Today you’ll hear a birth story told by Leah & Trevor, first-time parents. Leah is a hospitalist physician, and she’ll detail how her professional background informed the way she approached assembling her birth & pediatrician team. Her partner, Trevor, will share his insights about the experience of supporting her through labor. Leah & Trevor will talk about their uncomplicated birth with an epidural and a bit of pitocin when things weren’t progressing as readily as it seemed they should. She’ll also discuss how she couldn’t bear to be on her back for pushing and was encouraged to push in whatever way felt instinctive to her. You’ll also hear about some of her frustrations with the lack of anticipatory guidance in the breastfeeding support at her hospital as well as a few tips for expectant or new parents.
Episode Topics:
How being a physician played into Leah’s choices in her birth team and birth class
Description of the subtle way Leah perceived her early labor contractions
Vocalization techniques with partner matching/mirroring, positions that worked for her including using a kneeling chair, not installing car seat in car for transfer.
Gets to hospital and is 2.5 cm dilated
Epidural administration in triage
Progress is slow, so pitocin is used to help speed things up
When it comes times to push, Leah feels the instinctive urge to push and vocalizes loudly
Trevor’s vasovagal syncope (physical response to seeing blood) and how he did being there for the birth
Their decision to not circumcise their son
Leah expresses her strong opinions about and experience with breastfeeding and disappointment with the hospital postpartum unit’s breastfeeding support
Leah describes how real mom worry is and the importance of support in early parenting
Final tips -- the importance of 1) preparing for birth/early parenting, 2) getting out and about in the early weeks, 3) making a list of things you find are restorative for your self-care
Episode Resources
Dr. Lisabeth Shlansky, OB/GYN of MFM Associates
Breastfeeding Support Info (both NYC IBCLCs & online educational info)
Kate Dimarco Ruck, IBCLC, 347.974.0872
Evidence-Based Birth Article & podcast episode on circumcision
ACOG’s “Approaches to Limiting Interventions” report (initially issued in Feb 2017; revised Dec 2018 due to new data that came out about delayed pushing)
Transcript
Lisa:
0:00
You're listening to the Birth Matters Podcast, episode eight
Lisa:
0:12
Hey, there, and welcome to The Birth Matters Show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC Childbirth Education and Labor Support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence info and soulful interviews with parents and birth pros. Please keep in mind the information on the show is not intended as medical advice or to diagnose or treat any medical conditions. Today you'll hear a birth story told by Leah and Trevor, first-time parents. Leah is a hospitalist physician and she'll share how her professional background informed the way she approached assembling her birth and pediatrician team. Her partner, Trevor, will share his insights about the experience of supporting her through labor. Leah and Trevor will talk about their uncomplicated birth with an epidural and a bit of pitocin when things weren't progressing as readily as it seemed they should. She'll also discuss how she couldn't bear to be on her back for pushing, and was encouraged to push in whatever way felt instinctive to her. Before we get started, if you'd like to receive your free Pack for Your Best Birth Checklist and my free mini course with some expert tips for your best birth, please visit birthmattersonline.com/pack, which you can also find linked in the show notes. Okay, let's jump in.
Lisa:
1:34
Hey guys, glad to have you here today on this show. And why don't you go ahead and introduce yourselves.
:
1:39
My name is Leah and....
Trevor:
1:41
Hey, I'm Trevor. I'm the dad.
:
1:43
And I just gave birth to our baby boy Everett. It'll be three weeks ago on Wednesday. And we're doing great.
Lisa:
1:53
Three weeks. Oh my goodness. I'm so thankful that you're willing to share when it's so fresh on your minds, and yet you're probably very, very tired. So thank you for your willingness to do that so soon. So, Leah, I wanted to ask you, you are a physician, correct?
:
2:09
Yes.
Lisa:
2:09
And I wanted to just ask you what your thought process was and what it's like as a clinical care provider in the, your personal journey into pregnancy and giving birth. How did that inform your choice to take classes and how did that inform your choice of care provider and how you were giving birth? Any of that?
:
2:27
Yeah, I'm a hospitalist and I work in the inpatient setting, so I think my skew is towards like sick. I take care of sick people. I don't, I don't take care of well people, I'm not really in the like, healthy-well-making sure everything stays healthy and well-realm. And I mostly wanted to surround myself with people that I personally considered expert so I could really feel like I could trust their clinical judgment and their recommendations. And kind of no matter what path I had, whether I had like a totally uncomplicated pregnancy or, what—loads of complications— that I would feel comfortable. So, and I also a little bit was influenced by kind of having connections to practices, which like I think whatever field someone is in, like they kind of use that where they can. So, I ended up going with an OB group that was part of a maternal fetal medicine group. So I delivered with the OB side and didn't really interact with the MFM side, except they like read my ultrasounds. I have a coworker whose wife is in the group. So that made me feel comfortable like having kind of an extra layer of connection with them. And then whenever we met the providers in the group, they just seemed so competent and confident and like we could really trust them and, and, and really like they seemed very at ease. And I, I kind of never considered not delivering in a hospital setting. I think a lot of people are uncomfortable in the hospital and so like—kind of like you're uncomfortable in the hospital.
Trevor:
4:12
Yeah, I hate hospitals. But you're in the hospital every day.
:
4:12
But I'm like very comfortable. Like I don't find that to be an added layer of stress. I actually find it quite supportive so that it always just made sense for me to deliver in a hospital. And then like picking the other people to surround ourselves with, like when we picked our pediatrician beforehand, I asked someone who I really trusted and then you ended up seeing him, too. And he's like the best and perfect for us. And then thinking about taking a class, we knew people that took classes and didn't take classes, and I don't know exactly why—do you remember like specifically why we were like we're gonna take a class. I don't know. But then when it came to who, like crowdsourcing, basically everyone in in the greater Queens area just recommended you. And, and we liked that your approach was like pretty comprehensive and I think a lot of the focus is on pregnancy and sometimes not on what goes on after you have a baby, which in my opinion is way more challenging. I also had like an easy and complicated pregnancy and we liked that you covered after-birth stuff too. Yeah. So I think that's how being a physician informed me for the most part.
