Birth Matters Podcast, Ep 94 - When Prep & Advocacy Pay Off

New parents with baby in stroller, in front of a beach.

Millennials & die-hard Queens natives Suzanne & Edgar share the many smart things they did to prepare for the journey into parenthood and in hopes of having a healthy pregnancy & unmedicated birth: pre-conception couples therapy, going back on mental health meds in the journey to conceive, physical prep with exercise including yoga, nutritional support, chiropractic, acupuncture, meditation & mindfulness practices, hiring a doula, carefully choosing care provider, taking birth class, attending lactation support meetings during pregnancy, books, and more. Their birth story starts with being told they need an immediate induction due to low fluid. They decide to buy a bit of time by going to Suzanne’s “lucky diner” for a good meal beforehand, and her labor starts spontaneously. Suzanne experiences a faster-than-average 1st stage of labor but longer-than-average pushing stage. When the doctor says a cesarean might be needed after 3 hours of pushing, Suzanne is determined to give birth vaginally. Going into parenthood, she experiences some breastfeeding challenges that hit her mental health and shares about the hard decisions she had to make along the way. This story powerfully demonstrates how strong self-advocacy is often a gamechanger in many hospitals to have a physiologic birth and avoid unnecessary interventions. It also highlights how important supporting our mental health is in the journey into parenthood - directly from a parent who works in the mental health field.

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Episode Topics:

  • Anxiety surrounding trying to conceive at 39, no problems after getting back on mental health meds

  • Mental health and medication – concerns about being on or being off

  • Couples therapy pre-conception

  • Coming to doula collective, hiring doula Chana

  • Staying active in pregnancy

  • Meditation and mindfulness in pregnancy and labor

  • Going to La Leche League meetings prenatally

  • Coming to birth class

  • Consulted with a reproductive psychiatrist to reassure her staying on meds was safe

  • Challenges finding a care provider, settling on a provider in Garden City

  • Chiropractic & Acupuncture, prenatal yoga

  • Went to 41 weeks before provider wanted to induce, wanted to do membrane sweep

  • They say no to sweep, go in for next prenatal and amniotic fluid is low, they want to induce tonight

  • They consult with Chana on induction, they realize this isn’t an emergency

  • Go eat at her “lucky” diner for a meal, she has eggplant parmigiana

  • Going to the hospital and being told they have to wait

  • While waiting, her labor spontaneously starts. Pressure from hospital to stay

  • Getting a resident who didn’t like questions

  • Took ~1 hr to get into a room

  • Got a nurse at first who was overly strict with positions

  • Gave her a limit of 3 hrs to push before cesarean, coming up on that 

  • 4 hrs of 1st stage before pushing

  • Pushing sped up once she got a nurse who let her squat

  • Augmented with a bit of pitocin in late 1st stage

  • Asked for wireless monitoring but the nurses weren’t willing

  • Edgar sees his head come out, OB wants to use vacuum but they advocate to not

  • They strongly feel that advocating and prenatal prep made all the difference in the world in having a vaginal birth

  • Troubles latching, feeding colostrum with syringe

  • About a month in, not having enough diapers, baby losing weight, having mastitis & plugged ducts

  • 7 lactation consultant visits, some in person, some virtual

  • Identified tongue tie

  • Breastfeeding hit her mental health in a major way, so she made the difficult decision to stop

  • Gradually wean from combo feeding to formula feeding to prioritized

  • Make the best choice for you and your family re: feeding baby

  • Breastfeeding is not free, fed is best

  • Final thoughts (Suzanne): choice of care provider really important, prenatal prep, speak up and have support, mental health prioritization

  • Final thoughts (Edgar): build a team that you trust, find community of peers, partners also need friendship/community, be open-minded to different approaches and trust your intuition, take whatever time off that you can. 

  • Both: It takes a village!

Interview Transcript

Lisa: Welcome to the Birth Matters Podcast.  Hi, Suzanne and Edgar. How are you today? 

Suzanne: Hi, we're doing well. Thank you so much for having us today. 

Edgar: Yeah. Happy to be here. 

Lisa: And we have baby Omar here, so sweet. I know listeners can't see him, but he's so precious, so precious. We might hear little baby noises in the background.

 So could you please take a moment to introduce yourselves? Just share whatever you'd like to share, maybe where you live and how long you've been parents and just any of that good stuff. 

Suzanne: Yeah, sure. I'm Suzanne. I gave birth on April 29th, so at this point, it's almost 12 weeks. Omar will be 12 weeks on Friday, a couple days from now. So almost three months. We both live in Forest Hills, Queens. We're both natives to Queens, and so we're very proud to be raising our family here. I have a very exciting career in Public Health and Education. I work in the field of Public Mental Health at the New York City Department of Health and Mental Hygiene.

And I'm also an adjunct professor of psychology at John Jay College. My work is really important to me and, you know, really excited to just be here today and share a little bit more about our story. 

Edgar: Yeah. My name's Edgar, Suzanne's husband, and I'm also from Queens, like she mentioned before.

I also work for the City Government. I work in the Department of Education and I'm really excited to share about our birth story. Another feature I think that's important to note is. We're both millennials. I think that's really an important aspect of this journey for the story.

Lisa: I love it. Great. Thank you for introducing yourselves. 

The Pregnancy

So can you please share with us a little bit about the pregnancy, just anything you'd like to share, and that can even include trying to conceive, just anything about the pregnancy journey and how you prepared for the journey into parenthood.

Suzanne: Yeah, sure. I'm a little bit of an older parent, I was 39 at the time that we were trying to conceive. AndI personally felt that there was a lot of pressure just around my age and a lot of concern around that. And we were very fortunate that we had very little trouble conceiving. It really, it just took us about two or three months to conceive, and we were very lucky on that portion of the journey. 

Mental Health Concerns

I also think a large part of my concerns about the pregnancy journey was around mental health. So I, personally, have a mental health diagnosis, and have been taking medication for that diagnosis for several years.

And I always had a concern about staying on the medication during the course of the pregnancy. So I had initially actually gotten off of the medication when we were trying to conceive, which turned out to be the wrong choice. I felt as soon as I stopped taking the medication, I became more and more stressed about conceiving and concerned about conceiving and that was making it actually a little bit harder for us.

So just, you know, I stayed off the medication for about a month or so. When I went back on it, we got pregnant almost immediately. And so I do think that there was, I just think the power of the mind and the body connection, I think is really important here. Like, as soon as I was able to get into a more relaxed state, my anxiety was lower, I really felt a little bit more focused and grounded, and that really helped us on our conception journey.

And so I, of course, was monitored over the course of the pregnancy, and we can talk more about that, because again, that was a big concern that the medication would negatively affect Omar, which it did not.

Suzanne: So getting back on the medication was really key to having a successful conception and then also a successful pregnancy as well. Did you want to add anything about the initial portion? 

Couples Therapy

Edgar: Yeah. I mean, you could even argue it goes back to a year before we even started conceiving. We actually went into couples therapy, to even talk about the decision, because as millennials, I think we understandably we have a lot of real concerns about the supports and systems in place to help us be successful parents.

And even getting to that point of saying, yes, we're going to try to conceive, that was a journey in itself. So, couples therapy really helped us clarify what we wanted and get us on the same page. But yeah, definitely, As like someone with the firsthand experience of seeing like that shift in Suzanne's emotional and mental state, I fully support the decision to go back on the medication. That was a really big game changer.

Suzanne: Yeah. And I agree with Edgar, just about the speaking to the couple's therapist, just about determining whether we wanted to have children. You know, I do think as millennials, we face a lot of challenges around the cost of childcare, kind of lack of some of the supports to raise a family successfully in this country.

We are fortunate in that both of our jobs offered paid family leave. And we had longevity at our jobs, and so we had additional vacation time and sick time that we could use for our parental leave. But we recognized that not everyone has that, has access to all that leave time.

