Birth Matters Podcast, Ep 98 - Belly Birth for Breech with Bicornuate Uterus

As a teenager, Crystal learned she has a bicornuate uterus which significantly affected her menstrual cycle. So it’s no small miracle years later when she conceives naturally twice after being told she’d probably need to use IUI or IVF. When her son doesn’t seem to have room to flip from breech to vertex (or head up to head down), and because doctors are rarely trained to deliver a breech baby vaginally, Crystal has a belly birth. She shares a few bumps along the way including an allergic reaction to the pre-op antibiotics, challenges with healing from major abdominal surgery and initial breastfeeding, but also shares how overall it was a positive experience. So much so that only 14 weeks into parenthood, she’s already feeling ready to give it another go. She also shares some details about her son’s hip dysplasia, which is more common in babies who are persistently breech.

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Episode Topics:

  • As a teen at 16, Crystal went to a doctor because her period hadn’t started

  • Doc started her on birth control pills

  • Eventually learned she had a bicornuate uterus that was creating a lot of pain and irregular periods

  • Started a pill that helped her to only have a period every 6 months

  • Almost had surgery (partial hysterectomy) but ended up not doing it due to risks of being able to conceive later

  • Stopped taking pills and still only got periods 2-3 times per year

  • Meeting her husband

  • Seeking out fertility specialist, Dr. Cohen (Northwell Manhasset, Long Island)

  • Spontaneously pregnant – finding out from doctor was a surprise

  • Week 8 no heartbeat, had to have a D&C (Jan 2020, just before Covid shutdown)

  • Small wedding in October 2020 after postponed/canceled larger wedding plans

  • August 2020 started going back to Dr. Cohen

  • Letrozole to help her ovulate with timed intercourse, unsuccessful for several months

  • Docs trying to be sure she wouldn’t carry multiples (due to shape of uterus, not safe)

  • 3 rounds of IUI, didn’t work, start to discuss IVF but she didn’t want to do that

  • July 2021 conceived baby naturally, to their surprise and delight

  • Pregnancy was uncomplicated

  • Around 6 months discovered baby was breech (head up)

  • Going to MFM specialist for ultrasounds

  • OBs - Trongone & Patricelli

  • Went in at 40 weeks the Saturday of Easter weekend for her scheduled cesarean

  • Went into OR for prep

  • They didn’t allow her husband in until after she had the epidural

  • Ancef - antibiotic to prevent infection, through IV – Crystal had a temporary allergic reaction – broke out in hives, lips swelled up & she vomited, then she was fine

  • Doc walked her through everything

  • Baby born 8:52am after coming in at 8am

  • She couldn’t see much because of the drape

  • Husband peeking to watch what they’re doing with baby

  • Repair work takes around 20 minutes

  • 6 lbs 7oz birth weight

  • Going to recovery, holding baby around 1 hour later

  • They played their own music

  • 48 hours in hospital all a blur and lots of disruptions

  • Being told to triple feed and getting conflicting information from nurses, but lactation consultants were more encouraging

  • Surprised by how limited her mobility was after surgery

  • Mother stayed with them and did lots of cooking, hugely helpful

  • For her birthday 6 days after the birth, they took a walk with the baby and the dog around Astoria Park

  • No gas after surgery, took a while to have a bowel movement (after she was home)

  • Incision healing observations

  • Wants to have another baby, brief discussion about VBAC

  • Nolan born with hip dysplasia, did harness around 6 weeks

  • 4 weeks later ultrasound - one hip improving, other not

  • Upgrade to rhino harness for 4 weeks

  • Ultrasound, left hip completely healed, right hadn’t healed

  • Now scheduled - open reduction with body cast to fix right hip

Interview Transcript

Crystal: My name is Crystal. I live in Astoria. I've been here for 11 years now, so I can call it home, I guess, so they say. I am a restaurant manager here in the neighborhood and I just gave birth to my first child, a beautiful baby boy. It'll be 14 weeks in two days. So just a little over three months.

Lisa: And you just went back to work very recently. We were talking before we hit record about just the, you know, the joys and the challenges of that. There's such a tug and like a, yes, I'm happy to use the adult part of my brain, but also like, I miss my baby and I want to be with my baby.

Crystal: Yeah. America needs to catch up. 12 weeks is just, it's not enough.

Lisa: Mm-hmm agreed. Lots of work to do. So I am really excited for you to share today. Thanks for your willingness. 

The Fertility Journey

I know you said you were willing to start way back and share a little bit about your fertility journey and all that, please jump in wherever you'd like.

Crystal: Sure. Yeah. So I am 34 years old right now, but I would say that my actual story starts when I was 16, so half a life ago. When I was 16, I hadn't gotten my period yet and I was skinny, I was active, it wasn't really that weird, but obviously, I was a little bit on the older side to have not yet started menstruating.

So I went to see a gynecologist who was like, this isn't anything to worry about. He was like, I'm just going to give you some pills to prompt a period. Then we'll put you on birth control so that it's like happening every month, and you'll be good. 

So by about month three or four of getting a monthly period, I was in excruciating pain every single day, like non-stop pain.

Bicornuate Uterus

It felt like there was a tennis ball in my stomach. So I went and got an ultrasound to see what could be happening. And it turned out that I had a bicornuate uterus. So I was getting my period every month, but I was only getting it from the left side of my uterus. The right side was just filling with blood.

So, I essentially had four months worth of period blood as a bubble inside of my stomach. So this was shocking to learn, but at least it made sense as to what this pain was. So the doctor had to literally put me up on the table in the stirrups and go in with like a poker and pop this bubble and I bled out and it was like, okay, clearly there's an issue with this right side of your uterus. We should take you off birth control because getting a monthly period, this would obviously just keep happening. We did that, so I stopped getting a period. 

I come from the Hudson Valley, I was born in Kingston. It's not a small town, but we obviously didn't have doctors who had seen anything like this before. So my doctor was a little baffled and was like, I'm going to refer you to someone in Albany who will have more experience with anomalies like this. 

So I started seeing a doctor in Albany from that point who was, basically you know, women, you don't actually need a period every month. You'll be fine if you don't get it. What we're going to do is give you a pill every six months, which should drain you out, and then you'll stop having the issue of the one side filling up, because it won't be happening on a regular basis. You should be good. 

