Birth Matters Podcast, Ep 3 - Host Lisa's Unassisted Home Birth (Ready, Get Set, CATCH!)

In Episode 3, you’ll hear my second (kinda crazy) birth story, in which I changed care providers several times and switched from planning to give birth in an in-hospital birthing center to giving birth at home. You’ll hear quite a bit of talk about the perks of working with a midwife and will hear about a couple of different types of midwives, so this episode will provide some education on that topic. In case you aren’t familiar with what a midwife is, I’ll include linked information below.

To give just a very brief overview, a midwife is a clinical care provider (and is often, but not always, a nurse) who’s a great option for a low-risk, healthy pregnancy & birth and who tends to trust a woman’s innate ability to give birth to her baby and also tends to provide more holistic care. A midwife uses interventions & technology only if truly medically necessary, which is a good thing for healthy moms and babies. Midwives can work in hospitals, birthing centers, or homebirths. Last, I want to mention that a midwife and a doula are two separate things; a midwife is, as mentioned before, a clinical care provider and is protecting the physical health of the mom and baby. A doula provides non-clinical kinds of prenatal & labor support to the expectant parent and partner (if applicable). Meaning, she provides emotional, physical, strategic, & self-advocacy support.

Below is the full written birth story; podcast transcript below that.

Resources mentioned in the episode:

Midwife Model of Care - definition & benefits (according WHO)
Take Them a Meal - meal train coordination
Research Review: Systematic Review Finds No Increase in Adverse Outcomes with Planned Home Birth

Newborn Taylor girl, born at home (BirthMattersNYC blog)

The story of BABY GIRL TAYLOR’s (unintentionally) UNASSISTED (intentionally) HOME BIRTH

Important note: This is the tale of a second labor, not a first. My first was 20+ hours, as compared to a significantly shorter one the second time around (under 5 hours), which is the general trend for many women.

Also, please keep in mind that this was written before I started professional birth work/studies, so some things I might say herein won’t seem entirely expert.

Thursday, March 13, 2008

I stayed up late Wed. night preparing a powerpoint presentation for my boss for a board meeting.  Good I did, too, since I went into labor overnight and never made it for my last day of work!  Bryan got home from work and we went to bed together.  As we kissed goodnight, I remember saying, “You ready?”  Weird, since I didn’t know I was about to go into labor!  He said, “Not really.  Not sure we can ever be ready for something so big.  But I’m thrilled to be having another baby with you.”  Such an amazing husband.

As we went to sleep—around 1:20—I had what was the first true labor contraction.  I wasn’t positive, but I thought so.  However, I figured I should go to sleep if I could and save up energy.  Had no problem going to sleep.  Woke at 3am to go to the bathroom, but didn’t have any contractions.  Woke again at 5:50am and from that point on couldn’t sleep as the contractions started coming regularly.  Didn’t want to wake Bryan that early, especially because you never know how long labor might be, and he had just been pretty sick a couple days earlier, so I wanted to make sure he got enough sleep.  My contractions were really unevenly spaced, which was confusing—made me think perhaps either it was really early on, or perhaps we had another posterior labor.  I finally woke Bryan up at 8:30—I told him I thought we were in labor, and he said, very calmly, “Okay.”  I love his calming, peaceful presence.

Before I forget, wanted to mention something I found a little odd—I felt during contractions like I almost always had to stay completely upright—would normally think bending over, or on all fours (I hear of quite a few women spending much of their labor in this position) might help relieve some of the pain, as it did last time…but not this time at all!

We decided to call Cara, our midwife, at that point.  Talked with Cara from about 8:30 until 8:56.  She was at another birth (at a pediatrician’s office with the new parents and their new baby) on the Lower West Side of Manhattan.  Since my contractions were erratically spaced and I wasn’t yet vocalizing through contractions (she listened to a couple), she said to give it an hour and check back in at that point.

A bit from my husband (Bryan) here: Since our son (we’ll call him “Buddy”, 2 years + 9 months old) wasn’t awake but would be soon, I called friends to see if they were able to come over and help.  I got the husband (working) who said wife and kids were occupied in a class.  I told him I’d try to get our doula and call them back later if we needed help.  We went downstairs here to see if Lisa could be distracted from contractions by some food and activity.  She had some cereal, reclined on the couch and watched a few minutes of Gilmore Girls on DVD.  This didn’t last long, though, because the contractions started coming more frequently and she couldn’t concentrate on the show.  I was trying to time the contractions and get organized for the birth, and the contractions were coming so quickly that I couldn’t figure out how to use the irritating digital stopwatch we had on hand, so we were estimating intervals and duration (made more complicated because the clocks in the living room and kitchen weren’t exactly in sync, and of course I don’t use a watch, because how useful are those, really?  I called Doula Ellen’s cellphone but couldn’t get through, so called her home and got her daughter, who said she would try to reach Ellen.  Once Buddy woke up, things were moving really quickly, and the contractions were getting very strong.  Lisa decided to go upstairs so she could lie down, and I got Buddy from his room, took him downstairs, and started filling up the AquaDoula (labor tub).  Ellen called, and I told her we were in labor.  She asked me about the timing of the contractions, and said she wished we had called her earlier (we later explained the reason we didn’t call earlier was because the erratic contractions were so similar to the long back labor Lisa had with little Buddy), but that she’d come over as soon as she could.  The AquaDoula wasn’t filling very fast, because the connection to our little 1st floor bathroom wasn’t great, but I didn’t have much time to mess with it anyway, as Lisa was making dramatic sounds upstairs.  Buddy and I went up to check on her, and…

Back to Lisa’s POV: By 9:56, when Cara called us back, I was beginning to have the urge to push.  After hearing one contraction, she said, “Lie down on the bed,” (I already was, in an attempt to get the contractions to slow down), “I’m on my way…try not to have the baby before I get there!”

Bryan and Buddy ran downstairs to check on the Aquadoula, but they quickly abandoned the idea once Bryan realized I needed his help more than the tub needed to be filled.  They returned back up to me.  Buddy previously had been laughing and saying, “That’s silly!” whenever I’d groan through contractions, but then once they became the strongest (transition contractions), I began yelling through a contraction just as soon as little Buddy came up to me to talk to me—I felt so bad, because it really scared him, and he ran away crying.  After the contraction was over, I called him back over to me to explain that I wasn’t yelling at him, and he didn’t need to be scared, but that mommy was having some pain trying to get his sister out and it was just part of her being born.  We prayed aloud that Cara would make it to the house quickly, and that Baby Girl would wait for her to get there.  Soon thereafter, another strong contraction came on, so I quickly asked Bryan to get Buddy farther away from me, but it couldn’t happen fast enough so I scared him again.  Almost immediately after that, I began getting the uncontrollable urge to push and realized that Baby Girl wasn’t going to wait for Cara to arrive, and told Bryan that she was coming.  Remembering a birth story from The Compleat Mother that Ellen loaned me, in which a woman had a very fast labor and had planned to have a water birth but ended up squatting on her bathroom’s white tile floor, I told him I had to get to the bathroom.  Bryan, poor thing, was trying to figure out a way to help stall the labor (such as considering suggesting the knee-chest position, which I absolutely hate, especially when having the urge to push!  He—after the fact—told me he decided he’d better refrain from suggesting that out of fear of getting swift kick to the groin!  I said, “no not a kick, but probably a defiant yell!”)…So, I headed to the bathroom.

More from Bryan: Once we got in the bathroom, I got out my phone to call Ellen–thinking at least we could have someone talk us through this on the phone–but realized she had called me from some number I didn’t recognize (not her cell or home), so I figured I wouldn’t reach her.  Lisa, on the commode, said she felt the head(!), and, not sure whether she’s freaking out or just rolling with the pain, I ask Lisa to look at me and tell her “You can do this.  You can do this.”  She gives me a look which could mean, “Thanks, hon, you’re right, I needed that.”  Or it could mean, “You’re so sweet and that was so unnecessary.”  I call Cara’s pager.  We pray out loud that everything will turn out okay.  Not knowing when Cara would be able to call back, I call Ed and Marilyn, two doors down.  I half-ask/half-explain to Lisa why I’m calling them (Marilyn’s a retired nurse).  Marilyn answers, and I say, “Hi, Marilyn.  We’re having a baby, here at our house, right now, and we could use another set of hands.  Might you be able to come over and help us?”  Lisa’s phone rings in the bedroom (it was Cara calling back) and I almost ask Buddy to go get the phone, but I don’t know where he is (I figure he’s hiding out in a bedroom).  Lisa says, “My water broke.”  Marilyn didn’t ask if an ambulance was on the way (to my surprise), but did ask if someone was on the way, and I said our Doula and our Midwife were headed to the house but hadn’t made it yet.  She said she’d be over soon.  After the next contraction, Lisa said she felt the head (she’d realized that she had been feeling the bag of waters earlier).

Another contraction, the head appears, Lisa puts her hand on it, I put mine underneath, and Lisa says, “What do I do?”  I say, “Can you stand up?”  At some point I’m aware that little Buddy is standing near the door, watching.  Lisa stands up, and in one more push the baby slides right out, wet and purple and immediately crying.  We ease her onto my lap, and then lift her up to Lisa’s chest.  Buddy has this look on his face like he’s really not sure what he’s seeing.  We tell him, “It’s our baby!  It’s Baby Sister!”  And a big smile spreads across his face.  Lisa checks the umbilical cord and we stand there for a moment looking at each other.  The doorbell rings, and, thinking it’s Marilyn, I ask Lisa if she doesn’t think she should sit down(!), but she says, “I’m fine, honey.”  I ask again, and she says she’ll get into the bathtub.  I run downstairs and open the door, and there’s Cara.  I say, “We have a baby!”  She steps in and I point her upstairs.  Later, calculating by the times of the phone calls I made and the phone call Cara made to L’s phone, we determine that Baby Girl Taylor was born at 10:34AM.

Just a minute or so after Cara arrived, our neighbor Marilyn arrived as well.  Marilyn came upstairs, saw the baby, said hello and congrats, asked if we were okay, and once we told her we were and introduced her to our midwife, she left.

Mom and newborn, moments after homebirth (BirthMattersNYC blog)

Back to Lisa: Bryan got on the phone soon thereafter and started calling people to let them know about the birth.  I sat in the bathtub with Baby Girl on my chest for a good long time (in retrospect, I felt bad, because we should have at least grabbed a towel so she wasn’t cold as well as to shield her from the light because the bathroom was really, really bright)—probably a total of around an hour and twenty minutes or so.  She nursed quite soon and for about a good long hour—encouraging.  Bryan came and cut the cord once it had stopped pulsating—I think that was before the placenta was pushed out, but I’m not sure; can’t remember the order very well.

Mom and newborn, moments after homebirth (BirthMattersNYC blog)

Cara encouraged me (once she checked and had me check for myself to make sure it had stopped pulsating) to go ahead and push a couple times, and it came out pretty easily. She looked at the amount of blood in the tub, and said that I hardly lost any blood—a well below average amount.  If I recall correctly, at this point, Bryan had returned downstairs to make some breakfast.

While I was upstairs nursing Baby Girl, Cara did some cleanup. After she had a chance to warm some towels in the oven, she brought one up for baby.  I think one of them brought up some eggs and perhaps toast for me to eat while we were still in the bathtub.  Cara put any linens and clothes that had blood on them into a bowl with hydrogen peroxide (apparently amazing for blood removal), and then did laundry to clean everything up.  I’m not really sure of the order of anything, but I think Cara weighed and measured baby while I was upstairs eating some breakfast, too.

Then at some point Cara came up to help me get cleaned up, dressed, and come downstairs for her to examine me to see if I needed stitches. She was great and never rushed me at all.  It was really, really hard to get up after sitting on the hard bathtub all that long time on my tailbone, and of course I was quite sore. She helped me up, and then I took a shower to rinse off all the blood — some of which had dried because I sat there for so long. She tried to find clothes for me, but it was difficult to instruct her on where to find anything — particularly with regard to pants, since I hadn’t prepared anything and didn’t know what would fit. She helped me get dressed, and then we went very slowly downstairs.

Mom, newborn, and brother, moments after homebirth in Queens (BirthMattersNYC blog)

She put a chux pad on the couch underneath my bum and examined me.  I only had a tiny tear, she said, and she said it was so small that it could probably heal on its own if I was really careful for the next couple of days and didn’t do the stairs except when absolutely necessary.  She said she could do stitches if I wanted it, and I think she said she actually wishes she had gotten stitches after she had her son, yet it seemed like she was saying I didn’t really need them…it felt like a bit of a mixed message, but I appreciated that she wanted us to have the facts and make our own decision.

Mom, newborn, and our great midwife, moments after homebirth in Queens (BirthMattersNYC blog)
Our midwife checks the baby's vital signs, moments after homebirth in Queens (BirthMattersNYC blog)

Cara didn’t have any of our paperwork (such as birth certificate form, etc.) with her because she had to come so fast to us, directly from another birth instead of from her house, so said she would bring it at the 3-day visit.

Our midwife plays with our son, to make sure he feels included and valued in the moments after our newborn's homebirth in Queens (BirthMattersNYC blog)

Before she left, Cara took a family pic of us (see below), in which Buddy looked very unhappy…because he didn’t want Cara to leave! (She is not only great with her mamas but amazing with kids, too.) Instead it of course looks like he’s unhappy that his sister was born.  Got lots of comments on that one!

