Birth Matters Podcast, Ep 111 - A Pediatric ICU Nurse’s 3rd Preemie

Ellen, who shared her first two babies’ birth stories in Episode 26, returns to share her son’s preterm birth story following a relocation from NYC to California where they are now homesteaders growing toward self-sustainability. She had wanted an unmedicated birth with midwives, but due to her history of two premature births, she stays with a high-risk OB who provides midwife-like, compassionate care. At the 20-week scan, Ellen learns their son has a cleft lip, like his dad. Despite this, he ends up being the only one of the 3 for whom breastfeeding comes easily.   Ellen lays low and stays pregnant a bit longer than with her daughters, and despite her son being born a preemie, he doesn’t need the NICU after birth. She shares how much she struggled in the first month, despite all her preparation for and support in the postpartum period. The details of Ellen’s story drive home the importance of being quick to speak up if you’re ever not okay in the journey into parenthood. And stay tuned for some mental health resources that may be a lifeline for anyone who might be struggling; those will be shared in the commentary after Ellen shares her story.  

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Episode Topics:

  • This baby was sort of planned, but it didn’t happen until they stopped trying

  • Wanted to use birthing center or homebirth midwives, but history of 

  • At 20 week ultrasound, learned baby had cleft lip and marginal cord insertion - they didn’t communicate it in a compassionate way, but her MFM doc called her and put her mind at ease

  • History of preterm premature rupture of membranes

  • This baby made it longer than the others (to 35+1 weeks)

  • Had more round ligament pain this time, saw a chiropractor this pregnancy

  • MFM recommended stopping work at 31 weeks even though she was working at home

  • Watching 10 seasons of CALL THE MIDWIFE on Netflix, was watching one when her water broke

  • Hired a doula around 30 weeks after not hearing back from several she reached out to

  • Found her doula next to her chiropractor’s office - a nonprofit group of doulas. First person she met became her doula (was her doula’s backup)

  • She was very superstitious and didn’t want to message her doula until she was 35 weeks

  • She messaged her doula and later that day her water broke

  • Her mother knew she was in labor without being told

  • Drove to hospital

  • 3cm/70% effaced/-3 station in triage

  • UCSF was hospital – she works for them and they have excellent NICU care

  • This hospital provided a birth plan questionnaire. She didn’t want residents.

  • She didn’t like that they said they’d want to induce if her contractions didn’t start within 6 hrs (in past birth she was given 36 hrs)

  • Advocating to wait and decide on pitocin or not – she said yes but requested to keep it low. They started at 2, 1.5hrs up to 4, very much works

  • She went on all fours, hadn’t ever had back labor until this labor

  • Had to pee frequently and it was painful

  • They kept offering epidural. She signed consent to get them off her back but didn’t get it

  • She feels the need to push, resident comes in and sister advocates for someone more senior

  • Chief resident comes in

  • Pushes for only 8 minutes, but felt longer

  • Had visions of CALL THE MIDWIFE in her head while pushing

  • Baby came to her chest, no breathing problems despite being 35 weeks, delayed cord clamping, delayed weighing for an hour or so

  • Lots of specialists after birth - advice on best bottles for cleft lip, speech therapist, assessed for tongue/lip tie (no issue like her two daughters), could see all the info in MyChart

  • Unilateral partial cleft lip (they didn’t have details until after birth) - 3-6 months to fix; palette was closed. She has extensive experience working with Operation Smile (has done about 20 missions with them).

  • They will meet with a surgeon in a month to discuss surgery to 3-6 months

  • Linden had to be readmitted for jaundice

  • Feeling tons of pressure to supplement to get rid of the bilirubin and help him gain weight

  • New Year’s Eve no power, having to pump, all the pressure bringing on baby blues

  • Triple feeding - feeding at breast, pumping, then feeding baby pumped milk. Every 3 hours. 

  • She had only been sleeping 1 hr at a time, was struggling more and more

  • Stopped doing it after 2.5 days, just breastfed and baby grew just fine

  • Spoke up to family and friend saying she’s not ok

  • You can do all the things to prepare for postpartum but there’s only so much you can do and you need to speak up for help as needed, establish boundaries

  • Abhyanga postpartum ayurvedic massage in postpartum - helped with postpartum healing

Interview Transcript

Lisa: Hi, Ellen. Welcome.

Ellen: Hi Lisa. I'm so excited to be here.

Lisa: I'm so glad to see you again. You're now on the west coast, right? We met back in 2017 when you took my birth class. Would you mind taking a moment to introduce yourself.

Ellen: Yes, so my name is Ellen. I am originally from New York from Queens, and I met Lisa through my wonderful midwives at Central Park Midwifery. They referred her for a childbirthing class, which my husband and I took with our first baby in 2017. And since then, we've pretty much kept in touch. And I've had three babies since then and we've done this once before.

And just to point out, my sister also took your class recently, like last year.

Lisa: Yes, and she just came over for a visit with her daughter and I got to cuddle Autumn. It was so fun.

Ellen: She loves you.

Lisa: Love them too.

Ellen: Yeah, she lives in Astoria and I was like, oh my God. There is a wonderful resource that you can have there. Like she knows everything so I gave your information. She is really happy with the class and really enjoyed meeting you.

Lisa: Thank you so much for sending her my way. I feel like they're just sweet friends now. Neighborhood friends. That's been really nice. And she like brought over cupcakes.

Ellen: I know she told me, that was really sweet.

Lisa: Brought eggs and maple syrup before the birth from the farm that they farm sat. I loved it. It was so sweet.

Ellen: I know. Well, I told her, I said, Lisa gave me like a June bug. Like she's really into a holistic lifestyle and I'm sure she would enjoy the eggs and the cupcakes and that was really nice of her. I was actually jealous of the duck eggs.

Lisa: Oh my gosh. I had never had them before and she warned me that they can be very, I forget which word she used, but I loved them. I thought it was great. And it was so fun to try that. 

Ellen: They're fattier, so 

Lisa: Uh Huh

Ellen: They're usually really good for baking.

Lisa: I just fried it and I thought it was great. It was more rich, I think, but yeah.

Moving to California

Yeah. Nice. Well, so remind me how long ago you moved to the West coast, cuz you're in California now, right? Sacramento.

Ellen: So we moved outta New York in December, 2019. We moved to Oakland

Lisa: Right before the pandemic.

Ellen: My husband got a job in Oakland. And then the pandemic happened, which locked us in Oakland for a year. We had family in Sacramento. He grew up here, his mom was here, but still about an hour and a half, two hours away from Oakland.

So it's still hard to have any help at that time, I had two little kids. I had a two and a half year old, and a two month old, so it was really intense. And Covid started, and the world stopped and we figured living in Sacramento would be better with the help. So we moved here a year later. We bought our first house ever.