And at that time too, he was like, I think we may actually go in and surgically remove that right side because it's clearly like, something's off there. It's not communicating with the cervix and the vagina in the way that it should. 

Lisa: I was wondering if that was an option.

Surgery for Partial Hysterectomy Cancelled

Crystal: Yeah. So we actually scheduled a surgery. I was 17 and I had surgery on the books to get a partial hysterectomy.

And I want to say, like three days before the actual date, he called my house and talked to my parents and was like, "You know what, I keep looking at this and she's so young. I don't want to make this drastic of a move, because God forbid, like that's the side that is fertile and it's just having issues now. Let's just, let's not do this." So I'm thankful that the towel was thrown in on that. I mean, yeah, who knows? Maybe it would've been fine, had it been taken out.

Lisa: There's a bit of a gamble, maybe.

Yeah, yeah, it was a little too risky for a 17 year old. Makes sense.

Crystal: So, yeah, so then I just continued on with getting the occasional period prompted by these pills that I would take a couple times a year.

And I would ask through the years of seeing this doctor, I saw him all through like my college years, into my early mid-twenties. Occasionally, I'd be like, what's going to happen when I want to get pregnant? Obviously at that young, I wasn't ready yet, so it wasn't really something I was actively thinking about.

And the answer was always, I have other patients like you, it'll be totally possible. You'll probably just need some help. We'll cross that bridge when we get there. So I kind of just kept going through life, always in the back of my head with the knowledge that if and when I'm ready to get pregnant, it wouldn't be normal. It wouldn't just magically happen for me the way it does for a lot of women. 

More Natural, Regular Periods

Went through my twenties, at that point, I started getting periods a little bit more naturally, but never on a regular schedule. I kind of, I didn't have to take these pills anymore.

Usually, like two to three times a year, I would just magically have a period, which was reassuring that okay, my body's doing what it needs to do, but not every single month. I never got the pain that I had when I was 16, like that's never happened to me since. So then I met and started dating my now husband. Things got serious, we got engaged.

Thinking About Having Children

And at that point, you know, we both knew we wanted to have children, so it was like, okay, let's find a fertility specialist and start having the conversation of what are we going to have to do, because we're not getting any younger, we want to do this sooner than later. And we know that it's not, most likely not going to just be, let's try for a few months to get pregnant, I'm going to need some help. 

So, we were planning our wedding for May of 2020. And in that previous fall, so it was around October of 2019, we were like, let's start this conversation now. We found a fertility specialist, Dr. Cohen through Northwell Health in Manhasset, Long Island. And we basically went in for a consultation, just I told him my story. I told him that we were looking to try to conceive shortly after the wedding. So I figured a few months prior to the wedding is a good time to at least start the conversation and get the ball rolling so that I could figure out what I was going to have to do.

He took some blood, he got all my files from my previous doctor. We had two just sort of like conversational meetings. 

Already Pregnant

And after the second meeting, I'm at home and my phone rings and it's the doctor's office and I answer it and they're like, Hi Crystal. We just got your blood results back and you actually are pregnant right now. So I randomly was pregnant, unbeknownst to me. Yeah.

Lisa: Wow.

Crystal: I don't even know if I ever would've known that, had I not been going in for this conversation with this doctor. So, yeah, I found out I was pregnant in October of 2019. When they went in for, I forget what the week where you get the scan, where they're supposed to hear a heartbeat. I think it's like week eight. 

We went in for that appointment, so excited, there wasn't a heartbeat. It was, you know, a pregnancy that didn't take. I had to have a D&C and the D&C was actually on January 2nd, 2020, so way to start that year. Which obviously, that year was awful for everyone, but it was a telling sign that that's how that year started.

 The silver lining was that I got pregnant naturally, and that was very exciting for us. I had no help with that, it just kind of happened out of the blue. It didn't take, but it was exciting to know that okay, like my body can do this. So obviously, our May 2020 wedding got derailed and COVID happened, and I was out of work for a bit. And just like life flew in a whole different direction where like, thinking about a baby was off the table for a little bit. 

Wedding Plans Changed

And it wasn't until we decided to pivot our wedding plan. We threw out our like big 200 person wedding that we had planned. And instead of trying to keep pushing it back until when the world would be able to do that, we just were like, no, we want to get married, let's just do it in my parents' backyard. 

We had a small little ceremony in October of 2020, and shortly, but I want to say August of 2020, we were like, okay, we should start this fertility thing again, because we know we're getting married in October and we do want to get pregnant shortly thereafter. 

Letrozole and Timed Intercourse

So in August of 2020 is when I started going back to Dr. Cohen. They put me on a process where they were giving me Letrozole every month and we were doing timed intercourse. So I would take five days worth of Letrozole, which is like a pill to help you to ovulate because without getting like a regular monthly period, that means I wasn't ovulating regularly.

So I would take this pill, I would go in and they would scan me. And when they saw an egg growing, they would say, okay, here's your ovulation window. Have sex these five days and then come back and we'll see if it worked. And I did this for several months, unsuccessfully. 

Another caveat of that was because of my body, I absolutely was told, there's no way I could carry multiples. So they wanted to make sure before they told me to start having sex, that I wasn't forming multiple eggs. There was only one month where that did happen and they were like, don't even try it, because you just can't carry multiples and it's not worth risking it.

So August through about April, we were doing this month to month, never to any success. So come April, I was starting to get frustrated and was like, what's the next step? And they were like, the IUI would be the next step. So we did three rounds of IUI, three months in a row. None of those took, and then it was the talk of, okay, I guess we're probably going to have to go IVF. 

Conceived Naturally

I remember vividly having a Zoom meeting with my doctor, my husband and I, and my doctor, and him explaining, not diving too in-depth because he didn't want to totally freak me out, but just like explaining that it would be a long, arduous process with a lot of needles and a lot of time monitoring and it obviously doesn't guarantee success that way anyway.

And getting off that Zoom call and just feeling deflated and very sad and very much like, I know I want a child, but now it's just so unromantic, it's so clerical and sterile and like ugly almost, just being upset that that was ultimately how we were going to have to do it. And we were like, okay, let's just take like a month or two and not dive right into this and just kind of be, and just enjoy ourselves before we start the IVF process. 

