to get us out of there as well.

Jackie: And then the crazy thing that happened was, you know, they had not gotten, like, the newborn screen, you know, all of the results that they needed for him to be discharged yet. But we asked the nurse, you know, "Do you think we'll be able to be discharged?" and she said "Yes." So she had suggested that you go to the car to get the carrier and, you know, to bring some of our stuff to the car. And so you went to do that, on the nurses suggestion, and then you weren't allowed back in, because I guess they had changed the policy during that time?

Michael: Yeah, so I went to go get the car seat. And when I came back, they were putting up, like, signs on the door saying, "Absolutely No Visitors." So I went in and said, "Well, I just left a few moments ago. I just need to go back up to help carry stuff down stairs." They were like, "You can't go back up. The nurses will help her come down. They'll help her pack and come down with the stuff." But, so, sort in the time that I had left, they had changed the policy. Like, the nurses weren't even aware of the policy. The nurses upstairs were not aware that they had changed the policy. They were like, "Why not just come back up with the car seat?"

Jackie: And then all of a sudden, it became like we were fleeing the hospital. Yeah, you had called me, and you were like, "They're not letting me back up." And the nurse was in the room at that point, and she was like, "No, he has the armband, so he can just scan in and come in." And so I was telling you that, and you were like "No, you don't understand. They changed it." The nurse found out because you were on the phone saying it and I was repeating it to her.

Jackie: So then it ended up that, I think, everybody just kind of became really fearful at that point. Like, even the nurses. So she was like, "Yeah, just, you know, get the baby dressed and get out of here." That's basically what happened. So, you know, I just, like, through our last things into the suitcase and got him dressed. And the nurse—you know, I had to be wheeled in a wheelchair because I was holding Taro. And they helped. Two nurses came, and one person wheeled me, one person held the suitcase, and I held the baby, and we went downstairs and it was really scary. Like, the escalation from even just a day ago was so scary. So there were a lot of people in the lobby of the hospital. A lot of them were fathers who, I guess similarly had, you know, gone to get something or whatever and weren't being allowed back in. And there was, like, all the security and, you know, people just kind of being really fearful.

Jackie: And of course, we had never put him into the car seat before. Didn't quite know how that worked. And, you know, we were just sort of like—the carseat was just on the floor in the lobby of the hospital, and the nurse was like, "This is how you do it. Just get the baby in the car seat." It was, like, really stressful. And then, like, we just kind of ran out into the car. And, yeah, it was really bizarre. But then we came home and we've been here ever since.

Michael: Except for pediatrician visits. Yeah.

Jackie: So, yeah, the hospital situation was kind of scary, but one thing that, you know, I guess, ended up happening at that time they changed it that no visitors, no support people—so, you know, what they were saying was women would have to labor and deliver on their own without even a spouse or anybody there. Then the city eventually said, you know, "You can't do that." And there was—they changed that.

Michael: There were two systems that were like, "You can't have any support people."

Lisa: Yeah, New York Pres and Mount Sinai. Yeah. Two of the main ones,

Michael: I think Cuomo set said an executive order.

Jackie: Yeah.

Lisa: Yes. On Saturday, March 28th, I believe, is when the executive order came out saying, "No, hospitals, you do have to let one support person in."

Michael: Yeah, I can't imagine...the people that had to deliver in that span of time.

Michael: Can I mean that people that after tomorrow right in that stream of time,

Jackie: Right. And one of the things you know, I guess Kori, one of our doulas had, you know, said that—before, you know, the labor began or any of it for us, she had said that that might be happening, that they might be starting to say "No support people." So that was another thing that I was really fearful about, that I really wanted to get into the hospital while at least you were still allowed. Because the span of time between finding out that we weren't going to be able to have the doula with us and then, like, finding out that maybe you wouldn't even be allowed there was only like, a day or something.

Jackie: Yeah, a day would have made a big difference. and it just seemed like everything was happening so quickly. And we just needed to get into and out of the hospital and have the baby born, but that ended up happening. We got in and out really fast. You know, there were some scary moments, but everything ended up being OK.

Lisa: I'm so thankful to hear your timing. Yeah, because now I'm hearing at your hospital they're shuffling everybody around there. They're reconfiguring where the pregnant—the laboring people go, and postpartum people go. And I haven't heard the final word on what is actually happening there, but it's all kind of in upheaval right now.

Michael: Yeah. We see in Cuomo's press conferences that that is one of the hospitals that's considered a hot spot.

Lisa: Since I said what I just said, I just want to say that we're recording this on April 5th. So if you're listening to this in a week, or whenever you listen to this and you're giving birth at their hospital, it may have changed.

Jackie: We, actually, so we had to—we wanted the placenta. And we had to go back to get it because for some reason, they said that they needed to test me for hepatitis C in order to be able to give me the placenta. So they did that task, you know, right after I gave birth, but they didn't get the results. So we did actually go back to the hospital a few days later just to pick up the placenta. And that was a really bizarre experience where they wouldn't even let me inside of the hospital. So I was on my phone with the nurse and she was like, you know, "I'll come down and give you your placenta, so wait in the lobby." But the security guards wouldn't even let me into the lobby. So I was just waiting on the sidewalk with a cooler for the placenta. And then, you know, once the nurse came down, she was like, you know, "You need to let her in, because she needs to sign this release form. And, you know, I need to talk to her for a minute."

