Birth Matters Podcast, Ep 41 - Two Induced Births with Hospital Midwives

In this episode, Yuliya shares both of her babies’ birth stories. She explains how she made the intentional choice of working with a practice of in-hospital midwives as well as hired a doula for both births, as this was the kind of birth team that she felt could help her have the kind of physiological births she hoped for.

While she didn’t plan or hope to have 2 inductions, that’s how things played out given unexpected circumstances in each pregnancy of low amniotic fluid and then the pandemic. 

She details how she was able to cope with both medical inductions with non-pharmacological pain coping techniques using some of the techniques she knows intuitively and as a clinical psychologist as well as with the support of the team she so carefully chose.

Episode Topics:

• Choosing midwifery model of care (Central Park Midwives)

• How her background as a psychologist informed her pain coping strategies in giving birth

• Taking birth class, partner taking lots of notes

• In first pregnancy, doing things like evening primrose oil, eating dates, having midwife do membrane sweeps as contrasted to in 2nd pregnancy doing

• Hiring a doula for both births

First birth story:

• Going past due date

• Being told at a prenatal visit to hospital by an OB that induction was urgently needed due to low amniotic fluid levels and going to 41 weeks and 2 days

• Talking to midwife who says induction is medically indicated but they can go home, gather their things, eat lunch before going to hospital

• Checking into Mt. Sinai West for induction

• Challenges with IV administration

• Cytotec & foley balloon

• Not being able to get off continuous (wired) monitor even to go pee, having to use a potty chair

• Doula Cara arrives and sets up room to be conducive to laboring well

• Her contractions somewhat start taking over on their own so she’s able to get off continuous monitoring

• Cara does lots of massage

• Rebozo techniques not helping much

• 12 hours into labor, starting very low-dose pitocin at around 4.5 cm dilation

• Baby has very temporary drop in heart rate, but with some patience it came back up

• Next morning, midwife shift change

• Cracking dark jokes in transition

• Getting urge to push but needing to hold off while cervix finishes effacing

• She says she’s ready for nitrous oxide, but they tell her it’s too late

• After pushing for an hour, midwife recommends doing an episiotomy to prevent otherwise worse natural tearing and asks for Yuliya’s consent; Yuliya agrees

• Baby is born and immediately poops on Yuliya!

• Midwife Elaine does meticulous job with perineal sutures

• Not feeling immediately bonded to the baby

2nd birth story:

• End of pregnancy is in the pandemic, the stress of constantly changing policies in the hospitals living near the hospital hit hardest in the country at the time (Elmhurst)

• Scheduling an induction at 39 weeks, 6 days so as to be pre-tested for Covid and hopefully have fewer restrictions/requirements (primarily, PPE)

• Arriving at very quiet hospital/triage

• More IV administration challenges

• Yuliya decides, when given options, to start with pitocin instead of foley balloon

• Doula Audrey arrives before things get very intense  

• Getting bad heartburn when lying on side, taking medication for it

• Using the yoga ball, standing, moving around

• Surpassing the maximum dose of pitocin she needed the first time around without making a lot of dilation progress

• Midwife offers to artificially break waters, Yuliya requests to wait a bit

• Starts shaking like in her first labor, takes that as a sign of progress

• She agrees to have waters broken artificially

• Light meconium in the fluid, midwife explains that means that pediatrics will just need to check the baby out right after birth, probably totally fine

• Noah took lots of notes in labor

• More side-lying contractions, using rhythm to cope, Audrey helps her focus on meeting the baby soon

• Midwife helps her get into the “throne” position on the bed

• Feeling like her labor will never end and that it was supposed to be shorter

• Around 8cm, notices pitocin is at 14 units (for comparison, she maxed out at 8 units the first labor)

• Midwife Elaine & doula Audrey help her get into another side-lying position with one leg hiked up to open pelvis

• Getting urge to push and not wanting to stop even during the breaks

• Feeling the ring of fire and asking for an episiotomy (midwife says she doesn’t need one), baby is born very quickly

• She feels a more instantaneous connection with baby this time

• Early discharge from the hospital (earlier than normal due to Covid)

• Final reflections - remain flexible, choose a birth team who’s aligned with your preferences

Resources:

• Pain coping gene study

• Central Park Midwifery

• Pack for Your Best Birth Checklist & option for free email course

• Birth Matters Group Classes (Virtual / Astoria) & Private Classes

• Birth Matters online comprehensive childbirth prep course

Interview Transcript

Lisa: Welcome to The Birth Matters Podcast. Today I have with me Yuliya. Welcome Yuliya. So glad to have you here. 

[00:00:06] Yuliya: Thanks. Happy to be here. 

[00:00:08] Lisa: Would you like to share with us, how long have you been a parent? You're going to share two birth stories today, right? So how, how long have you been a parent and maybe what you do for a living.

[00:00:18] And maybe, you know, the area you live in as well. 

[00:00:21] Yuliya: Yeah. I've been a parent since March of 2017. And I had my second baby just this past May, so he's almost 12 weeks old. I'm a clinical psychologist by trade, on an extended leave right now. But that's what I've been doing for like a few years now, which I think has been really helpful in my birthing experience. Also, I live in Queens. I kind of grew up here, moved to Manhattan for a few years, and then me and my husband moved back here to like, be closer to my family and, have our kids here. 

[00:00:55] Lisa: You were in Queens when you took birth class with me, I think. Right? Yeah. So you had already done that. Where did you do that move before you got pregnant with the first one or after? 

[00:01:04] Yuliya: No, while I was pregnant, we moved and renovated our apartment and lived with my parents for a few months. 

[00:01:10] Lisa: Oh my goodness. 

[00:01:10] Yuliya: While we were doing all that. So that was fun. 

[00:01:13] Lisa: That's a lot.

[00:01:16] Yuliya: Yeah. So. 

[00:01:17] Lisa: And I'll just mention that Yuliya shared her written first birth story with us about three years ago. But I invited her to share it verbally because you'll hear different details. I'll link to the written birth story in the show notes for this episode in case anyone would like to read that version of it.

[00:01:35] Why don't we start off with sharing any ways that you prepared for your first labor and birth versus your second. Were there differences in the way that you prepared? 

[00:01:46] Yuliya: Sure. Yeah. So my first, I sought out some midwives. And they were an awesome team, Central Park Midwifery.

[00:01:53] I really loved working with them. I went there first for some, like, regular GYN care, just to kind of check them out and see if they felt like, you know, a good fit. And at that time they were delivering at Mt. Sinai West, which still had the birthing center, and I was really interested in giving birth there.

[00:02:10] So, that was another reason that I picked them. Unfortunately, I think they closed that down in January of this year. To do some renovations. And then the renovation stalled because of COVID, so, like, a lot of stuff has changed. But they were really awesome and I really connected with them. At the time it was Jo and Elaine. And so, luckily, I had both of them at my birth, so that was really cool. But, right now only Elaine is still there from my original team. 

[00:02:37] Lisa: how did you discover midwifery care -- that model of care? 

[00:02:42] Yuliya: I have a friend who is a nurse and she had been going to them and I had never really been happy with any of the OB care that I received. OBs that I saw for just general like, well women stuff or prescription birth control, whatever. They wouldn't really listen. They were kind of pushy, like, not really like listening to my concerns or saying like, "No, you have to come in every six months for a refill," or "Yes, you have to do a pelvic exam every six months."

[00:03:09] And, like, that's just not what's recommended. I know the literature and I dunno, I've never had really good luck with them. So she was like, "Hey, you know, I go to this midwifery practice on the Upper West Side. So give them a try." And they really aligned with kind of what we were looking for.

[00:03:26] Because they were very evidence-based, which I love, but also, they're like hands off, but in a very smart way, in an evidence-based way, which I think was really what drew me to them. 

[00:03:38] Lisa: I love that description hands off in a very smart way. I love that. That really speaks to me and what I liked in my midwives. Yeah. 

[00:03:47] Yuliya: Yeah. And that's, and you know, and they're also lovely people. So that was, it was like very easy to get along with them and feel really comfortable, which is what you really want when, you know, people are, like, touching you and doing all this stuff. And they're also very respectful.

[00:04:00] So I did my preconception counseling there. And then a few months later I was like, "Hey guys, I'm pregnant." And they're like, "Cool, we'll see you in a few weeks." So yeah, they were really, they were really awesome. Another thing I did definitely was the preconception counseling. So kind of talking to them about like vitamins to take or what to expect.

[00:04:23] We did genetic counseling because we're both Ashkenazi Jews. So like, to just kind of rule out any sort of genetic predispositions. So we did all of that and, you know, they were. on board with all of that stuff. And so from then on, we just stuck with them for care. So that was great.

[00:04:41] And then when I, we decided to have a second child I went back to them. They'd Also,been doing my GYN care, like the whole time, like the IUD and all that. So I went to them to get my IUD removed and then a few months later, "I'm pregnant." "Welcome back." They've had some staffing changes, but all of the midwives were really awesome. And Elaine was still there. So. 

[00:05:04] Lisa: At the time we're recording this it's late July of 2020. And, I just noticed on social that they hired a third. They were down to two and now they hired a third midwife. So I'm excited for them. I want to meet them because I've been going to them for GYN care, but Jo was who I had been seeing. So I need to go back and meet a new one. I know Elaine. Elaine's wonderful. 

[00:05:26] Yuliya: Yeah. She's awesome. Yeah, so I think Chloe left and now Jenna started. Another way that I, I prepared was definitely partly just -- kind of my training as a psychologist, I do a lot of CBT work, learned a lot about DBT. So kind of, how your thoughts impact your emotions, right? Like a lot of radical acceptance work. So, the idea that pain isn't necessarily suffering, which is a huge help in labor, because it's painful. But that does not necessarily mean that you have to look at it as suffering or something that's terrible or needs to be stopped or altered in some way.