Our family, the day of the exciting homebirth of our baby girl, in Queens (BirthMattersNYC blog)

Our dear pastor’s wife came over in the afternoon around 3:30 or so and cooked a meal for us in our kitchen while I lay on the couch (Cara’s orders!) and made calls to all my Texas girlfriends, family, etc. to share the good news and exciting story.

IMG_2744.JPG

In closing, I like to clarify that it was not the fault of my midwife or my doula that they couldn’t make it in time. Our little girl is a sassy one and there was no keeping her in; we think she wanted it to be a family-only affair! But seriously, Cara and Ellen are birth pros with total integrity and this was a very rare occurrence. I wanted to be sure, therefore, to mention that they both are wonderful and I would highly recommend either of them (in fact, Ellen was our doula through our first labor and we couldn’t have done it without her!).

The baseball mitt mentioned at the end of the episode.

The baseball mitt mentioned at the end of the episode.

So there you have it, folks. We will always describe our daughter’s birth as follows: “We had the simultaneously exhilarating and terrifying honor of catching our baby girl.” My beloved boss gave us a pink catcher’s mitt as a baby gift with the phrase, “Safe at home!” written on it along with her birth stats – totally fitting.

Have you considered the possibility of catching (or helping catch) your own baby? If it’s something that appeals to you, discuss it with your care provider. Many care providers are open to mom, dad, or partner participating in this way. Never hurts to ask!

Here’s our fearless girl recently…where does the time go?!

HEADSHOT - Ella Taylor - legit.jpg

Episode Transcript

Lisa:

0:00

You're listening to the Birth Matters podcast, episode three.

Lisa:

0:03

You were already in bed. I was about to get in bed and I felt another different contraction and I turned to you. I said, "Are you ready?"

Bryan:

0:14

And I replied something like, "I don't think we can ever be fully ready for this, but I'm so glad to be having another baby with you."

Lisa:

0:32

Welcome to the Birth Matters show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC childbirth education and labor support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence, Info and soulful interviews with parents and birth pros. Please keep in mind the information on the show is not intended as medical advice or to diagnose or treat any medical conditions. Today you'll hear my second kind of crazy birth story in which I changed care providers several times and switched from planning to give birth in an in hospital birthing center again to giving birth at home. You'll hear quite a bit of talk about the perks of working with a midwife and we'll hear about a couple of different types of midwives so this episode will provide some education on that topic. In case you're not familiar with what a midwife is, I'll include some links to information in the show notes.

Lisa:

1:27

To give just a very brief overview, a midwife is a clinical care provider -- and is often, but not always a nurse -- who's a great option for a low-risk, healthy pregnancy and birth, and who tends to trust a woman's innate ability to give birth to her baby and also tends to provide more holistic care. A midwife uses interventions and technology only if truly medically necessary, which is a good thing for healthy moms and babies. Midwives can work in hospitals, birthing centers or homebirths. Last, I want to mention that a midwife and a doula are two separate things. A midwife is, as mentioned before, a clinical care provider and is protecting the physical health of the mom and baby. A doula provides nonclinical kinds of prenatal and labor support to the expectant parent and partner if applicable. To be more specific, a doula provides emotional, physical, strategic and self-advocacy support.

Lisa:

2:19

Before we get started on the birth story, today's episode is brought to you by the Birth Matters Complete Online Course. If you can't squeeze in the in-person group birth class series or if you didn't feel like the one you took was comprehensive enough or if you don't even have a quality class available in your area. I have the perfect solution for you: Birth Matters Complete Course is an online recorded version of my in-person full series. It covers not only prep for an amazing birth with self-advocacy tips, best current evidence and tips for partners, but also holistic postpartum wellness, breastfeeding and newborn care. And to top it off, you get lifetime access so that you can use it as a refresher in this or future pregnancies. How awesome is that? For New York City locals, you have an option to add to the course an in-person one evening hands on comfort measures workshop, which is a really ideal option for the more tactile parts of the course. Check it out at birthmattersonline.com. All right, buckle up for a pretty wild birth story. You ready? Let's jump in.

Lisa:

3:24

Hey everybody. Welcome to today's show. Today I have with me once again my wonderful husband, Bryan Taylor. We're going to share our second birth story. Hey Bryan, how are you doing today?

Bryan:

3:35

Hey Lisa, my amazing wife, I'm doing very well. How are you?

Lisa:

3:39

I'm great. I'm looking forward to talking about this together because we haven't talked about it in a long time.

Bryan:

3:45

A long time. So this birth story is going to be shorter, faster, more exciting,

Lisa:

3:53

More exciting indeed.

Bryan:

3:54

A thrilling sequel.

Lisa:

3:55

Yes, yes. So it will be shorter because this labor was like a quarter of the length of time as compared to our first, which is very textbook. And, um, before we go into the Labor story and because it will be shorter, we thought it might be helpful perhaps to go into a little bit of our pregnancy journey and the different choices that we made along the way. We actually went through multiple, I hate to say went through, but we were seen by multiple different care providers in the second pregnancy. We started just going back to the OB doctor Rhee who we had enjoyed working with our first pregnancy, and then I really decided I would like to explore what the midwifery model of care might be like. I still was interested in giving birth at the same hospital in the birthing center at -- now former birthing center; sadly it closed in January of 2019, but back then in the second pregnancy in 2007, it was still open, and I had had a lovely experience that first time. I don't remember at what point in my pregnancy this happened, but we eventually hired Ellen Farhi again as our doula. And I feel like pretty early on she started to encourage us to consider giving birth at home. And at first, I don't know about you Bryan, I don't remember, but I was like, no, I'm not comfortable with that.

Bryan:

5:22

Right. And I think that her, her recommendation was probably based on the fact that you were already wanting to work with a midwife. You were already -- you knew that you'd had a positive experience at the birthing center and so you were aiming for that kind of environment again.

Lisa:

5:42

And she told me that they had made the rules of admission to the birthing center stricter since then, and she was really afraid that I would be banking on using it and that I could very easily or much more easily this time around risk out, and then be that more disappointed given that I had used it before. So that was a big part of her thinking and it took a lot of soul searching and research before we came to the conclusion that home birth actually felt safer and like the best choice for us. But we'll get to that in a little bit.

Bryan:

6:16

Do you remember when you started seriously thinking about using a midwife for the second birth? Was that a seed that was planted in our birth class and that you had just sort of put the idea aside until you had been through your first birth to see how that went? Do you remember what your thought process was there?

Lisa:

6:34

Yes, I think, I do think maybe the birthing class in our first pregnancy planted the seed. I don't recall entirely, but I think that's likely. I think that I actually did a little research in our first pregnancy maybe across the course of taking that eight week birthing class and I just couldn't find any practice that seemed to be in network and covered by our insurance. And that's such an issue and challenge for a lot of people to navigate all of that. So, and it was a challenge again in the second pregnancy, but I did end up finding a doctor's practice -- Dr Paka, Renuka Paka's -- practice, who had at the time had two midwives under her practice who therefore, because it would be billed to insurance under Dr. Paka's name, would have been and was in network.

Bryan:

7:29

Yeah. Just because I was kind of talking over you earlier, I just want to make sure that it was clear: insurance, the in-network aspect of finding a midwife was key in the decision the second time around with the second birth to go down that route to look for a midwife, because we were able to find one in network. Whereas in our first pregnancy that was not an option, is that right?

Lisa:

7:56

It either wasn't an option or I just wasn't able to find the option because New York just has so many care providers and so many hospitals and it's just, it's, it's hard to wrap your brain around and hard to find the time and energy to sift through it all. Especially if you're not connected to someone in the birth community like a doula yet who can curate that for you and can give really smart recommendations or a childbirth educator. One thing I wanted to point out is that at least here in New York, a lot of midwives have hired excellent billers who are really, really good at working with insurance companies to make them pay. With this birth, the midwife we ultimately ended up working with had this amazing biller. In fact, Cara said, don't even get on the phone with your insurance, just let her deal with it.

Lisa:

8:45

It is her gift in life to compel to, you know, get the insurance companies to pay and cover these things and we didn't have to pay. Don't think we had to pay a penny. It was amazing. I mean this was, you know, years ago when insurance was a little better than I think it might be today, but still they, I, I've heard stories from my students of them covering a lot of things that they didn't think they were going to. So I think almost the only thing we had to pay for was the rental of the tub that we ended up not using. And our midwife was so lovely. She actually refunded most of that fee because we didn't end up using it at all. So I found that practice and I -- looking back in my journal notes, I am reminded of how, what a stark contrast it felt like, how much less rushed I felt from the very first appointment with the midwife.

Lisa:

9:39

And so it was lovely care. And a few months into that, we were in Texas for Christmas for the holidays and we got a, I guess an email, I think it was an email saying that Yael, this midwife we were seeing and were so happy with, was retiring just very suddenly and we were so disappointed. And then the other midwife was leaving this doctor's practice to go on her own with another midwives practice up to the Bronx, from Manhattan to the Bronx. And so I followed her there. I went to her for a couple of visits and loved her. She was great, but it was not going to be covered by insurance. And so that was going to be tricky. And not only that, but right around that time in January in my, let's see, it was about at 30 weeks, I went to see The Business of Being Born, a documentary by Abby Epstein and Ricki Lake and it really, it was in a movie theater and I went with a couple of girlfriends at the recommendation of my doula, and that sealed the deal.

Lisa:

10:49

I walked away from that film, totally sold on wanting to give birth at home and within less than a week I had interviewed two homebirth midwives, had had a prenatal with one of them, had like chosen one and had also, we also had our first prenatal visit with our doula Ellen, the day after seeing Business of Being Born. I'm sure she was thrilled to hear, we're going to do it, we're going to give birth at home.

Bryan:

11:15

She gave us another film to watch, right?

Lisa:

11:17

Yes, she did. I don't remember the name of it, but it had Marsden Wagner, who's great, and that was also a contributing factor. But then I really had done a lot of research just to learn the statistics of like how safe is this really? And I started to learn: for low risk, healthy pregnancies, it's very, very safe, especially in a city where you have a hospital on almost every corner.

Lisa:

11:41

It's so quick to get somewhere in the unlikely event that you do have to transfer. The funny thing was when we secured this homebirth midwife, oh and by the way, the homebirth midwife we hired just happened to be Cara Muhlhahn, who is the main midwife you see in the documentary I mentioned seeing, The Business of Being Born. So she practices in Manhattan in Alphabet City. And she was just about to go away on a sabbatical. She takes like a month long sabbatical every year I think. And I was coming in to her right before she went away, and that was the only reason she had capacity was because a lot of people probably didn't feel comfortable booking her and having her be away for the last few weeks of their pregnancy. So I kinda lucked out on that. And she had an apprentice midwife and a backup really veteran midwife who were there, you know, in the hopefully unlikely event that I went into labor before she came back. So I was seen by yet another midwife, this apprentice midwife a couple of times while she was away, and

Bryan:

12:44

Hold that thought. Our daughter has slid a note under our bedroom door that says, "May I shower now?"

Bryan:

12:57

I think it's because of the noise that she's asking, not because she doesn't know that -- whether or not she needs one.

Lisa:

13:06

I think we should wait.

Bryan:

13:09

Ella. Okay. If you can wait to shower, I think it's just going to be a little too noisy, huh?

Lisa:

13:14

We're sorry.

Bryan:

13:15

We'll let you know when we're done. Okay?

Ella:

13:17

Okay.

Lisa:

13:19

Love you!

Bryan:

13:20

We're telling your story. We want to get it recorded nicely.

Lisa:

13:25

I wanted to clarify that the reason when I followed Chris McCloskey up to the Bronx -- the midwife with Dr. Paka's office who left to go to the Bronx -- that usually midwives who do hospital births don't attend homebirths. Usually a midwife is either catching babies at home or they're catching babies in the hospital. That's something that's not always clear to people, so I just wanted to make that clarification that that's the only reason that I left her practice was because she, she said, I would love to attend your birth at home, but I'm not set up yet. I don't have the equipment, you know, I don't own the equipment and I'm just not set up to attend a homebirth. So she sent me off with her blessing. She was very excited for me that I had made that choice, but she just wasn't equipped to be able to be my care provider for that birth setting.

Lisa:

14:21

One thing I want to mention about these midwifery visits is that when you give birth at home, at least in New York -- it might depend on where you live -- the midwife for the most part, if not 100% of the time, comes to your home to do prenatal visits. And wow, is that amazing. Especially when you're in your third trimester and you're exhausted and you're feeling large and uncomfortable. What an amazing gift that is to just not have to go anywhere, not have to get on the subway or in a car or whatever it is. So those were, that was like another whole level of amazing care, you know. So we had first the OB level of care. It's unfortunately a product of our healthcare system where everything is really rushed and you're probably waiting for much longer than you're actually being seen. And then the next level was going to an OB practice who had midwives and that's still part of the healthcare system.

Lisa:

15:16

But thankfully it was, it did feel less rushed. And then now we're experiencing version three where it's a homebirth experience and the midwife is coming to our house. And I just wish, I was like, why didn't I do this from the beginning? Oh my goodness. Here we are, you know, in our thirties weeks, and our little baby girl ended up coming a couple of weeks earlier than expected. So I just wish we had signed up for it earlier on. But you know, things work out the way they're supposed to. Cara came back from her sabbatical and she did -- just to play catch up, she had so much catching up to do, she had her clients come to her office in Alphabet City in Manhattan for a group Prenatal. And they had a, somebody, a guest there who was talking about hypnobirthing and did a kind of an educational seminar, which was really cool.