:
5:40
Leading up to giving birth, like yeah, I had a really great pregnancy. I felt really well. I had like the first trimester stuff and then after that I just felt great aside from being really hot. So I delivered on July 24th. The weekend before it was like a hundred degrees. So we were in the public pool a lot. And drinking. Like I only ate cold foods leading up to it, like smoothies, ice tea, salad, ice cream, like—but other than that, I don't know. I felt very lucky about my whole pregnancy. Yeah. Do you have any...?
Trevor:
6:23
Quite uncomplicated. I think we were really lucky that way. Another funny thing about it being July was we had more than one of the obstetrician folks say that there had been kind of a lull while it was super hot, the week leading up, and then the, then the heat broke.
:
6:44
On like Sunday night, Monday.
Trevor:
6:46
And then they had a whole bunch of people come in right after that. So it was just an interesting kind of very animal thing going on there where—yeah, it's a funny thing.
Lisa:
6:56
That's interesting. I hadn't heard about the temperature. I've always heard the moon cycles—on full moons, maternity wards are full, but hadn't heard the temperature observation. Interesting.
:
7:07
Yeah. I mean we are animal more than anything else, so yeah. So then birth was crazy...
Trevor:
7:14
Although ultimately uncomplicated. Again. Yeah, I mean the experience of it, I'm sure was insane...
Leah:
7:21
Super intense but not complicated, which I think is a great way to have a birth go. So one thing that I really liked that you kept—you were very like repetitive in a good way about.
Lisa:
7:34
I was going to say -- harping on it?
:
7:34
You like make sure we—it was driven home was that the experience of labor is not necessarily painful, especially in early phases of labor. And I was convinced I had never had a Braxton Hicks contraction because they—people kept telling me, "You will know, it is this. If it's not this, then you're not having one." And then when I went into actual labor, I felt these very, not even very, these pressure sensations. And the only reason I thought it might be labor is because they seemed somewhat regular. And I just like started timing them. I didn't even tell you that I was timing them. And then I was like, oh. And we were on our way to an OB appointment.
Trevor:
8:26
Just happened to have one that day.
Leah:
8:28
Yeah. And, it was the day before my due date and I was like, I'm kind of feeling these things like every eight minutes and, but I don't know. And, and then we were at my appointment and the tech, like, the person who takes your blood pressure and stuff, she was like, "Oh, you'll know," like, "If you don't know, you're not having them." And I was like, well, and then the OB came in and she was like, "Oh no, you're having, these are like, contractions." She felt them when she was examining me and, and that like started me off feeling quite confident because I felt like I could like trust my experience.
Trevor:
9:11
The first several we were up walking around.
Leah:
9:13
Yeah, we were on the subway.
Trevor:
9:15
Yeah. We had to stop occasionally. When you were having one, you'd stand there and not talk and so forth. But it was, yeah, we were riding on the subway. There was not an unmanageable thing really at all until several hours later.
Leah:
9:28
Yeah. Yeah. So then I stopped timing them and you kind of slyly started.
Trevor:
9:35
Sure. Right. Got an app, whatever.
Leah:
9:39
I don't remember if it was before or—and then they were every six minutes and then we were getting food and we got two to-go pizzas and like a lot of garlic knots because that's what I wanted.
Lisa:
9:53
And that's when I saw you, I think. Trevor did you hear that I saw you guys?
Trevor:
9:57
Yeah. Well I guess we were crossing the other way or something but that's so funny.
Lisa:
10:00
Yeah. You had already started crossing the street so I was like "I don't, I'm not going to chase them down", but now I kind of wish I had, because I had no idea you were in labor until later.
Leah:
10:10
Then we went home and for a while they were definitely getting closer together. But I was able to eat and watch Netflix. I watched, I was watching Queer Eye because it's like so positive and uplifting and I like happy cry every time I watch it.
Lisa:
10:29
Cool.
Leah:
10:30
And I think one thing that we learned in the class specifically that, Trev helped me with was like me matching his tone of like vocalizing and like keeping it low and open. And we did that a lot. And then, so I think everything probably started around 2:00 PM and I think by 6:00 PM it felt like they were every three minutes and we called the OB on call and she kind of walked us through options. Like "If you feel like you need pain control right now, then come. If you don't, then wait a little longer." So we waited and two hours later they still felt that way. And so we decided to go in, and
Trevor:
11:13
Before that we were—you, you, Lisa, told us several things like, you might want to be on a couch, you might want to be on a chair, you might want to be on a bouncy ball, something like that. And anyway, we've got...
Leah:
11:23
Oh, the kneeling chair. Yeah, we have a kneeling chair.
Lisa:
11:24
Oh, nice.
Trevor:
11:27
It was really nice for—what else did you do for comfort measures? I feel like that's important.
Leah:
11:31
Kneeling chair, you helping with the vocalizing, like, being in position, like kind of bent over the couch, not sitting normally on a chair, basically like ever. And in the car, like we did all this stuff that you said and it was so much better. So I was in the back and the car seat was in the trunk and I put myself like in the middle of the back so that I could hold onto the two front seats. And that was helpful. Yeah. So then we got to L and D and they examined me. And this was like the first time in the process when I became a little bit disheartened. So in the office I was like two centimeters dilated. And when I got there I was like two and a half. And then they examined me two or three hours later and I was basically the same. And one thing that was surprising to me was that I thought, I perceived that my contractions were quite regular, but they actually said that they were irregular, and that they were anywhere between two and a half and five minutes, and maybe that's why I wasn't progressing. But as you can imagine, timing your contractions at home is hard. And the difference between two and a half and three and four and five minutes like isn't that much. If I'm trying to reach for a button on my phone or tell Trevor to or you know, I'm trying to focus on the contraction, not ... whatever.