We moved in December, 2020, and then my sister moved here from Long Island. So now they live 20 minutes from us, 20 minutes away. And now we have a little homestead. We have a bunch of chickens, we have a huge garden. Everything just flipped from living in the city. Like we were living in the East Village, the West Side, Long Island City, Forest Hills, and then to a homestead in Sacramento.

Lisa: And I tell you all the time on Instagram, I have garden envy because you grow amazing things like, so many things. Were there pomegranates?

Ellen: So the house is a third of an acre. The house itself is about a thousand square feet. It's very small. It's a two bedroom house, but the lot is a third. So the garden itself is about a quarter of an acre, a little bit more. When we moved, there were already three pomegranate trees and a navel orange tree, two plum trees, a massive grapevine.

And since then, we've just planted more trees. We have like four apple trees, four Bradford pears, persimmons... 

Lisa: Have you started a farm stand yet?

Ellen: Not yet.

Lisa: Oh my goodness. That is really cool. Very different life, like you were saying from New York City urban life.

Ellen: Yeah. And we are just enjoying growing more of our food each year, so that's been the goal.

Third Pregnancy and Finding a Provider

Lisa: Love it. Love it. Wonderful. I'm curious to hear as you share your pregnancy and birth and postpartum story, just the differences between giving birth twice, in New York versus, California. But, So with that said, would you like to just share anything about your pregnancy?

Ellen: Yeah. So a lot of things are different, a lot of things are the same. So the third baby, we sort of planned it and then towards the end we just gave up and said, you know what, if it happens it happens, like one of those things, right? First baby, Evie, was an IVF baby, didn't think we could have a baby at that time.

Second baby was a surprise, third was pre-planned, gave up, and once we gave up it happened.

Lisa: That's how my sister was conceived.

Ellen: Yeah. And now we're like, no more and then living in Sacramento, the first thing I thought was, I wanna stay with midwives. Central Park Midwifery is like the thing that kept me sane. Like my midwives, Christina and Elaine are like the best.

Like, I wish I could have flown them here and I mean, there were times I would still message with them, so I wanted midwives. But in Sacramento it's not as easy to—

Lisa: Really?

Ellen: –use a midwife. It depends on your insurance, it depends on the hospital. A lot of the midwives here are practicing in birth centers, or home births, which has gotten bigger.

I met with some midwives in home birth centers. One of the caveats was once I say I had two premature births at 35 plus three, the second was 34, they're already hesitant to take me on until I was seen by a high risk doctor. So that was like a prerequisite to be followed in the birthing center.

So I saw a high risk doctor, gave our story and she decided to keep me. She said, you're giving birth earlier and earlier. There's a risk that you could give birth earlier than 34 weeks. I don't feel comfortable having you give birth in the birthing center.

Lisa: Your babies being essentially healthy.

Ellen: Cece was the 34 weeker, stayed in the NICU for a week, but she was a growing feeder. She didn't need any medical intervention, didn't need a feeding tube, didn't need anything. She was really concerned. So she kept me through the whole pregnancy, did so many tests, so many ultrasounds,the good thing is my high risk doctor, mentally, it was like a midwife. She listened, she was caring, she made sure every issue was addressed. She spent a lot of time with me. She was never quick to run out of the room. She was very respectful. Yeah. I had Covid at eight weeks pregnant and one of the things was I couldn't break my fever. it was 103.5. Tylenol would bring it down to 101. I was really nervous. I called the OBGYN office. They sent me to the ER. Once I got to the ER, they didn't do anything. They were like, you can go home, no ultrasound, nothing. even like a peace of mind or a kind word. It was not a good experience.

So I told my high-risk doctor, and she was so empathetic. She encouraged me to like a letter, tell about your experience. This should not happen. You know, your, your valid, your, all your emotions. So despite that, she's a high risk doctor. She was still very present in her care. And I think if it was somebody else, it would've been different. 

Cleft Lip and Marginal Cord

So, yeah, she followed us throughout the whole pregnancy. We did a 20 week ultrasound, and we found out that the baby has a cleft lip, and a marginal cord. And again, when I had the ultrasound done, you know how they keep you if something's wrong or something needs to be addressed. They put us in a room and automatically I'm like, why are we in this room? What is going on? And we just waited there. And then another doctor came in who was not my high risk doctor, she sat down very cold. She said, you have a marginal cord and the baby has a cleft lip.

Do you have any questions? I was like, many. What? I had never heard of a marginal cord.

Lisa: Because it never happened to the other two kids. It just wasn't a thing. And the cleft lip, I knew there was a chance, my husband has a cleft lip, But again, like it's not something you just say in passing.

Right. oh, this is casual. No big deal.

Ellen: Yeah, and I was like, what is a marginal cord ? I've never heard of it. And she explained it very briefly. She's it just means like the cord of the placenta is not centered, it might be deviated to the side. That just means the baby's not getting all the nutrition or oxygen. It could be a cause for concern later down the road.

Maybe we'll induce her early if 34 weeks, the baby's not growing. And I was like, this is not something lightly to be said. I had a feeling I was gonna go early, but even then it was just abrasive, so we left there just confused. I messaged my doctor right away and she called me.

She was like, let's talk about this. What are your questions? I'm not trying to minimize it, but it's really not a big deal. We don't really see anything going wrong with a marginal cord. It's just worth mentioning. And since your babies are born early, they might not even be affected. and she really just put my mind to ease.

And the cleft lip was like, it was hard to visualize. The baby's always prone, through the whole pregnancy, the baby's prone. We had no idea how severe his cleft lip was, if the palette was involved. and she just always said it doesn't seem like his weight's affected throughout the pregnancy.

She'd reassure me and say, the baby's growing. It seems like he's swallowing fluid, that maybe the palette's not open. Just things that really put my mind to ease, and towards the end, it was just like the same care and thought that she provided. Unfortunately she wasn't the one that gave birth to Linden but you know, her guidance through the months ahead was really more important to me. 

Pediatrics Background and PROM

Lisa: And with your background as a pediatric nurse, did that help you? I mean, it sounded like you didn't really know what all this, I mean, the marginal cord insertion, obviously that wouldn't be something, I don't think that as a pediatric nurse, that's like way before when you work with babies, but the cleft lip and the fact that Lo has that, what was your like existing knowledge base of that?

Ellen: I mean, it's super interesting, right? So yeah, the marginal cord, pediatric nurses don't really hear from it. And my background is pediatric ICU, so what we cover in our line of work is so different from well-baby or even neonatal or pregnancy. It's just a different process and mentality.

So I've never heard of it. Now I'm pediatric pulmonology, so knowing that the baby's premature, I guess I didn't mention this, that all three babies were PROM. but we knew that-

Lisa: Can you explain what that is for people who don't know?

Ellen: So PROM is -premature rupture of membrane and there's really no hard and fast reason why it happens.

It's a luck of the draw from what I see, or from what I've read or heard and from what my high risk doctor was telling me, it's just, each pregnancy tends to get earlier if you have a history of PROM, and that was a concern. So, three babies, my water broke pretty early. The first one was 35 weeks plus three days.