Jackie: So I luckily did not have to have the placenta given to me on the sidewalk outside the hospital. But it was right in the lobby, and she, you know, she showed it to me. It was kind of this bizarre experience, But the reason I bring this up is that the nurse at that point, which was a few days after the birth, so, maybe the 21st, the 22nd or something around there, was saying that the policies and everything was changing at the hospital pretty much daily. So at that point, she was saying that they were allowing a support person again, but they hadn't been the day before. So, you know, the day before that, women who gave birth would have had to do it by themselves without anybody. But then that day, they were allowing support people. And I said, you know, "How are you making the decisions?" And she just kind of vaguely said, "Well, it's, you know, depending on what else is going on at the hospital." I don't know if she fully knew how they were making the decisions, but, yeah, it was just a really crazy time. And I feel really bad for the women who had to give birth in that situation without a support person.

Michael: It's a harrowing tale. I don't know. We might have made it more—less positive than it was. I mean, it was a beautiful experience.

Michael: Yeah, no. I mean, there was a lot of here because of the virus and everything, but we had, I think, as really as good of an experience as we could have had

Michael: Under the circumstances, yeah.

Jackie: Yeah. I mean, there was the fear of the virus, but we got lucky in that the only way that it affected us was that we weren't able to have our doula with us. And then we got out a day early. We got early discharge, but that was not in any way negative to me. I was quite happy to be able to come home. I think, you know, even if—not just because of fears about the virus, but just, you know, obviously we're more comfortable at home. So we were happy to come home a day early.

Michael: Yeah. The speed of the process is something—I think that we were very fortunate. I think that, you know, the acupuncture, the castor oil, the vegan diet.

Jackie: Everything just just came together, as I guess, you know, everything does come together for everyone. But when you don't know how it's going to come together for you, it can be, at least, you know, for me it was anxiety inducing. And now I can kind of look back and everything worked out really quite perfectly. Now we have our baby.

Michael: He slid out effortlessly.

Lisa: Easy for you to say

Michael: From the last push, it was like one second and he was out. Less than a second, and he slipped out.

Jackie: Yeah, well, yeah, once his head came out.

Michael: Yeah. Once his head slipped out.

Jackie: Yeah.

Lisa: And had they told you what his station was in labor at all?

Jackie: No, they didn't. They just said that, you know, he had descended.

Lisa: Yeah, they often don't mention that as much as the dilation. I'm just curious because it sounded like he must have been very low for the pushing stage to be that fast and efficient. Not to rob you of any credit.

Jackie: Yeah, it was at least half him, like, he was ready at that point. And I do really think, you know, I know there's not a lot of research about this, but I do think that the acupuncture helped a lot. And I also think that the midwives brew helped. I mean, I guess people could be listening to this and say, "Well, it just must have been the timing," right? Which—maybe it was, but it's very suspicious that I finished drinking that at, you know, in the afternoon on Monday, and then basically, you know, 24 hours later, he was born.

Lisa: Yeah, I totally agree. I really believe those things are likely to have helped.

Jackie: And , I think, yeah. Also, just made the process easier than it might have been without them too, right? Maybe it helped it happen when it did but also made it smoother than it would have been.

Lisa: I'm curious. Would you like to share any about your—once you came home from the hospital—two questions: what have pediatrician visits looked like for people who are listening and are giving birth around this time? As well as: have you had, like, virtual follow-ups with your doulas?

Jackie: Yes. Okay, so for us, the pediatrician that we chose did not come to the hospital. So we set up our first pediatrician visit for that Friday. So he was born on a Tuesday. We came home from the hospital on Wednesday, kind of took Thursday to chill out. And then Friday was the first day that we went to the pediatrician. So we've gone three or four times.

Michael: And it's gotten progressively more...like the first time we went, it was kind of like a typical doctor's waiting room. There were other people there, but...

Jackie: Yeah, and the pediatrician, you know, this I believe that they've always had, they have, you know, the waiting room is segregated so that there's, you know, a sick waiting area and then the well waiting area. So the first time we went, there were people in both areas, and it was just kind of a typical situation. Although the people working there were wearing masks. I guess we were wearing masks, too.

Michael: And you were required to wash your hands.

Jackie: Yeah. When they called you in, they would say, "OK, go wash your hands for 20 seconds, and now you can come into the room." But it's, you know, so it's only been two weeks, and that has progressed quite a bit. Now the pediatrician is—first of all they're only doing well visits at certain times. And then they're doing sick visits at other times. And then they've even started spacing out patients so that, you know, they're disinfecting everything in the waiting area between the sick and the well, but also between patients, I believe. So, like, the last time we went, which was Friday, so two days ago, they started spacing visits so that the patients were not seeing each other. So when we were called in for our appointment on Friday, then they let the next family come into the waiting room, and they wouldn't allow them into the office at all before we had progressed through the waiting room into, you know, the exam room. So that has changed, you know, even in just the past two weeks.