[00:06:02] And also, a lot of mindfulness, so, like, diaphragmatic breathing and, you know, breath work and stuff like that, which is huge part of my training, you know, in school and with my patients, but also, in labor. That was a huge, huge help through both labors. Also, obviously taking your class was a huge way in which Noah and I prepared. He took so many notes. So... 

[00:06:27] Lisa: It's funny that you brought that up. I was going to bring that up because I was looking back at my notes that I had kept and it, it said "Noah took meticulous notes." Which I love, of course. As a teacher, you love to see people being that engaged and really caring about supporting their partner well, you know, so I loved that. 

[00:06:47] Yuliya: Yeah. He took so many notes and so, before both labors, we kind of reviewed them. I don't think I took any notes, but he definitely like, like everything was notated and organized. I think that was super helpful. I remember one of the exercises from class about like anything you can do for 60 seconds, the passage of time and how to like manage that idea was also really helpful to me. You know, because contraction's 60 seconds, so it's like, "Okay, it's here, let's get through this one and then, you know, just put that one away. And then enjoy whatever break you get between and then like, okay, the next one's here. So let's just deal with this one for 60 seconds and then forget it and put it away." So, that cognitive work was really helpful to me in helping to prepare, right? Because, like, if you think about it, yeah you can probably do pretty much anything for 60 seconds. Right. And that's really all that's required of you. You have to get through that one contraction for 60 seconds and then you're done with that one. 

[00:07:43] Lisa: Yeah. 

[00:07:44] Yuliya: You're done. You're okay. 

[00:07:46] Lisa: And I love that you're a psychologist because you came to class and entered your pregnancy and labors with an advantage over a lot of people because you really get that strong mind-body connection and the value of doing that work to get to a place of trust. 

[00:08:01] Yuliya: Yeah. And especially kind of how you think about a situation really changes how you experience it. Right. So if you're going into labor, kind of open to it and open to the fact that like, yeah, it's painful. Right? Like it hurts, but that doesn't necessarily mean that it has to be terrible or awful, or like you have to suffer through the experience -- really changes, I think, how you're able to cope with it. Right? And I had two very long labors. 22 hours and 16 hours. So I needed to hold onto something and that was kind of the mantra. " Okay, like, you're going to get the baby at the, like, this isn't suffering. This is just something that like I have to deal with right now, and then eventually it was over. Like, it does end. 

[00:08:48] Lisa: Yeah. Did you see that study? That just came out recently about the pain coping gene? 

[00:08:53] Yuliya: No. 

[00:08:54] Lisa: A student brought it up last week in class, and then later that evening it showed up in my feed and apparently five to 7% of birthing people have this inherited gene that helps them not perceive giving birth as painful.

[00:09:08] And I was like, "I wish I had that gene. That's pretty cool." But at the same time, it's more complex than that. Like we're talking about there's so much that you can do to make it more manageable. You don't have to have the gene to be able to cope well with labor.

[00:09:24] Yuliya: Right. Yeah. In my first labor, I also prepared by doing all the dates, like eating the six dates at the end, and the Evening Primrose oil and all the teas. And I had several membrane sweeps to try to jumpstart everything. None of it particularly worked for me personally. So the second time I decided to just kind of wing it a little bit more. So I also started a workout routine -- there's a Peloton behind me -- which really helped out, I think, the second time, to get me into a more physically ready space for an extended birth.

[00:09:59] I didn't work out the first time, but I spent a lot of time working out about half of my second pregnancy, which I found really helpful. And I really wish I had done the first time. 

[00:10:08] Lisa: So you traded in the dates and the Evening Primrose oil for a Peloton. That's a pretty, that's a nice upgrade.

[00:10:14] Yuliya: Yeah. Well, and then the pandemic hit, so it was great. Because we couldn't really go outside. Couldn't really do anything. And like, you know, you start to kind of go a little bit stir-crazy. You know, March, everything kind of closed, basically. And I didn't have the baby til the first week of May.

[00:10:30] So the Peloton really helped, like, just working out and moving, like, it helped kind of keep me going in that way, too. So. 

[00:10:39] Lisa: Hmm. And then I don't know if you mentioned yet that you hired a doula for both of your births, right? 

[00:10:45] Yuliya: Yes. Yeah. I hired a doula for my first birth because, you know, it was highly recommended by CPM. And I had a great doula who's unfortunately no longer a doula, but now a midwife. And she was actually doing some of her work with CPM during my first appointment. So that was cool to see her there. Cara Pauls. She's amazing. 

[00:11:06] Lisa: I was so excited to see that she was working with CPM.

[00:11:11] Yuliya: Yeah. Yeah. And I actually got to see her at my first prenatal appointment. So that was really awesome. And she did my whole intake appointment. And I was like, "But you were there!," like, she was like, "Oh yeah, I know everything." 

[00:11:20] Lisa: How fun. For your second pregnancy. Got it. 

[00:11:23] Yuliya: Yeah. The second time, I was like, kind of on the fence about getting a doula.

[00:11:31] And I talked to Elaine about it a little more, because she was there for the majority of my first labor, and she was like, "Look, how would you feel if it was just you and Noah in the room?" And I was like, "Okay. I will be hiring a doula." She was just so helpful. She helped both of us so much that I was like, "Okay. Yeah. I think we both need like the doula support for the second time. I interviewed a few doulas, and the one that I really connected with was, her name was Audrey Jessup. 

[00:12:02] Lisa: She's on my recommendation list. 

[00:12:04] Yuliya: She's awesome. I'm really glad that I got a doula. I mean, unfortunately there was some questions about whether she would even be able to make it to the birth. Just because, again, COVID hit, then you know, New York State was not allowing any support, then they allowed partner support, but no doulas. And then just a couple of days before I was supposed to give birth, they allowed doula support. And so I had a long conversation with her about her comfort levels about being there, because COVID, like, in a hospital and, you know, her safety is important, too, in all this. But Mount Sinai was actually testing all doulas as well as all support people and people in labor, so she was able to make it. That was actually the first time I saw her, basically since I interviewed --like, in person, was at the COVID test the day before my induction. So it was pretty wild. But I think doula support was just so integral to getting through both labors. They both had some twists and turns there. 

[00:13:09] Lisa: Which we're about to hear. Well, with that, did you want to add anything before you start going into your first birth story? 

[00:13:15] Yuliya: No, I think that's basically like, I covered the major points, of how I prepared for both. And, like I said, reviewed your class notes again the second time. So, you know, I think we were kind of prepared to go. 

[00:13:29] Lisa: Great. So in terms of your first birth story, start wherever in your pregnancy you want to start, but tell us how you went into labor.

[00:13:37] Yuliya: Yeah. So it was a pretty uncomplicated pregnancy. Everything was, you know, some nausea, you know, whatever, nothing too crazy. We had done your class, we had done, you know, our prenatal visits with Cara at the time. We talked about, like, laboring at home and, you know, when to show up at the hospital and all that kind of stuff and had talked about it with CPM too, right?

[00:14:06] Like you go into labor, what to do if your water breaks in the middle of the night and all of, all of this stuff. And we were eager, know, I stopped working at about 39 weeks. Because it just gotten to be like, just too hard to keep sitting, because I just sit all day, obviously, at work in therapy.

[00:14:22] So, you know, I stopped working and we eagerly waited for the baby. And then there were snow storms coming and Joe was like, "Okay, like, let's do a sweep," you know, maybe you can jumpstart this labor, and think it was like 39 weeks and change. I don't remember the exact day, but it was like late, late in 39 weeks.

[00:14:40] And like, "Let's do a sweep." Nothing. It was like 40 weeks and they're like, "Okay, well, you know, any day now. Let's do another one." "Okay. Let's keep going." And you know, still really nothing. So I had to start going to the biophysical profiles at the hospital, as well as the non-stress tests, because I was already past due. And at this point I was still really hoping to be in the birth center. Because at that point, I think they cut you off at 41 weeks or something around that, but there was a cutoff that they wouldn't take you in the birth center, after a certain point, but like, we were still kind of going strong and I went for the ultrasound at 40 weeks. And then 40 weeks, like three days. And then you know, almost 41 weeks. I think it was 40 weeks and six days it was like, cause, it was 41 weeks on a Saturday. So I went that Friday. And the non-stress tests were looking good. And like I was talking to the midwives and I was seeing them multiple times a week. They were like, "Baby looks good." His heart rate was, like, really steady. Waters look good." Right? Like, everything was totally fine. We're just like, "Let's just keep kind of going and seeing what happens." And so I had the biophysical profile on a Friday and then I had some Braxton Hicks, but nothing was really sticking and nothing was too painful. It was just kind of contractions were coming and going. And then, it was 41 weeks and two days on Monday when I went in that morning. And, like, Noah went with me and he was going to go to work and he was in a suit and his tie and was like, "All right, well, baby's not coming, so just gonna keep going to work after this."

[00:16:17] And so we went to the hospital and, you know, they did the non-stress test and it was like, "Oh, it's fine. You know, baby's responding well," you know, walked me over to the biophysical profile and then the tech was like, "Let me get the doctor." We were like, "Oh, okay." So we're just like sitting there, like hanging out.

[00:16:37] He's, like, checking his work email, like, "Oh, I gotta get into the office," you know, it was like 9:00 AM or something like that. And then we hear from the hallway the doctor talking to, I think it was Jo who was on call that day, being like, "Uh, I have your patient here. And, uh, she really needs to have that baby today, and you need to talk to her and like, you know, kind of get her in " before he'd even come in to talk to me.