The second one was 33 weeks and six days, and they kept me pregnant for another day to make it through 34 weeks, got doses of steroids to help with the baby's lungs. That's why the baby stayed in the NICU. And then the third baby, his water broke right at 35 weeks, which was like weight was lifted off my shoulders because it was such a marker, right? They told me that if the baby's born before 35 weeks, he's going to go straight to the NICU, all these complications, all these things that could happen. But as he made it to 35 weeks, he was actually 35 and one when he came out. A lot of things just changed.

It was like a world of difference. No NICU stay.

Lisa: Oh good.

Ellen: No intervention. He never left my bedside. Like it was just amazing. So back to PROM, it's premature ruptured membrane and just higher risk for premature birth and complications that come with it.

Symphysis Pubis Disorder and Round Ligament Pain

Lisa: Can I ask you a question about your own body and pregnancy? I know that you had some back issues and, symphysis pubis disorder, I believe, right? With one of your pregnancies, the second one, right? I believe. Yeah. Did you have any of those things in this pregnancy?

Ellen: I had more of a round ligament pain, and I don't know if that's because, I'm older, I'm 41 at this pregnancy, it's a third baby or just the body is the way it is with, you know, the relaxins and being heavier, all the factors, right? So I saw a chiropractor regularly for this pregnancy because I was afraid of the pubic symphysis dysfunction, which is when you have too much relaxin, that your pelvis is imbalanced.

It was so painful during my second pregnancy that I could barely walk. And I was afraid of that happening. So seeing a chiropractor, but this time it was more of a round ligament pain that at one point I thought I was gonna give birth earlier. Many sensations that's happening that you're just concerned.

And most of the time I ended up just staying in bed, like really listening to my body. If something hurt, just pause, honoring what my body and the baby's telling me. I mean, if you take it for granted, but it's so huge. And I think with the third pregnancy, I was just so much more in tune and respectful to what's going on with my body and just really listening.

The first two, you're like, eh, it's okay. Or even the first pregnancy, you're like, eh, it's okay. It hurts, but I'm gonna push through. And then as you experience these pregnancies more, you're like, you know what? There's something to be said when your body and your baby's telling you to stop.

Lisa: Mm-hmm.

Ellen: And I think if I didn't stop, I would've given birth much sooner.

Lisa: Very likely. Good for you. For listening and slowing down. So anything else to note about your pregnancy and processing the news of issues or slight concerns about baby.

Modified Bedrest and Call the Midwife

Ellen: The one thing that surprised me, my doctor really convinced me to stop working at 31 weeks and I was working from home. So I said, if I stop working now, I'm just gonna clean. 

Lisa: What am I gonna do?

Ellen: It would be worse. Yeah. But she said, don't underestimate the stress of working from home and don't think that it won't affect your baby.

I highly recommend you just take this time to process things and sit with your body. And I was like, okay. And I did. And I, I'm glad I listened to her. I was really reluctant because I like my job, I enjoyed it, I'm sitting. It could be worse, but when I stopped, I really stopped. Some parts of it when I said I was listening to my body, I would put myself in a modified bedrest and just rest. One of my mom friends suggested watching Call the Midwife on Netflix, which is like a BBC show on midwives. 

Lisa: Lots of births.

Ellen: I watched 10 seasons of it. 

Lisa: Wow. 

Ellen: I was,

Lisa: Over the next, you had four weeks.

Ellen: Yeah, but you know what, it helped me so much during labor. Like I have to give credit to it because as I was pushing the baby out, and I was telling my doula this, I was just envisioning all these babies being born in Call the Midwife and how, it sounds silly, but like I could envision his head coming out.

I felt his shoulders come out and I think just all those visuals from Call the Midwife really helped me process it. Yeah, so I chilled, watched Call the Midwife for 10 Seasons. When my water broke, I was watching Call the Midwife, and it just started it off. So it's been a big part of my pregnancy.

Lisa: How many episodes is that? That's many, many episodes.

Ellen: Well, each season was probably 8 to 10 episodes. It was a lot. I mean, I also had insomnia during pregnancy, especially during the later times. So it'd be 3:00 AM and I'm watching Call the Midwife on my phone, nestled in with my two other girls who are now three and five, and they're still co-sleeping with us while 30 something weeks pregnant.

And I'm laying in between the two, so I'm like snuggled in, could barely move. But I had my headpiece and my phone watching, Call the Midwife.

Lisa: I love that image. That is such a sweet image.

Ellen: I would send my friends pictures of how I couldn't even move. Like I literally have a toddler on each side and to get to the bathroom it was like, do I really need to go? Cuz it's really hard to get up.

Lisa: So maybe not as sweet and glamorous as it sounds.

Ellen: It's, no, but I also knew, it was like the last few times I'm gonna be able to do that, the baby will be with me in the bedroom, and they really can't stay in the bed because they kick and–

Lisa: Yeah.

Ellen: Yeah.

Finding a Doula

Lisa: Yeah. great. Well, so that sounds like it's leading into your birth story. Do you wanna just go into that?

Ellen: Yeah. So like I said, I was watching Call the Midwife and I was very superstitious with this pregnancy. So I, for the first time, have a doula because I wasn't going to have midwives during labor. So I needed an advocate. I needed somebody on my team, I needed an ally. 

Lisa: I'm glad you brought that up because I was about to ask that, but then I forgot that I was gonna ask that. At what point in your pregnancy did you hire your doula?

Ellen: I think about 30 weeks, pretty late, like 28, 30 weeks. And it was pretty serendipitous because I was looking for a doula months before, messaging a lot of doulas. Didn't hear back from any, so I said, okay, maybe it's just not meant to be. I found a chiropractor that specializes in pregnancy care. I went to see her, it's called, Sierra Valley Chiropractor in Sacramento.

And then when I pulled in, I saw a cute little store next to it. I was like, oh, that's a cute store. It has like baby stuff. So went to see the chiropractor, had my treatment and then I was like, oh, what's that store next door? It's so cute. She goes, oh, it's our nonprofit doula group.

I was like, oh, excuse me. So she talked to me about it. She said, yeah, we have a nonprofit. Me and another person opened it last year. It's here to serve the community. It's basically pay what you can. They have tiers of what you can pay, but they never turn anyone away because of money.

And they really wanna take care of the underserved. A lot of us women of color, it's not just easily accessible to have a doula. So she's like, why don't you go next door, talk to somebody and see what it's like. And if you feel like it's a good connection, take it from there.

So I went after that and talked to the first person I saw.

A sweet person. I didn't know at the time that she was a doula. I thought she was the front desk girl. She talked to me about it. She's like, you can fill out this form, asked me when I was due. She's like, these are the midwives that are available.

And as soon as I walked in, the place was just like, it just hugged you.