And magically, in that month or two we conceive naturally.

 The body's amazing, I think my body just so didn't want to go through that. 

That she was like, you know what, I'm taking that sperm and we're going to make it happen. That was July of 2021. And it was a pregnancy that did work out, zero issue and yeah, this past April, and now we have our little Nolan, magically.

Lisa: What a great story. Thank you so much for sharing all of that.

That's really, really cool. 

The Pregnancy

So, then what was your pregnancy like? You want to share anything about that and the ways you prepared for the journey into parenthood?

Crystal: Yeah, of course. Pregnancy for me was very easy. I kept kind of waiting for the shoe to drop. You hear the horror stories and see all the movies where the women are just consistently vomiting and so tired. I didn't have any of that. I didn't have any food aversions, I didn't have any real, like weird cravings.

I just pretty much felt good the whole time, more tired than usual, but that's to be expected. I think part of my superpower was that I did stay very active. I am a restaurant manager and you've been to where I work, it's a giant place with a lot of moving parts, a lot of stairs to climb. And I just kept doing it, and I think that kept me healthy. I feel like the days I felt worse during pregnancy were the days I was off and kind of just vegged out and stayed sitting. I didn't necessarily do any specific like yoga or working out while pregnant. My life kind of just was a workout. I think that kept me healthy and  it felt, it really was as best as one could imagine. 

Baby Breech in Month Six

Around month six is when they discovered that the baby was breech and he seemed like his head was up by my ribcage. It wasn't painful. In retrospect, it's kind of crazy that it was like that and it didn't hurt me. I would go in for my ultrasounds.

They had me seeing a maternal fetal medicine specialist for my ultrasound. So it was a little more, it happened a little more frequently than with a "regular bodied woman", just because I was slightly higher risk because of the anatomy of my uterus. So every time I went in there, starting with month five, we couldn't get a good shot of his face.

He was just so bundled up in a specific spot that, unfortunately, it was sad for me, I don't have those really nice ultrasound pictures of where you're starting to see. Does he have my eyes? Does he have dad's nose? Like I just kind of saw a little bundle because he would not move.

Little shy guy. Yeah. The opposite of me. My gynecologist, the gynecologist that the fertility specialist referred me to, it was an OB GYN practice of two gentlemen, Dr. Trombone and Dr. Petrocelli, both of whom were wonderful, five stars. All of my appointments with them, they made me feel at ease.

They were like kind, warm, great bedside manner. And they told me that, yeah, it was around six months. He was breech. He was bundled up. My uterus is very small because of the way it's shaped. And they were like, generally, at this point, we would start trying to turn the baby and do the things that they have to do to try to get him ready for birth.

But they were like, we don't even want to try that on your body, because he's just, he's in there and he's not going anywhere. They were like, if he does magically turn himself, then great. We can do a natural birth. But at this point, it's looking like cesarean is going to have to be what it's going to have to be.

Scheduled C-Section

So we put the date on the calendar and basically, just kind of counting down from there, as I'm sure you've heard other people say, or from your own pregnancy experience by like month eight, I was ready. I was just like over it, like ready to have him out, not even over it in that, because I didn't feel sick.

I was just, I just wanted my baby. I just wanted to be playing with my baby and hanging out with my baby and not having him inside of me. I wanted him outside of me. I wanted to tickle him. So I was kind of weirdly hoping that I'd go into labor and have to have an emergency C-section prior to my scheduled date, which is a weird way to think.

But I was like, hopeful for that to happen in a bizarre way. And it didn't, I went right up until the scheduled date which was exactly at 40 weeks. 

Lisa: That was going to be my question. Okay.

Crystal: Yeah. Because of the way the hospital, I know generally, with the C-section they want to do it like week 39 or even week 38, just so that you don't have an emergency situation.

But with the way the hospital was scheduled, the only date they could find me was like exactly at week 40.

Lisa: That makes more sense.

Went in for C-Section

Crystal: Yeah. Yeah, so went in for the operation. It was a Saturday morning. It was the Saturday of Easter weekend. I had an 8:00 AM appointment. They asked me to get there at 6:00 AM. So we stroll in at 6. 

And the nurse who was putting my IV in, it took her several tries to get it in my vein.

So that was a little nerve wracking and a weird bad omen to begin with, but it was fine. 

Lisa: That happens a lot with people, pregnant folks, for whatever reason and I don't know if it's like hard to find a vein, are people a little dehydrated, which makes it might make it harder? Or is it just the lack of experience of the person who's doing it? The nurse who's doing it? I don't, I don't know.

It's unfortunate though. Right?

Crystal: She kept saying too, it was, she kept being like, you have the most wonderful veins. Oh, your veins are beautiful, but then just missing them.

Lisa: Oh, geez. Then why is it going this way? 

Crystal: Literally, two other women had to come in. There were multiple people trying to do this for me. 

Lisa: That's unpleasant. 

Crystal: So I'm like, are you lying about my beautiful veins? Or are you just really bad at this?

So that was, yeah, that was the start of the day. But then we went in right on time. The process itself, I'm going to try to remember this as best I can. They brought me into the operating room. They wouldn't allow my husband in until after I had the epidural and was like up on the table.

Putting Her Mind at Ease

So I went in alone, and credit to this team, the doctor as well as like the other people that were in the room and the anesthesiologist, everyone was very pleasant and kind of had it down as to how to make someone feel like this isn't happening right now. Like we were chit chatting, we were talking about, I don't even, like fantasy football.

We were just like, chatting about other things that weren't oh, you're about to get your body cut open. So great, great on them. It very much helped to distract me. My husband was out of the room at that point, but could like hear into the room. And the next day, he was just like laughing, of course classic you, I just hear you and all these people get like busting a gut about like, who knows what? And you're about to have surgery. So credit to them, they did it. It felt like just people in a normal job another day at the office, like nothing scary at all, which put my mind in a very nice ease.

The anesthesiologist actually. Probably, he was like, yeah, I'm only a little bit hungover today, I had three glasses of wine last night, probably something you shouldn't say, but I kinda, it was comical to me. 

The Epidural

So the epidural went in, they laid me down. I then am like kind of mildly freaking out.