[00:17:01] So we're just like overhearing him from the hallway. Which was not super pleasant. So we're just starting to kind of freak out a little bit, like, "What's going on?" And he came in and he's like, "Well, you know, you have low water. We need to get that baby out, like, today. Can I trust you to go upstairs and get induced and check into triage?"

[00:17:21] It's like, I'm not a child. You know, we're like, "What? Like, what's going on?" He's like, "Yeah. You know, baby needs to come out." So Noah from all of this copious class notes, knew to take a minute to ask a question and to kind of slow things down a little bit. So he's like, "Well, can we talk to -- you know -- we're going to talk to our midwives," you know?

[00:17:42] I don't remember exactly what the doctor said, but he was kind of abrupt about it. And he's like, "Whatever, but, like, you just need to get the baby out." And so we called Jo and she was like, " Yeah, you know, I just talked to him, and seems like the water's pretty low and it's already 41 weeks and two days. So it sounds like we probably should do an induction." And I was like, "What do -- like, do I go upstairs? Like, what do we do?" We didn't have any of our stuff, Noah's dressed for work, suit and tie. And she was like, "How about, like, you guys go home and you meet me back at the hospital today at, like, you know, two o'clock, but like go home, have lunch, get your stuff, come back. Like, it's not an emergency that you need to get this started right away."

[00:18:23] That kind of helped us not panic as much, so it was good to know that if she didn't think it was an emergency, that we had time to go home and kind of get our stuff together. On the way out of the hospital, I called Cara to kind of let her know that, you know, We're going to need her that day, basically. You know, we came up with a plan. We took an Uber home, from the hospital to our apartment. I called my parents, because they were both at work. Like, you know, nobody knew what was going to happen that day. And so they both came home from work to drive us back to the hospital. I took a shower, like kind of get myself together.

[00:18:59] We ordered a pizza, like, had a pepperoni -- like a few slices of pepperoni pizza. Because, you know, I figured it was going to be a long day, long night. So we're like, "Alright, let's get some pizza." We had some garlic knots. You know, got finished packing our hospital bag. And, you know, my parents drove us back to Sinai.

[00:19:19] And then we went upstairs to triage and, you know, tried to check in. I sent my parents home because I didn't really want anyone hanging out, and, like, the idea of someone waiting on the birth to be done just seemed really overwhelming. And my mom's still not happy about it, but she's just going to have to deal with that. She still brings it up. But whatever. But at that point, it's kind of what I needed to mentally get through this. So we kinda got checked in, Jo was already there at the hospital waiting for us. You know, she greeted us and it was nice to, like, be greeted by somebody that you already know and have a relationship with, so that really calmed us as well. And then we went in, I got an IV. I tried to get the IV put in kind of higher in my arm, closer to the elbow, but he hit a nerve. It was very painful. So we had to backtrack and I had to put into my hand, unfortunately, which was kind of annoying. It took me like a week to get normal feeling back in that arm, but whatever. 

[00:20:21] Lisa: It seemed like you had trouble with the IV the second time, too. Right? 

[00:20:24] Yuliya: Yeah. I have the worst veins 

[00:20:28] Lisa: That can sometimes be painful if they're having trouble finding a vein. 

[00:20:31] Yuliya: Yeah. Yeah. And the second time she's like, "Oh yeah, the vein rolled." I'm like, "What? What do you want? Like, what am I supposed to do? 

[00:20:38] Lisa: Is there something I can do about that? 

[00:20:40] Yuliya: Yeah, like, my, my history with, with veins is awful, but, it worked out. Finally got it in. It was fine. And I also had, I was, GBS positive, both pregnancies. So that also kind of affected things because I needed to get the antibiotic treatment at least two doses, four hours apart before delivery in order to be considered treated. So that also played a role into why I needed an IV. 

[00:21:05] Lisa: Did they wait to do the antibiotics until your water actually broke?

[00:21:09] Yuliya: They started earlier because I guess they kept assuming I would have the baby at any point, which 

[00:21:13] Lisa: Even in the first labor? 

[00:21:14] Yuliya: Yeah. I didn't get my water broken until it was just about time to push, just because there was so little water, they didn't feel comfortable breaking the water.

[00:21:24] Lisa: Okay. 

[00:21:25] Yuliya: Yeah, so. You know, Jo gave me an exam. It was like, I was one and a half centimeters or so, so very, very minimal for 41 plus weeks. And the baby was still pretty high up. So I think negative three station, she said, from kind of what the notes were. Noah was taking copious notes throughout both labors as well, which is helpful because then, you know, like a lot of the details get lost and you forget because of all of the adrenaline. So I was actually really grateful that somebody was at least keeping track of the time and everything going on. 

[00:21:58] Lisa: Yeah. In my doula work, I take notes as much as I'm able to, just to try to help piece that timeline together. Because otherwise, it's hard to remember a timeline at all. Because you just -- your head's not there. Right? You're in labor land. 

[00:22:12] Yuliya: Yeah. And the clock is thankfully behind you. So, like, I knew it was there, but obviously I'm not going to check it. So it was like the time kind of goes out the window.

[00:22:22] So basically Jo decided to start with some Cytotec and a Foley balloon to kind of help get me to like at least three or four centimeters to kind of get stuff going. The Foley balloon was not my favorite. It kind of gets strapped to your thigh, like kind of... 

[00:22:36] Lisa: The tubing, right? 

[00:22:38] Yuliya: Yeah. The tubing for it. So that was unpleasant. 

[00:22:41] Lisa: Was it uncomfortable administering it or you just didn't like that tubing or was there more to it that you didn't like? 

[00:22:48] Yuliya: Yeah, administering was, it was kind of unpleasant. I think she like overfilled it a little bit. and then the tubing was uncomfortable and then once you get anything started, you have to be a hundred percent monitored at Sinai. So you have to be on the contraction monitor and on the baby heart rate monitor. You're kind of stuck to them. 

[00:23:08] Lisa: It's not wireless? 

[00:23:09] Yuliya: No. 

[00:23:10] Lisa: That restricts your movement a lot more. Yeah. 

[00:23:12] Yuliya: Yeah. And you also cannot go to the bathroom, even though the bathroom's in the room.

[00:23:18] Lisa: I don't get that. Like, why can't you get off the monitor just to go pee? 

[00:23:22] Yuliya: Right. Yeah. Sinai's the only one left that still does that. That's what Audrey told me later, but what are you going to do? So basically, they set up a bed pan on a chair in your room that you have to use. Your partner really has to help you out a lot with that stuff. Because you're not going to call a nurse in either for every single time you have to go pee. So that really sucked. You also can't like use the shower, right? So, like, a lot of options start to get closed off in terms of coping. You're basically stuck to however far you can get from your bed on your either IV pole or the monitors, which unfortunately is not that far.

[00:23:59] Lisa: I've worked there as a doula, but I guess never with continuous monitoring. So I just hadn't experienced that certain protocol before to realize that was a thing there. Hopefully they'll change that at some point. 

[00:24:10] Yuliya: I know. It's the continuous monitoring and not being able to get off for two minutes to go to the bathroom.

[00:24:17] Like what could really happen? 

[00:24:19] Lisa: Yeah. 

[00:24:20] Yuliya: So that's what we were dealing with at the beginning. The contractions started coming, but they weren't really like taking my breath away too much. So I labored for a few hours. We talked to Cara in the meantime, she came at around at, like, 8:00 PM that night. She helped.

[00:24:35] Because we figured it'd be easier for her to just kind of show up and help through the labor. We didn't know how long it was going to take. And also just logistically for her, it seemed easier to come and spend the night and kind of, be there throughout the whole thing. So she came in, she kind of darkened the room, put up the little LED lights and stuff.

[00:24:50] Because it was getting late. We turned on the TV and, like, were watching, I think, Dancing with the Stars. So that was like, like a nice light thing to kind of get our minds off of it, because it was still technically early labor. But we were in the hospital and if I could get some rest and be distracted, it was fine.

[00:25:07] Contractions were starting to come like every five, seven minutes. So they were pretty irregular. And still not particularly like painful or anything, they were just kind of like coming and going. I tried doing some side-lying, to try to pick things up a little bit. Because they were starting to kind of stall out a bit on the, on the monitor and stuff, which worked for a little bit.

[00:25:28] And so by like midnight, 10 hours into this whole thing, they kind of started to become continuous and getting a little stronger. By 1:00 AM, the Foley balloon was coming out. So I think it had kind of come out, but nobody had noticed or hadn't checked. So for a few hours, I wasn't able to like go to the bathroom at all. So that was really uncomfortable. Once the balloon came out, it was a big relief. And I was able to use my potty chair.

[00:25:57] Lisa: Whee!

[00:25:57] Yuliya: I know. But then I could also get off the constant monitoring for a little bit, because I was no longer, I guess, in induction mode. Labor was kind of progressing naturally, or, you know, my body was kind of doing it on its own so they could get me off the monitors for a few hours.

[00:26:17] I was still only like three to four centimeters at that point, 70% effaced, or something. And then baby had only moved down to negative two station. So it was still really slow going. It was dark outside. It was the middle of the night. Like I had lost all sense of time. I didn't really know what was going on, but things kind of seemed to still be moving along just very slowly. And at some point during that time, I started getting like really bad shakes, which, like, no one talks about it. Like,

[00:26:44] Lisa: You know, I added it to my teaching since you took class with me.

[00:26:48] Yuliya: Oh good. Like, I had no idea what was going on and it's not like you're cold. Your, just, like, whole body's convulsing and you just have no control over it basically. Cara said that was great. It meant hormones were...

[00:27:00] Lisa: Yup. It's all hormonal. Yep 

[00:27:02] Yuliya: Yeah. The hormones were surging and I was like, "That's great, but it was very unpleasant, very uncomfortable. It happened in both labors, but at least I knew kind of what to expect the second time. Because I really just, I hadn't heard of it. And like, your body starts doing something you have no control over. It gets kind of scary. 