Lisa:

16:08

And I think she also just really wants to build community. So she wanted to offer expectant parents a way to connect with other expectant parents, which I think is really, really nice. Even though I wasn't at first very keen on "Really? I'm having to go at like 30 I dunno, 37 weeks all the way down to Alphabet City from Queens? Okay, I'll do it." But in the end it ended up being a really lovely visit. And then the next week she came and did one visit in our home, thinking we were going to get more than one before our baby girl came. Not knowing that less than two days after she came for that first prenatal visit with us in our home that we were going to have our baby.

Bryan:

16:49

And it was great to be able to welcome her into our home, to have her spend time with our son Grayson, who was at this point coming up on almost three years old. So he was able to be comfortable with her. She was great with him. She was able to get the lay of the land of our house. This is going to be an important moment in our life as a family. And so it was just nice to have this person who is gonna be on our team, you know, welcomed into our home and kind of, you know, welcomed into this moment in our lives, in that very relaxed atmosphere.

Lisa:

17:28

Yeah. And I also want to mention whenever you're interviewing care providers, trying to select a care provider, same with doulas, I say the same thing with doulas is -- really, you know, interview more than one and be sure you're finding the right fit for you. Because I interviewed two different practices for homebirth midwives and they were, both practices were lovely and I really like both of them. I've even gotten to know the one that I didn't hire better since then and they're wonderful, but you just have to find the right fit for your personality. And for me, Cara, I can't even remember the quote, she said something in The Business of Being Born that really resonated with me along the lines of trusting the woman's body and then she's there for safety, that she's, you know, just watching over for safety purposes. And that just really made me feel safe in this choice to give birth at home.

Lisa:

18:20

I also wanted to just contrast one thing. I had more than one urinary tract infection, UTI in my pregnancy and it was asymptomatic. So I never would have known that I had them, except for that, when you go for your prenatals, they're having you pee in a cup and they're testing a couple of different things in that to just be sure we're all good. And so I had been diagnosed with a UTI at my OB's office earlier in the pregnancy and she said -- well at first it actually didn't get communicated to me. There was an administrative error. And then I found out later after the fact that I was already supposed to have been told and was supposed to be getting antibiotics and I didn't take them because of concerns of antibiotic over-usage that has been in the press in recent years. And I needed a reason.

Lisa:

19:12

I mean, maybe I should've just been the good patient and you know, done what I was told. But when I asked, I didn't get a, they wouldn't really tell me a reason. They just were like, oh, and you just, you know, it's just for good measure. You should just take it. As contrasted to when I switched to this midwifery practice, the first midwifery practice under Dr. Paka's care, they told me, "Well, Lisa, it's really important that you take these antibiotics because you're putting your yourself and your baby at risk of preterm labor if you don't, and wow. I was like, wow, I really wish someone had told me that -- had framed it in that way because if they had ever breathed those words, I would have instantly said, "Well, I'm absolutely taking the antibiotics then." So you know, that was just a contrast.

Lisa:

19:56

I felt like I just was being heard and my questions were really being thoughtfully considered and answered and they were giving me choices in my care in other ways and other decisions that we made. When we first showed up to Yael's practice, she gave me the option of, she said, "Do you want me to treat this like a first prenatal visit or do you want to use this as an opportunity to answer some questions?" And so I said the latter. Why don't we do that? I don't feel the need. I already had the first prenatal with a different care provider. You know, let's, let's go through some questions. Absolutely. Cause like who gets questions asked in really brief OB visits so much of the time? So that was really refreshing.

Lisa:

20:36

Let's review briefly just so we're all clear on who, who's your care provider, Lisa and Bryan, at this point? Who is your team? So we landed on Cara Muhlhahn, homebirth midwife. She was going to be our clinical care provider. Our labor support was my wonderful husband. And then we had hired Ellen Farhi again as our doula for the second time. And so they were on call for us. And about two weeks before my due date, I do remember, this isn't in my written birth story that's in these show notes. But I do remember I went shopping, I was running errands the day before I went into labor and I remember I was getting into the car, putting my bags in the car and getting in the car. And I remember having a stronger-than-usual Braxton Hicks contraction or some kind of contraction. And I remember thinking, Huh, but then I just went about my day because it, they weren't coming regularly but it just felt a little different.

Lisa:

21:39

Yeah. So that was the day before and then we were going to bed that night and were kind of night owls as you might've heard in the first birth story a bit. So at about 1:20 or so late night we were going to bed, I think you were already in bed. I was about to get in bed and I felt another different contraction and I turned to you, I don't know if it was as soon as that happened or if it was, it was in that ballpark sometime around then I said, "Are you ready?" Right? But I don't think I told you,

Bryan:

22:13

I don't think you did either. You just asked me the question and I replied something like, "I don't think we can ever be fully ready for this, but I'm so glad to be having another baby with you." Something along those lines.

Lisa:

22:28

Oh yeah, no that's it. That's it. I love it. So sweet. So I went to bed and then like an hour and a half or so later woke up and had to go to the bathroom and was having some contractions and again woke up, I don't know, the five o'clock hour and at that point I couldn't go back to sleep and was having regular contractions. Fairly regular, but at the same time irregular coming and coming and coming, but not with a regularity of frequency, as was the case with our first labor. And which misled me into thinking, "Oh, we have plenty of time." Now here's the funny thing. Two days before, less than two days before, when Cara came to our house for the first time and had a prenatal, she mentioned, "Oh, your baby girl is in a really perfect position." Oh, and by the way, one thing I didn't mention is that the baby had been, she had been transverse sideways at about 33 34 weeks, which was really concerning. But thankfully she did go head, head down. And so right before we went into labor, she said, "Yeah, she's in a beautiful position. I really think she's going to come really quickly when the day comes." And we had planned to have another prenatal visit the next week maybe with our doula and we were setting all that up and that never happened. I remember going into -- in the early hours of the morning, I remember going into what was going to be Ella's bedroom, the nursery, because we had a twin bed in there, a guest bed. And I remember lying down in there for a little while because I didn't want to disturb you but I couldn't sleep and I was afraid I'd be tossing and turning and keeping you awake. So I just thought I should let you sleep because we didn't know how long we were going to be doing this.

Bryan:

24:23

And also I'll just throw this in. I was probably sleeping a little more heavily than usual because a day or maybe two days before this, I had just had a bout of food poisoning. It was like the one of two times in my life I've had food poisoning. Not the best timing, but so I think you were particularly cognizant of that, knowing that, you know, I was already behind on sleep. You needed me to be as rested as I could be when we went into the main event. So hopefully that makes me sound like a little less of a jerk.

Lisa:

24:56

How can you be a jerk when you were asleep? How would you -- like, you didn't know I was in labor.

Bryan:

25:02

Yeah, I know, but it's coming up, I'm supposed to be expecting, you know, I'm supposed to be sensitive. I don't know.

Lisa:

25:09

Then I decided to wake Bryan up at about 8:30 and told him we were in labor, and you were so calm. Oh, I so appreciate your calming presence. You were that way the first time, too, and are just that way in general and it's a really lovely attribute. You just said, "Okay."

Bryan:

25:29

I was still sleepy.

Lisa:

25:31

Yeah, you were probably like, "Okay, let me wake up." And an odd thing that surprises me to this day is that my body in that labor, unlike the first for a lot of it, I could not lean over. Many women -- I would almost dare say most women, but let me say many -- find it very instinctive to lean over. It takes the pressure off the back and just tends to feel more instinctive than a lot of other positions, whether that's on all fours or leaning over a counter or hanging on a partner. But I, for part of my labor, I just had to stand straight up, which was so bizarre. And yet at a different point in this short labor, I also have a recollection of being almost in child's pose, pretty much in child's pose, actually. I don't know how you do that when you have the big baby bump, but I did and I was having to be completely collapsed. So it was like nothing in between. I had to either be standing straight up or completely hunched over, folded over even.

Bryan:

26:35

And you were doing that on the ground or on the bed?

Lisa:

26:36

I was doing that on the ground right by our tan chair and our armoir, just right in front of that. And I'm wondering if the, I can't remember if that was before I woke you. I think it might've been. But I don't remember. It's all so fuzzy, thanks to all the oxytocin and endorphins and things that are rushing through your body and making your brain kind of fuzzy. So shortly after I woke you, we decided to call Cara. Right?

Bryan:

27:04

Right. Almost immediately after.

Lisa:

27:06

Because she had told us, "Call me at the first sign of a contraction." Did I do that? No, this is like seven hours before the first one. But that very first one at 1:20 wasn't -- I didn't think we were in labor. I thought, "That's odd." But I didn't think we were in labor.

Bryan:

27:23

So we called Cara. You got on the phone with her so that she could hear, listen to you through some contractions, right?

Lisa:

27:32

Yes. And she was on the lower west side of Manhattan, just about as far from us -- in terms of getting to us -- in Manhattan as you could be. She was at a birth, she was having to go into the pediatrician with the baby. It was a little trickier for her to come join us as fast as she probably would have preferred to being our second time around because if it was the first time she'd have been like, "You have many, many, many hours," you know, but not in this scenario. She had planned to come to us just about as soon as we called, most likely. And we had talked with Cara and we'd actually talked with y'all l previous midwife in the pregnancy about like should we have our two year old with us? Should we find someone to take care of him? Like, we've never done this before, what do we do?

Lisa:

28:24

And we got different insights. I remember that Cara specifically said, "Oh, you'd be surprised at how great kids are at this kind of thing. They just really roll with the punches and kind of really, like, take everything in stride and they really step up to the plate for whatever is needed in each moment." So I found a lot of confidence in that. But at the same time we really wanted to have kind of a backup plan. So we did call when we realized we were in labor, and once I had woken you, we called some friends to see if they could help and then we were going to be calling our doula as well. And our doula said, "I wish you had called me sooner!" because I think she realized we were more progressed than yeah, we -- that we weren't calling her at the very first sign of labor.

Bryan:

29:07

Yeah. We're backup plan kind of people. We had a backup plan for calling friends into help calling neighbors into help. We had done an emergency run of what do we need to do if we have to get to a hospital nearby. We thought through that

Lisa:

29:25

And we almost did a hospital tour of the backup, like, farther away hospital that Cara likes to -- prefers to transfer to in the event that you have to do that. Cara kind of was like, don't go there mentally. Don't go there. But I just -- it really depends on your personality and for us it gave us more peace of mind to prepare for those different scenarios.

Bryan:

29:44

Right. And then -- the morning of, you know, nothing goes according to the plan, the way you think it will, but the, the mere fact of having thought through these different contingencies I think helped us stay in a more positive frame of mind. So that when I first made a call to a friend to see if someone could come over and look after Grayson and they weren't able to come over, no big deal. We are where we are, we're not in real, you know, we're not in the serious stretch yet. I'll keep an eye on things here. I'll try you back later. You know, in the back of my mind I think I still got the neighbors, the, if I have to call them, I can call them. I do think it's worthwhile if you're going to be giving birth at home to think through who's close by, either who's close by or who's always going to pick up the phone just because you don't know in the moment what you might need, or particularly if you can't get ahold of your midwife right away or your midwife can't get to you right away. I mean, this is more important with the second child than with the first, just because things can go so quickly. Is that fair?

Lisa:

30:49

Absolutely. What were you doing, Bryan, in these couple of hours that you were awake for before the baby came?

Bryan:

30:56

Well, I was trying to get the birth tub ready. We had already had it set up, but it wasn't filled with water, so I hooked the hose up to our little bathroom sink on our first floor. Got that going.

Lisa:

31:13

Well, hang on a second. So we had rented a specific for labor tub, like a portable tub called an Aqua Doula from our midwife because I had envisioned this beautiful, peaceful waterbirth. That was kind of my vision for how I thought that I wanted this -- our baby girls' birth to go, knowing that I might or might not be in the mood in the moment. But yeah, so that's the tub that Bryan's referring to.

Bryan:

31:41

Right, and just to back up just a hair, I don't know if we said this, when we talked to Cara and she heard where you were with your contractions, she said, "Call me back in an hour" at that point, so it was like almost nine o'clock so, so I was focused on trying to get the tub filled. Meanwhile, Grayson had woken up. I hadn't reached somebody who could come watch Grayson, but not a big deal. He was, quote unquote, helping me fill the tub. I was probably thinking about getting him something to eat, but didn't quite have time to get there yet. You had some cereal, you were on the first floor. We wanted to see if there was something we could do to distract you from contractions. So we put in a Gilmore Girls DVD and the contractions started to come on pretty strong. You were not in the mood for Gilmore Girls.

Bryan:

32:34

So at this point, because the contractions were taking so much of your focus, I was trying to focus on timing them. We had a sheet right where we were keeping track of the timing of the contractions.

Lisa:

32:46

It's very short.

Bryan:

32:47

It's a very -- very brief list. Yeah. And the contractions were a little tricky to time. I would say I was having a little trouble figuring out exactly how to notate that. And I was -- we had this digital stopwatch that didn't work very well and then the clocks in different parts of the room were set differently and I didn't have a watch because I don't wear a watch because how useful are those really? So it was a lot of guesswork and,

Lisa:

33:15

Oh and can I just explain real quick as you're talking about timing contractions, I think I might not have been clear earlier when I said that because the frequency, which is from the beginning of one contraction to the beginning of the next was erratic, it wasn't consistent, it was not textbook -- because of that, that made me think that we had a lot more time than we actually did in reality. What I meant by that was after my first experience of giving birth, I learned or was reminded of something that I had forgotten, that when there's a sporadic, confusing frequency like that, it can sometimes be indicative of a baby being in a posterior position, meaning that the baby's back, their head is down, but their back is against the mom's back. And what that can mean is that the frequency is just, I might've mentioned this in the first birth story, I don't remember, but it can make, it can slow things down.