Like I think I can still feel my legs. I definitely can still feel my legs, so they did a test where they pricked me up and down my legs and I definitely couldn't feel my legs. I was just being a little crazy.

Lisa: You were a little concerned about that hangover.

Crystal: One last glass of wine and he would've done this right. 

Allergic Reaction to Ancef

So they put in the epidural something called, I wrote it down, Ancef. It's something they add to the, or not in the epidural, in the intravenous, in the IV that I had. Ancef was in that, because it helps to prevent infection when you're undergoing surgery. So I had never had this before, but all of a sudden I broke out in hives while I was like on the table about to undergo the C-section and the anesthesiologist is first he's like, did you have a few bug bites on your face when you came in here today?

And I'm like, no, I didn't. He's like, oh, okay, you're getting hives. And then as he's saying that, I feel my lips just expanding. And I'm like, are my lips getting really big too? Like, I feel like, do I look like a Kardashian right now? And he was like, yep, your lips are blowing up and you're getting hives.

He's like, okay, this is an allergic reaction to Ancef. He's like, I'm going to just monitor it for a little bit. I don't want to give you Benadryl because that will make you sleepy and potentially have you fall asleep through this process, and I know you want to stay awake for it. So I'm just going to monitor and make sure it doesn't get any worse.

If it does get worse, that's when we'll do the Benadryl. It didn't get any worse, it kind of all went away. It was just like a quick allergic reaction.

Lisa: Oh, thank goodness.

Crystal: So that was, that was wild. And then I threw up, which I guess is a very natural reaction just to getting the epidural. I was, as I said, just kind of chit chatting and all of a sudden I felt this like, oh, oh God.

And they brought me a bucket. I threw up. The doctor was like, that's a great sign, that means it's working. Great. It was a quick nausea, a quick allergic reaction, and then I was okay. And then my husband came in and yeah, the doctor was great during the process. He was kind of walking me through what he was doing.

Baby is Born

It was pretty quick. I went in at eight o'clock. The baby was out by 8:52. That was the time of birth. He is just kind of walking through the process. I didn't feel a thing, which is great. All of a sudden, I just, I hear crying and I, oh God, choking me up. I look up over that curtain and there's my baby covered in after birth, but the most beautiful thing in the world.

Lisa: And I'm just amazed and stunned and have morphine running through my body so crazy, and then they bring him, the baby to the other side of the room to, you know, clean him up. And I can't see him over because I have the...The drape.

Crystal: The drape there. And that's when they start putting my insides back in, but my husband kind of stood up to watch what they were doing with the baby.

 He also was amazed at this beautiful thing and he, the way he describes it, he was like, so I didn't see, I didn't look down at what was happening with him, you know, returning all your parts into your body. But I will describe that I saw a lot of colors, so that's yeah, there was, he didn't get a good look, but he saw colors down there.

So, it probably took about another 20 to 30 minutes of the after part of sewing me back up, and again, he's kind of walking me through. Okay, now everything's in, we're sewing you. At this point, they're weighing the baby. Six pounds seven ounces. Great. 

In the Recovery Room

And then they brought me into the recovery room and they asked me if I wanted to hold the baby and I was shaking head to toe, like violently shaking, which is a pretty common after effect, like obviously, my body's in a shock. So I declined because I was just, I don't want to hold my baby while I can't even control my arms. So I declined it first, and then as I calmed down, I finally got him probably about an hour after he was born was the first time I held him and did the skin to skin and just the most wonderful moment in the world. I know some women don't get the feeling right away, which is fine. Everyone's different, but I definitely did get the feeling right away. 

Lisa: It's wonderful. Thank you. And did your husband get to hold the baby sooner than you did?

Crystal: Yes, he had him, I believe while we were still in the OR not even in the recovery room or maybe I'm mixed up, it's all kind of a blur, but he did, he did hold him first.

Lisa: Oh, good.

Special Requests

And did you make any special requests in terms of like gentle cesarean techniques or anything like that? Like playing your own music or anything?

Crystal: We did play our own music. Which I actually hadn't even thought about leading up to the surgery. It's like the last thing on my mind. But the doctor before wheeling me in was like, oh, you have your playlist ready to go? And I was like, oh no. And I'm like, Corey, while they're setting me up in there, put some good songs on a queue and he did. 

Lisa: Oh, that's nice that he asked proactively.

Crystal: Yeah. He was great. I really can't say a bad word about Dr. Petrocelli, he’s the one who delivered the baby.

 We were in the recovery room, then they brought us up to the bedroom that I stayed in for two nights. That 48 hours in the hospital is like, almost in a weird PTSD way like I remember it, but I feel like I kind of blocked things out. It's just a whole cavalcade of like emotions in your brain, sad, happy, scared. It's hormones, it's okay, now I have to keep this baby alive literally by myself with my breasts. How do I figure out how to do this? Is he getting anything?

 It's crazy that it's impossible to see if he is or isn't. And then there's like people just constantly coming in, nurses coming in, because they were giving me Tylenol and Motrin, extra strength Tylenol and Motrin every, I believe, every two hours I got one and then the other. So that was happening.

And then they were coming in to check on the baby every couple hours. And then it just felt like a nonstop knocks on the door, nonstop characters in and out. And it like, it's obviously, it's what they have to do, but I just wanted to be alone. So that was a little frustrating. 

Baby Losing Weight

There was a point where, as naturally happens, of course, the baby like lost weight in those first 24 to 36 hours, so you can't help but freak out. 

 There was a moment where, I want to say it was like 2:00 AM. Corey was asleep, but I was awake alone with the baby and a nurse came in and was like, Hey, the amount of weight that he's lost is not good, and it's irregular, you should start triple feeding.

Like you should start pumping right now, you should give him formula and you should breastfeed. And my brain kind of exploded. It's 2:00 AM, I can't even think about, I don't even know how to breastfeed yet. How am work this pump? 

Triple Feeding

Lisa: Like a whole extra skill and more stress. And that's all the rage triple feeding. I can't remember if I brought it up in your class, but I often do these days, because so many lactation consultants in hospitals are really just prescribing that to everybody. Triple feed, triple feed.