[00:27:19] Lisa: Yeah, it's hard. In teaching birth classes, I have to kind of pick the things that I think are going to be the most applicable for the highest number of people. Right? And so the more podcast interviews I've done, the more I realized, "You know what? I really should add shaking, too." Especially going toward active labor, that that's a very common symptom. So, yeah. And you're just confirming that fact. 

[00:27:41] Yuliya: And Karen was trying to get me to like, do some contractions, like on the toilet or side-lying or something, just anything to kind of keep the momentum going. And I really, really tried, but I remember just like trying to hold onto the bars, because it's kind of like the handicapped toilet, and I just couldn't really, because I was shaking just so hard. Like it was hard to move. It was hard to talk. Like it was hard to do anything. Just trying to manage it as best as we could. I'd also been on, you know, bags of saline and stuff. So I started to get really swollen. It was incredibly uncomfortable. 

[00:28:14] Kara was like --told me later that she was really freaked out by my feet because they were just like little balloons, just because they pu shed so much saline during labor. When you've got like any sort of induction happening that -- I dunno, there must've been like, just bags of that stuff. I definitely remember looking down and my feet were just like like, if you fill up a, glove with water and stuff, that's just what it looked like.

[00:28:38] So she was doing like a lot of massage, like neck massage, foot massage, just trying to kind of keep me comfortable and kind of keep me going, and, you know, contractions were definitely like taking up a lot more mental space, but like just trying to get through them and stuff. Just trying to get through like each one, that mantra that I spoke about before really helped with just like, "Let's just get through this one and then not think about it anymore."

[00:29:04] We tried not to even say like, "Oh, that was a big one." Like, "That was that one. Okay. We're moving on to the next one." And I found that really helpful, because it just didn't get me stuck in any particular contraction. It was just kind of helping me move through the whole thing.

[00:29:19] We tried the scarf technique, but it didn't particularly help. She said it's because I was a first-time mom and like, I guess my belly was just still too high up, but we did some neck massage, just anything to try to kind of relieve some of the physical pressure. Because you kind of notice it afterwards, just how tense you were the whole time. Like, even if you're not doing that much, like your neck is stiff, like your arms just hurt. Like everything just becomes very, very tense. And then about 4:00 AM -- so, the next morning - -Jo was kind of checking me again and she'd come in to see like how things were going. And contractions were slowing down.

[00:29:56]I kept feeling that it was, I was in constant pain, but like monitor was showing that things were slowing down. So they decided to do another check. And I was about like four and a half, five centimeters, so was still not that close yet, considering how long I'd been in labor for at that point. About 12 hours or so. And then Jo decided to start Pitocin, you know, and I asked her like, you know, I was really freaked out because you hear all these really terrible horror stories about Pitocin and of how, like, it's kind of built up as this thing that's kind of insurmountable. And then she's kind of telling me that, "Well, now we have to start this thing" that sounds really, really hard. 

[00:30:40] Lisa: It really has a stigma, doesn't it? 

[00:30:42] Yuliya: It really does. But you know, I kind of, asked her to wait like a couple of minutes and I, talked it over with Noah and with Cara. They were like, "Look, it doesn't seem like there's much of a choice. Like this seems like the right thing to do." There's obviously a choice, but like, this seemed like this was the right call at this point. We'd been in labor for a long time. We need to do something to keep it going. So we started up some Pitocin, at like 6:30 in the morning. 

[00:31:12] They took off the Hep lock for a bit and then started antibiotics. And then, because I was back on Pitocin, I had to go back on the constant monitoring. So my movement was restricted again. Which sucked, but she was kind of like between doing that and breaking my water, but because I had low water, and that's the reason for the induction, she just decided to go for the Pitocin. And since I trusted her and CPM, that was kind of like, "Okay, like, if you're telling me this, then it seems right." 

[00:31:42] Lisa: Yeah, isn't that nice to work with a care provider where if they are recommending interventions, you can really readily trust that they're being conservative. That they're not just being flippant and being quick to intervene. 

[00:31:57] Yuliya: Yeah, yeah, absolutely. 

[00:31:58] Lisa: Even though that's not what you wanted to hear? 

[00:32:02] Yuliya: No, and they knew that. We talked the whole time about, like, I don't want to do an epidural. I don't want an induction, but like here we are. It was all kind of an exercise in learning how to be very, very flexible. 

[00:32:15] Lisa: Yeah. That's birth and parenting too, right? 

[00:32:17] Yuliya: Yeah, pretty much. Yeah. So basically, we started some Pitocin, like very little, she said she was gonna start very low dose and then like, gently try to go up if necessary. I think it was like two units or whatever. And at that point, my son's heart rate dropped a little bit. So it was like 110 where it had been consistently at 130.

[00:32:39] But again, Jo was like, "Look, we just started the drip. I don't think they're related. Let's give it a few minutes. We'll monitor it more closely for the next half hour," but he rebounded and it was just some random dip. So she also gave him time to kind of catch up a little bit, which is good.

[00:32:58] That's what I always liked about them. That non-alarmist, like, "Let's give it a minute. Maybe this is a fluke." You know, I think she gave it like a half hour, but it was just a random dip and he rebounded and he was totally fine within that next half hour.

[00:33:13] Lisa: That's another thing I love about midwives, as well as any OBs who are lower intervention, more hands-off, because that continuous monitoring usually does put us at an increased risk of a C-section or other interventions. But if you hire a good care provider that you really feel like you can trust, they're not going to be as quick to have a knee jerk reaction when something like that happens.

[00:33:35] Yuliya: Yeah. Yeah. Because he was really stable and then he ended up keeping the 130 heart rate range for like the rest of the labor. So obviously it was just some random thing that kind of happened. So contractions were starting to get closer together and getting a lot stronger and they were starting to increase Pitocin, but thankfully they didn't tell me. Because I think that would have really messed with my head a little bit, but thankfully, you know, Noah was kind of watching it. So I found out about it later. So they went up to eventually like eight CCs. Because again, the contractions would get closer together and like stop, right? Like they would increase in intensity and then slow down.

[00:34:14] And it was just kind of this really frustrating, like back and forth, just my body not getting its act together at this point. Like it would just get, it was getting very frustrating for me to have them get more intense and then less, and then get closer together and then space back apart. It was just getting to be like quite a waiting game at that point.

[00:34:37] And then by, I guess the next morning, like, like later in the morning Elaine came to take over for Jo, and it was about like 10:15 in the morning and I was still only like seven or eight centimeters dilated. 80% effaced and baby still was at negative one. So, he was being pretty stubborn and I'd been dealing with contractions for so long already, hooked up to a monitor, right? Like all of this stuff, and it was just getting really hard to cope. 

[00:35:05] Oh, my other baby woke up. 

[00:35:08] Lisa: That's fine. If you need to go get your baby. 

[00:35:11] Yuliya: No, I think Noah's got him. I left some milk, so it should be okay.   

[00:35:14] The nurses kept coming in and asking me like, "What's your pain level from like zero to 10, like in the middle of a contraction, they would like keep talking to me. And saying like, you know, "We're not really picking it up on the monitors outside at the nurses’ station. Let me readjust. Are you having a contraction right this second?" And like touching me and like moving the monitors around and it's like the worst thing to be touched while you're having a contraction.

[00:35:43] It was horrible. It was like, "Oh my God. Don't talk to me, like, don't look at me. Let me get through this." Especially since most of my coping was kind of breathing through them and like, going very inward to cope. So having someone take me out of it and like, ask me, "What's your pain scale right now?"

[00:36:02] Lisa: You're not in that head space. 

[00:36:04] Yuliya: No. It was like, it's a contraction. It's a lot. Like, I don't know. I don't know what to tell you. It was getting really frustrating. I had already had three or four nurses at that point and they'd all been getting on my nerves; I was just getting really frustrated at the whole process.

[00:36:19] And at some point, I guess his, either his head was low or something or like something was off that, like, it just didn't feel like there was any break between the contractions. It was just this constant pain in my pelvis, and they're like, "Oh, there's no contractions."

[00:36:34] I'm like, "Well, I'm always in pain, so I don't really know what to tell you." It was just, just really frustrating to kind of deal with that medical intervention side of it. Like not the stuff that I was able to choose, but, you don't really get much say of what's going on in the hospital kind of around you.

[00:36:50] So even though technically the contractions were a few minutes apart, it really felt like it was just one long feeling of just painful -- I don't know how to better describe it. And one of the nurses kept offering to do like counter pressure or something. And I was like, "I just need you to like, leave me. I have a husband. I have a doula. Just leave me to do my thing." And so that was, that was really getting frustrating. So anyway then, I didn't really have any back labor or anything like that. It was really just everything was in the pelvis and just very pressured. 

[00:37:26] By like 11:00 AM, I think I started to have the urge to push, which is such a weird sensation because people tell you like, "Oh, you'll know when you want to push. And then you actually do. Like, you know, if you haven't experienced it before, it's really hard to describe, but it's like, "Oh yeah, like, there it is. Yeah. I need to start pushing now. Like I need to get this baby out." And at that point Elaine broke my water, which is basically just a long, looks like a knitting needle with the little hook at the end. And they just kind of put it in there and it's like, "boop!" 

[00:38:00] Lisa: Nick it. 

[00:38:01] Yuliya: Yeah, it doesn't hurt or anything. And I didn't really feel like anything, and then there wasn't really any water that came out. So at that point we were definitely like, "Yeah, that's the right call to induce the baby." Because he just didn't have any amniotic fluid left. 

[00:38:16] Lisa: And going back to how you knew you were entering the pushing stage. By that, do you mean just a feeling, or did you get the urge to push? Or what was that like, more specifically? 