So we really needed to think through the finances, the logistics, the leave time and all of that. And that was really good to talk about that in couples therapy. So that was one of the most valuable aspects I think, of this journey. Just really openly talking about that in the therapeutic environment.

Lisa: Thank you so much for sharing that. I think in this season of the podcast, one other couple talked about how valuable couple's therapy was. I don't think it was preconception, although I'm having trouble remembering exactly when it was. But I really appreciate you bringing that up because I think too few people, it doesn't occur to enough people, and I think that's such a wise step to really mindfully, thoughtfully prepare and protect your relationship in the process of these big life-changing decisions, you know? That was one thought. So thank you for sharing that. And then also interestingly, I don't know if you listened to the podcast at all, but just a couple weeks ago, or was it just last week?

Your doula aired her birth story, her first baby's birth story. And we're going to record her second and third soon, but she shared also a similar theme about how getting off of her mental health meds was not the right choice in pregnancy specifically. And now her advice to any of her clients would be stay on them in most cases . So, that's another kind of interesting likeness there, theme maybe, that I just wanted to kind of highlight. So thanks for sharing both of those things. All right. Continue. 

Stigma Around Couples Therapy

Suzanne: Yeah, and I just wanted to say, you know, I think there's a lot of stigma around going to couples therapy, like, oh, there must be something wrong in the relationship.

And we were in a quite healthy place in our relationship. Like, we just wanted to explore this topic in a structured environment with support. I completely support anyone who wants to proactively go to therapy just to explore those themes and, you know, it's a major life decision, so yeah.

Lisa: Yeah, how wise is that? Because too many people wait until there is a crisis and then often, it's like too late in many cases. So yay, again, I commend you for that, that's so fantastic. 

Suzanne: Yeah, absolutely. Yeah. 

The Story of Conception

I feel we did a lot of preparation in advance, you know, a lot of education, a lot of just kind of getting a lot of support around the pregnancy process. So of course, we started by coming to your doula collective meet and greet. 

Suzanne: I was very passionate about getting a doula for our journey. I wanted to be supported mentally, physically, you know, in all these different ways throughout the course of our pregnancy. 

Meeting Their Doula

Mother holding her newborn, alongside her doula. Both are smiling, with masks on.

So we came to your meet and greet and we met Chana Diamond, who is a fantastic asset, and she's just been, she's been so instrumental in our entire journey, both while I was pregnant, and then once I gave birth and even after, I've reached out to her. So I can't say enough good things about Chana, she's like almost like a family member to us now. We met many of your doulas and we really felt that Chana was a great match for us, particularly because she had that mental health background as a therapist.

So that was like a key part of our journey to make sure that we had a doula in place who we could work with. And I really was aiming for an unmedicated birth, and I will get to the story of how that unfolded, and she really absolutely helped us make that happen. 

Prenatal Fitness Pursuits

I think some other preparations we did, I personally, even before I was pregnant, I was very physically active.

I've run marathons and triathlons and that's like a very big part of my lifestyle, and I continued that during the course of the pregnancy. There's always like this kind of notion like maybe the pregnant woman shouldn't be as active or physically can't do as much when they're pregnant. I felt great my whole pregnancy, I ran the first and second trimesters and then I switched over to Peloton and yoga for almost the whole pregnancy. I felt really great the whole time. And I also did a lot of meditation, mindfulness, which helped me during the course of the pregnancy and then during the labor and delivery as well.

So there was this kind of just like holistic, I was really trying to take care of my physical and mental health during the course of the pregnancy. Did a lot around that. And then also I was very invested in learning about breastfeeding, so I would go to La Leche meetings and I read La Leche's book The Womanly Art of Breastfeeding.

Suzanne: So I was doing a lot of prep around that and identifying a lactation consultant, that we would work with postpartum, and also coming to your birth class. 

So there was a lot that we had done by way of preparation and making sure that we stayed physically and mentally well.

Did you want to add anything about that? 

Lack of Good Research on Medication During Pregnancy

Edgar: Yeah, Definitely all those supports were helpful. So I remember you also consulted with a researcher who specializes in like, what is it? Pregnancy and medications. Oh, yes. That was a big help, because that's another huge gap, in good data related to that. Which is, I think, why the lack of data and a lot of people have a lot of concerns related to taking medications throughout their pregnancy, because the data's just like really not there. 

Suzanne: Yeah. That was, thanks for raising that Edgar, because that was one of my top concerns. Just again, as I mentioned before, like I was really worried about taking medication, I had seen studies that it causes autism and ADHD and all these different diagnoses. And I'm a trained researcher, so I knew that some of the studies were not of the best quality. So I did, as Edgar mentioned, I did consult with a reproductive psychiatrist. And fortunately, we had the means to pay out of pocket for it because it wasn't fully covered by insurance, but we just needed that peace of mind. And she fully assured me that this was fine to take during pregnancy.

She noted the quality of a lot of the studies, that there are not a lot of randomized controlled trials around medication, and so it's correlation studies. So, some of the studies showing that there are negative outcomes with medication, like the pregnant person may have been taking multiple medications. So it's not possible to know which one led to that outcome. And so, once we had that appointment with the reproductive psychiatrist, my mind really got put at ease that this was the right choice for us, that, you know, our baby would be okay, and that this was the right thing for us to do. 

Suzanne: And I think that was evidenced by like, I felt great my entire pregnancy, and I really do attribute a part of that to the medication, for sure. 

Lisa: So great. You did all the things that we doulas and childbirth educators recommend for wellness in your pregnancy. And I just think that's so beautiful and I'm thankful that you had the resources and the awareness to make that possible.

La Leche League

One thing that popped out at me was most people don't even think to go to a La Leche League meeting prenatally. I always encourage people to in class, but do you remember like how early that was or what caused you to seek that out prenatally? 

Suzanne: Yeah, I think it was about five months or so, I was in my second trimester, I think. It was pretty early on. I went to quite a number of the meetings that were monthly. And I didn't really know much about them, but one of my friends lives in the neighborhood and mentioned, oh, you know, if you're planning to breastfeed, there is a La Leche meeting in Forest Hills that meets once a month. And I connected with the leader and was able to join those meetings. 

I was pretty dedicated to doing that every month and asking questions and they were very welcoming to pregnant people as well. You know, it was really nice, so 

Lisa: Nice. And was that virtual?

Suzanne: It was virtual. Yeah. 

I think all, as far as I know, even now we're recording this in July of 2022 and I think that they're all virtual still, but it makes it convenient, especially when you have a new baby and it's hard to get out of the house, you know. Great. 

Lisa: Well, anything else you want to share about pregnancy? 

Finding an Aligned Care Provider

Suzanne: One thing that was really important to me was the choice of care provider. 

That was a tough decision for us. So we had just moved to Forest Hills, just a few months before we started to try to conceive. And we had done extensive research trying to find a provider in this neighborhood and we narrowed it down to two.

One of them, it was a pretty robust practice, but there was a 90 minute wait when we went for the appointment. And then we found out that they would not accept our insurance if we got pregnant. So there would be like a $5,000 fee if I became pregnant because of the low reimbursement rate at our insurance. And so we ruled that one out. 

Suzanne: And then there was a second provider who was very close to our apartment, but the provider felt very interventionist, even before we got pregnant, they were already trying to push us on a track towards IUI I think it was, yeah, I think it was IUI. Like they were trying to, it was just like, we had only been trying for two months and they already wanted to push us down that road. 

Lisa: What on earth? Yeah, that's such a short period of time. 

Suzanne: They wanted me to get my tubes checked, which was a painful process. And I pushed back and I asked, why do I need to do this? We've only been trying for two months, and like, my test results had come back fine, like looking at AMH levels and things like that. Nothing indicated that I would have trouble conceiving aside from my age. And they were trying to send Edgar to get some tests as well.

 I thought I wanted this provider because of the proximity to home, and also that the baby would be delivered at New York Presbyterian Queens, which was important to us because we're both Queens natives, and we really wanted to continue that legacy.