Lisa: Oh, I love that description.

Ellen: It was like being in the womb, it was so comforting. The smell, the vibe, everyone's energy was low. It was very calming. She just said, yeah, these are the women that are available to be your doula. I'll set you up in a meeting with 'em. Met with one of 'em.

Her name is Aisha. She was great. She actually turned out to be the front desk at the chiropractor office, which I didn't know. So it turns out they all just run the chiropractor and the doula service. It seems like there's all moving parts because the front desk girl at Haven was also a doula.

Fast forward, my doula, Aisha, when my water broke, was not available. She had her backup come in, which was the girl at the front desk-

Lisa: You first met- 

Ellen: -who was Baja. Yeah, it was like a full circle. So I was glad that even though a backup came to my birth, it was somebody I already knew and liked, cuz she was really lovely.

Water Breaks and Labor Begins

Yeah. So going back, my water broke. I was very superstitious. I told my doula, I said, I have a history of preterm birth. I might give birth early. I don't have the option to labor at home if I give birth early, and you'll just probably have to meet me at the hospital. And I've never worked with a doula, so I don't know a lot of things about it.

I've only worked with midwives. So we had planned on that and I said, I'll touch base with you in my pregnancy, and for some reason I'm very superstitious. I didn't wanna message them until I made it to 35 weeks. 34 was my marker. I was like, okay. My goal was 34. Once I hit 35 that morning, I sent her a text.

I said, Hey, I'm 35 weeks. If I make it to 36, I can labor at home. She's like, oh, great. let's you know, think about that. Let's put our mind to that. Later, that afternoon, my water breaks. And that morning also another superstition, my husband and I were talking, we're like, when should we install the car seat?

We're like, I don't know, because the first time we did it, my water broke the next day. So it's so silly again. But of course he installed it that morning.

Lisa: No way.

And everything happened that afternoon. Yeah. Superstition reinforced.

Ellen: I know it was crazy. And the same story, right? I was laying in bed, not doing anything, relaxing, resting, watching Call the Midwife.

The same with the two births laying sideways. My water just breaks. It starts to leak. And obviously I'm going into denial. I'm like, no, it can't be. I probably just have to pee. I'm probably just becoming incontinent, because I'm later in my pregnancy and it wouldn't stop. And I, on the way to the bathroom, I gave my mom a look.

I must have given her a look. Went to the bathroom, went back to my room, went to the bathroom. And then I texted my husband, I said, my water broke. Let's try to get ready. Don't tell mom. And as he's walking in the room, my mom goes, she's giving birth isn't she. And I was like, dang it,

Lisa: You're not supposed to know.

Ellen: I was trying to keep cool. But you know, moms, they just know. My mom has this thing where her boobs hurt when something's going on. So she's like I just knew, something in my boob, and it's like a constant thing throughout her life.

Something happens, if she gets like a sensation in her, it must be like a breastfeeding connection.

She gets a sensation. She'll call all of us and say, is everyone okay? Because my boob was hurting. So something like that must have happened. She knew I was giving birth. By then we had everybody ready, we planned where the other two girls will be. My mother-in-law was coming in to help. Lo and I were already prepared, where our bags were ready, and we just drove to the hospital like, very chill. Partly in denial, trying to have conversations like, so how's the weather, how's work, on the way to the hospital? 

Checking Into the Hospital

And we get there, we went to triage. they checked me, they said I was three centimeters dilated, which I don't think I was dilated the first two births when I came into the hospital.

So it was new and I was 70% effaced. Obviously station was like, is it plus three? Plus three is, oh no, minus is three-

Lisa: Okay. I was gonna say, wow, this baby's about to crown.

Ellen: -minus three. So still, high.

Lisa: Although with a third baby could be plus three.

Ellen: Yeah.

Lisa: Yep.

Ellen: And we went with UC Davis, which is a big hospital in Sacramento within the UC system. It was intentional.

I worked for the UC system. I work at UCSF. I wanted a big hospital with a children's hospital with a NICU that can take care of a baby if they have to. In my mind, I'm like, if they really need to transfer the baby out, they can transfer to UCSF,already pre-planning, all these things.

I know doctors at UCSF, I know the NICU there is huge, so trying to preplan everything. but turns out like UCSF was such a great place to give birth in. It was just like a unison, like everybody knew their part. It was very organized chaos. They took me in triage. Before that, they made you fill out like a birth plan and had specific questions.

Following the Birth Plan

How, what interventions you want, what interventions you don't want, what is your ideal birth, what are things that are like, that you don't want in the room? What are things you want in the room? Do you want dim lights, music? It was very intentional, really good questionnaire. And they had a copy of it and they respected it.

They followed everything. One of the caveats I had was I was hesitant to work with residents mainly like, I don't know if they had interns in the L&D, but because if it's a preterm birth, I wanted somebody who has a lot of experience. So I wanted either a chief resident or an attending or a fellow, somebody who has more experience than residents.

And I know it's a teaching hospital. I've worked with teaching hospitals. I respect it. I've taught a lot of residents in the ICU but for this particular third preterm birth, that just put my mind at ease if I knew the group of people in the room had a really good experience. So that was followed, which was great up to the last point. 

Talk of Induction

The one thing in triage they told me was, okay, your water broke at 3:15. If you're not progressing in six hours, we're gonna have to induce you. And I was like, why? Because, my second baby, my water broke more than 24 hours before, and I wasn't induced till 36 hours later.

And you know, they gave me the spiel about infection and I tried to really hold back. I said, yeah, ok, you can check me in six hours, but let's see where I am. I've never been dilated before, so maybe it'll go faster. And they tried to let me walk for like, five hours. They see me walking, I'm not in pain.

I'm like smiling, you know, chugging along. And then, at the sixth hour, sure enough, they're like, you're not really progressing. You're like in a standstill. I don't think you're gonna give birth for a long time, unless we start you with something like Pitocin. And they try to explain Pitocin to me, which I've had for the two births.

And I was like, I know that it will progress, work pretty fast, but I really try to push for can we wait? Can we wait? And I don't like making decisions with people in the room. So I said, can you let me think about this and I'll let you know what I decide. And I talked to my doula, I talked to my sister who was in the room, Lo, my husband.

And it was just really at that point, I felt, I don't know what it is, but I just became passive. and I was like, okay, fine, let's start Pitocin, but let's start it really low and I don't wanna go up. I asked what's the protocol for going up? They said, every 30 minutes we'll go up.

I was like, okay, but I don't wanna go up until I'm ready. So I wanted to just give it to them just to get them off my back so I can labor.

Lisa: That makes sense.

Labor Escalates Quickly

Ellen: Yeah. So they started at two and it progressed really fast and it took me like an hour and a half to go up to four. And by then I'm having full blown contractions.

I'm like, it's getting really close, really regular. I have back labor, they're giving me modifications to go on all fours, which is great. I never had back labor before. It helped a lot. I was walking to the bathroom after every contraction cuz I had to pee. And it was painful. And at that time I didn't think to ask like, why isn't there a commode?