Crystal: Yeah. What are your thoughts on that? Because I don't know, it was very scary at the time and I kind of just was like, no, I'm not going to do that. Like maybe had days gone by and he was scarily losing weight, I guess I would have, but it just, it seemed like trying to prescribe something that wasn't necessary so soon to a brand new mother who was like still had morphine flowing through my legs. 

Lisa: And recovering from major abdominal surgery is no small thing, you know? Yeah. So triple feeding, there's a place for it. I see the reasoning behind it, often is, well, you know, so many births have had medications and lots of IV fluids, and those things can kind of delay, introduce some challenges surrounding breastfeeding and how soon the milk will transition or also known as come in. And so that triple feeding could help be sure the baby's getting enough and encourage your body, stimulate your body more frequently to encourage that milk to transition on the sooner side. But not everybody needs to do it. It can be, we see a lot of us doulas are seeing that it's really causing anxiety, it's triggering postpartum anxiety in a lot of people, because it's just so much extra work that we're putting on new parents.

And is it necessary? Maybe in some circumstances. But I know everybody doesn't need to do it. So did they happen to tell you in terms of the baby's weight loss, what the percentage of weight loss from the birth weight, what it was?

Crystal: Yes. I don't remember the exact number right now, but I know that it was not like, it was in the average window. It wasn't scary. It was like on the higher end of what's normal. 

Lisa: A lot of hospitals would've started to suggest triple feeding or formula feeding if the baby lost more than 7% of the birth weight, but you had a lot of IV fluids for the surgery so that your baby could have lost more than 10%, before we actually need to take extra measures.

Contradictory Information

Crystal: I think he was at like 10%, but yeah. So this one nurse came in and scared the bejesus outta me and told me you got to triple feed. And then 10 minutes later, a different nurse came in and gave me a couple of things of formula and was like, here's formula, and here's how you do it. And then a few minutes later, a third nurse came in and I was like, oh, I was told to triple feed. And she was like, no, you're normal, you don't even need to worry about it. 

So it was just a lot of different characters and a lot of different information. The birthing experience itself was very positive, but the two days in the hospital, I kind of think of negatively just because, I don't know, it's just weird to get contradictory information from seemingly everyone I was talking to.

Lisa: From the same hospital. Oh, I'm sorry. That's so frustrating, because you're like, I'm a new mom. What do I do with this information? Which person do I listen to? 

Lactation Consultants

Were any of them an IBCLC, an actual like certified lactation consultant? Do you know?

Crystal: There were two different lactation consultants who, because they would come by daily. So in the two days I was there, I saw two different actual lactation consultants and they were the best people that we dealt with in that hospital. They actually, each of those women put my mind at so much more ease, like everything is normal, helped me to put the baby where you needed to be, to sandwich the nipple to show me what to do, squeeze out the colostrum and prove to me that it was coming out.

Lisa: That's helpful, because a lot of us are like, eh, I don't know if I have anything.

Crystal: Yeah. Those two women were the best people we dealt with in the hospital, the rest of the nurses, and they're just doing their job, I don't know, it was a lot of, I almost I'd rather just be alone than you people trying to be helpful and putting things in my brain, that's making my brain all scrambled with a million different thoughts. 

Lisa: Yeah, and so listeners, as Crystal is sharing this, I just want to point out that most postpartum nurses don't have a high level of breastfeeding knowledge and if they do, it's often outdated. And so ask your birthplace if they have an IBCLC, an international board certified lactation consultant available, because that's the professional from whom you're much more likely to be able to trust the information you're getting is actually evidence-based and current and hopefully encouraging, you know? 

And was your postpartum room private?

Crystal: Yes. 

Lisa: Mm-hmm okay. Yeah. Again, imagine having a shared room as is true for most of our local hospitals after major abdominal surgery. Like, after any birth, I can't imagine it, but particularly when you've had surgery, I cannot even fathom more disruptions, you know, their visitors and their baby and all of that.

So I'm glad you had the, at least you had the private, even though I know it still wasn't ideal. 

Crystal: Small silver lining.

Postpartum Experience

I guess, and I guess foolishly, I was so concerned. You're pregnant, right? So all you're thinking about is the baby and the baby's health and, okay now I'm going to have this child and 10 fingers, 10 toes. Does he have all his organs, all of that, that I never really researched or thought about this surgery that I was having.

And I guess that's life now, now that I'm a mother, the baby comes first, I come second. So I was pretty blown away by how awful I felt for the days and weeks to come. And I should have researched it further, I just kind of naively was like, I'm healthy, I bounce back from things really quick. I'll be up and at 'em in like day five and it's no, very much wasn't, and that feeds into the crazy postpartum hormones in that I literally couldn't stand up long enough to change a diaper. So then in my head I'm like, I'm a terrible mother, I can't even change a diaper, I'm in so much pain.

So the first week or so, even after getting home was just a rough mind game of like, as a person who is so active, and so go, go, go, having to like really step back and be like, you're only a human, I have to heal. But trying to heal while also trying to keep this tiny human alive was a wild mind game.

Thankfully, my mother stayed with us for the first week who honestly, like, she just kept me and Corey fed, three meals a day, beautiful breakfast, lunch, and dinners. Like that alone was like, I mean, she was great with the baby too, but even just to be fed meals was a lifesaver. Like we wouldn't have even thought to make ourselves meals.

Yeah. And then it was very clear, once you start breastfeeding, like, oh, I need to eat more than I ever have, like, days I didn't eat enough, I'd be getting shaky, so yes, getting those extra nutrients was great. What else? In those early days? Yeah, it was hard, it was really hard. And not to get political, but knowing what's going on in our country right now, there were...

Lisa: Feel free to.

Crystal: There were like, it's just like Corey and I were the most well-prepared two people. We're in our thirties, we have good jobs, we have a stable roof over our heads.

 In going back to work, we've worked it out where our schedules are great for child care, like down to a T, we built and prepared ourselves perfectly. And we were super overwhelmed and there were days where I was like, I can't do this. 

So to know that we're in a country where they want just everyone to have to go through with having this child, I don't know, even if I was slightly less prepared, I don't know if I could have done this. Like if I didn't have my mother there for a week, I don't know what we would've done. So it's just, it's really upsetting when I think of that. 

Lisa: I know, yeah, we're going to see huge hits to maternal mortality, which is already awful. Like, let's make it worse by doing this, and then also mental health is going to take a huge hit. Because like you're saying, you and I are people of privilege and we, and it's still hard but like, I can't even fathom those other scenarios.