Suzanne: And so I was trying to kind of stick with the provider for those reasons, but then when I found out I was pregnant, I called the provider to get an appointment and they were out for about a month, and couldn't refer me to anybody who accepted the insurance. And so I was kind of in this bind, I was like, I don't know what to do, I don't have prenatal care right now. So I ended up calling my old OB/GYN in Long Island. I grew up in Eastern Queens on the border of Queens and Nassau. And I went back and like, it was just a totally different world, it was like a full service OB/GYN practice in Garden City, they have a midwife there, three wonderful OB/GYNs, and their customer service is outstanding. Every time I would go there I felt really valued, like they really cared about me. It was just like a day and night experience. 

And so I told Edgar, right, I'm just going to go like one time while the other doctor is away and then we'll come back to the local provider because it's more convenient.

He's like, no, we're not doing that. You're unhappy with this local provider, you need to go to the Long Island provider, he was very adamant. You feel in much better care, and our baby won't be born in Queens, the baby will be born on Long Island, but your care is more important, you know?

And so we were sometimes driving, you know, 45 minutes to get out to this provider, like sitting in traffic on the Grand Central Parkway, but it was like completely worth it. And Edgar really pushed me in that direction. And that's why I really wanted Edgar to be here today because he's like always pushing for us to go in the right direction.

Lisa: Yay, Edgar, thank you for encouraging her to receive the care that she deserves. 

New parents posing in front of a waterfront and a bridge overhead. Baby boy is on his dad's chest.

Edgar: Yeah, it was definitely a big emotional decision too, because we were really dead set on having our child be born in Queens. But I mean, just seeing the difference in the quality of care and just like, you really want to have a team of people that you trust and we really trusted these people at Garden City,so we definitely was a no-brainer once I saw like the change in quality of care. So all that to say is it is worth traveling if you're able to, like, if you're able to go to another borough or town or whatever it is. I do think it's worth it rather than just picking the convenient option for sure. So that was a major takeaway for me.

Suzanne: This isn't a cup of coffee where you go to the Starbucks on the corner, right. This is like your physical and mental wellbeing and the wellbeing of your baby, so it was completely worth traveling. And now I have warm feelings towards going out there and my feelings have really changed after the whole experience, which is great.

Lisa: Oh, I'm so glad that you found that provider. Often challenging, particularly like you were saying, with insurance restrictions. And then you're thinking like, I only have so much energy, can I really travel that far? But like you're saying, you need to not just like, and feel okay with your care provider, but ideally, you need to find one that you love and completely trust because, as you remember, when we went through the physiology of the birthing process, that oxytocin that creates the contractions, thrives best in an environment where you're surrounded by anyone who's in the room, you really like, and even love and trust, you know? So yeah,that just brings joy to my heart, knowing that you found a provider that you felt really safe with. 

Suzanne: Yeah, we felt really safe with him and all the other providers that were there, , all the medical staff and they were extremely responsive, which was important to me. Like, I wanted to know that if I called, no matter how trivial the question, like there were times, Lisa, were sometimes I'd get the doctor on the phone in 90 seconds. Like I'm not even exaggerating. They would put me right through. 

Lisa: That's unheard of!

Care Provider Responsiveness

Suzanne: They're amazing. No call goes unreturned, you can ask any question and they will call you back. They're phenomenal versus like the local provider that I had mentioned earlier, I just wouldn't hear back, it was, I just felt like, do they even know who I am at this place?

So having that responsiveness was important. Because for any person who's pregnant for the first time, you're going to have scary moments or you're going to have questions and you want to feel that your questions are not silly or that you can get an answer. And so that was really, I knew that about this provider, because I had like a 20 year history with him.

Suzanne: And so, so that was a major decision, you know, part of the decision for us too, the responsiveness. 

Lisa: Yes, listeners, listen to Suzanne when she says, you shouldn't feel like a number, is what I was hearing you say, I think. 

Suzanne: Yeah. 

Lisa: And too many of us come, you know, just feel like a number in New York City, providers where it's just so busy and so overbooked. So, I'm really glad you didn't feel like a number.

All right, anything else on pregnancy? And if not, feel free to jump into the birth story whenever you're ready, Edgar?

Edgar: I think something that also helped is like, because I think Suzanne was very active and stuff, I do feel like that made it a lot easier when we got to like the birth.

And we were very fortunate that Suzanne didn't have any kind of like nausea. What's the saying, like, you're waiting for the other foot to drop or something. I was just waiting, because I hear so many stories, but we were very fortunate that she was mobile and she physiologically speaking, like she wasn't too different.

So we were able to still go out and like go on little dates and stuff like that. That made a, I think that made it easier to go through the journey, so we were fortunate in that way. 

Suzanne: Yeah, it did. I was on the Peloton till like two days, but I think I was like past my due date and I was still riding the Peloton.

Like I just felt normal pregnancy, which I had never thought I would. I thought, because of like my mental health background, I thought I was going to be depressed. I thought I was going to have low energy and it was the complete opposite. I felt really great the whole time. It was like pregnancy was a really positive experience for me.

I think we hear a lot of stories about the nausea, about the back aches, and I did have a little bit of that, like aches and pains. 

Saw a Chiropractor

I forgot to mention I saw chiropractic care during the pregnancy, and that really helped get everything aligned and helped me feel really good.

Lisa: Nice. Do you happen to remember, now or later, for the show notes who the chiropractor was? 

Suzanne: Yeah. It's Dr. Louis Angulo in Kew Gardens. He's not specific to pregnancy, he doesn't know the Webster technique, but he certainly treated me the whole pregnancy. It's called Back Together Again Chiropractic Care. Highly recommend him. He doesn't do a lot of excessive treatments, he just does the right amount for you. Like I was only going in, when I had pain, I would go in once every two weeks or so, and then when I was just maintaining, it was just like once a month just to keep everything aligned.

And so the chiropractic care also helped with the pregnancy, the labor and delivery. And then I also should mention, I did a lot of reading around positions and I, and we talked about this in your class too, like positions for labor and delivery, all of that. I felt like I was going to want to squat when it was time to push and I don't think I would've known that if I hadn't gone to your class and hadn't done some reading on my own.

So all of that kind of helped with the physical aspects of preparing for labor and delivery. 

Lisa: I love that. Yes. Always recommend chiropractic care and a little attention being paid, as you know. You know, that I focus on that to optimal fetal positioning and, that's you really can, I mean in an otherwise uncontrollable process, it's nice to have some little sense of agency and that whole Spinning Babies idea and you know, doing a few things here and there that could help things along, why not? In my book, like most of us like to have a little bit of a sense of agency, you know? 

Suzanne: Yeah, we also did, I did spinning babies, I did a lot of yoga, which I actually think helped the baby get into the right position, and I sat on a yoga ball almost the whole pregnancy, which really helped I think get everything aligned.

And I forgot to mention, we also did acupuncture at Earth and Sky in Long Island City, which you recommended. 

Lisa: Yeah, they're great. 

Suzanne: That was closer to the labor and delivery time, we wanted to try to get the timing of the contractions right. So we went for some prenatal acupuncture. I think I went two or three sessions, and so that was really helpful too. So I think we took a pretty holistic approach to everything, like we tried to attend as much as we could, you know. 

Lisa: You totally did all the things. I love it. I love it. If only everybody could get all of that fabulous care, we would have fewer interventions and healthier births and that's great. So I'm really thankful you were able to do that. 

Suzanne: Thanks. Yeah. Yeah. So maybe Edgar, do you want to tell the birth story? 

Lisa: Go right ahead. 

The Birth Story

Edgar: So yeah, our provider let us go to 41 weeks. We were at a point where we had an appointment the day before the due date.