Lisa:
13:08
And a lot of the apps kind of average the frequency, so that you might not notice the erratic nature. It depends on how it's laid out but I wonder if maybe that might've been another factor.
Leah:
13:18
This one I think did tell you every one but like sometimes I missed one because Trev was in the other room, and at that point, even though they were, you know, irregular up to five minutes, it was still, I was still having a contraction very, very frequently. I think one of the harder parts—we didn't actually talk about this because it was like so early on that by the time like we were to talking about stuff—one of the harder things was when Trevor had to go park the car and I was like by myself in the little bay. I was like in the triage area and like trying to labor on this bed by myself and I think one time a nurse came in, but other than that I was by myself. And whenever, even though you were only gone like less than 15 minutes, like I had probably at least five contractions.
Lisa:
14:09
That feels like a long time when you're having a lot of contractions.
Leah:
14:12
Yeah. So then the OB examined me again and this was like at 11:00 PM or something and I think I had had contractions that frequent for close to five or six hours and I hadn't made any progress. And then I decided to get an epidural, and it was mostly because I didn't have any sort of trajectory. Like I couldn't say to myself like, "Okay, I can do this for six more hours" or any.
Lisa:
14:44
That'll play mind games with you, right?
:
14:45
Yeah.
Leah:
14:45
It really does, not knowing where the finish line is.
Leah:
14:49
Yeah. And although I really loved all of the OBs in the group, I loved some more than others. And the one who was on that night was a little more junior. And I asked her like, "Well, what could happen?" And she wouldn't really say what was more likely. Like she said all the options. But like I know the options. I know I could progress. I know I could stall out. I know it could stay like this. Like, I want to know what you think is more likely. And she didn't really offer that. So I got an epidural, which also was a very intense experience. Like having to sit up and be still. But the nurse was amazing. She was great.
Trevor:
15:29
The anesthesiologist was good, too.
Leah:
15:30
The anesthesiologist was really good.
Lisa:
15:33
Trevor, I'm guessing you left the room? They probably had you leave the room?
Trevor:
15:37
No, I was ok.
Lisa:
15:37
Oh, you were there.
Trevor:
15:43
Stuff going in is ok. It's the blood coming out that's....
Leah:
15:43
He left for the IV.
Trevor:
15:43
I was trying not to blow it all at once. So I left for the IV. And then the very, very end I left when there was like guts coming out.
Leah:
15:57
The placenta.
Trevor:
15:57
But other than that I was there...
Leah:
16:02
He watched the birth.
Trevor:
16:03
...Watching the whole thing. Yeah.
Leah:
16:06
We don't have to talk about too much.
Trevor:
16:12
Just a blood problem. There was really not very much...
Leah:
16:15
Yeah. So then I slept, which was cool. And then I woke up and still hadn't progressed and [grrr]. So then the doctor who was on during the daytime and was going to be on like that evening as well was the one who I had seen in the office the day before and he was like, "Oh, you are having contractions." And she was just like, we thought she wasn't our favorite. But I think she is actually. She was just perfect for us. Like really calm, very present but not calm in like a sleepy way, like still very like actively calm. Does that make sense? Yeah.
Trevor:
16:53
She was just what you needed.
Leah:
16:53
She was really perfect for me.
Lisa:
16:56
Oh and by the way, if you—no pressure at all, but if you feel inclined to share any of the people you worked with, the names of them, if you want to...
Leah:
17:05
Yeah. Her name is Lisabeth Shlansky, from MFM. So the group we see is called MFM Associates, but they have a general OB side. Dr. Shlansky is amazing. You can't like really pick her because you get everybody in the group.
Trevor:
17:21
The whole group is great.
Lisa:
17:21
It's a great group. I've always heard good things about them and I think it's helpful. A lot of the listeners will be New York City people who are looking for care providers. So it's nice to hear names, I think.
Trevor:
17:29
And the delivery was at Sinai Main Campus, so that gives a little context.
Leah:
17:34
So she recommended that I get pit, which in general I was against pit, but it was more like if I hadn't had an epidural yet. And we talked about it and I asked her why and she said like, "Well, if I break your water you might still need pit. But if I just give you pit it'll probably be enough to like move things forward on its own." And I only got pit for a few hours and then they turned it off because my body kind of took over. And then I quickly went from four to six to eight to 10 within a few hours.
Lisa:
18:05
And just for listeners, "pit" is pitocin, synthetic oxytocin to help strengthen or lengthen contractions. Just wanted to clarify the definition of "pit."
Leah:
18:15
And then I started pushing—and this was cool. So the nurse kept being like, "Tell me when you feel like you need to push." And for a while, not a while, but not, I don't, I don't—my sense of time is like not really present, but I was like, I don't know if I need to push. Like I have pressure down there but I don't know if I need to push. And then all of a sudden it was like, "Oh, I get it. This is what that is. All I could do, like I was like, "I have to, I have to, like nobody—I can be by myself, I don't care. And so I started pushing and I don't know what the pushing phase feels like without any drugs on board, but I felt a lot. But it was mostly like the most intense down and out pressure that I could imagine or maybe not even imagine. And during my labor there were things that you had taught us about that were reassuring to me. One of the things was like the "ring of fire."
Lisa:
19:29
I never know if that's going to be encouraging for someone or terrifying for you.
Leah:
19:33
It was great because like they tell you "Keep going, you're almost there," and you're like, "Well, what does 'almost there' really mean?" But like you don't really have the wherewithal to be like asking that question and maybe they're not going to give you an honest answer anyways. But I knew that—from you—that when you felt this ring of fire that it meant that you really were almost there. Like maybe one or two pushes away. And I felt it and the OB was saying like, "You're, you know, one more, one more." But then I like was like, "Oh man. Like it's true. Like this is actually, it's real."
Lisa:
20:09
So you were feeling the ring of fire even with the epidural?