Jackie: But it feels good that they're that they're doing that, right, in some sense, you know, I guess for some people, it could be kind of alarming. But for me, it's reassuring. You know, it's a little bit scary right now just to to leave the house for ourselves, but much more so with baby. So it's nice to know that they're taking those precautions. That felt good. And then we did also have a follow-up with the doulas. So the original contract that we had with them was that they would, you know, come to our house two times for postpartum follow-up visits. Which, of course, you know, wasn't possible now. So we did another Zoom meeting with them. And that felt—you know, of course, it would have been nicer to have them here in person, but it still felt really nice and kind of celebratory to do that because we had had this, you know, sort of months-long relationship with them where we were gearing up for the birth. And so it was really nice to then have that meeting where, you know, they met the baby over Zoom, and we just kind of debriefed about everything. And, you know, I asked them some questions just about my own postpartum care. And they gave some advice about that. But it kind of felt like a little bit of a party, you know, a celebratory party, just getting to meet with them over Zoom.

Lisa: Well, is there anything you haven't gotten to share that you would like to share? Or do you have any reflections or tips for expectant parents?

Jackie: I mean, I guess my tip is, you know, just—it's going to be okay. You know, like, I think that, you know, everybody's birth story, of course, is different. And people have different values and different hopes for what will happen with their birth story. And, you know, I feel really lucky with the way that things turned out for us and happy about what happened. But it still was not, you know—if it were possible to order your birth exactly to your specifications, you know, we didn't get that. We didn't get exactly what we hoped for, but we did have a good experience. And the end result is that we have a baby, so that's amazing. Yeah. And so just, you know, everything will be okay. It won't necessarily be what you expect.

Michael: And just having—I think having knowledge will empower you and make you feel like you have some agency over what's going to happen. Which is, I think, always going to be, you know, validating and emotionally important.

Jackie: Yeah. I mean, there's so much that you can't control about it, but I think the thing that you can control is just seeking out resources and people that will support you and make you feel at least empowered in the decisions that you are able to make in the things that you are able to control. So, yeah. So the three things that really made a difference for me and for us, I think, were hiring the doulas; going to Lisa's birth class; because both of those things just gave us knowledge and information but also pointed us toward resources where, if there was something that we wanted more information or we wanted to explore more, we could. So those two things, and then the third thing was the acupuncture, because for me, it felt like I was doing something to try as much as possible to make labor happen sooner, but also just the experience of going to acupuncture was really kind of a mindful thing to be able to do, and gave me just a space where I was able to kind of, like, reflect and prepare mentally and emotionally. So if you're listening to this and you've never had acupuncture, what happens is you know, the doctor will talk with you and, you know, sort of monitor you. They check your heart rate and your blood pressure and everything and make sure that you're okay for the acupuncture. And then you you lie down on a bed in a very warm room and they put needles at certain points into into your body. And that can be a little bit painful. But then, once the needles are in place, it's actually very relaxing. And so you just sort of lie on a bed with a heat lamp over you in a quiet room by yourself for anywhere from half an hour, to, you know, I guess longer. For me, the longest I ever did it was 45 minutes. But, you know, that was a time when I was just in a dark, quiet room, and all I could do was sort of lie there and be still, and, you know, kind of think about the labor and the birth that I knew I was waiting for. And so I would try to, you know, communicate with the baby when he was still inside me, and just used that that time to just reflect and try to prepare mentally and emotionally. And that was really valuable for me, too.

Lisa: Thank you so much for sharing that. That really resonates for me, because whenever I've gone for acupuncture or to the chiropractor and I'm just lying on the table, I'm like, "Oh, my gosh, I feel like I'm at a spa. This is so great to get me to stop doing, doing, doing, and to just, like you said, be mindful." And I love what you said about using that time to communicate with the baby. That's lovely. Awesome. Thank you so much. Well, I so appreciate, especially so soon after birth, your willingness to come on and share your birth story. It's gonna be really valuable for the listeners. And I'm gonna try to air it as soon as possible.

Jackie: It was nice to share it and sort of, you know, debrief again, by telling the story. So thank you.

Lisa: Yeah, thanks again. And I hope to see you before long. Be well!

Jackie: Thanks, you, too.

Michael: Thank you.

Lisa: Bye.

Lisa: So that's Jackie's and Michael's story of their son's birth. I'll talk a bit about this in next week's episode, but you can see that the support Jackie and Michael received from their doulas was invaluable, even when the actual labor support was virtual. Before we go, please remember, as Jackie said, it will all be okay. And another thing that another one of my students said: "It's not a great time for a pandemic. It is a great time for a baby." Thanks so much for listening to the Birth Matters Podcast. Until next week, please stay safe, wash your hands, and be gentle with yourself. ---END---