And so, he wanted, our appointment was Thursday, so we showed up on a Thursday and then he said, okay, tomorrow's a due date so if you don't go into labor, like let's try to schedule you for a membrane sweep on Monday. And so that was a big decision, because like, you know, I think our nerves are definitely I can speak for myself, my nerves are definitely through the roof, I'm like, what's going to happen, this is it, this is the moment. 

And so we were kind of going back and forth on the appointment and we scheduled it. And then we, you know, we went back home, we talked more about it and we said like, okay. So, and we also consulted with Chana like on the decision. 

And we eventually decided like, we're going to wait,we're not going to do the membrane sweep, we're going to just see if it happens naturally. And then we'll just stick to like a regular cadence and see him next Thursday. And then if that, you know, we'll decide something then by next Thursday. So that'll be like a week, almost a week after the due date. And, you know, things progress well, we head into like, now we're at a week after the due date, so they take another ultrasound to see what the fluid levels look like.

Induction due to Low Amniotic Fluid

He comes back to us and he says, okay, well, I think the levels of fluid are lower than I want them to be, so we're going to induce you tonight. So that all of a sudden, of course cortisol goes up, I'm like, okay, so, this is going to happen. 

And if I can just add what we wanted to have an unmedicated birth, so we worried, we were concerned that like, if we did the induction, that would increase the likelihood that I would need more interventions and you know, potentially need an epidural, so... 

And going back to prepping for this moment, we did have Chana come in a few weeks before and you know, she had this great technique of like having flashcards and something I remember she said is like, it's not like a flow chart.

 Because you have one intervention doesn't mean it's a domino effect, you're going to get all these other interventions. So I tried to remember that great advice she gave us. But there definitely felt like a sense of urgency all of a sudden. And I tried to wrap my head around what that means, like the low amniotic fluid, but I think maybe I just went into lizard brain and we're just like, okay, let's take a pause here.

Edgar: Let's call Chana, and let's see what our options are, just to see what she thinks. And we literally walked out of the provider's office and we went to a bench and we called her, we FaceTimed her right away and she was available thankfully. And she told us like, I know that they're telling you there's a sense of urgency but they didn't say that it was an actual emergency, so you actually have some time. 

Lucky Diner Meal

And so, I was just thinking about your class and like how, a lot of times something that works against you is like, if you're not properly nourished, and so the first thing that popped into my mind is like, Suzanne's beloved lucky diner in New Hyde Park. Many moons ago when Suzanne was a highschooler, she went to that diner and had a meal and then she got a hundred on a math assessment, a state assessment. So it's now... 

Lisa: It's the lucky charm. I love it. 

Edgar: Nothing to do with her intelligence or anything else, it's just the diner food, it's great. So I said, you know what? We have a few hours, this is a big deal. Let's go there, let's go to the lucky diner. Let's try to slow things down. We live in Forest Hills, so it's not an hour drive, like we'll get food and then we'll go, we have our bags packed already. Because I remember your class recommended packing the bags at like 36 weeks . We have time, so like, let's slow down. Let's go have a meal and then let's do this. Let's see what happens. 

And Chana also was very encouraging. She was like, you guys have time, go have a meal. And I was so anxious, I was like, we can't stop for a meal, this is an emergency. But between Chana and Edgar, they really slowed down the process, which I think was really instrumental here. 

Lisa: And I'll just chime on in if it's okay for a second, to say that on this podcast, people have shared how, like, it sounds like it's an emergency this low amniotic fluid, some people get sent straight to the hospital and then they sit and wait there for 12 hours to start the induction. And so I always now bring up that story in birth class, to drive home the idea to check with the care provider, probe a little bit because it's clearly not an emergency if you get there and you wait 12 hours, right? So these people could have gone home, calmly gathered their things, gone to the lucky diner to have a meal, take your time. So coming back with questions rather than just assuming it's a life or death emergency can be really useful.

So you're furthering that messaging. Thank you. 

Suzanne: And if I can add, one additional reason we chose this provider was because they're not very alarmist. I had asked him about additional invasive testing and he's like no, you don't need that. And he let me go past my due date, he's a little bit more lenient about things like that. Even he didn't send us directly to the hospital, he was like, go home, get your stuff, and then come back. So I think that's where the choice of care provider does really matter.

Right? Like they're going to set that tone for how emergent this is. So that was helpful too, knowing he was giving us a little bit more time. And I trusted him, that if he's saying we need to do this tonight, I really trusted we need to do this tonight. Versus someone who was just unnecessarily intervening all the time.

Edgar: Yeah. Yeah. So then we went to the diner, we had a meal and it was a good meal. I forgot what I ordered, probably had like fries and a burger or something. 

Suzanne: I had eggplant parm and pasta. 

Lisa: Because that's all the rage right now, right? I've been hearing clients have been telling me that this Eggplant parmigiana is like a trick to going into labor.

Suzanne: I've heard that, that's why I ordered it. Yeah. 

Lisa: Love it. 

Edgar: It was definitely an emotional meal, cause I'm like, this is the last one probably before we have a child in our life. And so we had our meal, then we drove back to came back here to Forest Hills and then we did get a call from the provider and he was like, oh, where are you guys?

Edgar: I'm like, oh, we're home, we're packing our bags. And we're like, oh, because they're waiting for you here. I'm like, okay, yeah, we'll be there shortly. We're already home, we're packing our bags, we're heading back there. 

Driving to the Hospital

So thankfully, we didn't get into traffic or anything. It was a really smooth ride to get back to the hospital with our stuff. And then when we get there, they tell us they don't have a room available and they couldn't tell us a time when a room would be available. So we're in the waiting room outside of the maternity delivery area, and we're looking at each other and we're like, what does this mean, what are we going to do now? And we're going back and forth on like, well, if it was a real emergency would we be waiting right now? 

Lisa: They would take you to triage or a closet or something to like, not a closet, but a hallway or something. If it was really an emergency, to start the induction. 

Edgar: And so all of a sudden, as we're talking, Suzanne gets up and she says I'm feeling something. And I'm like, what's going on, and I'm like, are you just nervous? And she's like, no, I'm feeling like I'm going into labor. 

Lisa: The lucky diner.

Edgar: Yeah. And so I look at her, I'm like, okay, I'm going to ask these people. Because another part of our plan was to do as much of this laboring at home. We really, that was our plan heading into even Thursday, and so we were like, okay, let's really try to get an answer from them on what the time looks like for us to get a room because if they don't know, what's the point of being here? It's a short drive, so we could probably just go home and then come back. And so they came back out to talk to us and they called the OBG, one of the other providers in the practice that was on duty for that night. And they insisted that we stay.

Edgar: So I said, okay, can you work with us here? Can you give us at least a timeline of when we're going to get a room? And so they said, okay, we'll be right back. 

Triage Room

And then they said, okay, well, we'll have you in triage in 30 minutes or something. So we get in there, they put us in like a triage room, and I think a resident comes in. And they say, we're going to start plugging you into the what is it? The monitor. We're going to plug you into the monitor, it's not the mobile one because they don't have that for the triage . 

And so then, all of a sudden they say, alright, and we're also going to give you this IV, they didn't explain why. 

Edgar: The resident really couldn't explain why, and then it was only after they talked to the OBGYN that they came back and said, we're giving you the IV in case of an emergency C-section. So it wasn't necessary for us, it was just like, they were planning for a C-section, which you know, I think rubbed me the wrong way a little bit, but that was the beginning of a little bit of a tense relationship with the resident.

Because they clearly didn't like that we were asking questions, but I'm glad we did, because they put us on the monitor and they're like, yeah, you're definitely starting to have contractions, like surges. 

And so I was really amazed, I'm like, I guess they scared you into labor.

 Because it just, it didn't happen until we actually got to the hospital. If we had gone right after and been rushed, like we may have been induced because we didn't give ourselves that time, so. 

Suzanne: And also, they didn't like that we were asking questions. Like, I asked to get the provider on the phone to see if I could be sent home now that I spontaneously went into labor and they did get the provider on the phone and then they made it very clear that I had to go through the resident from there on out. Like they were not happy with me pushing back and asking questions. And so I didn't care, I just was like, this is my birth, 

Lisa: Good on you. 