Leah:
20:11
Yeah. That's why I think my epidural was pretty light.
Lisa:
20:15
It sounds like it. And it sounds like you were also getting the urge to push. Yeah? It sounded like it.
Leah:
20:20
Oh my God. Yeah. Yeah, those, yeah.
:
20:23
Must have been really low because usually the epidural will kind of prevent those things from being felt.
Leah:
20:28
Yeah. I mean I had the epidural basal and I had a push. And then they like topped me off twice. But they, the OB specifically was like, if we can avoid topping you off, like giving me an extra dose.
Trevor:
20:41
Right towards the end...
Leah:
20:42
Like when we—yeah, when we think you're like an hour before pushing. Yeah. So that you can participate more.
Lisa:
20:49
I'm so glad to hear that because that's what I'm always, I always recommend people ask for, but usually most care providers don't encourage that, like proactively. So that's great.
Leah:
20:58
Yeah, she was great. Yeah. So I felt like a very intense urge to push, I felt every one of my contractions during pushing, I felt the ring of fire. I had a small tear, I felt her suturing me, and she was like, "We can get lido, but it's not in my tray. Like I have to get lido." And by the time the lido came, she had just sutured me. She just, every so often I like felt another,—we call it "taking a bite," like where you go in with the needle?
Trevor:
21:29
You should talk about the side, too.
Leah:
21:29
Yeah. So my, what I had read and learned and heard about and seen from being like rotating as a medical student on OB is that when you're having the pushing phase, you like contract for like 60 seconds-ish and then you have like a three to five minute break. My contractions were 60 to 90 seconds long with about a 60 second break.
Lisa:
21:57
Oh Wow. Wow.
Trevor:
22:02
They kind of got high...
Leah:
22:02
And stayed high. Yeah. So it was like pushing was like super intense and they did the, you know, like "count to 10 three times, push" sort of thing. But by the time they got to 10 three times I was not done. So I'd be like, "Can I have a fourth?" And then we do the fourth and then sometimes they'd like kind of ask me to rest, like for me and the baby. And sometimes I would be like, I didn't know if the sensation I was having was a contraction. And so I'd look to the nurse and be like, "Can I push again?" And she'd look at the monitor and like confirm that I was having a contraction. So that was crazy and not, I think—the nurse in a sweet way kind of had a surprised look on her face for a lot of it, because it was so close together, and she would be like, "Yeah, yeah, you're having another one!"
Lisa:
22:59
Wow. Yeah. That's hard with—you and the baby both need that time to recover. It sounds like it could have been challenging. And so it sounded like you were saying that at times they wanted you to kind of lay off exerting more to give both of you a break. Is that it?
Leah:
23:13
Only a little, and once the OB came in she kinda didn't really say that at all. She just like told me to go for it I think.
:
23:21
Yeah, because chances are then the baby's gonna come out sooner if you have more time pushing.
Leah:
23:25
Yeah. So I think my pushing phase was like 45 minutes, and at the end when they wanted to put me up in the stirrups and take off the bottom of the table, they—I had kind of for most of the whole experience, not been flat on my back. Like I had been on one side or the other, or even if I was a little bit on my back, like kind of wedge. And then whenever they wanted me to be like flat flat with my legs up and like all that pressure on my tailbone, I just refused. Like I couldn't do it. It was so painful, way more painful than the pushing. Pushing wasn't like pain. It was just like so intense pressure, and a little pain, but like getting, and I like looked at my OB and I was like, "I can't, I cannot, I can't, I cannot do this."
Lisa:
24:22
Good for you.
Leah:
24:22
And like in my head I was like, if they make me do this, they're going to have to knock me out. Like I cannot be flat. So she delivered me on my side. No stirrups, no, no bottom of the table off. And afterwards, she said that she doesn't really do that very much. but it all made sense based on what you had taught us about kind of your tailbone just being like totally in the way. And that that position is not natural for getting baby out. And my body was like screaming that at me. and
Trevor:
25:01
I feel like you were much more comfortable asserting that because of your class.
Leah:
25:05
Yeah, totally. Yeah. Because it didn't seem weird. It seemed like the variation that I was having. So yeah. So then he came out and he was great and that was good.
Lisa:
25:21
I'm assuming he came straight to your chest?
Leah:
25:24
They took him over to the little table thing for like a minute because he had like part of a membrane on his face when he came out. His first APGAR was an eight and then he was a nine and yeah. So I had him within a few minutes and he had the corniest conehead there ever was.
Lisa:
25:43
I hope you got a good picture.
Leah:
25:45
He looked like a Good N Plenty. Like he's so, like.
Lisa:
25:49
I love that description. How long did it take to go down?
Leah:
25:54
The next day.
Trevor:
25:56
Yeah, that was another thing. I was glad you'd prepared us for too because I don't, it was a weird looking kid for the first little bit there.
Speaker 4:
26:02
They are. Right. Not just your son. They're all funny looking.
Leah:
26:06
What else? Oh yeah, I was, maybe you can talk. I thought it was so cool that you actually were able to watch, like I didn't think you'd be able to do that.
Trevor:
26:18
Yeah. I didn't know if I was going to be able to meet either.
Leah:
26:19
Like able to—not allowed, like be able to, handle it.
Trevor:
26:22
Yeah, no. Yeah. So I get this vasovagal response, which is when I see blood or give blood or whatever or have blood drawn, I just pass out and it's uncomfortable. There's, I've tried loads of things and not, not much works. But yeah. So I did leave the room for when they were hooking you up to the IV and then, and then at the very, very end when they were clamping the cord and getting the rest of the placenta out and so forth. That I avoided looking at, too. But aside from that, I was there for the whole thing and it was, you know, not uncomfortable. There, it's just not a bloody process really, except for the very predictable part. So yeah, I was a little worried about that too.