Lisa:

34:12

It can make for slower progress because the angle of the baby's head, yes, I think I did talk about this, but just in case you didn't hear the first one, I'll say it. And for reinforcement, it can just mean that the baby's head is not as effective at dilating the cervix. And so it can just take a lot longer. And so that's what I thought. Oh Great. We have another posterior baby on our hands because of this confusing frequency. So we must, -- I'm sure we're in for many, many hours of labor. So back to what you were -- ways that you were, things that you were doing.

Bryan:

34:40

As I was trying to fill the tub, I called our doula Ellen. I don't know if her phone was, I don't know. Anyway, I couldn't get through to her on her cell phone. So I called her home line, got ahold of her daughter, asked her daughter to let Ellen know, you know, that we needed to hear from her. Things were progressing. Then at some point in here you moved from downstairs up to our bedroom and you wanted to lie down.

Lisa:

35:08

I was trying to remember if I want to lie down. Yeah because I already was lying down when we talked to Cara the next time and she said, "Lie down to slow things down." But yeah, I guess, I don't know if it was this instinctive thing of like, "I need to slow this down a little bit," because it was just, it felt like a train had hit me. I was like, it was, it went from zero to a hundred, like, so fast. So it made it a lot harder to tolerate because there was, it was not a gradual buildup, like it tends to be in a first labor.

Bryan:

35:39

Right. So an hour after we had talked to Cara, she called back, you were having the urge to push, she heard you vocalize through a couple of contractions or maybe just one. She tells you to lie down but you were already lying down and she said, "I'm on my way. Try not to have the baby until I get there."

Lisa:

36:01

And later she told us she was, like, running red lights and, like, just waving to people who were cursing at her. She was, like, breaking all the laws. She's like, "I've gotta get to a woman having a baby. I'm a midwife!"

Bryan:

36:14

So the water's still running in the aqua doula. So I go back downstairs to check on that. But it's becoming clear that a, I can't keep checking on that. I think I just turned the water off because of the sounds that were coming out of you.

Lisa:

36:29

I was making very loud sounds.

Bryan:

36:30

Yeah. I felt like I needed to be closer to where you were. Grayson had been kind of coming back and forth with me. He had been going in to check on you from time to time and not entirely clear of the reason for these sounds that were coming out of you.

Lisa:

36:47

Roaring sounds.

Bryan:

36:49

Yeah. And he, he would say, "That's silly" -- that was one of his phrases -- when he heard you make some of these big sounds. And then at one point he got a little too close to you, during a contraction and the force of the sound scared him a little bit.

Lisa:

37:04

He thought I was yelling at him, I think. I felt so bad. Yeah. I roared right in his face and I think he -- did he burst into tears?

Bryan:

37:13

He, he cried a little bit.

Lisa:

37:15

And then when, once that contraction was done, I was very quick to say, "Oh, sweetheart, come here. Let me hug you. I'm so sorry. Mommy's just working to get Ella out. It's not you at all. Please don't, don't think it is."

Bryan:

37:27

And so that calmed him down and then you asked me to kind of take him away. But before I could do that, another big contraction came on and he was scared again.

Bryan:

37:39

You do what you can. And then the, after that second scare for him, after he was scared a second time and disappeared and we didn't, he, he went out of the room. Then you started having the...

Lisa:

37:53

Urge to push. Yeah. And into my brain popped this story. I had read, our doula had given me not just a documentary to watch, but also, some old, um, I don't know if they were old. They were sort of classic in their tone in their photography or something. It's called the Compleat Mother compleat, spelled C-O-M-P-L-E-A-T. And I remembered reading a birth story in that, in which a woman was in a similar situation to mine and she instinctively went to the bathroom to give birth. And I thought in that moment, my waters have not released, my waters have not broken or ruptured yet. And wouldn't that be nice to minimize the mess? And so I went very quickly to the bathroom, sat down on the toilet with this urge to push. And you were coming? I think I said, "She's coming! She's coming" because I could feel that she was coming. So you came up to join me, but at the same time, right around the same time you were making a call,

Bryan:

39:03

Right. So you were in the bathroom, I got on my phone to call our doula. I'm thinking at the very least while our midwife is on the way here, if I can get our doula on the phone, our doula can, you know, be talking us through this as it happens on the phone.

Lisa:

39:22

And she was in midwifery school to become a midwife at the time.

Bryan:

39:26

But the number from which she had called me was not the number where she now was -- something like that. I couldn't get through to her. Meanwhile, you're on the, on the toilet and you tell me that you feel the head.

Lisa:

39:39

Haha. I thought it was the head.

Bryan:

39:41

And I couldn't tell whether you were really rolling with it or whether you were freaking out. So, remembering something from the Birth Partner book by Penny Simkin, I went into the bathroom, got right face to face with you and said, "You can do this. You can do this." And you gave me this look that I couldn't quite tell -- it was either a look to say, "You're right, I needed that." Or it was a look to say, "You're so sweet, but I didn't need that. That wasn't helpful. I'm fine...

Lisa:

40:21

"Get out of my face."

Bryan:

40:21

"Get out of my face."

Lisa:

40:25

I don't remember.

Bryan:

40:27

So I call Cara's pager. This is back in the days when people had pagers. I can't even remember what I -- I guess I left a voicemail for Cara just saying something like, "This is happening." Then I call our neighbor two doors down Ed and Marilyn our sweet neighbors. Marilyn was a retired nurse. I tell her, "Hi Marilyn. This is Bryan. We're having a baby here at our house right now."

Lisa:

40:50

And of course he said it just like that too. Nice and calm, casual, no big deal.

Bryan:

40:57

A lot of repressing going on. And you know, and I say, "We could use another set of hands. Might you be able to come over to help us?" Meanwhile your phone rings in the bedroom while I'm on the phone with Marilyn, I am starting to go to the bedroom to answer your phone and I hear you say, "My water broke."

Lisa:

41:21

And that was what I was feeling that I thought was the head. It was actually the bag of waters bulging.

Bryan:

41:26

So Marilyn said -- asked me if anybody was on their way to help. I said yes. I said, "Our doula and midwife are headed here, they're just not here yet." Marilyn said, "I'll be over there soon." After the next contraction, you said you felt the head again. Only this time it really was the head. You go from here.

Lisa:

41:45

Well and so you were kneeling right in front of the toilet. Right. And as she, I was having this urge to push and I as, as she started to emerge, I, I stood up and, and I just had my hands there to catch her. And, and Bryan, your hands came right below mine -- so that we had all four hands on deck catching our baby girl, and she pretty quickly, you know, being our second time to give birth and being in an upright position as well, she came out quite quickly. And being a couple of weeks early, too, she was on the, you know, smaller end of the spectrum in terms of size, which also meant that it was that much easier for her to come out.

Bryan:

42:26

She slid right out. She was very wet, very purple. She was crying right away. At some point in here we become aware that Grayson is standing in the hallway looking on, so we, we ease Ella -- have we said her name yet?

Lisa:

42:43

Yes.

Bryan:

42:43

Okay. So we ease Ella onto Lisa's lap and then you lift her up to your chest and we tell Grayson, "It's our baby. It's baby Ella."

Lisa:

42:55

Yeah, to try to change the expression on his face, which was very confused. He's like, "What is that thing?"

Bryan:

43:05

And so a big smile spreads across his face.

Lisa:

43:09

I just wanted to interject real quick, something that I was reminded of in reviewing the journal, that when Ellen came for a prenatal, he thought that the baby was coming that day. So when she left the prenatal visit and there was no baby Ella, he was really mad. He was really disappointed and upset. I just thought that was really funny though. You know, just like, hmm, that's a two year old, almost three year old. Yeah.

Bryan:

43:33

Do you remember what are your, what are your thoughts of that moment of -- here she is, we caught her.

Lisa:

43:41

Well, the moment of her coming out was simultaneously exhilarating and terrifying and it was such a relief once she was out and she immediately cried and because it was, it was kinda cold in that bathroom and it was also bright. It was really bright. So I would have cried too, coming out into that cold and bright environment, but it was a relief. I was glad that she gave out a good cry, given we didn't have a clinical care provider there, although she did come almost immediately after that. Right. We were kind of like, what do we do now? And, and I just started heading toward the bathtub, because I thought, "Okay, I'm just gonna park myself there with the baby."

Bryan:

44:27

Right. So we're standing there looking at each other for a moment. Later on we figured out that this is, we're going to say 10:34 AM, almost two hours exactly after you had woken me up that we have caught our baby girl

Lisa:

44:41

And less than five hours from the first strong contraction., right? Like from the first time I thought, "Oh, we're -- I think we're in labor."

Bryan:

44:49

Yeah. So there's this moment of this is incredible. Now what? And you start to head to the bathtub, I say, "Oh, can you do that? Are you okay? Are you sure you're alright to..." You say, "I'm fine." There's a knock at the door or the doorbell rings. I go downstairs. I think it's Mariyln because figure our neighbor has just arrived. I open the door. It's Cara, and I say, "We have a baby!" And she steps in and I point her upstairs. And do you remember her coming into the room? Do you remember when you realized that she was there?

Lisa:

45:25

I don't really because I was in baby land.

Bryan:

45:28

Yeah. So, so by the time Cara came upstairs, you were already in the bathtub with Ella on your chest.

Lisa:

45:37

And in hindsight, I wish I'd thought to get a blanket or a towel to put on her because, because like I said, it was chilly in that bathroom. And of course she had me as a warmer, but she also could have used a nice layer on her other side without any, you know, and Cara reminded -- she, she's like, "Oh, we gotta get a towel on her. I'm going to go." She warmed them up in the oven, several towels up in the oven, which was nice and warmed her up.

Bryan:

46:01

As I was saying earlier, you know, we're backup plan people, but this was not our backup plan. And if we had thought that we were going to have the baby in the bathroom, we probably would've set the bathroom up a little differently. We would have had the, the warm towels or, or different lighting or something.

Lisa:

46:19

I should have known when I read that birth story in the Compleat Mother, something in me was like, that sounds like a cool way to go. So my body and my baby just decided, "Let's do that."

Bryan:

46:31

Well, and in Grayson's birth, the doctor told you, "I am not going to deliver this baby on the toilet," and something in you said, "I am going to deliver this baby on a toilet."

Lisa:

46:44

Sometimes I think that that might be the case because it's just a very instinctive place to go. Whenever I teach birth classes, I talk about that a lot. The fact that sitting on a toilet, especially in the pushing stage, but honestly at any point it feels right to you, can feel so incredibly instinctive, less uncomfortable when you're in the pushing stage. So much of the muscle coordination that is required to effectively push a baby out is the same kind of muscular coordination that's required of pooping. And that's where your body knows how to do that. So it just -- it just makes sense. And yeah. Plus it's also nice for the bag of waters to break into the toilet and not make a big mess. So that was pretty ideal.

Bryan:

47:29

Cara showed up maybe -- I mean within a couple of minutes we think -- of the birth. And then about a minute after Cara showed up, our neighbor Marilyn showed up.

Lisa:

47:41

Because she was just, maybe you said this earlier, she was just getting out of the shower when you called her and she had to get dried off and dressed and stuff. So.

Bryan:

47:47

Right, no, I hadn't mentioned that. Yeah.

Lisa:

47:49

Yeah. So she, she couldn't get over to us quite as quickly as, as we thought we were looking for. Right.

Bryan:

47:55

So Cara was upstairs attending to you. I brought Marilyn upstairs. Marilyn said hello to you, met Ella, met Cara, asked if you needed anything, asked if everybody was okay, if anybody needed anything. Cara really had things under control and you felt good. And so we said, "Thank you. We're all right, thanks so much for coming by. And so Marilyn went out and I started calling people to let them know that Gabriella had made her appearance.

Lisa:

48:28

Cara was doing so many things, probably a lot of the stuff she was doing I don't even know about. But one of the things that I found so interesting, and I've used this trick ever since, is putting anything with blood on it in hydrogen peroxide. That is, like, this miracle worker. It just completely removes it. And that was one of the things, she was doing laundry for us. She was just really taking good care of us.

Bryan:

48:49

So we think that you were in the bathtub with Ella on your chest for maybe an hour, almost an hour and a half, hour twenty, something like that.

Lisa:

48:57

Yeah. Boy was my tailbone sore after that. I should have like put something underneath me instead of that, just that hard surface.

Bryan:

49:04

She nursed soon after, soon after

Lisa:

49:08

For a good long hour or so. And we were so glad that Cara arrived no later than she did because of the placenta delivery. We knew that Bryan was not gonna want to have to deal with that.

Bryan:

49:20

Not a good job for me.

Lisa:

49:20

If you listened, just listened to the first story, you'll hear a little bit about that. We were, yeah, we were very thankful for that and thankfully the amount that I bled was less than normal, less than average. So nothing concerning there at all. And we waited for the cord to stop pulsating before Bryan cut it as we had hoped to do. And then we ate. You guys made some eggs and toast and brought that up to me.

Bryan:

49:45

It was such a relief to have Cara, you know, really looking after you and Grayson and I went downstairs, I made some breakfast, I made some scrambled eggs and toast and so everybody was able to eat a little something. I made enough for Cara and, and that was a lovely moment just to enjoy this bit of breakfast immediately, post-birth in our home.