It's heartbreaking. Yeah.

Crystal: I mean one positive, so I gave birth to him on April 16th. And as I mentioned before, it was Saturday of Easter weekend. So the hospital was very quiet, which was a big positive. When we were leaving the hospital, was it Monday or Tuesday? I don't even remember now, Monday, when we were leaving on Monday, it was like chaos, because it's like a weekday and it's not a holiday weekend anymore.

So we were very thankful that we happened to get this surgery scheduled for what was a very quiet, peaceful day in the hospital. 

Their First Walk Outside

So it was April 16th, my birthday is April 22nd, so six days after he was born was my birthday, and I was super proud of myself because for my birthday, we took a walk around the park with the dog and the baby.

 It was my first walk, not terribly far, but all I wanted was to get that stroller and get out with the family. So we did like a small loop around Astoria Park. And because my mom was still here, Corey and I were able to go out to dinner, just the two of us. Obviously right down the street, and by, you know, 45 minutes in we were like, okay, we're ready to be home and back with the baby.

But it was very nice to be able to get to do that. Six days post-surgery, I shaved my legs a little bit to go out to dinner, I was starting to feel a little normal again. And then as the days and weeks progressed, you get into a rhythm and things just got better and better.

Any Post-Surgery Issues?

Lisa: Going back to right after the surgery or the few days after, did you have any issues with gas and bloating?

Crystal: I didn't actually.

Lisa: Some people really do and some people don't, that's why I just wanted to ask.

Crystal: Yeah, I didn't. I did have, and it was pretty normal, but it took, I want to say like 48 hours for a bowel movement. 

Lisa: That was going to be my next question.

Crystal: It was like on the cusp of, I was out of the hospital, I didn't poop at the hospital and I was home and my mother was here. And she bought some suppositories and some Ex-Lax, but it didn't get to that point to where I needed to use it.

Like it naturally happened on I think, like day three post baby.

Lisa: So they sent you home, you said after 48 hours?

Crystal: Yes.

Lisa: That's fast.

Crystal: Yes.

Lisa: Yeah, usually it's more like three and a half days or so, but although during COVID, they had been sending people home like a full day earlier. And maybe you must have just been doing so well that they felt like they could send you home.

Crystal: Yeah. I could have opted, I could have asked to stay longer. I feel like my mental health got a lot better when I was out of there. So I'm grateful to have gotten out of there and be in my own environment, even though I was still in a lot of pain, like I'd rather just be in my bed.

Lisa: So it sounds like they didn't insist on seeing a bowel movement before they sent you home, but I'm sure they needed to see that you were urinating again.

Crystal: Yes.

Lisa: Some hospitals are stricter on things like seeing a bowel movement before sending you home than others. 

Crystal: Yeah, they did.

I was able to take a shower too while I was there, which was nice.

Lisa: Oh, nice. With like, was a nurse spotting you and just being sure you were all stable and everything? 

Crystal: No, I went in alone. I mean, I was like holding on and it was quick because I couldn't stand very long, but that first shower was one of the best showers of my life.

How did the Incision Heal?

Lisa: Yes, for sure. And what about the incision itself? Any observations in terms of, did you apply pressure if you had to sneeze or cough or just any observations on the incision and how it healed? 

Crystal: It did hurt with sneezing and coughing and laughing. There was like tape on it. And then when I went back for my four-week postpartum visit with the OBGYN, he removed the tape kind of just like a rip off, like you were getting waxed or something. But yeah, and never any infection, never anything totally unbearable.

I do remember like obviously it hurt badly, and specifically in starting to breastfeed, my nipples hurt really badly. So I remember for the first two to three weeks, every time I would get in the shower feeling like not even enjoying it, because the water hitting both my nipples and my stomach was just like pain.

But you toughen up and you get over it.

Breastfeeding

Lisa: Yeah. And did you find that you needed to do something like a football hold, alternative kind of ways of holding the baby when you were feeding him, because of the incision?

Crystal: Football hold actually never worked for me. I didn't try it a bunch, but just kind of classic feeding is how he started to take. So I never really wavered from that. As soon as I got home, I liked using the Boppy pillow, just kind of putting him right on there.

 That never bothered my stomach. And breastfeeding has, I've been lucky, it's gone really well for me. After those scary first few days, we did get in a rhythm. It hurt badly. I think, unless you were going through it, it's impossible to describe how much it hurts at first. Like just a chomping on your very sensitive nipples, is not pleasant.

And I was scared in my brain, is this going to hurt forever? Corey laughs because literally, in those first few days and weeks, he would know when the baby latched, because it would be compounded with me going like, as soon as I got the latch, a gasp of pain. But because we're resilient and the human body is awesome, there was just one day where I woke up and oh, this doesn't hurt at all anymore. It's just totally adapted to what needs to happen. 

Lisa: And can you just clarify, when you say it was painful, were you having any of the more severe issues like bleeding nipples or like blisters or cracked nipples, anything like that?

Crystal: No, and that sounds horrific, I never...

Never really any, they were like a little kind of chafed and purpley in those first few days, but I think it was just getting used to something they've never experienced before. But yeah, not the extreme to where I'd have to wear a nipple shield or anything like that, it was just, I think just a matter of getting used to it.

Lisa: Sure. Yeah, and I just wanted to ask that, in order to try to make a distinction for listeners, that if you were having those more severe kind of things, absolutely, call a lactation consultant, get them to come to your home if you can at all, Because there might be something going on that we need to figure out and work out otherwise.

But it does sound like yours was within the range of much more normal and to be expected, but not fun, and I'm right there with you, I had so many, I struggled for a long time, but I was bullheaded, I was like, going to do this, I was determined.

Benefits of Breastfeeding

Crystal: And actually from your class, I remember you highlighting a bunch of points of the positives of breastfeeding for the baby, as well as for the mother and specifically, the note that it helps to, in a very non-technical way, get rid of my baby weight, the contraction of the breastfeeding.

And I remember in those early days, literally feeling my uterus contract, as soon as he would latch, and feeling myself getting back to my normal body every time I would breastfeed, which is weird, but I remember that from your class and it's super interesting.