Suzanne’s birth doula, Chana Diamond, and her sleep consultant (also a postpartum doula & babywearing educator), Adriane Stare — both doulas with East River Doula Collective.

Suzanne: And I'm going to ask questions, Chana really empowered us to do that as well, to just let it be known what it is that we want out of our birth. And I know you can't control everything, but there were things that we wanted to, we really wanted to ask questions and push back as much as we could where we felt so. 

Lisa: Good. 

Edgar: So then we're in triage and they're monitoring us and Suzanne is trying to walk around with the IV attached but it's hard because, well, actually, I think after they confirmed she was having contractions, I think they gave us the option of getting you off so you could use the bathroom and then you decided to walk around a bit or something. 

You were trying to move and then it took maybe an hour or so to get a room. And we were in a room by ourselves and then the nursing staff came, plugged you into stuff.

And then we were still in touch with Chana to see when Chana would come and the timing was really great because she came I think maybe five hours after we were there already or four hours. So like that's when we got our room and it was like, this is like the delivery room.

 It feels like a blur, but the nurses came and then they really tried to help us get into. The first nurse we had wasn't really supportive of like letting Suzanne get into different positions to labor, like squatting or other things that would make her feel more comfortable.

Edgar: I think the OB wanted her to push on her back, which is already like, not like advantageous to pushing. And then after that we got another nurse who came on rotation and she was more open to trying different positions and that definitely was a game changer, like being able to squat, being able to move around.

Chana came and she put candles around, was really supportive, letting her know that she can do this. They let Suzanne labor or push for a few hours. 

Three-Hour Pushing Deadline

Suzanne: They gave me a limit of three hours to push.

Yeah. And I was coming up on the three hours and they were telling me that I was going to need a C-section if I didn't finish in the three hours. And boy, did that get me into pushing much harder. 

Lisa: Almost no better motivation. 

Suzanne: I wasn't thrilled about the time limit, I didn't quite understand why, if that was an evidence-based practice or what? Because the whole labor time, the whole labor and delivery was nine hours, which I didn't think was very long. So they gave me the three hour limit, but yeah. 

Edgar: Oh yeah. And I think the only thing they cited was,the OB said that they were just concerned about the baby's heart rate.

But I think in my head, I was saying like, I think when the pushing happens, like the baby's heart rate slows down after because like maybe they're also tired of the movement or whatever. But that was the one thing they cited is like, we feel a discomfort of having the heart rate keep dropping after you've been pushing for three hours.

And so that's when, really Suzanne's motivation went through the roof and they gave her oxygen too to help her push. Eventually, they measured her. I remember the diameter or what was it? 

Suzanne: Oh, yeah, the dilation. 

Edgar: I remember there was, it was like after four hours, you were pretty much like nine. 

Suzanne: I was nine and a half centimeters and I didn't even realize it. There was no opportunity for me to get the epidural because I was already so far along. And I think the way that I got there was, I had done a hypnobirthing class and so I just kind of worked through every surge individually, and I knew it was finite. Like I knew okay, this is going to last 60 seconds, and then I'll get to the next one, and that really helped me. It's not permanent pain, you know? So are you saying, just to clarify, I heard you say four hours, I think, before pushing, are you saying from the first contraction that you felt Suzanne?

Yeah, I think it was about that amount of time. Yeah, because we got to the hospital at eight, around 8:00 PM and I think I started pushing, he was born at 5:00 AM, so if we backtrack... 

Edgar: You may have started pushing like midnight, maybe, or a little before. 

Mindful Approach to Labor

Lisa: That's unusually fast for a first timer.

But I'm sure, like you were saying that hypnobirthing, those techniques are so effective for many people at just helping that, because of that mind, body connection, helping your mind trust the process and then your body just surrender to that great work that your body, your uterus, and your baby are doing, getting tension out of the way. Right? And so that alone can be powerful in helping things to progress more readily. 

Suzanne: Yeah. They said that they rarely see people like able to do it without the epidural. And I really think it was just my mind was really powerful, like I just really, I didn't let the pain overwhelm me.

I was just like, we're going to get through each one. I was shocked when they told me it was like five o'clock in the morning, I felt like I had only been pushing for like an hour or like had only been laboring for an hour or two. I didn't realize it was nine hours at that point, because I just got, I almost got into a trance-like state.

I was just going one surge at a time, not thinking, I wasn't thinking like how much longer is this going to take? I just took it. It was like a very mindful approach, I think, like just one at a time. And I really do think that helped keep me calm and that helped make the delivery really successful. Yeah.

Lisa: So it sounds like you were even using the hypnobirthing techniques, not just in the first stage of labor, but also in the active pushing part. 

Suzanne: Yeah, I would say so, yeah, definitely. And then when the second nurse, there was a nurse shift change. And so the second nurse allowed me to squat and push, which was a game changer for us.

So just like to your point, in the class, I know we go over laboring positions and pushing positions. And Omar started really descending once I was in the squat position. So like advocating again for yourself around positions, around interventions, that was like, I really feel like if we hadn't equipped ourselves with that knowledge, this birth would've looked completely different.

It wouldn't surprise me if it had turned into a C-section, I really could see that very quickly turning, like if you didn't know the right position to be in or preferred position, or if you didn't ask questions, like I can see, I'm just all about arming yourself with knowledge for this process.

Lisa: Absolutely. 

Edgar: I think it was maybe three hours in, they did give us some Pitocin. But by that point, you were pretty dilated already, I think. But, we did ask for wireless monitoring and that, I don't think you got off, though. It got up too much. You were really on the bed a lot. 

Suzanne: Yeah, I was limited in the laboring positions for sure. I was pretty tied to the bed. I was able to stand up, but I couldn't really walk around much because I was connected to the monitor. So that was one, we would've preferred the wireless monitoring, but that either wasn't available or they didn't–

Edgar: It was like, they really wanted, they said it was too fidgety, they really still wanted the constant data, like this constant data stream. So the wireless monitor was too sensitive to movement, which is kind of ironic, because I'm like, isn't that what it's for? 

Lisa: I know, right? Yeah. A lot of nurses have that opinion that it's like more work for them, that they may have to adjust it more frequently. So a lot of them are like, nope, we don't want to use it. Well, that's too bad, I wish you had been able to have that. 

Edgar: Yeah. Chana and I were just really trying to remind Suzanne, like we really believe in her. And it just like, when they brought up the real possibility of a C-section, definitely the energy shifted. And I just remember just like, you know, sorry, just getting a little emotional here. Yeah. I was scared. I was really scared. 

Edgar: But, yeah, I just really believed in her, you know, it was like a very, I was very scared for her, but I just, I really believed in her and lo and behold, like, you know, he started to really move down. 

And I just remember the feeling of I just, I saw his head come out a little bit and that was like a really big shift for me.

I was like, this is going to happen, it's going to happen naturally. I just had to tell her like give her that feedback, like I see it, we see that he's coming down and but I really like, I feel like Suzanne's attention to her body. 

And she's run marathons like plenty of times before this, I really can't imagine you like not, you need to really prep your body for something. The energy I saw her expend that night, I don't think I could ever imagine anybody else doing it, like without having that conditioning and that forethought to like really treat their body. And I could see it, I could see why people, even before you get in there, like the marathon, that is this process. Why would you want to experience any pain? I think some nurses said like, yeah, a lot of times people come in before it even starts, they want that epidural because they're just so scared of the pain.

Vacuum Recommendation & Hospital Being Risk-Averse

So and even after his head started to come out, they wanted to try the vacuum. 

Suzanne: Yeah. Yeah. There was, it was just a lot of like trying to apply interventions. 

Edgar: Don't really we don't want that, he's almost out, let's give this another, let's give it more time, so you really...

Lisa: Is this still the resident? 