Lisa:

50:05

We enjoy our post-birth breakfast, don't we? Yeah. I feel a theme here.

Bryan:

50:13

While you were eating, Cara weighed and measured Ella.

Lisa:

50:17

And I loved the scale that they have. It's like a little stork bag where they're just holding it in midair and the little baby's in this little stork bag. It's so cute. We have a picture of it that we'll put on the show notes page

Bryan:

50:28

And then she helped you get cleaned up a little bit and get dressed.

Lisa:

50:34

Yeah, that was hard because I was, like, trying to tell her what I wanted to wear and where to -- and she just sort of had to pick whatever she could find. You know, and especially when you've just given birth, you don't know what's going to fit. And it's a little tricky. But she did it. She was great.

Bryan:

50:50

And then she helped you come downstairs and then she examined you?

Lisa:

50:55

Yeah, she just put some chucks pads there, waterproof pads on our couch, and did an exam and said I had a little tear but nothing big. And she said, it's so minor that you know, I can stitch it up if you want, but I don't have to. So she just, again, she, like, gave me the option, whereas in a hospital usually they just do whatever they deem appropriate. And I just really appreciated that. Although I was a little confused, I was like, I don't know how to make this decision, so that it was a little tricky. It's good to have options, but also can be tricky to know which to choose. But ultimately I said, "Nah, let's just leave it alone." But she said, "It's going to be really important if you don't get stitches to really lay low for the next couple of days. Do not do any stairs." She said, "You have to stay on one floor for the next two days to allow that healing to begin optimally." So I did that thankfully, and that house, we were living in Forest Hills at the time out in Queens, and thankfully we had a bathroom on the main floor. Otherwise it would have been trickier to not do any stairs.

Bryan:

52:00

Cara didn't have any of the paperwork with her because she had had to rush through Manhattan traffic to get to us directly from another birth, but she brought the paperwork at her three-day visit, and before she left she took a family picture of us on our couch. And looking at the picture, Grayson looks quite unhappy and now you might think that it's because he's not thrilled with his baby sister. But actually he was unhappy because he knew that Cara was leaving and he had enjoyed having her around. She was so good with him. He was a little upset that she was going to be going for the day.

Lisa:

52:34

It was so lovely to have given birth at home and to not have to go anywhere, to not have to transfer in labor was golden to get somewhere. And then equally if not more, golden was not having to be woken up by strangers. Having, you know, nurses and doctors coming in and out and visit the, you know, the person you're sharing a room with often in New York City hospitals coming in and out all through the night, not having to worry about transportation, getting home and so many logistics. It was amazing to just be home. It was like night and day. Amazingly different and wonderful. And then to have our midwife coming for a few postpartum visits, there's another big difference in care is that with an OB in a vaginal birth, they send you home from the hospital and they say, "Bye bye. See you in six weeks."

Lisa:

53:30

You know, and if it's a c-section is going to be more like three weeks. But still it's, that's several weeks. Whereas a midwife is coming to you sometimes the day after the birth, sometimes three days after the birth. And then it varies among midwives, but they're gonna be doing much sooner, much more thorough, consistent early postpartum care, which I think is so important. It's one of many ways that we're just not in our standard medical system, not taking good care of moms, and why we have some of the worst outcomes in the developed nations of the world. So to experience that difference was just really magical. And also -- this is true for many people --when it's not your first time to give birth, when it's your second or your third or whatever, you just tend to bounce back a lot faster. So I was so grateful, and that's such a thing of grace because you have another little one, at least one that you're caring for already. And so it's amazing to be able to bounce back more quickly. I remember that that recovery felt at least three times as quick, if not moreso.

Bryan:

54:33

Later that afternoon, our pastor's wife came over to our house having received the news that Ella had arrived, and she cooked us a meal in our kitchen, which was a beautiful gift. And if you have ever received a meal from someone in a time of sickness or a time of where you just needed another set of hands, you know what a beautiful gift that is, what a big help that is, and it can be an opportunity to just sit and catch up with someone in a moment where it's good to have some company. We really appreciated receiving meals from our church. Our church at the time had a meals ministry. They had a schedule where people would sign up to bring meals to those who needed them. That's something that we continue to participate in today. In our current church, Lisa organizes that for other people and I would encourage you to participate in that kind of thing. You know, through some kind of group that you're a part of wherever possible.

Lisa:

55:34

Yeah. If you have family or friends or a faith community who can support you in that way, there are great websites that allow you to do that. Takethemameal.com is what I use. They're free. You just set up a webpage for the recipient and you can highly customize the dates and you can put all the dietary instructions in there and that is the top thing I always recommend requesting and it's the best time in your life to ask for help. You just need help. We're not meant to do this alone and the meals are golden -- beyond golden.

Bryan:

56:06

And you can also feel free to say to people, "Thank you so much for bringing a meal; we can't visit. We're going to enjoy this food. Thank you so much." You know, it's fine. People get it, they're happy to help and if you need some time and if they need to go on their way, that's cool. This is a, this is a time where you can ask for that and expect them to willingly grant you that and they're going to be happy to, to contribute in any way that they can.

Lisa:

56:37

A lot of people I talked to who decide to give birth at home have a lot of concerned friends and family and we had, I think we just had one. I think most of our family kept their thoughts to themselves unless you protected me from certain things. But we did have one friend who is a physician's assistant and has worked in ERs and you know, emergency situations a lot and has seen a lot of scary things. So she expressed to us that she was really, really, really scared that we had chosen to give birth at home and it was hard to know how to respond to that in a loving way. And you know, show appreciation for her concern but not change our minds. You know, because we were quite confident. It was a very thoughtful decision. It wasn't a rash decision at all. It took months for us to change our minds about where we were giving birth.

Bryan:

57:35

Right. And it wasn't just based on an abstract principle. This was a decision that was only made after we had -- and particularly you -- had done a lot of research looking at the information and talking through our specific situation with care providers we trusted and coming to a decision about what was going to be best for you and for our baby.

Lisa:

57:59

Right. So all that to say that especially if you do choose to give birth at home, you may want to be cautious, proceed with caution in who you share that with, just knowing that you may get a lot of judgment and a lot of scared people and a lot of people trying to change your mind a lot or just one in our case, thankfully, but that's a very common thing that I hear from people who've chosen to give birth at home is, sometimes there are family or friends who are very, very against it and are very scared and really usually not with any evidence-based reason. You know, it's just a very emotional reaction because our culture is so set around the medicalized form of birth. So I just wanted to mention that. Do you remember how you felt about my changing views on where we should give birth and with whom we should give birth.

Bryan:

58:53

I don't. I mean, I remembered vividly the story that our birthing class teacher had told us of her catching her own baby in her home, which when I heard the story I thought was bonkers. But you know that along with everything that I learned after that about the birthing process and about how people, you know, around the world give birth and how that compares to our typical view of, of, of birth here in the United States. All of that plus, you know, my trust in, in you and I knew that this was not something that you were taking lightly and this was not something that you were going to enter into without really thinking through it that allowed me to be excited about it.

Lisa:

59:43

I feel really fortunate to have a partner who was so supportive of that because it's not always the case. You know, sometimes couples clash on this topic and I think it's really important when you're making a choice to give birth in a setting that's not traditional, it's really important to be on the same page as much as you can, you know. But I feel like the involved parties need to be onboard with it as much as possible. And I think that some midwives might not even work with someone who, if they're both not onboard with it, because it's just setting things up to not go very well. If there's any stress or strife over that decision.

Bryan:

60:21

And as the decision was made and as we were approaching the due date, we kept an open line of communication about, "What are we both going to need in order to feel as prepared as we can be? You know, how much planning do we need to have in place? How many, how many people do we need to be able to call on?" So that we both felt good about what we were getting into.

Lisa:

60:45

One of the things that our midwife, Cara said after the birth was that she really thought that somewhere in my psyche that I just wanted this to be a family-only affair. And I don't know if that's true or not. I was like, "No it's not." I don't know that I said that to her, but I was thinking, "I don't think so." I'm like, I'm not sure I had that confidence level or -- you know, I wasn't a doula yet, I wasn't a - and even if I was a doula, a doula is not a clinical expert. But I just thought that was a funny observation thought that she had.

Bryan:

61:27

If we were to have another home birth, would you do anything differently this time?

Lisa:

61:34

I haven't thought about that at all since we decided we were done after two. And our third baby so to speak is our adopted dog. Well, I mean I would hire a homebirth midwife from the get-go. That's not really what you were asking, but wow. I would have loved to have that care through the whole pregnancy. That would have been amazing. And I probably would call somebody earlier. But the thing is I have no regrets because I love our story. You know, I absolutely love our story.

Bryan:

62:13

Tell them about the gift from your work.

Lisa:

62:15

Within about a week of Ella's birth, we received a package in the mail, a gift, and it was from my workplace, which was a nonprofit called Hope for New York. And we unwrapped it and it was this sweet little pink catcher's mitt. And they had written on it, Ella's name, her birth date, birth time, birth weight, all of those things. And then it said safe at home and the card was addressed, "To the best catcher!" So that's our birth story, our second birth story.

Bryan:

62:51

You did it!

Lisa:

62:51

You did it, too.

Bryan:

62:55

I was there.

Bryan:

62:58

One other thing I might throw in is one or both of you -- either the mother or the partner -- try to write down these details soon after they happen. Because looking back over this, there are many details that I had just completely forgotten and, or changed in my mind. And it's great to be able to look back. Lisa journaled this and I made a few notes here and there at the time and you saved some emails that you had sent around this time and that's a, a great way to, to look back and be reacquainted with these smaller moments that otherwise would get lost in the stream of time.

Lisa:

63:39

Definitely. Yeah.

Bryan:

63:41

Anything else you want to say?

Lisa:

63:42

I think that does it. Thanks for coming on the show again, Mr. Bryan Taylor.

Bryan:

63:47

It was my pleasure. Thank you for having me. I feel right at home here.

Lisa:

63:52

In our bedroom where we're recording this. Alright, signing off.

Lisa:

64:01

So there is our second crazy birth story -- or bonkers as Bryan put it. For the first time expectant parents out there, please remember this was not a first birth but a second one, which just tends to progress more quickly and unpredictably. I want to be sure to give our doula, Ellen Farhi props and all the credit for the fact that we ended up giving birth at home. I will be forever grateful for the education, support and encouragement she provided both in our first pregnancy and labor and then in our second pregnancy. In our next episode -- and oh, the irony of my having just told you this story wasn't indicative of a first labor -- you're going to hear another kind of crazy story in which one of my birth class students' first labor starts when her water breaks during a class meditation exercise on my classroom floor and she meets her baby only five hours later. So be sure to tune in next week. Here's a sneak preview.

Student:

65:01

While we were laying there and I was very relaxed and that was, you know, enjoying the soothing music you put on and just feeling very, very comfortable. My, I felt a very, very -- what felt like the strongest kick that I had had up until that point. And then as soon as that passed, I just felt a warm flood.

Lisa:

65:23

Thank you so much for listening to the Birth Matters podcast. We'd love to hear from you. So please feel free to shoot us an email to podcast@birthmattersnyc.com and as always, please subscribe, like, and review this podcast wherever you're listening. See you next time. And remember, you are stronger than you likely think. And you've got this!

Lisa:

0:00

You're listening to the Birth Matters podcast, episode three.

Lisa:

0:03

You were already in bed. I was about to get in bed and I felt another different contraction and I turned to you. I said, "Are you ready?"

Bryan:

0:14

And I replied something like, "I don't think we can ever be fully ready for this, but I'm so glad to be having another baby with you."

Lisa:

0:32

Welcome to the Birth Matters show. I'm your host, Lisa Greaves Taylor, founder of Birth Matters NYC childbirth education and labor support. This show is here to lessen your overwhelm on the journey into parenthood by equipping and encouraging you with current best evidence, Info and soulful interviews with parents and birth pros. Please keep in mind the information on the show is not intended as medical advice or to diagnose or treat any medical conditions. Today you'll hear my second kind of crazy birth story in which I changed care providers several times and switched from planning to give birth in an in hospital birthing center again to giving birth at home. You'll hear quite a bit of talk about the perks of working with a midwife and we'll hear about a couple of different types of midwives so this episode will provide some education on that topic. In case you're not familiar with what a midwife is, I'll include some links to information in the show notes.

Lisa:

1:27

To give just a very brief overview, a midwife is a clinical care provider -- and is often, but not always a nurse -- who's a great option for a low-risk, healthy pregnancy and birth, and who tends to trust a woman's innate ability to give birth to her baby and also tends to provide more holistic care. A midwife uses interventions and technology only if truly medically necessary, which is a good thing for healthy moms and babies. Midwives can work in hospitals, birthing centers or homebirths. Last, I want to mention that a midwife and a doula are two separate things. A midwife is, as mentioned before, a clinical care provider and is protecting the physical health of the mom and baby. A doula provides nonclinical kinds of prenatal and labor support to the expectant parent and partner if applicable. To be more specific, a doula provides emotional, physical, strategic and self-advocacy support.

Lisa:

2:19

Before we get started on the birth story, today's episode is brought to you by the Birth Matters Complete Online Course. If you can't squeeze in the in-person group birth class series or if you didn't feel like the one you took was comprehensive enough or if you don't even have a quality class available in your area. I have the perfect solution for you: Birth Matters Complete Course is an online recorded version of my in-person full series. It covers not only prep for an amazing birth with self-advocacy tips, best current evidence and tips for partners, but also holistic postpartum wellness, breastfeeding and newborn care. And to top it off, you get lifetime access so that you can use it as a refresher in this or future pregnancies. How awesome is that? For New York City locals, you have an option to add to the course an in-person one evening hands on comfort measures workshop, which is a really ideal option for the more tactile parts of the course. Check it out at birthmattersonline.com. All right, buckle up for a pretty wild birth story. You ready? Let's jump in.