Lisa:
27:11
As was my husband in both of our births because he has vasovagal syncope as well. And it runs in his family. I think I shared that with you in class, but just for listeners to know, I think that's so encouraging for you to share that most of it is really not bloody and it's amazing how much we can like in the moment, kind of like just make do and, and adjust, like not look at things if we need to not look at things, you know.
Trevor:
27:39
Yeah. You know, from your class we kinda knew what all, what it was gonna look like and what the steps are going to be and so forth. And so I was just prepared for when it was going to be bloody and when it wasn't. And yeah, I was able to focus my attention where it needed to be.
Leah:
27:50
Yeah. And then we also can, we made a list of the things that Trev was supposed to be in charge of asking about. So you like asked about successfully—like asked about, and then they did delayed cord clamping and asked about and then they, not you, but they showed me the placenta and delayed his bath and I, I kind of felt like, "How are we ever going to be able to ask these things?" Like, it's going to be like so much going on and not...but, like there actually isn't that much going on. There's kind of like one thing going on. So it felt fine to ask those questions.
Trevor:
28:29
Having a list was really helpful though.
Leah:
28:30
Yeah. Yeah. And a lot of our other questions we had gotten out of the way in the office. So like they, you had taught us about cord traction and they were like, "No one in our group does cord traction. Like it's against our practice." So we were like, okay, we don't even have to worry about that.
Lisa:
28:46
Good. I am thrilled to hear that. That's great.
Leah:
28:48
Yeah. Yeah. Yeah. Birth felt super intense and like quite, I would say, especially the pushing phase—because it was so intense—just felt like very, very empowering because there were moments, there was like a specific moment when I was like, "I don't know if I can do this. Like I, this is so hard."
Trevor:
29:16
That was about three minutes at the very end.
Leah:
29:18
Yeah, yeah.
Lisa:
29:20
You mean the end of pushing or the end of first stage transition?
:
29:24
End of pushing.
Lisa:
29:25
Ah, okay.
Leah:
29:26
And I was like so tired and—but between like you and, and Dr Shlansky, like—Oh one other, just being like so present and feeling like I could trust what you guys were saying. Like I, it helped me, like get through it, I think, with other people there. Like, without those very specific voices, like saying the things that I needed to hear. The other thing that was really cool is so, you know, they like teach you or not, I don't know who "they" is. There's this idea of like closed glottis and like quiet and like pushing and that helps you bear down and all this stuff. So I was doing that, but I am not an actually like quiet person. Like I'm, I vocalize like if I stub my toe I scream, and Trev just knows I'm fine cause I just am loud.
Lisa:
30:24
That's your coping.
Leah:
30:24
Yeah. But when Dr Shlansky came in, I guess at one point I was screaming or vocalizing whatever and she was like, "Oh, do that. That makes it even better". She told me to like scream and I think I was really loud.
Trevor:
30:42
You were. There's nothing wrong with that. Yeah.
Leah:
30:45
And she, and like part of me kind of knew that that was better for me. But I think there's a sense, even though I am so comfortable in the hospital like that one thing, like I don't want to be the person on the unit that everybody can hear. But when she told me to like, I was like, "Yeah, like, okay."
Lisa:
31:03
Oh I love to hear that. I'm loving these care providers. This doctor in particular. And I just want to point out as you're saying that, that recently in the last a couple of years, ACOG, American Congress of Obstetricians and Gynecologists put out a new report on approaches to limiting interventions saying, you know, not only did they issue a report on bringing down c-section rates, but then they issued a further more detailed report on just bringing down interventions of all kinds. And one of those things that they focused on was no, women shouldn't always have to push the way that the nurses are—the directed pushing, the Valsalva maneuver. But they should push however they feel is instinctive because that's going to look and be a different way from one woman to the next. And so I love that your doctor was so supportive of doing the thing that felt most instinctive for you for effective pushing. That's really great.
Leah:
31:57
Yeah, I think like her being okay with like the fact that my pushes were longer, and screaming, and not being on my back, like all of those things. She was just like right there with us. We love her.
Lisa:
32:13
Clearly. That's fantastic. And Trevor, any thoughts that you have on what it was like to go through labor with Leah and you know, as the partner?
Trevor:
32:24
it was very intense, but it didn't feel like something I was unprepared for, really at all. There's not much to do really, but just be there, you know, be a hand to hold onto and so forth. But yeah, it, I'm glad I was prepared for it and yeah. There's not too much to say. I don't, I don't know what I would've done differently.
Leah:
32:46
Yeah. I think you said Trev said that a few times. He's like, "I don't know how, I don't know what we could have or would have wanted to have done differently." You said that a few times, like during the process. Yeah. Yeah.
Trevor:
33:00
I think we were just, I was prepared to do whatever was necessary and there just didn't seem like there was that much that was—which is a good thing. There was not so much to do. Yeah, so I was just there and you know, squeezing when you needed squeezing. That's kind of it. So...
Lisa:
33:16
And you seem very laid back and I, it seems like you would be a calming presence.
Trevor:
33:22
Yeah, we even out. We even each other out pretty good. She's, she's the screamer and I'm the, I'm the laid back one.
Lisa:
33:29
Same dynamic in my relationship, in my marriage. And I love that—something you shared before we hit "record" was a, you do want to share that about just how it wasn't quite as frantic as you...
Trevor:
33:40
Oh, sure. Yeah. I think the impression you have going in is that it's going to be this wild, unpredictable thing, but we knew, I think we were prepared, we knew about when to get in the car and go, I think that was timed about right. I think generally the impression is "Great, have a contraction, get in the car." So that's—from your class you told us, that's just not the right thing because they'll send you home and, and also you're more comfortable...
Leah:
34:09
Not in the car.