Edgar: The resident was there, but like now I think after the Pitocin was administered, and we were like maybe six hours in, I think the OB was like now around and she wanted to try the vacuum to get the baby out faster. And we said no we feel like they're almost out just give us some more time.

New parents smiling at the camera; mom has newborn baby boy on her chest.

And lo and behold, he came out, like they really, but at the end they were really,once they saw the baby's, I think Omar's, maybe like ears or something, I think they were more on board with okay, I don't have to, I'm going to try to get this baby out. And so, she was, the OB on site, really now felt more like on our team, less of like a, I'm speaking on behalf of the hospital and trying to be risk-averse sort of thing. 

Suzanne: Yeah. I think that was a big part of this for us too. Everything felt so risk-averse, like everything was like, get the baby out as soon as possible, just like by whatever means necessary.

And that was very different than what we wanted. And we knew going into a hospital setting that it was going to be that way. Even like the least interventionist hospital, I think would still have wanted to apply interventions. And so, I know I mentioned this before, but we felt like we really needed to keep pushing back and I truly think that, that's the only reason why I was able to have the natural birth that I wanted, because we just kept asking questions and kept saying no. And whether they liked it or not, we were like, no, we're not doing it this way. You know? 

And so that was a, I think I had some trauma after the birth because of that. Just because of like how many interventions they were trying to apply, the IV from the very beginning, you know, the vacuum, threatening the C-section like if I didn't do it in time, in the three hour time limit, which like, as we know from your class, that's going to increase your cortisol level, like being under that stress, which could actually prolong the labor and delivery.

I think it's a problem with our litigious culture in general, like just wanting to get the baby out by whatever means necessary. And so it took me some time to process all of that afterwards, but having Edgar and Chana there by my side and really encouraging me, I really think that helped make it all possible. I didn't take any narcotics or anything like that. So I was like a very clear mind, I was also able to push back and I straight up said, I don't want to have a C-section. And I'm like, we're not doing that.

Suzanne: You know? And so and I really did everything in my power to avoid that. 

Edgar: Yeah, it was definitely, you need to be really mentally and emotionally strong to really push back. Becauseyou know, I really, really trust, it was an informed decision, the hospital and we heard great things about it, but I think at the end of the day, like they're also a business too, right?

They're trying to avoid lawsuits. So, but yeah, it was definitely quite an unforgettable experience and, just like it's a real marathon, it's like you're training for the hardest marathon of your life.

And I was really in awe, just like everything Suzanne did. You're really incredible. I wish more, I don't know what it's like now, I don't have any data, but like, I feel like if more partners were there to see this, like, you'd really get so much more respect for pregnancy and labor.

Suzanne: Yeah, I really did treat it like training for any other event that I did. You know, as I said, I've run marathons and I dedicated a lot of time to that. And I did the same thing here. Like all of the things that I mentioned, just like going to the classes, being physically fit, watching my nutrition, all of that.

I truly think that helped with the outcome. And so I just encourage other people to be physically active and just arm yourself with that knowledge of what you want your birth to look like. 

Suzanne: And you know, like have some flexibility with it, of course we didn't know we were going to go in and be like with a possible induction, so we had to be flexible, but also I trusted my body and I felt prepared for it. So all that preparation really did pay off. Yeah. 

And Omar was born very healthy, active, you know, he was curious as soon as he entered the world, he was looking around and he was perfectly healthy when he was born, which was amazing. We had the natural delivery that we wanted, with very little intervention. And despite the fact that I took the medication, he's thriving, there was no negative impact of that medication, which was something that had weighed on me so much.

So it seems like all of our choices were really the right ones, every choice that we made along the way resulted in this amazing birth that we had and this amazing, beautiful new family member that we have. So we're really thrilled about how it all turned out despite some of the challenges.

Lisa: So glad to hear that. It's really encouraging. And yeah, I have no doubt, all the things you did, the ways you prepared and advocating for yourself as just echoing what you were saying, made all the difference in the world. But you know, and it kind of makes me sad that you had to advocate so strongly.

And yet, that's just the nature of our US healthcare system, and when we're choosing to give birth in a hospital, that's just part of it. And you know, it's not always an OB or hospital midwives' fault that there are these challenges, it's just such a multi-layered business, like you were saying, and there are safety officers breathing down their neck, enforcing these, not necessarily evidence-based rules of like, you can only push for three hours or else we need to move to a C-section. Because as you said, there is, well, there it's complicated, but one of the major concerns is a lawsuit or, you know, a negative outcome.

So, but I'm so happy that you had overall as close to as possible, the kind of birth that you had hoped for. 

Natural Hospital Birth Book

Suzanne: I was going to say, I also had read a book called Natural Hospital Birth. I like that one.

Yeah. I read the book cover to cover and I was like, I really hope I don't, because like the whole premise of the book is you're going to have to push back. That was like what I gathered from it. So like I went in with that mentality. Okay, the book is saying, you're going to have to, they're going to want to do X, Y, and Z intervention and you're going to have to keep pushing back.

And I'm like, I hope that's not my experience, but that was in fact, my experience. Right? Like it felt very much like that. I recommend that book to anybody who wants to try to have a natural birth in a hospital setting. I wasn't a good candidate for like a birth center because of my age and because of the medication.

But you know, we knew we had to be in a hospital setting because of some of the risks that I faced. But, it can be done, like the natural birth can be done in a hospital, but it takes work on your part, right? Like on the, on the birthing person and their partner, if they're there, you know, like really have to feel comfortable to push back a lot, and make it clear what you want.

Suzanne: So, yeah. 

About Breastfeeding

Lisa: Well, where would you like to go from here? I think you mentioned you might want to share some about breastfeeding. 

Suzanne: Yeah, I was really dedicated to breastfeeding. As I mentioned, I went to La Leche meetings from like my fifth month of pregnancy onward. I read the book from cover to cover, I identified a lactation consultant with my insurance company and I really was like, the AAP says, we need to do this for at least six months, I'm going to try to do it for six months, maybe a year. And it went well in the beginning. Omar exceeded his birth weight within a week of being born, but I had some challenges at the hospital. Like for colostrum, I had to feed it to him with a syringe, I couldn't really get him to latch and I didn't find the lactation support to be that great at the hospital, unfortunately. I don't know if it was just the person that I happened to see.

So I had some struggles in the beginning, but my postpartum doula came over the second day of Omar's life and she helped me get a start with breastfeeding, and then he was doing okay in the beginning, as I mentioned, he exceeded his birth weight. And then it was okay for about a month, and then I realized he was taking a really long time to nurse, like 45 minutes to an hour sometimes.

Suzanne: And I wasn't seeing a lot of dirty diapers, and then I was getting mastitis, I was getting plugged ducts and I was like something's not going right here. I had about seven lactation consultant visits, four in person and three virtual. I was really struggling and I was not producing, when I would pump, I wasn't getting a lot of product, I wasn't getting a lot of output. 

And it was eating me, it was really consuming me, like I was really like,of course, I have to do this for six months, the AAP says I have to do this for six months, and breastfeeding is like the best thing ever, you know, liquid gold and all this and that, I really got myself really stressed about the fact that it wasn't working that well for us. And then Omar was losing weight. He wasn't staying on his growth trajectory, and I knew something wasn't right. And so it turns out he had a tongue tie that was affecting his ability to latch correctly. And that was in turn affecting my milk supply. As you know, it's kind of a cycle. But I just, like, the way that it had affected my mental health was really profound.

 I was constantly anxious, I was pegged to the couch for like 45 minutes to an hour at a time while I'm trying to feed him, which is not pleasant for anybody, you know, then we don't get time with him, we were limited in what we could do because it was taking you so long to feed him.

Decided to Switch to Formula

And I felt like a failure, I feel like I'm like a relatively healthy person, I prepared myself with all this information, like, why is this not working out? I'm going to give him formula like what? Everyone says, like breast milk is the best thing to feed your baby. And we came to the difficult decision, like that was agonizing for me, that we needed to switch to formula.