Lisa:

3:24

Hey everybody. Welcome to today's show. Today I have with me once again my wonderful husband, Bryan Taylor. We're going to share our second birth story. Hey Bryan, how are you doing today?

Bryan:

3:35

Hey Lisa, my amazing wife, I'm doing very well. How are you?

Lisa:

3:39

I'm great. I'm looking forward to talking about this together because we haven't talked about it in a long time.

Bryan:

3:45

A long time. So this birth story is going to be shorter, faster, more exciting,

Lisa:

3:53

More exciting indeed.

Bryan:

3:54

A thrilling sequel.

Lisa:

3:55

Yes, yes. So it will be shorter because this labor was like a quarter of the length of time as compared to our first, which is very textbook. And, um, before we go into the Labor story and because it will be shorter, we thought it might be helpful perhaps to go into a little bit of our pregnancy journey and the different choices that we made along the way. We actually went through multiple, I hate to say went through, but we were seen by multiple different care providers in the second pregnancy. We started just going back to the OB doctor Rhee who we had enjoyed working with our first pregnancy, and then I really decided I would like to explore what the midwifery model of care might be like. I still was interested in giving birth at the same hospital in the birthing center at -- now former birthing center; sadly it closed in January of 2019, but back then in the second pregnancy in 2007, it was still open, and I had had a lovely experience that first time. I don't remember at what point in my pregnancy this happened, but we eventually hired Ellen Farhi again as our doula. And I feel like pretty early on she started to encourage us to consider giving birth at home. And at first, I don't know about you Bryan, I don't remember, but I was like, no, I'm not comfortable with that.

Bryan:

5:22

Right. And I think that her, her recommendation was probably based on the fact that you were already wanting to work with a midwife. You were already -- you knew that you'd had a positive experience at the birthing center and so you were aiming for that kind of environment again.

Lisa:

5:42

And she told me that they had made the rules of admission to the birthing center stricter since then, and she was really afraid that I would be banking on using it and that I could very easily or much more easily this time around risk out, and then be that more disappointed given that I had used it before. So that was a big part of her thinking and it took a lot of soul searching and research before we came to the conclusion that home birth actually felt safer and like the best choice for us. But we'll get to that in a little bit.

Bryan:

6:16

Do you remember when you started seriously thinking about using a midwife for the second birth? Was that a seed that was planted in our birth class and that you had just sort of put the idea aside until you had been through your first birth to see how that went? Do you remember what your thought process was there?

Lisa:

6:34

Yes, I think, I do think maybe the birthing class in our first pregnancy planted the seed. I don't recall entirely, but I think that's likely. I think that I actually did a little research in our first pregnancy maybe across the course of taking that eight week birthing class and I just couldn't find any practice that seemed to be in network and covered by our insurance. And that's such an issue and challenge for a lot of people to navigate all of that. So, and it was a challenge again in the second pregnancy, but I did end up finding a doctor's practice -- Dr Paka, Renuka Paka's -- practice, who had at the time had two midwives under her practice who therefore, because it would be billed to insurance under Dr. Paka's name, would have been and was in network.

Bryan:

7:29

Yeah. Just because I was kind of talking over you earlier, I just want to make sure that it was clear: insurance, the in-network aspect of finding a midwife was key in the decision the second time around with the second birth to go down that route to look for a midwife, because we were able to find one in network. Whereas in our first pregnancy that was not an option, is that right?

Lisa:

7:56

It either wasn't an option or I just wasn't able to find the option because New York just has so many care providers and so many hospitals and it's just, it's, it's hard to wrap your brain around and hard to find the time and energy to sift through it all. Especially if you're not connected to someone in the birth community like a doula yet who can curate that for you and can give really smart recommendations or a childbirth educator. One thing I wanted to point out is that at least here in New York, a lot of midwives have hired excellent billers who are really, really good at working with insurance companies to make them pay. With this birth, the midwife we ultimately ended up working with had this amazing biller. In fact, Cara said, don't even get on the phone with your insurance, just let her deal with it.

Lisa:

8:45

It is her gift in life to compel to, you know, get the insurance companies to pay and cover these things and we didn't have to pay. Don't think we had to pay a penny. It was amazing. I mean this was, you know, years ago when insurance was a little better than I think it might be today, but still they, I, I've heard stories from my students of them covering a lot of things that they didn't think they were going to. So I think almost the only thing we had to pay for was the rental of the tub that we ended up not using. And our midwife was so lovely. She actually refunded most of that fee because we didn't end up using it at all. So I found that practice and I -- looking back in my journal notes, I am reminded of how, what a stark contrast it felt like, how much less rushed I felt from the very first appointment with the midwife.

Lisa:

9:39

And so it was lovely care. And a few months into that, we were in Texas for Christmas for the holidays and we got a, I guess an email, I think it was an email saying that Yael, this midwife we were seeing and were so happy with, was retiring just very suddenly and we were so disappointed. And then the other midwife was leaving this doctor's practice to go on her own with another midwives practice up to the Bronx, from Manhattan to the Bronx. And so I followed her there. I went to her for a couple of visits and loved her. She was great, but it was not going to be covered by insurance. And so that was going to be tricky. And not only that, but right around that time in January in my, let's see, it was about at 30 weeks, I went to see The Business of Being Born, a documentary by Abby Epstein and Ricki Lake and it really, it was in a movie theater and I went with a couple of girlfriends at the recommendation of my doula, and that sealed the deal.

Lisa:

10:49

I walked away from that film, totally sold on wanting to give birth at home and within less than a week I had interviewed two homebirth midwives, had had a prenatal with one of them, had like chosen one and had also, we also had our first prenatal visit with our doula Ellen, the day after seeing Business of Being Born. I'm sure she was thrilled to hear, we're going to do it, we're going to give birth at home.

Bryan:

11:15

She gave us another film to watch, right?

Lisa:

11:17

Yes, she did. I don't remember the name of it, but it had Marsden Wagner, who's great, and that was also a contributing factor. But then I really had done a lot of research just to learn the statistics of like how safe is this really? And I started to learn: for low risk, healthy pregnancies, it's very, very safe, especially in a city where you have a hospital on almost every corner.

Lisa:

11:41

It's so quick to get somewhere in the unlikely event that you do have to transfer. The funny thing was when we secured this homebirth midwife, oh and by the way, the homebirth midwife we hired just happened to be Cara Muhlhahn, who is the main midwife you see in the documentary I mentioned seeing, The Business of Being Born. So she practices in Manhattan in Alphabet City. And she was just about to go away on a sabbatical. She takes like a month long sabbatical every year I think. And I was coming in to her right before she went away, and that was the only reason she had capacity was because a lot of people probably didn't feel comfortable booking her and having her be away for the last few weeks of their pregnancy. So I kinda lucked out on that. And she had an apprentice midwife and a backup really veteran midwife who were there, you know, in the hopefully unlikely event that I went into labor before she came back. So I was seen by yet another midwife, this apprentice midwife a couple of times while she was away, and

Bryan:

12:44

Hold that thought. Our daughter has slid a note under our bedroom door that says, "May I shower now?"

Bryan:

12:57

I think it's because of the noise that she's asking, not because she doesn't know that -- whether or not she needs one.

Lisa:

13:06

I think we should wait.

Bryan:

13:09

Ella. Okay. If you can wait to shower, I think it's just going to be a little too noisy, huh?

Lisa:

13:14

We're sorry.

Bryan:

13:15

We'll let you know when we're done. Okay?

Ella:

13:17

Okay.

Lisa:

13:19

Love you!

Bryan:

13:20

We're telling your story. We want to get it recorded nicely.

Lisa:

13:25

I wanted to clarify that the reason when I followed Chris McCloskey up to the Bronx -- the midwife with Dr. Paka's office who left to go to the Bronx -- that usually midwives who do hospital births don't attend homebirths. Usually a midwife is either catching babies at home or they're catching babies in the hospital. That's something that's not always clear to people, so I just wanted to make that clarification that that's the only reason that I left her practice was because she, she said, I would love to attend your birth at home, but I'm not set up yet. I don't have the equipment, you know, I don't own the equipment and I'm just not set up to attend a homebirth. So she sent me off with her blessing. She was very excited for me that I had made that choice, but she just wasn't equipped to be able to be my care provider for that birth setting.

Lisa:

14:21

One thing I want to mention about these midwifery visits is that when you give birth at home, at least in New York -- it might depend on where you live -- the midwife for the most part, if not 100% of the time, comes to your home to do prenatal visits. And wow, is that amazing. Especially when you're in your third trimester and you're exhausted and you're feeling large and uncomfortable. What an amazing gift that is to just not have to go anywhere, not have to get on the subway or in a car or whatever it is. So those were, that was like another whole level of amazing care, you know. So we had first the OB level of care. It's unfortunately a product of our healthcare system where everything is really rushed and you're probably waiting for much longer than you're actually being seen. And then the next level was going to an OB practice who had midwives and that's still part of the healthcare system.

Lisa:

15:16

But thankfully it was, it did feel less rushed. And then now we're experiencing version three where it's a homebirth experience and the midwife is coming to our house. And I just wish, I was like, why didn't I do this from the beginning? Oh my goodness. Here we are, you know, in our thirties weeks, and our little baby girl ended up coming a couple of weeks earlier than expected. So I just wish we had signed up for it earlier on. But you know, things work out the way they're supposed to. Cara came back from her sabbatical and she did -- just to play catch up, she had so much catching up to do, she had her clients come to her office in Alphabet City in Manhattan for a group Prenatal. And they had a, somebody, a guest there who was talking about hypnobirthing and did a kind of an educational seminar, which was really cool.

Lisa:

16:08

And I think she also just really wants to build community. So she wanted to offer expectant parents a way to connect with other expectant parents, which I think is really, really nice. Even though I wasn't at first very keen on "Really? I'm having to go at like 30 I dunno, 37 weeks all the way down to Alphabet City from Queens? Okay, I'll do it." But in the end it ended up being a really lovely visit. And then the next week she came and did one visit in our home, thinking we were going to get more than one before our baby girl came. Not knowing that less than two days after she came for that first prenatal visit with us in our home that we were going to have our baby.

Bryan:

16:49

And it was great to be able to welcome her into our home, to have her spend time with our son Grayson, who was at this point coming up on almost three years old. So he was able to be comfortable with her. She was great with him. She was able to get the lay of the land of our house. This is going to be an important moment in our life as a family. And so it was just nice to have this person who is gonna be on our team, you know, welcomed into our home and kind of, you know, welcomed into this moment in our lives, in that very relaxed atmosphere.

Lisa:

17:28

Yeah. And I also want to mention whenever you're interviewing care providers, trying to select a care provider, same with doulas, I say the same thing with doulas is -- really, you know, interview more than one and be sure you're finding the right fit for you. Because I interviewed two different practices for homebirth midwives and they were, both practices were lovely and I really like both of them. I've even gotten to know the one that I didn't hire better since then and they're wonderful, but you just have to find the right fit for your personality. And for me, Cara, I can't even remember the quote, she said something in The Business of Being Born that really resonated with me along the lines of trusting the woman's body and then she's there for safety, that she's, you know, just watching over for safety purposes. And that just really made me feel safe in this choice to give birth at home.

Lisa:

18:20

I also wanted to just contrast one thing. I had more than one urinary tract infection, UTI in my pregnancy and it was asymptomatic. So I never would have known that I had them, except for that, when you go for your prenatals, they're having you pee in a cup and they're testing a couple of different things in that to just be sure we're all good. And so I had been diagnosed with a UTI at my OB's office earlier in the pregnancy and she said -- well at first it actually didn't get communicated to me. There was an administrative error. And then I found out later after the fact that I was already supposed to have been told and was supposed to be getting antibiotics and I didn't take them because of concerns of antibiotic over-usage that has been in the press in recent years. And I needed a reason.

Lisa:

19:12

I mean, maybe I should've just been the good patient and you know, done what I was told. But when I asked, I didn't get a, they wouldn't really tell me a reason. They just were like, oh, and you just, you know, it's just for good measure. You should just take it. As contrasted to when I switched to this midwifery practice, the first midwifery practice under Dr. Paka's care, they told me, "Well, Lisa, it's really important that you take these antibiotics because you're putting your yourself and your baby at risk of preterm labor if you don't, and wow. I was like, wow, I really wish someone had told me that -- had framed it in that way because if they had ever breathed those words, I would have instantly said, "Well, I'm absolutely taking the antibiotics then." So you know, that was just a contrast.

Lisa:

19:56

I felt like I just was being heard and my questions were really being thoughtfully considered and answered and they were giving me choices in my care in other ways and other decisions that we made. When we first showed up to Yael's practice, she gave me the option of, she said, "Do you want me to treat this like a first prenatal visit or do you want to use this as an opportunity to answer some questions?" And so I said the latter. Why don't we do that? I don't feel the need. I already had the first prenatal with a different care provider. You know, let's, let's go through some questions. Absolutely. Cause like who gets questions asked in really brief OB visits so much of the time? So that was really refreshing.