Trevor:
34:10
Not in the car. So we're, you know, for several hours we were sitting here eating pizza. You were watching Netflix on the kneeling chair. And that was certainly more comfortable than having to do that same thing in the triage department, you know? Yeah. So we stayed home about as long as we could have, I think, you know, you started to get really uncomfortable. That's when we went in. And then yeah, it was sorta just a measured process where, you know, we, we decided to, you decided to get the epidural, which I think was absolutely right thing to do. We decided to get the pit when you decided to get the pit and, yep. It was super intense for you I think you could say, but it was all pretty predictable. You know, we got in the car, we parked the car, we got the everybody into the hospital. We—there's long periods of waiting for sure. The, the, contraction monitor setup is, is kind of interesting.
Leah:
35:09
Yeah, that kind of sucked.
Trevor:
35:09
It's an interesting thing. There is, I didn't know how much to trust it, I guess. So you, you're watching this thing and it kind of spikes, it plateaus and it goes back down. And I didn't know if that's, you were feeling that exactly or not so that, that was something interesting to watch. But yeah, the, the whole process was—it just came and it went, you know, there was, there was no panic involved—not on my end anyway. So I think that's encouraging.
Lisa:
35:38
Yeah, I think it is. Thanks for sharing that. What about after birth? Wanna share anything about postpartum? Initial breastfeeding and all that?
Trevor:
35:47
Yeah. I'd like to say something about while we were still in the hospital: we decided to not do a circumcision and that's something I feel pretty strongly about. I feel like it's, it's not our decision to make actually, that's something for him to decide when he, when that's something that's interesting to him. I sort of likened it to if it was culturally normal to cut off one of their toes or something, would you do that too? And no, that's, that's, that's just not, that's not for you. That's, that's something I feel strongly about. But I wanted to say that.
Lisa:
36:20
I'm so glad you're saying. I'm sorry, go ahead.
Leah:
36:22
No, go ahead.
Lisa:
36:23
I was just gonna mention that I will in the show notes, I'm going to link to a great podcast that just came out from Evidence Based Birth on the topic of circumcision. And she goes into a lot of the human rights aspect of it, exactly what you were just talking about and the history of it. It is really interesting and a little disturbing to know about. So it's a really, really informative podcast that I'll, I'll be sure to link to. Thanks for bringing that up.
Leah:
36:49
Yeah. And I will say that we were—felt very supported about that decision. Like I think yeah, the, the response that we—because we got asked like multiple times, like not asking like to make sure, just like asking because they were checking off their boxes and their responses were either neutral or very positive. Like "Yeah. Good. Don't do that." Like they
Trevor:
37:12
Yeah, we even got a high five at one point.
Leah:
37:14
Yeah. I think that was also from one of the OBs in our group. Yeah.
Lisa:
37:19
And, and yeah, families who are choosing to not circumcise is on the rise for sure. I think it's up to about 40%, last I heard, families who aren't. So yeah.
Leah:
37:30
So I have a lot of opinions about breastfeeding and breastfeeding culture and breastfeeding support and I am more like—now these feelings that I have about all of this is more like existential. In the first few days I was quite angry, I think is the best way to say it. So, so I will say that I am successfully, exclusively breastfeeding and happy about it and it has a lot of worry and anxiety associated with it because there's just so much that's new and changing, and he changes and I change, you know, there's so many variations and it's—so much is on a spectrum, but we're doing great. But, so, in the hospital I didn't know—because I didn't know what I didn't know. I didn't know how little breastfeeding support I actually got. And...
Lisa:
38:33
Does Mount Sinai East have an IBCLC available right now?
Leah:
38:39
They had an LC that came in, but I don't. I don't know if she was an IBCLC. I'm not sure. Based on what she said. I don't think she was.
Lisa:
38:53
Okay. Yeah, cause of course that could make a big difference. It's been several years ago that I worked there as a doula, but I know there was an IBCLC but that wasn't super recent so I wasn't sure. And it might depend on the time of day and the day of the week.
Leah:
39:07
Yeah, she did say to me that she—I asked her something about the haakaa, which is like for people who don't know, it's like, a way to hand express or to gather milk if you like, have let down, aggressive let down so you don't like lose it into an a nursing pad or something. But I asked her something about the haakaa and she didn't know what it was.
Lisa:
39:26
What?
Leah:
39:26
Exactly.
Lisa:
39:28
That's all the rage right now.
Leah:
39:29
Right. So that like lets you know a little bit about her, where she was. Anyways, basically she saw him successfully latch, but that was on barely day two of life, like day one and a half of life. And she saw him do that twice and we left the hospital. And then on.
Trevor:
39:49
We were in the hospital for about as little time as you're even really allowed to be.
Leah:
39:51
Yeah, because I delivered Wednesday pm and we left Friday morning.
Trevor:
39:56
Yeah, so we got into the, I don't know what you call it ,
Leah:
40:01
Oh, like the room that you go to after you deliver at like midnight.
Trevor:
40:06
Yeah, we got there at 11 o'clock at night and they count—you've got two midnights. So we were there then out.
Leah:
40:12
And we were happy to be out, like in general, but when my milk came in on day four, which is very normal for it to come in around there, that was a Saturday evening. My milk came in so hard that my breasts were like extremely engorged, super painful, and he couldn't latch or nurse and I had no idea what to do. And I ended up hand expressing in the middle of the night, Saturday to Sunday. I gave that to him in a bottle. I felt horrible because there's all this stuff about like "Don't give bottles, nipple confusion and blah, blah, blah." The next day I still couldn't latch. And so we gave him a little formula and then we were worried that he was becoming dehydrated. He was like a little—"listless" seems too strong of a word—like a little bit sleepier and was a little yellow. This was a Sunday. We called the on-call pediatrician for our group who is not Dr Resnick, who is not anyone in Dr Resnick's office, they call-share. And the person who I got on the phone was like, "Well, just pump." And I was like, "I don't know how to pump." And she was like, "It's not hard. Just look it up on Youtube." So not very compassionate.
Trevor:
41:30
I think part of the thing was there was very much this "breast is best" business. Which is great, but ultimately "fed is best" is more—you've gotta, "breast s best," but just, you know, you gotta get stuff into them.