Lisa: I always love yeah. in class to share about the uterine involution shrinking process for sure, and how your baby's helping you to heal.

That's the part I really like to always point out.

Crystal: Beautiful, helping you to heal, I like that.

I love it, I almost get choked up every time I look down at him feeding from me, and it's really awesome to watch him grow and know that's all from me. Oh, that's the proudest accomplishment of my life.

Lisa: I love that. 

The Experience of Attending Birth Class

I was wondering if you would like to reflect at all on coming to birth class. I remember your cohort was smaller than usual. I usually have seven or eight couples, I think we started with more than two, but like it dwindled. I'm forgetting exactly, but I know we ended with just two couples.

Right. That was such an interesting dynamic, that's so different from most of my classes where one couple, you were, almost pretty sure you were going to need to have a belly birth to have a cesarean, and then the other couple was close to having a home birth, they were really wanting and I think did end up giving birth vaginally.

And I do my best in class to try to customize things, to meet the needs of everyone in class, but it's tricky because birth classes mostly gear toward preparing for vaginal birth, as you know, there are recorded lessons from my online course that do cover cesarean.

 I'm curious about what that was like for you and I won't take it personally at all, it helps me to grow and learn, but any reflections on that and did it, I hope it didn't feel like you were being othered, but I could understand how it could have. I don't know, just any of those reflections. 

And it was also, one other thing I'll say before I let you have the floor, is just finding that balance between you know, there was always this possibility that baby could turn flip head down, but I didn't want to get your hopes up because I didn't know how possible that was or not. And I appreciated the fact that you felt pretty at peace with the idea that belly birth might be the best birth and necessary birth for you and your baby. Anyway, those were some of the nuances that I was kind of juggling with your cohort, but anything you'd like to observe or reflect on that.

Crystal: Yeah. I mean, honestly, of course, because we didn't have a vaginal birth, to Corey and myself, the most useful of the classes were the latter two or three that were more post-birth, that were about the diaper change and the swaddle and the things that we really needed to know, and didn't know, as a couple. I don't have younger siblings, I've never really been around a small baby on the regular.

So the actual tangible skills that we learned from your class were certainly more helpful for us, because we didn't go through labor, but I genuinely was engaged and enjoyed learning about how deep you dove into the labor process. Honestly, just for an educational experience, because biology is awesome and the human body is awesome, and just to really dive into that was very, very cool. 

So to me, there was a while towards the end where I was almost like, why doesn't everyone just do this? I got to pick my date, I know exactly when it's happening, I know exactly when I can work until. I know it's going to be done within an hour, it's a pretty quick process. This is great, sign me up, cool.

But in retrospect, that healing process was terrible. In the weeks following, I was like, oh, okay, this is why everyone doesn't sign up for this because it's a much harder post-birth than vaginal delivery.

Overall, like we're super happy we took the class, super happy. And I think I said it even in class, through this whole process, people, we don't talk about things enough. We don't talk about this process enough. As a woman who had a miscarriage, I'm a huge advocate for talk about your miscarriage, once I had mine, learning all the people in my life who had had one, and I've never known, the more we communicate, the more we learn from each other, and you know, we're not alone. I think as women, we want to be so strong and want to figure it out for ourselves. I feel like that went on a weird tangent. 

It was fascinating to learn the actual ins and outs of what a labor looks like versus all I've ever seen was TV shows where a gush of water comes out of a woman and the classic breathing and like the dumb tropes that you see in movies.

Would You Like Another Baby?

Lisa: I'm curious, if you don't mind my asking, do you think you would like to have another baby? 

Crystal: Yes. 

Lisa: Yes, you would.

Crystal: Yes, and it might be crazy, but I'd like to do it tomorrow. 

Lisa: Wow, that's pretty soon. 

Crystal: I know having just gotten over that pain and all the crazy, crazy hormones, we would like two children and I want them to be fairly close in age and I want to make it happen sooner rather than later.

Lisa: One thing that occurs to me physically is that, you know, now that you've carried a baby full term, given birth, the uterus has been stretched out a lot, and after we've given birth once, it seems to be stretchier. So I kind of wonder, it seemed like when, in our discussions during class, you felt like maybe the shape of the uterus, but also like the size of the space that the baby had was part of what was causing him to stay breech.

And so I kind of wonder, maybe in a subsequent pregnancy, maybe there's going to be more room in there for a baby to flip, to head down. If that were the case, would you just want to go ahead and schedule another cesarean or would you hope for a VBAC? 

Vaginal Birth After Cesarean

Crystal: I'm under the impression, I may be wrong, that once you have a cesarean, you kind of have to do it again.

Lisa: No, actually evidence supports having a vaginal birth after cesarean. I mean, I can't speak to the nuances of a bicornuate uterus, I wouldn't think it's different, and you do have to, if you want that, what we call a trial of labor, to try to have a vaginal birth in subsequent times. It's very evidence-based, but you have to find a care provider who's supportive of that because there are not a lot of them. Because for so many years, it used to just be the default to return to having a cesarean after, many are stuck in that older way of thinking.

But yeah, there's a lot of evidence to support that. So just for your knowledge, for your options and possibilities, just something to ponder and if it's of interest, but some people are like, no, thank you, I'd rather just do another cesarean and that is your choice.

Crystal: Yeah, I know. I definitely would be open to doing vaginal if that were possible. Yeah, that's good to know. I really thought, and again, knowledge is power, we just have these assumptions, but...

Lisa: If you're interested I can email you some information on VBAC. 

Baby Born with Hip Dysplasia

Crystal: Oh, I guess the other little thing that might be interesting for the audience is that Nolan, that's my son's name, Nolan Wesley, he was born with hip dysplasia, which is pretty common for breech babies. So both of his hips were out of the sockets. They did an ultrasound in the hospital on day two, then they referred me to a pediatric orthopedist who we went in for our first appointment, actually on my birthday. So day six of the baby's life, we brought him for this appointment and they put him in a Pavlik Harness to correct the dysplasia.

And four weeks later we got ultrasounds done again, and it looked like one hip was improving and the other one was not really moving. So they changed him up to the Rhino Harness, which is like a little turtle shell thing. It's like a little bit harder and more secure, so they thought that might work better.