Why am I walking to the bathroom? It's really painful. I'm like trying to justify it myself. Maybe it's helping me go faster. Let's just do it. Let's get through it. And then they put the Pitocin to four mls per hour and that's where it stopped and I just went and it was like I felt the baby coming.

Outta nowhere. I was like, I have to push. I have to push. Before that, of course, they talked to me about epidural, do you want epidural? Can you sign the consent? Just in case? And again, a lot of the things I said yes to was just to get them off my back because I felt like they'll keep asking. I said, I'll sign the consent.

I don't think I want it, but I'll sign it. The resident, the anesthesiologist, talked to me, got through that. But in my head, I didn't want an epidural. I wanted to labor on my own, just go with my body. So four mls per hour. My contractions are steady, strong, consistent, regular, I'm ready to push.

Pushing Stage

I said I'm gonna push. And they're like, okay, but the doctor's not here. I was like, I don't care. I'm gonna push. The resident comes in and at that point I'm already like deep into contractions. I had no energy to fight, no energy to say no to anyone. My sister goes to the resident and says, no offense, but she really would like a chief resident.

You can be in the room, but she wants a chief resident or an attending in the room. And he was really respectful. He was like, oh, I totally understand. And they brought the chief resident in who was really kind, lovely, super calm, amazing. But in my head I was like, it's just gonna go.

Things are just gonna happen. I don't have any say anymore. I just need to push. I don't care who's in the room, I'm gonna push. And they're like, you have to wait. We're getting ready. I was like, I have to push. And I felt the baby coming down and again, Call the Midwife, in my head, I'm like, the baby's gonna come out.

The baby's gonna come out. I thought I pushed for a long time. They told me later on it was eight minutes. It was so fast. I went from zero to a hundred. I was you know, contracting, going, stopping, recovering, having contractions to like, the baby's out. 

Birth and a Magical Golden Hour

The next thing I remember, I felt the baby's shoulders pop out of my body and this big sigh of relief just washed over me, and the baby was out.

I heard the baby crying. They had this whole setup for the NICU. The NICU team was there in case the baby had issues breathing because he's 35 weeks. Amazingly enough, the baby didn't even reach the warmer. The baby was put on my chest, was not even weighed for an hour after. All the things in my birth plan were followed.

Delayed cord clamping, put the baby on my chest right away, delayed interventions because the baby is 35 weeks and was healthy. There were no interventions. To the point that my sister was like, everybody left the room, the baby was on my chest, the whole team left the room. My sister's like, wait, they're not like, what?

She was not used to that. My sister was there for the birth of the other two kids. She was like, they're not gonna take the baby? They're not gonna weigh the baby? They're not gonna look at the baby, like anything? And she's like, it's so calm. It's crazy. It was just like very, what I needed in the moment, the support, the words, the energy.

So the baby never left my side. The nurse came in an hour later, she's like, I think I should weigh the baby. I was like, oh yeah, thanks. So 35 weeks. The baby was born at six pounds, four ounces, which was amazing.

Lisa: Wow. You just must cook babies who, who develop more quickly than the others, than most people.

Checkups and Cleft Lip

Ellen: Yeah. I mean, we're lucky that all three were preterm, but all three are healthy, good lungs. The last one had a good weight. It was such a short stay. We came in December 28 at 3:00 PM. We were discharged December 31. So it was such a short stay for us. We were used to a longer stay.

The baby passed the bilirubin test, the weight, he lost like 7%. So not that much. Was latching. I was breastfeeding, I was making milk. I mean, there were concerns with the usual weight, watch the bilirubin, go back to the pediatrician in the day. Check the bilirubin. During that, what two to three day stay, because the baby has a cleft lip, I met with so many people, so many supportive staff, speech therapy, who gave me recommendations of what bottle to use because he is preemie. He may have a problem latching, you probably will need to use a bottle and need to pump and gave me recommendations for the best cleft bottles to use and gave me samples.

The lactation specialist checked in with me, checked with the latch. I was really eager to have him check for tongue tie because the two girls had tongue ties that affected breastfeeding, that had to get frenectomies, which is when they correct the tongue tie. The baby did not have a tongue tie.

Had the–

Lisa: Hooray.

Ellen: cleft lip. Yeah. Has a gum notch, but latched better than the two girls that didn't have a cleft.

Lisa: That is remarkable.

Ellen: Yeah, and then the nurse practitioner for the cleft care team came in to meet with me. She's I just really wanna meet with you before you leave. We're gonna have more meetings after this, but I wanted to check in to see if you have any questions.

It was just, everything was addressed. When we left, we met with all the people that needed to leave. and the other thing was MyChart, which is an electronic medical system, was accessible to us, which is the first time I'm experiencing it. The first two births, I think MyChart was already there, but it wasn't as accessible. Like this time it's an app. Every note that every provider puts in was accessible. So if I forgot something the lactation specialist said, I could read her note.

I could read the, yeah, speech therapist, my discharge, what the doctors thought of their assessment. It wasn't something I'm just supposed to remember. so that helped a lot. I could see the baby's weight, I could see the baby's labs as they came in before they, the doctors even saw them. so it was just great.

Like when we left, we felt very prepared. Yeah, it just seemed so easy.

Cleft Lip History

Lisa: Is there, like a surgery that will need to be done at some point for the cleft lip, or what does that look like? 

Ellen: So, typically the timeframe to correct the cleft, so let me go back. We didn't know that the baby's palate was going to be closed. We knew he had a cleft lip. That was really it. We didn't know how severe, what was impacted. When he came out, he had a unilateral partial cleft lip, which means it didn't go up to his nose line and just like at the lip.

And so it's three to six months to fix a cleft lip. His palate was closed, which was probably the best thing because I was concerned about feeding and feeding issues with a cleft palate. And I know you know this, but I have an extensive history of working with babies and kids and adults with cleft lips, palates, face. I volunteered for Operation Smile, which is a nonprofit organization that provides corrective surgeries to babies and even adults with clefts. Internationally, I've done about 20 missions with 'em, and we would do 150, 200 cases in a week in countries like Madagascar, Rwanda, like in the mountains, India, Bolivia, Jordan.

So that experience tied along with my husband having a cleft, everyone said, this baby has the best, the optimal people that will surround him. You have all the experience of babies having clefts. And just emotionally, I know you asked about surgery-wise, but Lo really felt, there was a lot of big feelings of the baby having a cleft because he had a cleft, and he grew up having surgeries, revisions, having going to go through the, feeling of inadequacy, having a cleft or people seeing my scar.

He would tell me stories of even up to now, he would come up running and he would notice people laughing and he is like, is it because of my cleft? It's a childhood trauma for him. and he was afraid that was gonna happen with the baby. Just a lot of feelings that he was going through.