Lisa:

20:36

Let's review briefly just so we're all clear on who, who's your care provider, Lisa and Bryan, at this point? Who is your team? So we landed on Cara Muhlhahn, homebirth midwife. She was going to be our clinical care provider. Our labor support was my wonderful husband. And then we had hired Ellen Farhi again as our doula for the second time. And so they were on call for us. And about two weeks before my due date, I do remember, this isn't in my written birth story that's in these show notes. But I do remember I went shopping, I was running errands the day before I went into labor and I remember I was getting into the car, putting my bags in the car and getting in the car. And I remember having a stronger-than-usual Braxton Hicks contraction or some kind of contraction. And I remember thinking, Huh, but then I just went about my day because it, they weren't coming regularly but it just felt a little different.

Lisa:

21:39

Yeah. So that was the day before and then we were going to bed that night and were kind of night owls as you might've heard in the first birth story a bit. So at about 1:20 or so late night we were going to bed, I think you were already in bed. I was about to get in bed and I felt another different contraction and I turned to you, I don't know if it was as soon as that happened or if it was, it was in that ballpark sometime around then I said, "Are you ready?" Right? But I don't think I told you,

Bryan:

22:13

I don't think you did either. You just asked me the question and I replied something like, "I don't think we can ever be fully ready for this, but I'm so glad to be having another baby with you." Something along those lines.

Lisa:

22:28

Oh yeah, no that's it. That's it. I love it. So sweet. So I went to bed and then like an hour and a half or so later woke up and had to go to the bathroom and was having some contractions and again woke up, I don't know, the five o'clock hour and at that point I couldn't go back to sleep and was having regular contractions. Fairly regular, but at the same time irregular coming and coming and coming, but not with a regularity of frequency, as was the case with our first labor. And which misled me into thinking, "Oh, we have plenty of time." Now here's the funny thing. Two days before, less than two days before, when Cara came to our house for the first time and had a prenatal, she mentioned, "Oh, your baby girl is in a really perfect position." Oh, and by the way, one thing I didn't mention is that the baby had been, she had been transverse sideways at about 33 34 weeks, which was really concerning. But thankfully she did go head, head down. And so right before we went into labor, she said, "Yeah, she's in a beautiful position. I really think she's going to come really quickly when the day comes." And we had planned to have another prenatal visit the next week maybe with our doula and we were setting all that up and that never happened. I remember going into -- in the early hours of the morning, I remember going into what was going to be Ella's bedroom, the nursery, because we had a twin bed in there, a guest bed. And I remember lying down in there for a little while because I didn't want to disturb you but I couldn't sleep and I was afraid I'd be tossing and turning and keeping you awake. So I just thought I should let you sleep because we didn't know how long we were going to be doing this.

Bryan:

24:23

And also I'll just throw this in. I was probably sleeping a little more heavily than usual because a day or maybe two days before this, I had just had a bout of food poisoning. It was like the one of two times in my life I've had food poisoning. Not the best timing, but so I think you were particularly cognizant of that, knowing that, you know, I was already behind on sleep. You needed me to be as rested as I could be when we went into the main event. So hopefully that makes me sound like a little less of a jerk.

Lisa:

24:56

How can you be a jerk when you were asleep? How would you -- like, you didn't know I was in labor.

Bryan:

25:02

Yeah, I know, but it's coming up, I'm supposed to be expecting, you know, I'm supposed to be sensitive. I don't know.

Lisa:

25:09

Then I decided to wake Bryan up at about 8:30 and told him we were in labor, and you were so calm. Oh, I so appreciate your calming presence. You were that way the first time, too, and are just that way in general and it's a really lovely attribute. You just said, "Okay."

Bryan:

25:29

I was still sleepy.

Lisa:

25:31

Yeah, you were probably like, "Okay, let me wake up." And an odd thing that surprises me to this day is that my body in that labor, unlike the first for a lot of it, I could not lean over. Many women -- I would almost dare say most women, but let me say many -- find it very instinctive to lean over. It takes the pressure off the back and just tends to feel more instinctive than a lot of other positions, whether that's on all fours or leaning over a counter or hanging on a partner. But I, for part of my labor, I just had to stand straight up, which was so bizarre. And yet at a different point in this short labor, I also have a recollection of being almost in child's pose, pretty much in child's pose, actually. I don't know how you do that when you have the big baby bump, but I did and I was having to be completely collapsed. So it was like nothing in between. I had to either be standing straight up or completely hunched over, folded over even.

Bryan:

26:35

And you were doing that on the ground or on the bed?

Lisa:

26:36

I was doing that on the ground right by our tan chair and our armoir, just right in front of that. And I'm wondering if the, I can't remember if that was before I woke you. I think it might've been. But I don't remember. It's all so fuzzy, thanks to all the oxytocin and endorphins and things that are rushing through your body and making your brain kind of fuzzy. So shortly after I woke you, we decided to call Cara. Right?

Bryan:

27:04

Right. Almost immediately after.

Lisa:

27:06

Because she had told us, "Call me at the first sign of a contraction." Did I do that? No, this is like seven hours before the first one. But that very first one at 1:20 wasn't -- I didn't think we were in labor. I thought, "That's odd." But I didn't think we were in labor.

Bryan:

27:23

So we called Cara. You got on the phone with her so that she could hear, listen to you through some contractions, right?

Lisa:

27:32

Yes. And she was on the lower west side of Manhattan, just about as far from us -- in terms of getting to us -- in Manhattan as you could be. She was at a birth, she was having to go into the pediatrician with the baby. It was a little trickier for her to come join us as fast as she probably would have preferred to being our second time around because if it was the first time she'd have been like, "You have many, many, many hours," you know, but not in this scenario. She had planned to come to us just about as soon as we called, most likely. And we had talked with Cara and we'd actually talked with y'all l previous midwife in the pregnancy about like should we have our two year old with us? Should we find someone to take care of him? Like, we've never done this before, what do we do?

Lisa:

28:24

And we got different insights. I remember that Cara specifically said, "Oh, you'd be surprised at how great kids are at this kind of thing. They just really roll with the punches and kind of really, like, take everything in stride and they really step up to the plate for whatever is needed in each moment." So I found a lot of confidence in that. But at the same time we really wanted to have kind of a backup plan. So we did call when we realized we were in labor, and once I had woken you, we called some friends to see if they could help and then we were going to be calling our doula as well. And our doula said, "I wish you had called me sooner!" because I think she realized we were more progressed than yeah, we -- that we weren't calling her at the very first sign of labor.

Bryan:

29:07

Yeah. We're backup plan kind of people. We had a backup plan for calling friends into help calling neighbors into help. We had done an emergency run of what do we need to do if we have to get to a hospital nearby. We thought through that

Lisa:

29:25

And we almost did a hospital tour of the backup, like, farther away hospital that Cara likes to -- prefers to transfer to in the event that you have to do that. Cara kind of was like, don't go there mentally. Don't go there. But I just -- it really depends on your personality and for us it gave us more peace of mind to prepare for those different scenarios.

Bryan:

29:44

Right. And then -- the morning of, you know, nothing goes according to the plan, the way you think it will, but the, the mere fact of having thought through these different contingencies I think helped us stay in a more positive frame of mind. So that when I first made a call to a friend to see if someone could come over and look after Grayson and they weren't able to come over, no big deal. We are where we are, we're not in real, you know, we're not in the serious stretch yet. I'll keep an eye on things here. I'll try you back later. You know, in the back of my mind I think I still got the neighbors, the, if I have to call them, I can call them. I do think it's worthwhile if you're going to be giving birth at home to think through who's close by, either who's close by or who's always going to pick up the phone just because you don't know in the moment what you might need, or particularly if you can't get ahold of your midwife right away or your midwife can't get to you right away. I mean, this is more important with the second child than with the first, just because things can go so quickly. Is that fair?

Lisa:

30:49

Absolutely. What were you doing, Bryan, in these couple of hours that you were awake for before the baby came?

Bryan:

30:56

Well, I was trying to get the birth tub ready. We had already had it set up, but it wasn't filled with water, so I hooked the hose up to our little bathroom sink on our first floor. Got that going.

Lisa:

31:13

Well, hang on a second. So we had rented a specific for labor tub, like a portable tub called an Aqua Doula from our midwife because I had envisioned this beautiful, peaceful waterbirth. That was kind of my vision for how I thought that I wanted this -- our baby girls' birth to go, knowing that I might or might not be in the mood in the moment. But yeah, so that's the tub that Bryan's referring to.

Bryan:

31:41

Right, and just to back up just a hair, I don't know if we said this, when we talked to Cara and she heard where you were with your contractions, she said, "Call me back in an hour" at that point, so it was like almost nine o'clock so, so I was focused on trying to get the tub filled. Meanwhile, Grayson had woken up. I hadn't reached somebody who could come watch Grayson, but not a big deal. He was, quote unquote, helping me fill the tub. I was probably thinking about getting him something to eat, but didn't quite have time to get there yet. You had some cereal, you were on the first floor. We wanted to see if there was something we could do to distract you from contractions. So we put in a Gilmore Girls DVD and the contractions started to come on pretty strong. You were not in the mood for Gilmore Girls.

Bryan:

32:34

So at this point, because the contractions were taking so much of your focus, I was trying to focus on timing them. We had a sheet right where we were keeping track of the timing of the contractions.

Lisa:

32:46

It's very short.

Bryan:

32:47

It's a very -- very brief list. Yeah. And the contractions were a little tricky to time. I would say I was having a little trouble figuring out exactly how to notate that. And I was -- we had this digital stopwatch that didn't work very well and then the clocks in different parts of the room were set differently and I didn't have a watch because I don't wear a watch because how useful are those really? So it was a lot of guesswork and,

Lisa:

33:15

Oh and can I just explain real quick as you're talking about timing contractions, I think I might not have been clear earlier when I said that because the frequency, which is from the beginning of one contraction to the beginning of the next was erratic, it wasn't consistent, it was not textbook -- because of that, that made me think that we had a lot more time than we actually did in reality. What I meant by that was after my first experience of giving birth, I learned or was reminded of something that I had forgotten, that when there's a sporadic, confusing frequency like that, it can sometimes be indicative of a baby being in a posterior position, meaning that the baby's back, their head is down, but their back is against the mom's back. And what that can mean is that the frequency is just, I might've mentioned this in the first birth story, I don't remember, but it can make, it can slow things down.

Lisa:

34:12

It can make for slower progress because the angle of the baby's head, yes, I think I did talk about this, but just in case you didn't hear the first one, I'll say it. And for reinforcement, it can just mean that the baby's head is not as effective at dilating the cervix. And so it can just take a lot longer. And so that's what I thought. Oh Great. We have another posterior baby on our hands because of this confusing frequency. So we must, -- I'm sure we're in for many, many hours of labor. So back to what you were -- ways that you were, things that you were doing.

Bryan:

34:40

As I was trying to fill the tub, I called our doula Ellen. I don't know if her phone was, I don't know. Anyway, I couldn't get through to her on her cell phone. So I called her home line, got ahold of her daughter, asked her daughter to let Ellen know, you know, that we needed to hear from her. Things were progressing. Then at some point in here you moved from downstairs up to our bedroom and you wanted to lie down.

Lisa:

35:08

I was trying to remember if I want to lie down. Yeah because I already was lying down when we talked to Cara the next time and she said, "Lie down to slow things down." But yeah, I guess, I don't know if it was this instinctive thing of like, "I need to slow this down a little bit," because it was just, it felt like a train had hit me. I was like, it was, it went from zero to a hundred, like, so fast. So it made it a lot harder to tolerate because there was, it was not a gradual buildup, like it tends to be in a first labor.

Bryan:

35:39

Right. So an hour after we had talked to Cara, she called back, you were having the urge to push, she heard you vocalize through a couple of contractions or maybe just one. She tells you to lie down but you were already lying down and she said, "I'm on my way. Try not to have the baby until I get there."

Lisa:

36:01

And later she told us she was, like, running red lights and, like, just waving to people who were cursing at her. She was, like, breaking all the laws. She's like, "I've gotta get to a woman having a baby. I'm a midwife!"

Bryan:

36:14

So the water's still running in the aqua doula. So I go back downstairs to check on that. But it's becoming clear that a, I can't keep checking on that. I think I just turned the water off because of the sounds that were coming out of you.

Lisa:

36:29

I was making very loud sounds.

Bryan:

36:30

Yeah. I felt like I needed to be closer to where you were. Grayson had been kind of coming back and forth with me. He had been going in to check on you from time to time and not entirely clear of the reason for these sounds that were coming out of you.

Lisa:

36:47

Roaring sounds.

Bryan:

36:49

Yeah. And he, he would say, "That's silly" -- that was one of his phrases -- when he heard you make some of these big sounds. And then at one point he got a little too close to you, during a contraction and the force of the sound scared him a little bit.

Lisa:

37:04

He thought I was yelling at him, I think. I felt so bad. Yeah. I roared right in his face and I think he -- did he burst into tears?

Bryan:

37:13

He, he cried a little bit.

Lisa:

37:15

And then when, once that contraction was done, I was very quick to say, "Oh, sweetheart, come here. Let me hug you. I'm so sorry. Mommy's just working to get Ella out. It's not you at all. Please don't, don't think it is."

Bryan:

37:27

And so that calmed him down and then you asked me to kind of take him away. But before I could do that, another big contraction came on and he was scared again.

Bryan:

37:39

You do what you can. And then the, after that second scare for him, after he was scared a second time and disappeared and we didn't, he, he went out of the room. Then you started having the...