Leah:
41:49
So then that afternoon, my sister in law came and helped me and I pumped and did manual expression and hot water bottles and shower and all this stuff. And then we saw the pediatrician the next day and he was doing better and now he's great. He like regained his birth weight and plus some and he eats great and all this stuff. But I just felt like now in hindsight and talking to my friends, all of the problems that I had were extremely predictable, super, super common. And there's this like intense pressure and idea and culture to breastfeed without the support. And it made me so, so angry. Like so angry. I booked a ICBLC appointment on Saturday when all this was happening, but the next available was Wednesday, which in baby time is forever. And you know when we went to the pediatrician on Monday, he was like, "Well, didn't the hospital give you an on-call number?" No. Like "Didn't he, didn't they tell you about Boober which is some like app to get a consultant like within a day?" No. And so I just felt like basically my only resources were friends and family and I have friends and family and like I'm educated and have—my closest friends and family breastfed. But that's not common. Like, and I was like, God, this could've gone so differently. Like this could have been such a different experience with just like a little bit of tweaking, like having some anticipatory guidance in the hospital, which is so—for all aspects of healthcare, like, putting my doctor hat on, like, anticipatory guidance is so, so important. Like it prevents things that hospitals and doctors and care teams really care about, like readmission and complication and satisfaction rates and all this stuff. And I just felt like I didn't get any of that. and there are now, everything that I did to fix those issues seems very intuitive. But before you know it, it is not intuitive.
:
44:12
Oh, absolutely. Yeah.
:
44:14
And when we saw Dr Resnick, he was like, "Well, if you can hold onto that passion for like six months when you actually have some time," he was like, "Do something about it." He was like, "You work in that hospital, you work in the hospital." We are also thinking of maybe telling our OB about it because like they deliver there, like, they want their patients to be satisfied. Yeah. So that was really, I don't know. Still, it's, I think it's so upsetting. But now he's doing great and breastfeeding is tiring. But like I think it's so cool. Like his fingernails grow really fast and we've cut his fingernails like three or four times already. And like thinking like these fingernails are made of my breast milk. Like yeah. Like it's not just his poop and his pee, but like the stuff on his body ,like we see it growing in front of us. It's really cool. Yeah.
Trevor:
45:08
We had some trouble figuring out the right size diapers.
Leah:
45:12
Yeah. We tried to get these fancy diapers, they were too big. And then we got like less fancy diapers. Fancy meaning like organic chichi fru fru. Then we got like slightly less fancy organic diapers and he was still poop-shooting out the side of them. Then we got Pampers Swaddlers and they haven't leaked once.
Lisa:
45:33
That's what was perfect for my first born, but didn't work for my second, which was odd. But yeah, so if you have another baby in the future, it might be a different brand that works.
Leah:
45:43
Yeah. So we'll see. Yeah. But now things are, you know, I have a healthy dose—not healthy—I have a good dose of anxiety, probably not healthy, but it kind of comes and goes throughout the day. And I think I understand like what "mom worry" is now, which is like a different type of worry that is like—might make me cry—that's very like deep and, and more real than other worry that I've ever felt. But now because I do have really great resources around me, like friends, family, but also professionals, like—I have these worries, I email the LC that I saw, what's her name? Kate. Kate Ruck. Yes. Yeah. She's amazing. Love her. Also from you. Thank you. I email her and she responds and is like super supportive and great and like science-based but in a very warm way. But I feel like now we really do have like a community around us to give us the support that we need, like professional and friend and family wise. But it is a steep learning curve,
Lisa:
47:08
isn't it? Yeah, man. Those first three months are the steepest. It's temporary. It does get easier. But it also, you know, you're happy that they're not as tiny and needing everything all around the clock eventually. But then you're also like, oh but I miss the little cuddly tiny... you know, it's this mixed thing.
Leah:
47:29
Yeah he is super cuddly and quirky. He maybe he's like me. He, we call him Peeper because he's always like making constantly making sounds like peeps and squawks and squirks and he—almost all day today, every time I nursed him he's been like cooing to himself like through the whole nurse. He's like, hmm-hmm.
Lisa:
47:55
I love those little sounds. So fun. Has he found his voice yet? Did his cry change or...
Leah:
47:59
Yeah it's stronger now. Yeah. It's like a real cry. But he, other than like crying when he's pooping, like to push the poop out—those ones sometimes are like a little hard for him to get over—he doesn't really cry for no reason. And even then that's a reason. Yeah, he's like a really sweet baby and has so many facial expressions and we have some like toy things that are black and white, like have that contrast and like seeing him look at those is really cool because he doesn't really like truly look at anything else really. But yeah, he kind of holds attention at these black and white geometric things and there's ones that they're like cartoonish but they're a little bit more like faces like they like it's like a panda bear face or something and like he really likes those ones, which I think is really cool. Like because they have contrasts where the eyes should be and like maybe the shape of a head, I don't know, but maybe I'm anthropomorphizing. Yeah. But it's, it's cool. He, it's cool to see his little kind of patterns throughout the day. Like how he sees his day going.
Trevor:
49:20
Yeah, he's great. He really is perfect. I am looking forward to him being a bit more interactive. I think I'm going to really dig in parent-wise once I, I'm getting more feedback.
Lisa:
49:37
Sure, kind of in a fetus-like state at the moment.
Trevor:
49:38
Fourth trimester is a real thing, for sure.
Lisa:
49:44
Well I just always like to open it up for any tips or advice or wisdom—last kind of parting things you'd like to share with expectant parents who might be listening?