And I wish he was here to talk about it because he really sees himself in Linden. 

And he cried looking at him because it's like looking at him as a baby and what he has to go through coming forward with all the surgeries, with all the experiences as a child, as a teenager, with a cleft.

But when Linden was born and I posted pictures on social media, he's our baby, he's beautiful. I posted it without telling people that the baby has a cleft beforehand. I didn't even tell my parents or our parents the baby had a cleft. It was a thing that we kept to ourselves. We didn't think it was anything to really, you know, it is what it is.

The baby has a cleft, wasn't gonna affect anything. But when the responses came in after I posted the picture, the baby has a cleft, and posted a picture of him and everybody was like, he's beautiful. He's perfect. 

Lisa: Hmm.

Ellen: Lo was really touched by it and he almost felt like for him to see people respond that way to Linden, almost like was therapy for him. Because then he didn't know what people were saying when he was a baby. But for people to receive Linden the way they did and calling him beautiful, it almost felt like he was being called beautiful as a baby. And it really gave him a lot of, not closure, but a sense of peace.

Lisa: Maybe some healing.

Ellen: It gave him a lot of big feelings, and he said that he knew people weren't going to say anything bad, but just the way people received him and the people responded to him, it really humbled him.

Scheduling Cleft Lip Surgery

So, going back to the surgery, we've met with the cleft team and we decided that they can fix it at three to six months. They left it up to us.

We meet with a surgeon next month. The cleft team is very big here. They have a panel meeting with every parent for four hours, and that's with a multidisciplinary team. I think this is typically because, if the baby had a cleft, then there's more people involved, right? Hearing is involved because typically kids with cleft palates, their hearing's affected, their speech is affected, nutrition. Linden only has a cleft lip and it hasn't really affected anything. His feeding's great, latching, gaining weight. And so when they said they usually fix it at three to six months, given that he was born roughly a month ahead, early, I said, we'll wait till about four months cuz then he'll be corrected.

I want him a little bigger. And given that his feeding is not affected, there's really no rush. So we're in the process of that. But growing-wise, which was another thing, this is gonna be a long podcast, Lisa, because feeding was crazy. The pressures given to me by every corner about gaining weight, I was so confused. He only lost 7% of his weight and his bilirubin was low, but it was just at the mark of, we had to get readmitted for bilirubin lights to get his levels corrected.

Readmitted for Bilirubin Levels

Lisa: Didn't that happen with at least one of your girls had to stay extra time for that, in the hospital? 

Ellen: So two of the girls needed lights. Evie, our firstborn, we were still in the hospital when her levels were low enough to go on lights. So she ended up staying. We never took her out. We went home. She was still in the hospital. Cece our second was in the NICU, and she had been planned to be in the NICU for a week.

So they did the lights while she was in the NICU. Linden came home with us, the next day, his levels were low, but not low enough for treatment. And this is happening in New Year's Eve, right? Like holiday. So we had to go to a different lab and see a different doctor, almost like an urgent care to get his lab tested.

Comes back, at the threshold, at the threshold of needing treatment. So we go in, I don't know, I think it was January 1st, then we went back in. December 31, the level was low, too low for treatment. January 1st, we did it again. It was right at the marker of needing treatment. And one more thing, New Year's Eve, Sacramento was going through these storms and we didn't have power all through the night.

Lisa: Oh no. You're kidding.

Ellen: So it was like three days postpartum with a three day old. Granted, Sacramento winters are not as brutal, but we didn't have power from 7:00 PM New Year's Eve to 6:00 AM New Year's day. So we were like huddled in bed. I was pumping, thank goodness I had a portable pump.

Lisa: Good.

Ellen: We had lanterns, candles. I mean, the whole experience is crazy along with the pressures of he needs to gain weight, he needs to lower his bilirubin levels. It drove me into baby blues. I just felt so much pressure in every corner trying to deal with a newborn, confused with why his weight is such a big deal when my two girls lost more than he did.

Feeding Pressures and Triple Feeding

And this push to feed him formula so he gains weight faster, so he loses bilirubin faster. You're not making enough that it's compensating. So many messages from, I mean, all well meaning right, everybody means well. But it was a lot. And when friends would check in and say, are you okay?

How are you doing? And I would explain, we have to try to get him to gain weight. We have to try to get his bilirubin down. Every person was like, just feed him more. Just feed him more. And I was like, I am feeding him almost to the point where I used the metaphor of feeding him like those ducks in France, just almost like overfeeding him.

I dunno how much more I'm gonna feed him and I'm losing my mind and I'm feeding him formula when I'm making milk. And Lo is asking me, why are you feeding him formula? And I literally said, I don't know, because everybody's telling me to. And I just want him to gain weight. I just want him to be okay. And you kind of lose your brain.

And then one of the protocols for helping babies gain weight was this thing called triple feeding.

Lisa: Oh yeah, it's all the rage here in New York.

Ellen: Oh, you know, I've never heard of it.

Lisa: I've started teaching about it often. Yeah.

Ellen: It is--

Lisa: and its anxiety producing, right?

Ellen: It's terrible. It's terrible. It's helpful, but it's terrible. So triple feeding is when you breastfeed for 30, 40 minutes and then you pump while simultaneously feeding your baby the breast milk that you pumped before, and then doing it every three hours. You theoretically have an hour in between each of these feedings, 24 hours a day for how many days it needs to happen.

I did it for two and a half days, and I don't understand how people or moms can do this because you're already feeling, you're trying to heal. You're already stressed out, you're already anxious, you're feeling all the mom guilt. And you have this pressure to do all these things for your baby to gain weight because of the threat of readmission to a hospital.

It was a lot. At two and a half days, I just said, I threw everything out. I said, forget this, and that's the kinder word. I really cursed it out. I said, I'm not doing this anymore. I'm just gonna put him on my boob. He's latching well, there is no reason, I can't do this anymore. I kept him on my boob, his weight just skyrocketed.

Back to Birth Weight

There was this like, we need him back to his birth weight in a week, and he was still down eight ounces and we had six days to work with to get him back to his birth weight. So he was born at six pounds, four ounces. When we went back to the pediatrician, he was six pounds, three ounces. Just from straight breastfeeding.

Lisa: Oh, but they wanted you, but was that enough? 

Ellen: They said

Lisa: That's why I made a face like, oh no.

Ellen: Well it's one ounce, right? I was like, if that's not enough, I dunno what to do. Like you can't--

Lisa: Yeah.

Ellen: I was feeling very victorious at that point.

Lisa: Good, good. I'm glad.

Ellen: I was doing this, and he's gaining weight and he did it and we did it through breastfeeding

Lisa: Good for you.

Ellen: Yeah. I felt very triumphant, I was like, yes.

Lisa: Yes,

Ellen: I think when that happened the whole time, I was sleeping an hour a day since birth, that's two weeks. Once I found out he gained weight, I slept for four hours and felt like a new human being. Four hours because I had to feed him again, right. 