Suzanne: Like he wasn't growing enough, my mental health was suffering, I was constantly anxious. There were times where like he would be crying and I would be pumping and I would ignore him for a minute or two. I needed to attend to him, but because I was attached to the pump, it was like interfering with my ability to care for him.

And that didn't feel right to me, I knew and because I was feeling so anxious and depressed about the situation, I wasn't as sensitive as of a caregiver as I could have been. And so we slowly started tapering off. We started combo feeding for a little bit, and then I just decided that even keeping up with the pumping it was just too mentally taxing for me personally.

Suzanne: I know some women, I know some people are able to keep up with it. I personally couldn't. We are the kind of couple, we really like to go out and take Omar out different places and be out in and around the city.

 I found it very difficult to be tied to a pump every two or three hours. And so we ultimately decided, for our mental and physical health, that we were going to stop with breastfeeding. So he was breastfed for about two months and then we did combo feeding for the last month. And now we're almost exclusively on formula. 

Suzanne: I fully support anyone who wants to breastfeed and is able to, and I think it's wonderful and I'm glad that he got the breast milk for almost three months in some form, but I also am completely okay with our decision to switch to formula.

 I did everything possible to try to make this breastfeeding relationship work, and it was just a real struggle for us. And so I had to prioritize my mental health and our family's well-being, over this AAP recommendation about six months or more. Right. And now I heard the recommendations even like two years, which, in a country where we don't offer a paid parental leave and there's no guaranteed paid parental leave. 

Lisa: That's not okay. 

Suzanne: It's not okay. I'm like, I contribute more than half of our income to our family. And so, I know I need to go back to work and I'm not going to be able to dedicate my full time to breastfeeding him.

And that's just the reality of our personal situation. You know? Like everyone is different. If you have the ability to stay home for a year or two with your baby, that's wonderful, but we are not, we're just not in that position. 

Lisa: Hardly anybody is.

Suzanne: I think like a big lesson for me was, you know, I was getting a lot of advice from lactation consultants and La Leche and like even friends that were like, correct his tongue tie, correct his tongue tie, like that will fix the relationship with breastfeeding. But ultimately, we needed to listen to what the right thing was for our family.

Like, even if we corrected his tongue tie and he, well, first of all, that was going to take a while to do for him to relearn how to feed, this idea of pumping so frequently was just negatively affecting our mental health, as a family. And so regardless of what the AAP said, regardless of what the lactation consultant said, ultimately, the right choice for us was to stop breastfeeding. 

And this is not to discourage anybody from breastfeeding again, if you're able to do it and if it's working well and you're successful, then by all means do, but for us it was doing more harm than good in our particular case.

And so like, I just want to let other women know, it's not easy, it's really not an easy feat. And if you need to supplement or you need to go to formula, like I think it's okay. My personal opinion is that it's okay. Like your baby will thrive. 

Omar's doing a lot better now. He's gaining weight, he's sleeping longer. We're able to play with him more. He's interactive. He's just grown by leaps and bounds since we switched to formula. And so like, that was just the right choice for our family. So, you know, I just encourage everybody to make the right choice for themselves. So I don't know. 

Lisa: Absolutely. 

Suzanne: Yeah. 

Edgar: Yeah. It's definitely a very big emotional decision. I think where I drew the line was like, Suzanne went to CityMD for a third week in a row because of a possible infection. And what really took me aback was that the provider that she was seeing, it's not someone she has a relationship with, but instead of seeing the pattern of like, okay, maybe this isn't working out for you, they still wanted her to keep breastfeeding.

 For someone to show up to your place three weeks in a row with issues and for them to still pivot towards pitching breastfeeding is good, you should do it anyway.

Smiling parents posing in front of a Rockaway Beach sign; mom is wearing baby boy in a wrap against her chest.

That really just convinced me, it's not about her wellbeing, This is just like this dogma, I don't want to say dogma but like, there's just like this really strong bias towards...

Lisa: You can say dogma. 

Edgar: Breastfeeding or bust, like, you know, and it's just like really not aligned with the realities of a working mother and also just everything you know, like our story.

Suzanne: Yeah, that's part of why I felt such immense pressure to do it. You know, this provider didn't know me at all and was already like really pushing me to continue with breastfeeding, despite the fact that it was harming my physical and mental health.

 I got mastitis twice, I had a plugged duct, I was in a lot of pain. And so it just felt like such an enormous pressure, like based on the AAP recommendations, based on this provider's recommendations that like, I was doing something wrong if I gave this up. Like I was harming my baby or I was being lazy or like taking the easy way out by using formula.

Suzanne: And now my whole mentality has shifted around that. I think I just wish the AAP would give some parallel recommendations, if you choose to formula feed like. Maybe these are some best practices for formula feeding if that's the option that you want to go, like present, I would just, I wish that people were presented with that as a viable option as well.

And not, you know, I know breast milk has wonderful qualities and everything, but if for some reason you can't or choose not to breastfeed, then there are a lot of wonderful formula options as well. And so I know some people have had issue with the AAP recommendations, this that came out recently, I also am part of that group that has some feelings about it. 

Lisa: Yes, yeah, no, I actually I just recorded my next podcast, that's airing taking them to task for like. I mean it's not AAP's fault that there is no support in terms of parental leave and policies surrounding pumping in the workplace and all of that stuff, those systems we need to have in place, but it's problematic, nonetheless.

And they did try to make sure the wording was like, as long as it feels mutually beneficial for two years or beyond, but it is very problematic. And we who have given birth and who might be trying to body feed need to be seen more like a whole person and not just a host for carrying a baby and a host for feeding a baby and you know, yeah our mental health matters so much. So I am in full support of that, and I always want to amplify stories like yours in this way, because while I am a big advocate for breast milk and the benefits of all of that, I'm also a big advocate for mental health and wellness. And your baby and your family, and you need to be healthy. They need you to be healthy. You need to be healthy for you. 

Suzanne: It was hard, it was a really hard decision for me because I work in the field of health. Like I work for the New York City Health Department and we promote breastfeeding actively in the health department and we have a lactation room that's wonderful. And I always thought oh, I'm going to, you know, when I go back to work, I'm going to be pumping in the lactation room two or three times a day. And I really am into physical health and mental health. And so I was like, I want to do the best thing for the health of my baby, but this is affecting my mental health and he's not getting enough.

And so it was like a very difficult bind for me. Like I felt almost like a hypocrite, like, oh, you work for that largest health department in the country and you're not breastfeeding, like sort of thing. 

But that's just not our story, our story is that we tried it and it didn't work for us and we had to pivot to something else and now we're thriving as a family, like we're truly thriving as a family and that's more important to me than absolutely than meeting the six month goal, you know? 

Lisa: You are doing the absolute healthiest thing for your family and maybe the harder choice, because of that emotional investment and the conflict that you were feeling, you made the harder, but the wise choice for you and your family.

Suzanne: Yeah. Thanks for the support. Yeah. Yeah. So it's really okay. I'm a big advocate of fed is best, you know, whatever you choose to do it with a loving heart, your baby's going to care more that you're there with them and happy and present than what type of milk that they're being fed, you know?

Lisa: Do you mind my asking with the formula shortage, have you had any tricky things surrounding that? 

Suzanne: We've been very fortunate. We are in some "buy nothing" groups in the neighborhood in Forest Hills and people often will say I have an extra can of Enfamil, does anybody need it? Like, we're going to go pick up a can today. So we've gotten some that way. And then fortunately, on websites like Walmart and Costco, you're able to actually order. We have enough here for Omar for the next few weeks, so we haven't, we really haven't had any issues and our families have really stepped up too. When they see some in the pharmacy, they can pick it up for us.

And so, our families have been really supportive of our decision. They can actually like actively help us now with feeding him because if they see a can of formula, they can pick it up in the pharmacy, so, so we haven't had any issues finding formula, thankfully. Did you want to add?