[00:38:29] Yuliya: Definitely feeling like the urge to push. And I just remember before that kind of, I vividly remember the feeling of like, "Oh my God," like, "I can't do this anymore." Like I don't think, I'll be able to get through this. Just wanting it to kind of be over. I don't remember when, but at some point I asked Elaine if I could just die and she said no. 

[00:38:49] Lisa: "No, I won't let you. You're not allowed." 

[00:38:51] Yuliya: I was like, "Okay. That's fine." 

[00:38:54] Lisa: That does sound like transition. 

[00:38:56] Yuliya: Yeah. I was like, "I just want to die. I want this to be over." She's like, "No, you're going to be okay." I was like, "Oh, okay, that's fine." So yeah, I guess I was like cracking some jokes in the midst of all that. But I kept wanting to start pushing and she checked me and she said, no, there's like a lip of the cervix that was still left. And she was afraid that if I started pushing at that point, that it would inflame it more and make it harder and longer to push him out.

[00:39:22] So we were just trying to do some breathing and hoping that the contractions would help ease that kind of stuff. 

[00:39:29] Lisa: That happened with me and my first baby, as well as just one side of the cervix was a little bit still not effaced. Did the midwife Elaine, thin it out manually or... 

[00:39:40] Yuliya: No. I think she was just waiting for the contractions to kind of do it for me. So she was just trying to get me to like, keep my chin down, breathe, like, try not to push you know, if I can help it 

[00:39:53] Lisa: So hard if you're feeling that urge.

[00:39:55] Yuliya: Yeah. And I just kept asking like, "Is it over? Like..."

[00:39:59] Lisa: Please let me push!

[00:40:01] Yuliya: Yeah. Like, "How much longer?" And then she kept using her iPhone flashlight to be like, "Nope, still not done." And she was just like sitting on the front of the bed in front of me, just on the yoga ball. She was the one using it. I wasn't. 

[00:40:17] And at some point, I think they got in like another thing of the, of the antibiotic bag going. So, like, I was all treated, or whatever. I think I must've gotten like three or four bags at that point. Because they kept thinking, like, "Baby's coming any point now." And he wasn't. So like Elaine was kind of just trying to keep me from pushing through it too much.

[00:40:39] I think at some point I asked for like, "Oh, I would like some, like, medication now, or, like, some oxide." She's like, "No, it's too late." So I was like, "Oh, okay." Very resigned to the fact that I was just going to have to get through the rest of this thing, because I think nitrous was an option at Sinai. I don't know if it would still be, with the pandemic, but I imagine probably not. 

[00:41:07] Lisa: No. ACOG has put the kibosh on it. They've said, "Sorry," the aerosolization factor has made them suspect that it's not safe to use right now. So they've said, "Nope, not for now." I actually wonder if that's going to end up being a permanent thing. We'll see. Hopefully not, hopefully it will come back at some point. 

[00:41:28] Yuliya: Yeah. Basically, I was just like, "Okay, I want some help now." Like, I'll take the meds". And they're like, "No, it's too late. You're like nine centimeters at this point -- or 10 or whatever. Like it's almost baby time." And I was like, "Oh, well, I guess that's fine." And so by like 1:30 or something like that it was apparently time to start pushing. And I tried sitting on the birthing stool. They got me one, they found it somewhere on the floor. I found it really uncomfortable. So after like one or two contractions, I was like, "Nope." Cara was really encouraging me to go like on all fours and push that way. And at this point I'd been in labor for like, 20 something hours. So I was just really exhausted. 

[00:42:10] Lisa: Sure.

[00:42:11] Yuliya: I tried to do some contractions like on all fours kind of facing the bed and things like that. But by the time it came time to push, I was just too tired. I was like," I just want to sit." 

[00:42:24] Lisa: Sure. 

[00:42:25] Yuliya: So they got me kind of in the bed, like not fully reclining, but kind of like sitting up. And, Cara was on one side and Noah was on the other side. He wasn't too thrilled, but what are you going to do? And so... 

[00:42:37] Lisa: Why is that? 

[00:42:38] Yuliya: Oh, he was hoping to like, not be so up close, but 

[00:42:42] Lisa: Okay. 

[00:42:45] Yuliya: But he didn't really have a choice. At that point I started pushing and I just, it's really also kind of a strange sensation of like, there's not really pain anymore.

[00:42:54] At that point, it's mostly just like kind of a lot of pressure and a lot of relief between the contractions, which is different than it felt during the active labor and transition where it just felt like contraction upon contraction upon contraction. And Elaine was trying to coach me on when to push and kind of like "Press down here" or do whatever. Like, and then she was trying to kind of stretch the perineum to kinda minimize the damage. And I saw her working hard at doing that. But I just kind of felt his head go in and out, in and out, it was just this long and frustrating process. I felt him come down and then between contractions, he would kind of go back up and go down and then like back up 

[00:43:29] Pushing lasted for about an hour or so and towards the end of it, Elaine was like, "Look, I know you don't want this, but I think we have to do an episiotomy. Because we had talked like less intervention and blah, blah, blah. And she was like, "Look, if I don't do this, there's just going to be more damage at this point. He's stuck on like a tiny, tiny bit. As soon as I do this, I think he's gonna come out." 

[00:43:56] Lisa: And that's one of the very few true medical indications for an episiotomy, if it's going to cause more damage if you naturally tear, then yeah. It makes sense. 

[00:44:06] Yuliya: Yeah. So she was able to control it and she was like, "Do you consent? Is that okay?" And I was like, "I don't care at this point. Just cut me. Whatever." Like, I just wanted to be done. 

[00:44:15] Lisa: I love that she asked you if you consent, because a lot of care providers wouldn't. They would just do it. And sometimes they wouldn't even bring it up that they're about to do it, which I think is unethical.

[00:44:25] Yuliya: Yeah. Yeah. But she definitely asked, she definitely asked. And I was like, "Yeah, whatever," at this point, I'd been pushing for a long time and it just felt like he was stuck. Like, it just felt like he wasn't able to kind of come out. And as soon as she made the small incision, out popped his head in the next contraction.

[00:44:40] So definitely a hundred percent the right call at that point. And then, apparently, he had the cord wrapped a little bit around his neck. She was able to kind of maneuver that off 

[00:44:51] Lisa: Even though it sounds scary, right? 

[00:44:52] Yuliya: Yeah. Yeah. But there didn't seem to be any issues with it. His heart rate was steady. He was totally fine. Handling labor really well. And then, like, I pushed and she helped pull the rest of him out. And as they were kind of bringing him up, in a very, like, you know, Simba in The Lion King moment, he pooped everywhere.

[00:45:14] "Here's your baby!" Meconium on my arm, my leg, everywhere. 

[00:45:21] Lisa: I'm hearing the music in my head from Lion King as the poop is descending.

[00:45:26] Yuliya: And then of course, because of meconium, they have to check the baby. We were going to do the delayed cord clamping, but Lynn was able to kind of wait a little bit, because it was clear even to me that he pooped as the rest of his body was coming out, like that's when the poop came out. Because it was not on him, basically. It was just mostly on me. 

[00:45:46] Lisa: Lovely. 

[00:45:47] Yuliya: Yeah. Great. 

[00:45:48] Lisa: Get used to that, Mom. Right? Induction into parenthood. 

[00:45:53] Yuliya: Oh, yeah, totally. And it was this very surreal moment where they plop a baby on you and you're covered in poop and he's screaming, you know, like, "What is going on?" And so I was holding him, and Noah cut the cord and she was able to kind of help push the blood back in for the cord and stuff.

[00:46:14] But because of the meconium after they did that, they had to take him to like, be looked at right away just to make sure that he didn't inhale anything and do like some suction and stuff like that. So it wasn't that like magical, like, "I get to hold my baby now!" moment. so that was, you know, that kind of sucked, but like at that point I was just in so much shock after delivering the baby, I don't think I registered too much. And then Elaine of course, had to stitch me up and she's very meticulous about it. I joked with her in my second labor. I was like, "This is going to take a while. Isn't it?" And she was like, "I have, I have to make sure it's like really perfect. Like it has to be, it has to be perfect and great. Like I need to take my time."

[00:46:52] Lisa: At least she gets it right, right? 

[00:46:53] Yuliya: Yeah, she does. And it was great. I had to like make small talk with her about, I don't even know what, like she's like stitching me up and the baby's over there. Noah's with the baby I'm like, "I guess we have to chat." Like you know, when I redid my bathroom, I put like a bidet shower in, and I was like, "Oh, that'll be nice to use that." I don't know, I was just making conversation. Because it's such an awkward time. Like all of these tools are in the room and the spotlights are on overhead.

[00:47:19] And like your midwife's stitching you up, the baby's not in your arms. So what do you do? You gotta pass the time. I don't know. It's very strange. But then eventually they you know, they gave him back to me and it was still kind of a shock for a while, I think. You kind of expect that it'll be like some immediate thing.

[00:47:37] And you know, I don't think it gets talked about enough that sometimes it takes a while to really like internalize that you just had a baby and to like feel bonded and kind of feel that connection. And definitely, I think it took a little bit of time for me. To really like fully get in there probably like a week or two to really like, understand that this all happened, this is all OK. And like, thankfully a friend of mine had mentioned that earlier. Like, don't feel bad if it's not something that's immediate, like it will come, but. Yeah, there's a lot of stuff that just happened and your body went through a lot. 

[00:48:10] Lisa: Yeah, these days, I always mention that in class, because it is so important for people to not feel guilty if they're meeting their baby and they're like, "Who is this alien? I don't know you," you know, and it, and a week or two is actually pretty quick. A lot of people, it takes months to really grow into that feeling of connectedness. And that's also another version of normal. 