But I was living off one hour of sleep a day for two weeks. 

Lisa: Oh, you can't survive for long on that. I can't believe you were able to go that long.

Reaching Out for Support

Ellen: Yeah. And that's when I made a post about not being okay because I wasn't okay. And I was reaching for support. I was reaching for a village, for my tribe, for moms to encourage me, to help me. It really wasn't okay. And I knew if I didn't reach out and I kept saying, I'm okay, I'm fine. No one's really gonna help.

And I needed help. I need people to know where I'm at emotionally, respect my boundaries, and just listen. And they did. And it just turned things around.

Lisa: Yes. Listen to Ellen. Speak up. Speak up cuz this is a tough time. It's exhausting, you're healing and then they're telling you to triple feed and good for you for listening to what you needed, along with what your baby needed and you showed them.

Ellen: Yeah, I mean, the story probably seems like it's all like in bits and pieces everywhere, because that's where I felt during the first two, three weeks of having a baby. My mind was like in bits and pieces trying to make everyone happy by him gaining weight, by doing all the things I was told. But I just felt like if I didn't say I'm not okay, nobody was gonna listen.

And this happened with my own family, with my moms, my mother-in-law, my mom. I needed to tell them I'm not okay. I'm very sensitive right now. I'm very vulnerable. Everything is very different. So I just need you to not say anything that could hurt me. Because everything is hurting. And they were so good and they just cradled me.

And I'm sure I was probably like not the nicest person all the time, but they just took me in. My oldest sister was just like, advocated for me saying she's just going through a lot and you just need to listen. You don't need to tell her how to feel or what to do, or you know how to do things.

Just let her be. And I think that's really what healed me. And so like I think I posted a week after that I'm starting to feel better. There were times where I would just cry all day outta nowhere and I just literally voiced out to Lo, I feel like I'm not doing anything right. And it's so weird because I've heard moms say that and think oh that's silly.

But it really feels like that.

And this was so recent too, and I just wanna thank you right now. I'll thank you again in a little bit, but I'm so grateful that you were willing, and even, it seemed, eager to share your story amidst this early postpartum. I think I actually wanted to talk to you a week after cuz it was so fresh, and I wanted my feelings to really speak for itself. I might have cried a lot then, but I think the raw emotion and the feeling of how it was happening, it was, now looking back, I might be missing some details, but it was raw and I thought I have a lot of support, and even when I talk to my doctor, she's like, you have a lot of support. You have your mom, you have your mother-in-law, you have a sister, you have your husband who's amazing. And I'm like, yes. And if I still feel this way, imagine somebody who doesn't.

Lisa: Right? Yeah. I'm glad you have support and I'm glad you spoke up. Yeah. Cuz nobody can know we're struggling if we don't say anything. That helps people know how to be more sensitive and supportive.

Ellen: Yeah. And I don't know if it comes with age because I don't remember any of my friends, unless I wasn't paying attention or you know, my sister was saying, it was really hard and I was like, it's so hard. Postpartum is so hard. And before this I was more focused on postpartum care than labor and delivery. You know me, with my meat, my bone broth, all the butters, all the milk, like all nutrition, like dense nutrition food, making everything, sourdough everything. Growing our food. I was focused on postpartum and healing and it still happened to me.

I was like, 40 days. Nobody talk to me, nobody visit. Already putting up my boundaries. I would talk to my coworkers and be like, postpartum. You know, my sacred time and it still happened.

Lisa: But like you said, if you didn't have that support, it could be so much worse than it is. Not to minimize at all what you're going through, but just to encourage people who are listening to still plan intentionally for that support. Right. What advice would you give to people listening?

Postpartum Advice

Ellen: I would say, you can plan as much as you can, but I think the main thing is being in-tune with yourself, really knowing when you're not okay. It's okay to say you're not okay. I think there's this stigma that we have to be strong moms and take it all in and carry it all and be okay.

And it's really not like that. And I think when we try to hold all those things together is when we fall hard. When we try to keep things, quote unquote, keep things together and fix everyone and be there for everyone. Take it all, take all the roles and not ask for help is really when you break.

I asked for help. My husband knows. I'm like, I need to give people jobs because everybody wants to help and if you don't direct them, they're gonna help in ways that you don't need or you may not like. I don't need you to hold the baby. I need you to fold the laundry.

Lisa: Yes. Very clear. Yeah, I heard a tip a while back, about creating a list of if you are fortunate enough to have people coming over and asking how they can help, to have a list on the fridge and keep it up to date, obviously as much as you can, and just say, oh, go pick something on that list.

Unless you can think of something right in the moment, but it's nice to have just a list to just send them over there.

Ellen: Yeah, I think, so, the two girls that I work with, one girl that I work with, we gave birth days apart, so we had each other's support through pregnancy. And another girl that I work with, she's pregnant now, so I'm giving her kind of this is what happened to me. It may or may not be helpful for you, but like in retrospect, just already having your, I hate to say rules, but things that you want in postpartum. Please don't visit right away.

Please leave the food at the door. Don't expect me to entertain you. and don't be upset if I don't want people around. It's not you, it's me protecting my space and my energy 

Lisa: Mm-hmm.

Ellen: Things like that and please don't wear perfume or a strong scent. Please don't hold the baby. The things that everybody says, don't hold the baby unless I ask you.

Don't kiss the baby. Don't kiss the baby. Don't kiss the baby

Lisa: People wanna kiss those babies. Yeah.

Book Recommendations

Ellen: Yeah. So just having those guidelines before birth, so then when the baby is here, it doesn't come out like. You have so many rules. You just have this is what I have in mind that is really what we would like to be respected. And just remembering that postpartum is your time. It's sacred, it's your time. It's your time to heal, it's your time to be with your baby. I started reading The Fourth Trimester post-birth and everything is just like, yes, yes, yes, yes. All the things about, having your village, your support system, nourishing food, boundaries, like all the things are there in that book.

If anybody needs a resource.

Lisa: It's one of my current top two recommended postpartum wellness books. I love it. I'm glad you brought it up. I'll make sure to include that in the show notes.

Ellen: What's the other one that you recommend? 

Lisa: The Fourth Trimester by Kimberly Ann Johnson. Yeah, they're tied for my two favorites currently and they're very different from each other.

That's the other one. Yeah. 

Ellen: What book did I say? I thought this is the

Lisa: I thought you said The First 40 Days. Did I? I maybe. No,

Ellen: I love that book too

Lisa: You said The Fourth Trimester. Sorry,

Ellen: This is the book that I read, The Fourth Trimester is.

Lisa: So you said that one. I'm sorry. Forgive me. I'm gonna link to both of those in the notes.

Ellen: The First 40 Days is what I gift to a lot of moms because I hadn't read The Fourth Trimester. But now it'll be this book that I'll be gifting. 