Leah:
49:55
I think one thing that you really helped me realize but I think maybe I didn't truly realize it until I was in labor was that like I—you really, really should trust your body and like the sensations that you're having even if they aren't classically what you thought they would be, like, they are real and they, they do represent something, and having the confidence to like believe in that. Because many of the things that I experienced, mostly beginning of labor and pushing were not how I had imagined they would be based on like, I dunno other people's experiences and movies maybe. But that kind of like trust in my own body I think is really, really important. And then I think one other thing is that like I think there's this idea that it's a good thing to be very like cool and go with the flow, which I agree, like it is good to be kind of a relaxed go-with-the-flow sort of person and I, but I think that might lead some people to not want to prepare or plan. And I'm really glad that we've prepared and planned. Like I'm really glad that we took your class, that we took notes during your class, that we wrote to-do lists, that—because it allowed us to go with the flow when it actually mattered. Like, you know, I packed my hospital bag while I was in labor. I was okay doing that because I felt like my mind was fairly at ease. Like I was like "I can pack a bag. Like I don't have like a thousand things going on in my head" and, but I think people do get caught up in this idea of like, "Oh, like whatever happens happens. Like we don't need to read or prepare," but like it's actually quite freeing to be prepared. I dunno. Do you know what I mean?
Trevor:
52:00
I think that's great. Yeah. I think another thing that's surprised me a little bit is we got him home and we've had him—been home two and a half weeks and we were out with him every other day, maybe something. So we've got him in the bassinet taking him to the park and we've been to restaurants and so forth. So that's, I think if I had known that going in, I would have been a little less—like I was pretty worried about the first couple of weeks that we'd be really sort of shut in and so forth, but that just hasn't been the case. We, you know, we've been, we've been out with him, we've had a bunch of people come over, so it's been really, really not bad at all.
Lisa:
52:35
Yeah, that's great. And it sounds like you've been intentional with getting out because I think for some people, for me, even, that I guess maybe I should have been more intentional and my husband did have me like go outside but I feel like we—maybe it would have been healthy and helpful to get out a little bit more than we did in those first few weeks. So that's, you know, in a gentle way, being gentle with your body of course. But that's great that, I love that you felt like you had a little more normalcy than you expected, it sounds like.
Leah:
53:03
Yeah, and I think Travis has helped like push me, not push, like guide me back to that. Like this morning it was a beautiful morning and either he or I was going to walk the dog and like I was thinking I would just like go back to sleep for 15 minutes and he was like, "Are you sure you don't want to walk the dog?" And like I went and walked the dog and I'm so glad I did. Like it was really restorative for me and I just this morning actually like was writing a list of like things that I want to do throughout my day that I know help restore me and like, well I want to be more intentional about it because like I know I know how to make myself feel better, more uplifted, more like myself, and I think I have the bandwidth now to like incorporate that in a more intentional way, and like I'm excited to do that. Like simple things, simple things like having a smoothie instead of in the morning instead of, you know, something less healthy and refreshing and I don't know, like these small things that I think I have the bandwidth to kind of put back in. Yeah,
Lisa:
54:18
I think that's beautiful because the small things really do make a difference. Awesome. Thank you so much. This has been a great discussion. I'm so happy to hear all these great details and I'm so happy that it went well. Yeah. That you had a positive empowering birth experience. So I hope to see you at the next reunion. I actually think I am about to spread the word about a September one, so maybe before it gets too cold, we'll, I'll try to have another one in Astoria Park, so hope to see you there and meet your little one. And maybe your dog too. Yeah,
Leah:
54:49
Yeah, Huckleberry will come. He's very baby friendly.
Lisa:
54:53
Alright, well thanks so much. Talk to you soon.
Leah:
54:54
Ok, bye.
Lisa:
54:57
So there you have it. Leah and Trevor's story. Just to reiterate, if you hear hospital personnel saying "Time for some pit," they're talking about synthetic oxytocin called pitocin here in the US. It's the most popular drug in labor and delivery units and is used both to start labor for induction as well as used lots for speeding up a labor that's deemed to not be progressing at the rate your care provider or hospital would like. When Leah was talking about the epidural and mentioned having a push, she's referring to the PCA or patient-controlled analgesia button, which means you can give yourself an extra dose of pain medications. A lot of folks like having the PCA button because it gives a sense of control or agency. Also when Leah shared her experiences with early breastfeeding in the hospital. I wanted to just clarify a couple of things.
Lisa:
55:50
First, there are different certifications of breastfeeding professionals, also called lactation consultants. The IBCLC that I mentioned stands for International Board Certified Lactation Consultant and is the top expert in breastfeeding—much more so than any other lactation certification or a pediatrician. If you listen to episode six I gave an example of special expertise an IBCLC has that most clinicians do not. Many birth or postpartum doulas have a different certification such as a CLC, BLC, or LC, which are all nonclinical, but instead more educational roles. For uncomplicated breastfeeding issues, the lower certified professionals can often be helpful, but I usually recommend that if someone hires one of the lower certified professionals, it's someone who has a good deal of experience under their belt. Otherwise, I recommend hiring an IBCLC, as that's going to be the most reliable information in most circumstances. For those local to New York, please note I have listed plenty of recommended IBCLCs on my website at birthmattersnyc.com/breastfeeding.
Lisa:
57:00
The second thing I wanted to point out is that the lack of anticipatory guidance in the hospital in which Leah gave birth is unfortunately not unique to her hospital. This is something I hear all the time from students and is a reason why in class I focus a lot on providing resources for support for once parents are home on their own after birth, and for when their milk comes in, which is a very common time to need support in new ways. So that wraps it up for today. Please be sure to share this podcast with a friend or on social media. You can find us everywhere @birthmattersnyc. Listen up for what we have coming up next week.
Lisa:
57:41
I think one of my favorite memories of that whole experience was we're in a private room, our doula leaves and we're in the room and it's dark and she's in a little bassinet next to our bed. Rick is like sleeping on this pullout couch and we're whispering to each other like we're in sleepaway camp and talking to each other about like the best parts of the whole night we're like, "And then this!" and like, "We should really go to sleep because she is gonna wake up." and like 'You know what was awesome?" And like we felt like two little kids and then we'd like both look and we're like, "There's a baby over there. Like this is amazing." ---END---