[00:48:30] So I think that's really important for expectant parents to be aware of. Thanks for sharing that. 

[00:48:36] Yuliya: Yeah. Yeah, for sure. And also, it was just very helpful to kind of note that because you becoming a parent in that moment and like this person was inside of you and now they're outside of you. Like, it's just such a strange paradigm shift, and they're like, "Here's your kid." And like, "Now breastfeed!" And "Now do this!" And like, it's so overwhelming, especially I think the first time. I was more ready for it the second time, obviously. But the first time you're like, "What just...like, I haven't processed what just happened. Like, now I have to take care of this person. I haven't slept in a day." Like, it's just like so much stuff that's going on at the same time.

[00:49:10] Lisa: Isn't it a strange thing about like -- perception of time is subjective of course -- but there's so much time leading up to the birth, then when it actually happens, it all feels very condensed and rushed and like sudden, you know, like, "Wait. What?"

[00:49:27] Yeah, yeah. Something interesting to mull over a little bit and figure out what's in that, that you can grow and learn from. 

[00:49:37] Yuliya: Yeah. So that was basically my first experience and I was very happy with my care providers. You know, it was a hospital birth and it was you know, all these cascades of interventions, but I still felt respected the whole time. And I felt like it was a good experience overall. 

[00:49:55] Lisa: Yeah. That's what's important, that you feel respected and that it overall was good. As you go into parenthood, we need that, right? 

[00:50:02] Yuliya: Yeah. 

[00:50:03] Lisa: All right. Birth story number two. I can't wait to hear all the details. Launch right in. 

[00:50:09] Yuliya: Yeah. So we obviously decided to go with CPM again, because we had such an awesome experience with them last time. And I got a doula Audrey, like in January, so I was like, all set to go, like, gonna have a really different experience this time. Like, I really wanted to go into labor naturally and kind of do all the things that I didn't really get to do the first time. Also, just trying to get, like, a more intervention-less, birth experience, and everyone's like, "Yeah, and it'll be faster and easier.

[00:50:39] But then, you know, in March, obviously, COVID hit, and you know, things were starting to really change like in the city. And at some point one of the midwives, Christina, was like, "Look, you know, if you want, you can think about doing an induction, like a scheduled one, just to kind of have some control over what's going on."

[00:50:57] Because at some point, you know, I had to have someone watch my older kid, who was three at that point. And like, it was starting to get a little bit complicated with who was going to do that. Because someone had to be quarantined or -- like all of this other stuff just kind of started cascading. And so I was mulling it over and they're like, "Oh, you know, you might be able to break your water and you'll have the baby a few hours from then," and like all this other stuff. 

[00:51:20] So we talked about it a lot and eventually as COVID started to get worse, you know, it was March, then it was April, it was getting kind of crazy. So we decided like, "Okay, let's get some control over the situation." Because I thought it would be very stressful. I was also GBS positive again. So I would need the antibiotics in order to do an early discharge. You know, there was so much confusion in that time of like what the hospital policies were, like, what you had to do -- for COVID testing, there weren't enough tests. You couldn't have a support person. You could have a support person. It was just like, everything was just constantly changing all the time. Half my prenatal appointments were on Zoom, it was a very, very different third trimester experience than the first time. 

[00:52:03] Lisa: And were you working in these last few weeks of your pregnancy? Were you working as well? 

[00:52:08] Yuliya: Yeah. Yeah. I was working from home. I was doing teletherapy while Noah was also working from home. So it was just a mess. And we live in Queens. So all we heard was like sirens going off, like, ambulance sirens all the time. We're pretty close to Elmhurst. So it was just like, it was a scary mess the whole time. Originally the plan was that my parents would watch Henry, like, our older son. But then my dad still had to go into work. So they weren't a safe option at that point. So at that point we were like, "Okay, like Noah's parents can take him, but they live further away. They live in Jersey. 

[00:52:42] All of our doula prenatal appointments were on Zoom. So we didn't really get to hang out with her and, you know, do any of the in-person stuff. You know, everything was kind of virtual. It was just a very different experience in that way. So eventually we decided that like, "Look, let's just go with the induction."

[00:53:01] Because at that point if you had an induction, you could get the COVID test the day before and there would be a lot less restrictions on the hospital stay. You wouldn't have to wear a full PPE the whole time and like 

[00:53:11] Lisa: That's huge. 

[00:53:12] Yuliya: Right. 

[00:53:13] Lisa: Especially the masks. 

[00:53:14] Yuliya: Right. They recommended that I wear a mask, but I wasn't required and I didn't end up doing it. So that was kind of the big difference. So I was like, "Okay, well at least I already know what induction is. Let me see what happens." So we decided to schedule an induction. It was 39 weeks, six days. So he was full term.

[00:53:34]And I was able to schedule it with Elaine who had done my my first delivery and a bulk of my prenatal appointments with my second pregnancy. So that was also something that was like, "Okay, like this is something we can like feel good about. And hopefully it'll be a quick labor and, you know, kind of easy and whatever. And by this point it was like the first week of May. So things were calming down, but the hospital still hadn't lifted any restrictions.  We went to get our COVID tests, all three of us, the doula me, and Noah.

[00:54:01] So at least in that point, like we felt like we had some sort of control over what was going on in this kind of really weird time. So, you know, we got to the hospital, My inlaws took my son the day before. So we got to kind of relax the night before the induction. It was scheduled for, I think, Wednesday at 10:00 AM.

[00:54:19] So, you know, we got to relax, ordered some dinner, like just have a quiet day after we got our COVID tests. Obviously ,we were all negative. So, Wednesday morning we, we went to the hospital. Noah had to wait downstairs while I went upstairs with my paperwork. At the silent triage area -- I was the only person in there. It was like super weird. But Elaine was already there waiting for me. And, you know, we were running a little bit late, but like, it's not like they can start without me getting there. So, they did another IV, another failed IV. Had to do it on the other hand, I was there with like a little baggy of ice on my hand, like icing it, so it stopped hurting. 

[00:55:01] And so I talked to Elaine, I was like, "Well, how are we going to do this?" And she was like, "Well, we could do like the Foley, or we could go straight to Pitocin." And at that point I was like two centimeters dilated. And I was like, "Let's just skip the Foley. Let's go straight to the Pitocin. Like, I don't see the point of doing this. It's just going to be uncomfortable. Like, what's the point?" She's like, "Well, are you sure?" I'm like, "Yeah. You know, that's really what I would prefer." She's like, "Okay, let me talk to the attending." She was basically 50-50, and she was like, "Whatever you feel more comfortable with, we can just go with that."

[00:55:34] So the attending agreed, I think. And so we started with Pitocin. And I got hooked up. The potty chair was set up again... 

[00:55:41] Lisa: Your favorite place. 

[00:55:43] Yuliya: Yeah. So that was like really, really fun. And then I remember like, as she was stitching me up in my first labor, it turns out that my bladder was so full that she like had to cath out like a thousand CCs of urine. That's probably where a lot of the pain was coming from towards the end of the labor of just like the bladder being full and not being able to empty. So this time I was like, "Okay, I'm going to make sure I'm going to go pee a lot and like really keep an eye on output and like all this really fun stuff."

[00:56:10] So, you know, they started the Pitocin and it was just like kind of chill contractions. They started coming pretty regularly, like five minutes apart or something like that. They had me on like all these gizmos, like trying to keep the monitor from slipping.

[00:56:23] So they kept upping the Pitocin and it was like very mild and it's like two and then four and then six and the eight. I was bouncing on the ball, doing all that kind of stuff. And then I called Audrey and was like, "Look, I'm at eight, like eight -- whatever -- units of Pitocin, you know, maybe you should start thinking about coming soon."

[00:56:41] You know, because eight was where we capped out with my first labor. So I was like, "Oh, maybe it'll like be pretty soon hereafter." So Audrey came at around like three o'clock and the contractions are starting to get stronger. But, still I was able to kind of, mentally pop out for it and then pop right back in.

[00:56:57] So nothing too crazy. But it was nice to kind of see her in person and hang out a little bit also before like the real, kind of hard parts of labor were coming up. So I thought it was good to have her there earlier. Then it was like 10 CCs. Nope. He was still at negative two station at that point.

[00:57:18] So it was like, "Okay," so 12. They kept bumping it up every like 45 minutes or so. And I was coping pretty well. I was just kind of getting tired, just because we had to get up early and kind of get to the hospital and stuff. So I decided to like lie on my side for a little bit. Audrey was trying to get me to like keep the contractions going, so we turned off the light, tried to get some rest. It was like four o'clock or something. I was like, "Okay. Maybe not like that much longer to go". But I started to get like really bad heartburn, which had plagued me like the whole pregnancy. So as soon as I started the side-lying contractions, the heartburn hit really badly.

[00:57:54] And they gave me some -- like -- the liquid antacid stuff that they give you before a C-section. And so it was really nasty, but like it worked, but eventually that wore off, too. And we were just like hanging out, just like -- you know, the only way that I could tell the passage of time was the blood pressure cuff kept going off next to me. Because it was really painful when the blood pressure cuff was going off. Like, I don't know, they made it really tight. So I just put it down next to me. And so every 30 minutes Audrey would like jump up, wrap it around my arm, like take the blood pressure and like take it off again. And the nurses were not too happy, but we were being fairly compliant. So they let me kind of go with it. But at that point, I think that still the blood pressure cuff hurt more than the contraction. 

[00:58:38] So, so it was pretty slow going still. I was sitting on the ball. I was trying to move around, like I was bouncing on the ball while sitting up at the edge of the bed, like leaning forward, you know, moving the bed around, all this other stuff. 

[00:58:53] Lisa: And were those things like self-led, or were those things Audrey was recommending? Or were they, it was, it was a combination? 