Four weeks after him being in that, he went for another ultrasound and it appeared as though his left hip was pretty much completely healed, but the right one still hadn't moved at all. So as we speak, we're now scheduled to actually, he has to go under, and do a little procedure. We're doing an open reduction which will put him in a little body cast, to fix that right hip and pop it into place in two weeks, August 3rd, we're going in.

So that'll be another challenge. Now he's starting to learn his legs and it's kicking and he seems so happy that it's nerve wracking to think he'll be like casted up. How will he take it? Will he like become, I don't know, how will he sleep? Everything is a new curve ball to have a baby in like a body cast in a couple of weeks.

 That's the latest challenge now that we've conquered the hurdles of me feeling better, the baby kind of getting in a groove, he's sleeping great, everything's cool, now we have to deal with this curveball. But that's life, and hopefully, the good thing is that this was caught really early.

 I'm in a Facebook group of moms with babies with hip dysplasia and seeing these stories of, my child was just diagnosed at two years old and we have to undergo this surgery and go into the spica cast. He doesn't know anything yet, so it's kind of the best timing. If you're a child who's used to walking and then all of a sudden you can't for six weeks, that's got to be a hundred times worse.

Lisa: Wow. Well, and are there any, for anyone who's listening who might have a child with a similar issue, you mentioned a Facebook group, but which I believe I know about, but I might just double check that with you, because I'd like to include that in the resources page, if it's open to anyone who might find that supportive. But are there any other resources on that topic that you think could be helpful for people?.

Crystal: I don't know the name offhand, but I can send you, my husband found a blog, a mother who took the time to like really deep dive into what products are good, what sort of chairs are the best for your baby to sit in while in this cast? What sort of body carriers are the best? What are some good techniques for how to hold him when feeding, because his body will be different now? I don't know the name of that offhand, but I will send it over for the notes.

Lisa: My heart goes out to you in that, and I hope that is it a surgery coming up?

Crystal: Yes. Yes. 

General?

Yes, poor little guy. There's two different ways they do it. They're going to go in and try to put the ball into the socket and pop the hip without having to cut into him. Under x-ray, put the ball where it needs to be and then cast it up.

The doctor said there's about a 20% chance that that's what they'll be able to do. If they find that they're not able to do that without cutting into him, they will have to cut, but it'll still be under the anesthesia. They'll just make a small incision under his groin area, so it won't even be like a visible cut, and then they'll have to go in and physically do this. So one or the other, depending on what they see when they're in the x-ray.

Lisa: Have you found other people in that Facebook group who've gone through that particular surgery?

Crystal: I haven't deep dived into it. 

Lisa: I was just curious if there had been, if you had found support in that specific way.

Crystal: No, that's something I should do, I'm sure, because people all day I'm getting notifications like all day, every day of various questions and answers and this and that and the other. So I should kind of read on more like real life experiences about that from other mothers. I'm sure they're on there.

Lisa: Well, thanks for sharing that. 

Incision Healing

I just wanted to ask a question about the incision healing. Did they recommend that you do some massage, scar tissue massage?

Crystal: No, all the doctor recommended was getting Mederma, just like an oil that I've been putting on pretty regularly, but it's healing up nicely.

Lisa: Yeah. I think I sent you a brochure from a pelvic PT with some tips on that. If, in case it's ever helpful, I can send that again. But most pelvic PTs recommend doing this massage just to be sure that the fascia, as it's healing, the layers don't kind of meld together, because that can create pain, it can just create some issues. So that might be something to consider doing.

Crystal: Always thoughtful, Lisa.

Lisa: Well, I just figured, I thought that any surgeon who does it or OB, would standardly recommend that. 

Crystal: No.

Lisa: All right. 

Anything Else to Share?

Anything else that you haven't gotten to share that you were hoping to share? It can be anything, but I'm just thinking about any observations about the emotional arc of this journey or any psychological or emotional reflections. 

Crystal: It's really worth it, everything is worth it. I am a person who always bounced back quickly, I'm like a goer, a mover, a shaker. And it was a harsh realization to kind of have to take a step back and lay in bed for a few days. But once you get your routine going and seeing that little face every day, and once the smiles start, it's just, it's so magical and so beautiful, the greatest thing in the world, the greatest thing I've ever done. As I said, I'm eager to do it again, despite all the pain, despite all the mental turmoil that comes with it, I want it again. I am just so happy with this baby. I'm so happy with this decision. I'm so happy that everything worked out for me, you know, since I was 16 years old, kind of not knowing if it could happen and having it happen in the way that it happened, it's really awesome. Thank you for letting me share my story. I love talking about this stuff. I think it's, as I said before, important to communicate, important to know you're not alone, to know that there's so many women. And I'm not even old, but I feel like now that I'm in my mid-thirties, a lot of other women have fertility issues and have to do this, that and the other to get themselves pregnant.

And it's weirdly a taboo thing to talk about, and it shouldn't be. I have a very dear friend who is having a hard time, they're trying and kind of she's starting to maybe, I should do acupuncture, maybe I should do this and that, and it's uncomfortable that people in her life will be like, hey when are you guys getting pregnant? It's uncomfortable that's a question that we as women, get a bunch once we're like married and of a certain age. Like, it's almost disrespectful to be asked that because you don't know, you don't know the backstory, or maybe you just don't want children and that's fine too.

Everyone has a story and I appreciate that you have this podcast and you do your classes and you advocate for women and for everyone to share their stories so that we all learn a little bit more and get a little more open-minded and the whole thing.

Lisa: Absolutely. Yeah. Thank you so much. I'm grateful to have this podcast because like we were saying, there's limited time in class. I honestly really wish that it was marketable to have a much longer series, so we had a lot more time to really go into every birth scenario, but busy New Yorkers won't sign up for anything longer than what I offer.

 That's where it gets so tricky in choosing what we're going to focus on and all that. But I love having the podcast to be able to take deeper dives into and try to destigmatize cesarean, because if it's necessary or if someone's choosing it for whatever personal reason, nobody should feel any shame around that.

 So we really need to destigmatize that. So thank you for sharing your story so that hopefully people who are on a similar path, can just find encouragement and education and just how beautiful and powerful your story is and your birth. I just love it. So thank you for sharing.

Crystal: Thank you.