Edgar: Yeah, definitely. It's hard to find it in your local stores. So we've had to resort to online and having people help us get leads on which stores have it in stock, but we are, we're in like a good position now, but for sure, it's not a good thing to have in the back of your head that there's still supply issues. And, so I'm really looking forward to when he can start solids. 

Lisa: Yeah, you're halfway there. 

A Position of Privilege

Edgar: I know. So I'm very excited about that. I know it's not forever, thankfully, he'll eventually eat solids and purees and other stuff and that'll feel like a huge relief. Also it comes with its own problems because then now you have to be creative with what they need.

Throughout the way, like I'm definitely, I think it's hard, It's important to, to highlight like we're coming from a place of also privilege. We're both working for The City, we both have really stable jobs. We've been able to pay for everything we've talked about we've had to pay for, right. We've had to it's all money and time. 

Edgar: And I've taken three months of leave time to be here in this, in the beginning of his life. And I know that's exceptionally rare, for a partner to have that time and she's taken four months and that's all from a position of privilege. And that's important because we've been able to explore these options and we've been able to deal with a pivot, but I know not every family has that time and that money to do the experimentation that we've had.

Suzanne: So definitely, I feel very, very happy about how everything's turned out, but it has been definitely a very big emotional journey, for sure. And it's been great to have support from friends and family throughout. Yeah, it's been a real blessing. We're so fortunate that we've had this time with him and to work through some of the challenges with breastfeeding, right? That is something that if we had to go back to work in a few weeks like that would've been impossible. and we did spend, I would say we spend several thousand dollars trying to get the breastfeeding to work.

So when people say it's for free, it's not free. Between paying out of pocket for some lactation, we got a hospital-grade pump, we've had his tongue tie corrected, like all these things, it does cost. So, you know, just want to recognize that not everybody has the means to do that.

Again, when recommendations come out, just bearing that in mind, there are resources that are necessary to make breastfeeding work. 

Suzanne: In some cases, I think people are lucky and it kind of goes very naturally and easily, but if it doesn't, then the supports that you need can be time intensive and costly as well.

 But you know, in the end we made the right choice for our family. We're all very happy now and everyone's doing great. We're glad that we worked through that emotional kind of roller coaster. 

Final Tips

Lisa: Great. Thank you. Well, is there anything that you wanted to share that you haven't gotten to share, and/or are there any tips or insights like final ones to wrap it up that you'd like to share with listeners, expectant parents or new parents? 

Suzanne: For me, like the choice of care provider is so key. I just really, I feel happy when I think about my care provider, I feel really good about my choice and just asking questions about their style and my provider was very supportive of me having a natural birth.

He's like, I know how you want to do it, and he was really behind me the whole time. And I know that there are other providers that don't feel that way, that they're like, oh, 39 weeks, you need an induction, like very by the book. And so just going with your gut about the provider and making sure you feel a hundred percent comfortable with them or not, maybe not a hundred percent, because there's always, probably something you disagree with but 85, 90% comfortable, that's been a big lesson for me. 

And just the like care and education that you put in during your pregnancy can really make a difference at the end, with the labor and delivery. So just everything from trying to take care of yourself physically and mentally, however you choose to do that. And also, just really, I found your course to be really valuable and like all the independent reading I had done and just equipping yourself and not being afraid to push back on what you want out of your birth.

Right? You know, even if you're in a hospital setting, just not being shy, and this is your only chance, this is your one and only chance to have the birth that you want to have. Pushing back and feeling confident and having that support if you can have a doula there to help you with that, I think that's really valuable.

So those were some of the key takeaways for me. 

Oh, and also just making sure your mental health is good. And if you need to take medication, just, if you have the opportunity to meet with a reproductive psychiatrist to check on that. But there are plenty of medications that are safe for pregnancy.

 I encourage people to continue on their medication regimen if they can during pregnancy. So those were some of my main takeaways. I think, for your birth and pregnancy journey, build a team that you trust. I know that Suzanne was, other than the medical and having the doula, Suzanne also had the very lucky, she had friends who were also pregnant at the same time and it was, I could see just like how important it was for her to just talk to people to help normalize, like the fears and anxieties you have. 

Edgar: Same goes for the partner, for me, I definitely benefited from having a few other partners who I could reach out to and just be like, Hey, I'm also kind of nervous about this, and so it was like really nice to have that support for myself as well. Because I could be more there for Suzanne, for sure. And also be open minded about different approaches or ideas or thoughts, because if there's something I've learned, is you really need to trust your intuition and try to find something that works for your lifestyle for your family. Because I think we had a lot of ideas of like how we wanted it to go and things shifted around a lot and that's okay. That's like a very normal part of this process. And just like, if you're able to take the time, definitely take the time. I know that I had to use vacation time to be here as long as I am, and I don't regret it for a second. I can't imagine not being here for this time. As the non-birthing parent, it's just like, it's wild to me to think that someone could do this all on their own. it really does take a village. It is a myth, the belief that two people can do this completely on their own. Even having someone come by for a few hours of relief in a week makes a huge difference. Definitely don't forget that. 

Suzanne: Yeah, I echo the whole concept of it takes a village. I mean, Edgar was a phenomenal partner in this whole process, I couldn't have asked for somebody more supportive. And then as Edgar said, like I had a lot of friends and all these other meetings La Leche and everyone, like our doula and our, this whole support team really made it possible.

 I don't see how anybody can do this on their own. And like, now when we're postpartum, our families both live, like our parents live 20 minutes from here, like both sets of families. And we're still relying on them for support even postpartum, and it's just made such a difference. So the more you can build up that network, I think the better your birth outcome will be.

Going Back to Work?

Lisa: Yeah, thank you so much. You're exiting the fourth trimester right around now, right, and so you're going back to work really soon? 

Edgar: Yeah, I'm going back to work next week. I'm going to start part-time thankfully, even have that privilege. Like I don't have to start right off the get go five days a week.

Lisa: Nice. 

Edgar: I have enough time. It's a really big emotional thing for me, especially because I don't have the flexibility of staying at home to work anymore. 

Lisa: That's what I was going to ask. 

Edgar: So I'm actually looking for remote jobs, just because of this, like my new priority is to be here for him. My career goals are taking a backseat right now to, to me wanting to be here with my family. 

Lisa: Yay for having your priorities in check. 

Suzanne: I'll be going back in September, also part-time. So I'll be working three days per week and I'll be home two days per week. Yeah, it would be nice to also have some flexibility, our jobs are currently in person, so we'll see what the future holds. We hope to also get remote work so we can spend more time with Omar and our family. 

Lisa: My niece who had her baby in May just a few days ago, quit her teaching job. And which is a really hard emotionally charged thing, because it's her career, you know, but you don't, once you have this little baby in your arms, you're like, I can't imagine leaving this little one, and your priorities do shift and yeah, so I'm always encouraged when I see people realizing that and really taking action on that, however they can and however needed. 

Suzanne: And I think that's a message to employers, too. If you can offer a flexible option, then please do, because otherwise you're penalizing caregivers or you're going to lose talented people who are caregivers, because it's not fair to make somebody choose between their family and their job, right? If your job can be performed remotely, then there is a world where you can do both. You can be a caregiver and perform your work. So that's just a separate message just to employers, that if you can offer that flexibility, we caregivers really do appreciate it.

Lisa: Yeah. Well, thank you, Suzanne and Edgar. It's been so lovely to hear all these details and just be really encouraged. I know that this is going to be really educational, all the many ways you've prepared and advocated for yourself and for people who are listening. So thank you for taking the time, especially so early in your parenting journey.

I know you're still probably exhausted and getting ready to go back to work, and my thoughts and prayers are with you as you do return next week and then in September. 

Edgar: So, thank you. Thank you for what you do. Thank you. 

Suzanne: Yeah. Thank you, Lisa.