[00:58:59] Yuliya: It was a combo. Sometimes she'd recommend something. Sometimes I'd be like, "Oh, I'm tired of like standing, you know, I need to sit down for a little bit." Because again, like time is such a weird thing at that point. Like, at some point I'm like, "How long have I been doing this?" She's like, "Oh, it was like 30 minutes." I'm like, "Oh, that's why I'm tired of standing. I've been like doing 30 minutes of contractions, just standing around." And you know, I would try to like lean on the bed to try to cope with the contractions and then I would go on my little potty chair. 

[00:59:28] They were very excited. One of the times there was blood. So we're like, "Yay. That means something's happening. Baby's moving. That's great." Audrey was like, "Look at that like little baby bed over there in the corner. Like, you're going to have a baby in there soon." I was like, "Yeah okay, cool." So, you know, because that's what everyone tells you. But it was not, unfortunately to be.

[00:59:49] At that point I'm starting to get like nauseous and just like really uncomfortable. And it was like seven o'clock or something. And I was still only like three and a half centimeters dilated. But Elaine did a check and said she could feel the bag of waters bulging, which she said meant that baby was descending. So he was getting closer. and she asked about breaking the water, but I asked her if I could have some time to like, think about it. Because everyone, including them were saying like, "Okay, once you break the water, you know, especially as a second time mom, it's going to escalate very quickly and you'll have the baby very soon."

[01:00:26] And for me it was like, "Oh, so I have to basically consent to things getting worse very quick. Like. More painful and more uncomfortable, very quickly?" 

[01:00:35] Lisa: A hard thing to want to sign up for. 

[01:00:37] Yuliya: Yeah. And so I was like, "Can I have some time to think about it?" She's like, "Okay. But it's really going to like help speed stuff up."

[01:00:43] And Audrey agreed, but I was just like it was, it was like a mental leap that I just wasn't prepared to take at that point. So I just decided to wait a little bit longer. And then a little bit later, I also had some chest tightness. Took us a while to figure it out it was the heartburn that was back again. So they had to like push Pepcid in my IV, which finally was like the only thing that actually helped, but it was like hard to breathe and my chest was tight. And like another thing I was like, how am I in labor and having heartburn, like, what is going on? 

[01:01:12] Lisa: Yeah, because the baby's supposed to be lower at this point. So you would think there's not so much crowding creating that heartburn. 

[01:01:18] Yuliya: Mmhmm. And it was like so intense and I was like, "What is happening? " So it was like a couple of hours. And then, by like 9:45 or so that night I was like, "Okay, you can break the water."

[01:01:31] Elaine and the nurse eagerly were like, "Okay, like, let's get this show on the road." My poor nurse, she was really holding out for me to have that baby. 

[01:01:38] Lisa: On her shift. 

[01:01:39] Yuliya: But she ended up missing it. It was so sweet, but she kept coming in and asking me questions. And then she was like, "Oh wait, you don't have an epidural."

[01:01:47] I was like, "Yeah. Could you wait like a second?" She's like, "Yeah. I'm so used to all the moms having epidurals that like, I forget that some don't." "Yes. Give me a minute." But she was, the nurses were a lot sweeter and calmer this time, so it was a more pleasant experience that way. And then I started to feel the shaking again, and I was like, "Okay, that's great. Like, this means progress." So, you know, we celebrated that a little bit. And then soon after that kind of subsided a little bit, she was like, "Okay, you know, we should probably break the water."

[01:02:22] And so I consented to that and again, they came in, but this time it was very different and it was just this huge gush, like again, not painful, but just this huge gush, and it was so gross. 

[01:02:33] Lisa: It was like hot, hot fluid, right? 

[01:02:34] Yuliya: Yeah, hot fluid that just gushes out randomly, like, "Oooh, what is that?"

[01:02:39] Lisa: Yeah, because you didn't really experience that the first time. 

[01:02:43] Yuliya: And then she, they kind of put a pad in there and they saw that there was a little bit of meconium, and I was like, "Oh no, is that like...what does that mean? 

[01:02:51] Lisa: Your babies like to poop early on.

[01:02:56] Yuliya: She was very reassuring like this whole time and she was like, "It just means pediatrics is going to come down when you're pushing and then they're going to check out the baby and that's it." 

[01:03:06] Lisa: Just like before. 

[01:03:07] Yuliya: Yeah, she's like, "It's going to be fine. Like there's not that much. It looks like it was just like a little bit, a trace of it." So it was very nice that she was again, like very, just calm and reassuring, like, "All right. Like. It's fine." And also, this whole time, she wasn't telling me like any centimeters or anything -- this is all stuff I found out later from Noah's notes -- which I think was really helpful to just not get that in my head.

[01:03:30] Like, I didn't see how much Pitocin was there. And like, I was just kind of going through labor as it was happening. 

[01:03:36] Lisa: That's so good to know, because as I was reading the written stories, I was thinking, "My goodness, she was really in her thinking brain to be getting all this much detail." So that explains it, that Noah was writing down those details. Okay. Thank you. 

[01:03:49] Yuliya: Yeah. The only thing I noticed was like every time, the blood pressure monitor was going off I knew 30 minutes had gone past. That's like the only concept of time I had, it was like, "Oh, another one, like, ah!" But yeah, so she was just like very, she's very calm and very reassuring.

[01:04:04] So I started doing some more side-lying contractions. They're like, "Okay. Things are supposed to speed up now." And there was, there was just no difference. It was the same, like constant chugging along with contractions of like, you know, two, three minutes apart lasting about a minute, like nothing intensifying, nothing changing, just random bursts of liquid coming out, like at random times.

[01:04:28] It was getting very frustrating and it was getting to be like close to midnight. And I was like, "What is happening? Why is there no baby here yet?" Which I think is another thing -- that expectation that was kind of set up, through no fault of anyone's. Right. Like, even just knowing other people who had like, "Oh, I was in labor for five hours or six hours, the second just kind of flew out." It doesn't always happen that way apparently. 

[01:04:53] Lisa: Yeah, and I honestly really think that a lot of times when we've given birth before, if we go into spontaneous labor, we're much more likely to ignore it for longer and not call it labor. that was true for me. I felt a contraction at like 1:00 AM with my second baby. But I didn't really count that as labor starting, because I was able to sleep for like four hours or so. 

[01:05:13] And so it wasn't until four and a half hours later that I woke up. I was woken up by stronger contractions and that's when I started the clock. So I actually think that had been my first labor, I would have counted it at one o'clock, you know?

[01:05:28] So, because you were induced, the timing's going to be different because you, you know, that you're being induced. So you're on the clock. 

[01:05:35] Yuliya: Right. 

[01:05:35] Lisa: Plus, inductions just tend to take longer 

[01:05:37] Yuliya: No, totally. And it was definitely like, it was stressful to kind of know, but also, because it was an induction, the contractions were coming very quickly. It was like only a two, three-minute break for many, many hours.

[01:05:50] Versus like, I imagine what would have happened if it had been a spontaneous labor wouldn't have been clustered so close together for quite some such a long time. 

[01:05:58] Lisa: Definitely. That's hard. 

[01:06:01] Yuliya: It was really helpful to have my doula there and my husband there and just like trying to talk me through it. I found it mostly helpful to kind of do the breathing work and kind of... I was doing some tapping at some point of like the hospital bed, just when they were starting to get it, like really, a lot more painful, a lot more difficult to cope with. And focusing again on that little, little baby bed thing that they have in the corner of the room. "There'll be a baby and it's going to be okay." And Audrey helped me kind of focus mentally on that stuff as well. And then I was telling her that I was having some pressure in my pelvis. And she was like, "Okay, that's great. Like, everything's pointed very well, but, you know, it was still, like, five hours from the birth of the baby."

[01:06:42] And then I remember Noah crunching pretzels, very loudly. And I, at that point, I was like, "If you don't stop eating, I will kill you." Like I was like, "I can't do this. You have to stop chewing." 

[01:06:54] Lisa: Isn't that-- it's so funny in labor, how different smells can really bother us or sounds can bother us. Yeah, that was one of my favorite parts that I highlighted in your written birth story was, "Noah was chewing pretzels loudly. The chewing was very annoying."

[01:07:06] Yuliya: Well, it was so bad, but you can smell the pretzels and pretzels don't have a smell. Like it's just every, all your senses are just super weird at that point. But Elaine said I was a lot nicer to him this time than the first time. So I don't even know what I could have said the first time. I must have blocked that out. So then she helped me maneuver the hospital bed into this like throne position. Just another plug for the midwives that they help you kind of get into all of these funky positions in the bed. And the bed goes into all these weird things. You know, I would never have thought to do that if it was just like me and Noah, like who knows how to operate this bed? 

[01:07:42] Lisa: Sure, yeah. 

[01:07:43] Yuliya: So I was in that for a while. And that was helping to kind of bring the baby down. Because it was an easier way to kind of use gravity.

[01:07:50] So I was just kind of sitting in like a, I guess, a throne-like way, a little bit more supported. So that was good, but it didn't really help to move things along very much. And that was frustrating again, because this was about like 2:00 AM at that point. And then I started to get really nauseous and started throwing up, which again was a really good thing. Because it creates a lot of cervical change. Okay. But like throwing up and gushing water and having a strong contraction all at the same time though, it was just, there's just, there's so many sensations at that point. Audrey was trying to get me to drink water. And I was like, "No, water has too much flavor. Like, just give me the ice chips." 