Lisa: Love it. Before we start to wrap things up, I wanted to go back, and ask you a couple things about birth, if you don't mind going back to that part.

Ellen: Yeah.

Labor Support System

Lisa: So one of my questions was, it sounded like, did you have in your labor room, you mentioned your sister, doula, and Lo, were they all three there?

So you were allowed three people.

Ellen: Yeah. But that's a loophole because a doula is considered, sort of like your team, so they're not counted as somebody that you're bringing in and they could verify the doula. She was on the website. Typically, you have to have them approved before, but since she was already there, they just asked for the website.

They verified that she's on it. She wasn't counted as one of my support people. So my sister was able to be in the room with my husband. 

Lisa: So nice. And did the doula just meet you at the hospital or did she come to your home? 

Ellen: Met me at the hospital. She was great. She was so calm and so many tips and walking. She did acupressure. She was guiding me in breathing techniques. She was guiding Lo. And my sister too, like, if you want to support her, this is what you could do. I asked her for certain things, what do you think about, this or that, or, she just had a lot of experience and at the same time very calm. So it was really nice to have. 

Comfort Measures in Labor

Lisa: Yeah. And you at least partly answered my last question, which was, were there comfort measures that, I know that in your other births you and Lo had meditated together. You had done counter pressure techniques, I think. You did mention, I think being on all fours at some point with this birth and then you just said acupressure.

Were there any other things that you didn't mention that you remember? 

Ellen: Me, pregnancy wise, I was running like four miles a day up to about two months. I mean, two to four miles a day. And then as I got pregnant, I became walking for 30 minutes, working out for 30 minutes, up to five months. Five months is when I went on a lull. And I just did a lot more prenatal yoga.

And this is all, self practice. Or I'll watch something on Yoga Glow or something. A lot of meditation. And reminding myself like how to really utilize my breath during birth. There's this, I feel like you're the one that taught this when you like breathe, it's almost like a cow.

Just howling, like how you keep your jaws open to keep your cervix open. Yeah, and I have a, my sister took a video while I was giving birth, from the head up and I can hear myself breathing that way. And it's really what helped me push the baby out so fast.

Lisa: Nice. Thank you 

Abhyanga Massage

Ellen: One thing about postpartum that I wanted to add, and you may have experience with this. I did a postpartum, abhyanga massage. 

Lisa: Say that again. What kind of massage?

Ellen: Postpartum abhyanga massage.

Lisa: I'm not recognizing the word at the moment. I know Mayan uterine massage. But say more, tell us.

Ellen: Yeah. So postpartum abhyanga massage. So abhyanga massage is an Ayurvedic massage that they use oils, as a part of the massage to promote relaxation, de-stressing, toning of the uterus.

It even helps with hormone balancing as they do like lymphatic massage and drainage. It happens in a warm room. They basically use oils to pour over your body and kind of move the energy, move the stale blood, move everything around your body. And I would say that was like bliss.

Somebody gifted it to me. My husband's friends gifted it to me. They gifted me a massage. I knew I wanted an abhyanga postpartum massage, and I found an Ayurvedic center in Sacramento that specializes in it. It was amazing.

Lisa: Great. I am going to research that now because I'm surprised I've been doing this work for a long time, but I don't believe I've heard of that, so I look forward to learning more. Thank you for sharing that. And maybe I can get the information for the place where you went in case anyone's listening from California. Yeah.

Ellen: Yeah.

Recovery and Postpartum Reflections

Lisa: Thank you. So are there any other things that you haven't gotten to share that you were wanting to share before we wrap it up?

Ellen: I think that was it. I have a list, I jotted down some things, but I feel like I've talked about all of them.

Yeah, so right now we have our own rhythm, breastfeeding. I'm almost close to my 40 days, it took me a while to walk outside the house and moving further away from the house. Yeah, so trying to respect my healing body along with garden season. 

Lisa: Ah, yes, nice. I love it. Well, I look forward to seeing your future gardening, but for now I'm glad that you're just nesting and healing and bonding and asking for support as needed. Maybe some other people can help with some of the gardening if certain things need to be done now, I don't know what the timing is of different gardening things in California.

Ellen: Yeah. No, Lo, my husband, is helping a lot with the physical labor, like compost and all that stuff. 

Lisa: Good, good. Well, please give him my love. And maybe we can regroup, after the, is it a series of surgeries? 

Ellen: Yes. I mean, but these surgeries happen throughout his life. So the first one is in about four months, and that's the big one. And then it just becomes revisions throughout, a couple of years later. 

Lisa: I see. Okay. Yeah. Well, I'd be interested to hear how the first one goes and to learn more. Cause I don't think we've had anyone on this podcast sharing about that. So it might be really helpful and educational, if you're interested. If you wanna come back a third time.

Post-Op Breastfeeding Benefits

Ellen: Of course. The nurse practitioner for the cleft team is such an advocate for breastfeeding. when she asked me, how's feeding going? And I said, I'm feeding him formula. She's like, why? Because I'm making enough breast milk. We highly encourage you to just keep him on the breast because recovery will be a lot smoother, if he can breastfeed because typically they're not allowed to bottle feed after surgery, but they can breastfeed. 

Lisa: How interesting.

Ellen: So she was like such a proponent, like highly supportive, breastfeed him if you can, it'll be so much better for him. Pain, recovery, everything will be much better because typically they're just hungry.

So after surgery, you just can put him on the boob instead of giving him pain medicine. Which I was like, yeah, of course. I mean, I knew this because I worked in this field. I'm like, totally. 

Lisa: Right. 

Ellen: And I think that's what motivated me to just breastfeed him more. 

Lisa: I'm just, I'm so curious to learn more about all of the details underlying all of that. Is it, I would think partially it has to do with the components of the breast milk, but then I'm also thinking of the mechanics, the difference of the muscular mechanics and the mouth mechanics. Breastfeeding versus bottle feeding. 

Ellen: So it's different for cleft lips and cleft palates. Cleft palates, I don't believe they can breastfeed even if they were doing that beforehand. For cleft lip.

Lisa: Cuz the suction. Yeah.

Ellen: Because the breast tissue is softer, and it has to do with the suction too. It doesn't affect the stitches as much as bottle feeding.

Lisa: Interesting. Yeah, it makes sense because it's further back with the breast and the mouth. It's further back than a bottle would be, up at the front where it's healing and where there are stitches. That makes sense. Yeah. That was where my brain went, but I wasn't sure, cuz I've never learned about that before. So thank you for sharing.

Ellen: So like in third world countries, you would literally, as soon as they come outta surgery, we'll put 'em on the boob. Mom, sit down, here's the baby. Give him the boob and they're fine because they're just looking for their mom. 

Closing Remarks

Lisa: Yeah. Well, thank you so much Ellen. It has been such a joy to see you again and to hear this newest story and knowing that your little family's complete now. Your family of five.

Ellen: Thank you, Lisa.