[01:08:29] Because they were hydrating me with the IV bag, but they're like, "You have to kind of keep drinking water, too." I was like, "No, I can't have water. Too much flavor. At that point, like, everything feels weird. It's also weird the second time when you kind of have this metacognition of like, "Oh, this is the transition phase." When you start to feel like you don't, you know, you can't go on anymore. So I had this weird fight with myself: "Is this really transition? Am I just telling myself it is because I know what to look for mentally?" it was kind of a strange mental space to be in, which was different than the first time.

[01:09:04] Lisa: Because you weren't being told the dilation, or hadn't been having cervical checks recently or what? 

[01:09:10] Yuliya: I knew it was like, "Oh, I can't go on," like, started having those thoughts. I was like, am I like forcing myself to have those thoughts or am I really having these thoughts?"

[01:09:18] Well, I guess it was just too much awareness, I guess. And again, just wanting to be done already. That, that was the predominant feeling was like, "I just want to be done. Like I just need this to be over." Elaine took out the flashlight on her phone, and was like, "No, you're still like at eight centimeters, but like really soon."

[01:09:36] And it was just like, "Oh my God, like, I've been doing this forever and I'm still not there yet?" And they were like, "But that means like really, really soon!" And it still was like three hours away. Because at that point it was just like 14 hours of labor or something. So it was just kind of mentally, it was more of a head trip, I think, than the first time. 

[01:09:59] Lisa: Well, and were you feeling at all -- I'm just curious -- with everything that's going on in the world with COVID and everything, was there anything in you that was like, "Just give me a break! Like, all of us need a break right now. And so I deserve a shorter birth."

[01:10:16] Yuliya: Yeah. I was like, "This was supposed to be short. This was supposed to be easy. Like, I just want to get it over with already. Like, I'm done." Like, I'd been stuck at home with like a three-year-old, you know, and like hugely pregnant. I was like, "Can something just be easy for once?" 

[01:10:35] Lisa: Yeah. 

[01:10:37] Yuliya: So at some point I guess I asked Elaine if there's something medical I could do or take, and she was like, "I'm not even sure what that really meant, but no, like, do you really want to consider that?" I remember her being like, do you really want to consider those options right now?" And I was like, "No...." 

[01:10:55] Lisa: You just needed to say it. 

[01:10:56] Yuliya: Yeah, she was like, "I didn't think so." Okay. Like walking, trying to cope with the contractions, I saw the Pitocin was at 14. I guess they were like kind of hiding from me at that, like nobody was saying it, they were just coming up and bumping it. I, well, I was noticing it. So that was kind of a mind trip as well. It was like, "Oh my God, that's so much!" Like, I mean it's... 

[01:11:19] Lisa: where did you max out at the last, the first birth? 

[01:11:22] Yuliya: Eight. 

[01:11:23] Lisa: Oh, wow. 

[01:11:23] Yuliya: So this was like 14 and I think at some point they might've gotten even higher. I don't remember, but... this was just getting to be so much.

[01:11:30] And then, by like 4:30 in the morning already, I was effaced but the baby was still high up. And she convinced me to do some more side-lying contractions. and so I just remember the flurry of her and Audrey moving, like this thing and that thing and getting the stirrup out and like to side-lying with one leg up on the stirrup and like some weird acrobatic thing that was happening.

[01:11:52] And I think that's when her and Audrey bonded. She's like, "Oh my God, it's so great working with you." I was like, "Guys, I'm like, come on, like focus back a little bit." But as soon as I got into that side-lying position, I don't know what happened, but it was just the worst pain that I'd had the whole labor. I just remember it being so bad that I was like banging on the like the bed, pulling the sheets, just like, I was like screaming. I know it wasn't supposed to, but I couldn't help it. It was just like the worst part of the whole thing. 

[01:12:21] Lisa: What do you mean you weren't supposed to? You can be loud if you need to. 

[01:12:25] Yuliya: It was like, it was really, that was like the worst part, but I remember that very vividly.

[01:12:30] And then at some point they let me get out of that position so I could use the bathroom, or the chair. And on the chair, I, I guess I had like a moment of pushing or something, at least that's what Audrey said later. She was like, I think that's the first time I heard, like you were actually starting to push, like I had zero control over it. It was just like, "Oh, like, it's coming and I'm pushing". So that's when they knew that things were getting close and then like around 5:30, I guess, in the morning Elaine said, "I think it's time." I guess she was checking me at that point. All of a sudden everything was getting rushed in like all of the trays of all the equipment and the lights were on.

[01:13:07] And you know, all this flurry of commotion was happening. And then she was like, "I can see the head." I didn't have any energy to try anything besides just laying on my back with like both legs up. Because I was like, "I'm tired. Get this baby out." And then basically, just kept pushing for the solid, like 20 minutes. I remember the first time he was going in and out, I was like, "I'm not doing that again." 

[01:13:29] Lisa: Without breaks? 

[01:13:30] Yuliya: Pushing for as long as I possibly can. And Elaine was just like, "Do whatever you gotta do."

[01:13:36] She was like -- apparently there was a little lip left and she said she was going to help me, like she said "Hold on." And I was like, "Nope." I was just like, "I'm not letting him go back in. I'm just going to push him out. This is almost over. That's it. Like, not stopping." I think in like 20 minutes he was out. 

[01:13:56] She was like, "Oh, let me... nope. Okay. You're going to keep going. All right. Alright. Never mind. You should just do what you gotta do." And I just remember the ring of fire. I didn't really have that the first time, I guess. Because maybe the episiotomy or something, but this time she was just like, "Okay, just like, stay right here, stay with this, just go slow."

[01:14:14] And I was like, "Just cut me already!" And she was like, "I don't have to! Stop it!" I was like, "Okay, fine." And then eventually, he came out. I had like a small second-degree tear or something. So, I think it just tore the scar tissue from the episiotomy, which is very common.

[01:14:33] But she was like, "I don't have to cut you. Just keep pushing. It's fine." And then Audrey was like, "It was only four minutes." I was like, "Not to me!" Felt a lot longer. And then I felt the body come out with like a "plop," almost. It was like, "Thank God." So he came out in three or four pushes maybe, but like continuous ones, I was like not stopping.

[01:14:56] And then he was kind of purple. Like, I dunno, I guess he was struggling a little bit, he didn't yell or anything. So, they rushed over to clean him up and warm him up and get him going. And he was okay, but after Noah cut the cord, they had to take him again to get suction. And they got a bunch of meconium out of his lungs, but he was okay. It was another big baby. My first was eight pounds, five ounces. This was eight pounds, three ounces. So not little dudes. 

[01:15:25] And so it was finally over and I started shaking again at that point. And Elaine was like stitching me up and it was just like, definitely a lot more connection or emotion or something like that, but it felt quicker this time. Like in that moment, I was like, "Oh my God, I love this baby. Like, this is my baby. I get it now." Like, it was a very different experience than the first time. I kind of knew what to, what was happening a little bit more. But I wasn't able to hold him for a bit just because of the shaking and the chain stuff, but... And she's like, "Okay, now time to deliver the placenta." And I was like, "I don't want to." So apparently, I was a bit obnoxious towards the end, but it was fine. 

[01:16:09] But that was kind of the end of it. And then all of a sudden, everyone leaves the room and it's just quiet.

[01:16:17] I definitely remember noting that, it was like, "Oh my God, it's silent. What, what just happened again?" The sun had come up and it was just like, "What is going on?"

[01:16:27] Lisa: And in light of COVID, did Noah stay? 

[01:16:31] Yuliya: He did. He was able to stay the whole time. Audrey went home obviously, but Noah was able to stay and stayed the whole night.

[01:16:38] And we were out there, out of there by lunchtime the next day. 

[01:16:42] Lisa: Seems like most of the hospitals locally have been discharging a full day earlier than normal. So anything you want to share about your postpartum experiences? 

[01:16:53] Yuliya: I had a weird thing the second time postpartum.

[01:16:55] I was actually feeling really great. I took Motrin for like a day or something. But other than that, there was not really any pain, I was feeling really good. Then like day five postpartum, I started having really terrible pain. And I thought it was like a UTI, but turns out I had urinary retention.

[01:17:13] I had to go to the ER, five days postpartum, and they had to drain the bladder and sent me home with a catheter. So another thing -- who knew? I recovered, and I'm fine now, but that was definitely like a scary thing. So I learned that having formula in the house was a really good idea. Because I had to leave overnight and I wasn't pumping yet. Because it was day five, so... 

[01:17:37] Lisa: Right, sure. Hmm. Well, thanks for mentioning that. So, anything that you haven't gotten to share that you would like to share before we wrap things up? Or any tips or insights that you would give to expectant parents who are listening? 

[01:17:53] Yuliya: I guess just being flexible. And just because things aren't going, like the way maybe you've envisioned it, or like write about, or whatever, does not mean that it can't be a good experience anyway. And I think the importance also of having a really strong support team and medical team that you really, really trust. That way you're not second guessing the medical decisions.

[01:18:16] And knowing that their philosophy is aligned with yours, I think is also really helpful. So just because it's an induction or whatever doesn't mean that you must immediately get an epidural or like, or you can't cope or it's so much worse or whatever. I didn't really find that to be the case. I think you can cope if that's important to you. And also, again, pivoting is the heart of parenting. So it's an early lesson in all that. 

[01:18:45] Lisa: Absolutely. Yeah, definitely. Great. Well, thank you so much, Julia. This has been so nice to reconnect after several years and hear both of your stories told verbally.

[01:18:58] I wish you the best as you continue to make this transition into life of as a family of four, especially in these challenging times. Hope I can maybe meet your newest little one at some point down the road at a future reunion. 

[01:19:12] Yuliya: Yeah, hopefully. 

[01:19:14] Lisa: All right. Well, tell Noah hello and thanks again. 

[01:19:18] Yuliya: Thank you. 

[01:19:19] Lisa: Have a great one. 

[01:19:20] Yuliya: You too. Bye.