Lisa:

37:53

Urge to push. Yeah. And into my brain popped this story. I had read, our doula had given me not just a documentary to watch, but also, some old, um, I don't know if they were old. They were sort of classic in their tone in their photography or something. It's called the Compleat Mother compleat, spelled C-O-M-P-L-E-A-T. And I remembered reading a birth story in that, in which a woman was in a similar situation to mine and she instinctively went to the bathroom to give birth. And I thought in that moment, my waters have not released, my waters have not broken or ruptured yet. And wouldn't that be nice to minimize the mess? And so I went very quickly to the bathroom, sat down on the toilet with this urge to push. And you were coming? I think I said, "She's coming! She's coming" because I could feel that she was coming. So you came up to join me, but at the same time, right around the same time you were making a call,

Bryan:

39:03

Right. So you were in the bathroom, I got on my phone to call our doula. I'm thinking at the very least while our midwife is on the way here, if I can get our doula on the phone, our doula can, you know, be talking us through this as it happens on the phone.

Lisa:

39:22

And she was in midwifery school to become a midwife at the time.

Bryan:

39:26

But the number from which she had called me was not the number where she now was -- something like that. I couldn't get through to her. Meanwhile, you're on the, on the toilet and you tell me that you feel the head.

Lisa:

39:39

Haha. I thought it was the head.

Bryan:

39:41

And I couldn't tell whether you were really rolling with it or whether you were freaking out. So, remembering something from the Birth Partner book by Penny Simkin, I went into the bathroom, got right face to face with you and said, "You can do this. You can do this." And you gave me this look that I couldn't quite tell -- it was either a look to say, "You're right, I needed that." Or it was a look to say, "You're so sweet, but I didn't need that. That wasn't helpful. I'm fine...

Lisa:

40:21

"Get out of my face."

Bryan:

40:21

"Get out of my face."

Lisa:

40:25

I don't remember.

Bryan:

40:27

So I call Cara's pager. This is back in the days when people had pagers. I can't even remember what I -- I guess I left a voicemail for Cara just saying something like, "This is happening." Then I call our neighbor two doors down Ed and Marilyn our sweet neighbors. Marilyn was a retired nurse. I tell her, "Hi Marilyn. This is Bryan. We're having a baby here at our house right now."

Lisa:

40:50

And of course he said it just like that too. Nice and calm, casual, no big deal.

Bryan:

40:57

A lot of repressing going on. And you know, and I say, "We could use another set of hands. Might you be able to come over to help us?" Meanwhile your phone rings in the bedroom while I'm on the phone with Marilyn, I am starting to go to the bedroom to answer your phone and I hear you say, "My water broke."

Lisa:

41:21

And that was what I was feeling that I thought was the head. It was actually the bag of waters bulging.

Bryan:

41:26

So Marilyn said -- asked me if anybody was on their way to help. I said yes. I said, "Our doula and midwife are headed here, they're just not here yet." Marilyn said, "I'll be over there soon." After the next contraction, you said you felt the head again. Only this time it really was the head. You go from here.

Lisa:

41:45

Well and so you were kneeling right in front of the toilet. Right. And as she, I was having this urge to push and I as, as she started to emerge, I, I stood up and, and I just had my hands there to catch her. And, and Bryan, your hands came right below mine -- so that we had all four hands on deck catching our baby girl, and she pretty quickly, you know, being our second time to give birth and being in an upright position as well, she came out quite quickly. And being a couple of weeks early, too, she was on the, you know, smaller end of the spectrum in terms of size, which also meant that it was that much easier for her to come out.

Bryan:

42:26

She slid right out. She was very wet, very purple. She was crying right away. At some point in here we become aware that Grayson is standing in the hallway looking on, so we, we ease Ella -- have we said her name yet?

Lisa:

42:43

Yes.

Bryan:

42:43

Okay. So we ease Ella onto Lisa's lap and then you lift her up to your chest and we tell Grayson, "It's our baby. It's baby Ella."

Lisa:

42:55

Yeah, to try to change the expression on his face, which was very confused. He's like, "What is that thing?"

Bryan:

43:05

And so a big smile spreads across his face.

Lisa:

43:09

I just wanted to interject real quick, something that I was reminded of in reviewing the journal, that when Ellen came for a prenatal, he thought that the baby was coming that day. So when she left the prenatal visit and there was no baby Ella, he was really mad. He was really disappointed and upset. I just thought that was really funny though. You know, just like, hmm, that's a two year old, almost three year old. Yeah.

Bryan:

43:33

Do you remember what are your, what are your thoughts of that moment of -- here she is, we caught her.

Lisa:

43:41

Well, the moment of her coming out was simultaneously exhilarating and terrifying and it was such a relief once she was out and she immediately cried and because it was, it was kinda cold in that bathroom and it was also bright. It was really bright. So I would have cried too, coming out into that cold and bright environment, but it was a relief. I was glad that she gave out a good cry, given we didn't have a clinical care provider there, although she did come almost immediately after that. Right. We were kind of like, what do we do now? And, and I just started heading toward the bathtub, because I thought, "Okay, I'm just gonna park myself there with the baby."

Bryan:

44:27

Right. So we're standing there looking at each other for a moment. Later on we figured out that this is, we're going to say 10:34 AM, almost two hours exactly after you had woken me up that we have caught our baby girl

Lisa:

44:41

And less than five hours from the first strong contraction., right? Like from the first time I thought, "Oh, we're -- I think we're in labor."

Bryan:

44:49

Yeah. So there's this moment of this is incredible. Now what? And you start to head to the bathtub, I say, "Oh, can you do that? Are you okay? Are you sure you're alright to..." You say, "I'm fine." There's a knock at the door or the doorbell rings. I go downstairs. I think it's Mariyln because figure our neighbor has just arrived. I open the door. It's Cara, and I say, "We have a baby!" And she steps in and I point her upstairs. And do you remember her coming into the room? Do you remember when you realized that she was there?

Lisa:

45:25

I don't really because I was in baby land.

Bryan:

45:28

Yeah. So, so by the time Cara came upstairs, you were already in the bathtub with Ella on your chest.

Lisa:

45:37

And in hindsight, I wish I'd thought to get a blanket or a towel to put on her because, because like I said, it was chilly in that bathroom. And of course she had me as a warmer, but she also could have used a nice layer on her other side without any, you know, and Cara reminded -- she, she's like, "Oh, we gotta get a towel on her. I'm going to go." She warmed them up in the oven, several towels up in the oven, which was nice and warmed her up.

Bryan:

46:01

As I was saying earlier, you know, we're backup plan people, but this was not our backup plan. And if we had thought that we were going to have the baby in the bathroom, we probably would've set the bathroom up a little differently. We would have had the, the warm towels or, or different lighting or something.

Lisa:

46:19

I should have known when I read that birth story in the Compleat Mother, something in me was like, that sounds like a cool way to go. So my body and my baby just decided, "Let's do that."

Bryan:

46:31

Well, and in Grayson's birth, the doctor told you, "I am not going to deliver this baby on the toilet," and something in you said, "I am going to deliver this baby on a toilet."

Lisa:

46:44

Sometimes I think that that might be the case because it's just a very instinctive place to go. Whenever I teach birth classes, I talk about that a lot. The fact that sitting on a toilet, especially in the pushing stage, but honestly at any point it feels right to you, can feel so incredibly instinctive, less uncomfortable when you're in the pushing stage. So much of the muscle coordination that is required to effectively push a baby out is the same kind of muscular coordination that's required of pooping. And that's where your body knows how to do that. So it just -- it just makes sense. And yeah. Plus it's also nice for the bag of waters to break into the toilet and not make a big mess. So that was pretty ideal.

Bryan:

47:29

Cara showed up maybe -- I mean within a couple of minutes we think -- of the birth. And then about a minute after Cara showed up, our neighbor Marilyn showed up.

Lisa:

47:41

Because she was just, maybe you said this earlier, she was just getting out of the shower when you called her and she had to get dried off and dressed and stuff. So.

Bryan:

47:47

Right, no, I hadn't mentioned that. Yeah.

Lisa:

47:49

Yeah. So she, she couldn't get over to us quite as quickly as, as we thought we were looking for. Right.

Bryan:

47:55

So Cara was upstairs attending to you. I brought Marilyn upstairs. Marilyn said hello to you, met Ella, met Cara, asked if you needed anything, asked if everybody was okay, if anybody needed anything. Cara really had things under control and you felt good. And so we said, "Thank you. We're all right, thanks so much for coming by. And so Marilyn went out and I started calling people to let them know that Gabriella had made her appearance.

Lisa:

48:28

Cara was doing so many things, probably a lot of the stuff she was doing I don't even know about. But one of the things that I found so interesting, and I've used this trick ever since, is putting anything with blood on it in hydrogen peroxide. That is, like, this miracle worker. It just completely removes it. And that was one of the things, she was doing laundry for us. She was just really taking good care of us.

Bryan:

48:49

So we think that you were in the bathtub with Ella on your chest for maybe an hour, almost an hour and a half, hour twenty, something like that.

Lisa:

48:57

Yeah. Boy was my tailbone sore after that. I should have like put something underneath me instead of that, just that hard surface.

Bryan:

49:04

She nursed soon after, soon after

Lisa:

49:08

For a good long hour or so. And we were so glad that Cara arrived no later than she did because of the placenta delivery. We knew that Bryan was not gonna want to have to deal with that.

Bryan:

49:20

Not a good job for me.

Lisa:

49:20

If you listened, just listened to the first story, you'll hear a little bit about that. We were, yeah, we were very thankful for that and thankfully the amount that I bled was less than normal, less than average. So nothing concerning there at all. And we waited for the cord to stop pulsating before Bryan cut it as we had hoped to do. And then we ate. You guys made some eggs and toast and brought that up to me.

Bryan:

49:45

It was such a relief to have Cara, you know, really looking after you and Grayson and I went downstairs, I made some breakfast, I made some scrambled eggs and toast and so everybody was able to eat a little something. I made enough for Cara and, and that was a lovely moment just to enjoy this bit of breakfast immediately, post-birth in our home.

Lisa:

50:05

We enjoy our post-birth breakfast, don't we? Yeah. I feel a theme here.

Bryan:

50:13

While you were eating, Cara weighed and measured Ella.

Lisa:

50:17

And I loved the scale that they have. It's like a little stork bag where they're just holding it in midair and the little baby's in this little stork bag. It's so cute. We have a picture of it that we'll put on the show notes page

Bryan:

50:28

And then she helped you get cleaned up a little bit and get dressed.

Lisa:

50:34

Yeah, that was hard because I was, like, trying to tell her what I wanted to wear and where to -- and she just sort of had to pick whatever she could find. You know, and especially when you've just given birth, you don't know what's going to fit. And it's a little tricky. But she did it. She was great.

Bryan:

50:50

And then she helped you come downstairs and then she examined you?

Lisa:

50:55

Yeah, she just put some chucks pads there, waterproof pads on our couch, and did an exam and said I had a little tear but nothing big. And she said, it's so minor that you know, I can stitch it up if you want, but I don't have to. So she just, again, she, like, gave me the option, whereas in a hospital usually they just do whatever they deem appropriate. And I just really appreciated that. Although I was a little confused, I was like, I don't know how to make this decision, so that it was a little tricky. It's good to have options, but also can be tricky to know which to choose. But ultimately I said, "Nah, let's just leave it alone." But she said, "It's going to be really important if you don't get stitches to really lay low for the next couple of days. Do not do any stairs." She said, "You have to stay on one floor for the next two days to allow that healing to begin optimally." So I did that thankfully, and that house, we were living in Forest Hills at the time out in Queens, and thankfully we had a bathroom on the main floor. Otherwise it would have been trickier to not do any stairs.

Bryan:

52:00

Cara didn't have any of the paperwork with her because she had had to rush through Manhattan traffic to get to us directly from another birth, but she brought the paperwork at her three-day visit, and before she left she took a family picture of us on our couch. And looking at the picture, Grayson looks quite unhappy and now you might think that it's because he's not thrilled with his baby sister. But actually he was unhappy because he knew that Cara was leaving and he had enjoyed having her around. She was so good with him. He was a little upset that she was going to be going for the day.

Lisa:

52:34

It was so lovely to have given birth at home and to not have to go anywhere, to not have to transfer in labor was golden to get somewhere. And then equally if not more, golden was not having to be woken up by strangers. Having, you know, nurses and doctors coming in and out and visit the, you know, the person you're sharing a room with often in New York City hospitals coming in and out all through the night, not having to worry about transportation, getting home and so many logistics. It was amazing to just be home. It was like night and day. Amazingly different and wonderful. And then to have our midwife coming for a few postpartum visits, there's another big difference in care is that with an OB in a vaginal birth, they send you home from the hospital and they say, "Bye bye. See you in six weeks."

Lisa:

53:30

You know, and if it's a c-section is going to be more like three weeks. But still it's, that's several weeks. Whereas a midwife is coming to you sometimes the day after the birth, sometimes three days after the birth. And then it varies among midwives, but they're gonna be doing much sooner, much more thorough, consistent early postpartum care, which I think is so important. It's one of many ways that we're just not in our standard medical system, not taking good care of moms, and why we have some of the worst outcomes in the developed nations of the world. So to experience that difference was just really magical. And also -- this is true for many people --when it's not your first time to give birth, when it's your second or your third or whatever, you just tend to bounce back a lot faster. So I was so grateful, and that's such a thing of grace because you have another little one, at least one that you're caring for already. And so it's amazing to be able to bounce back more quickly. I remember that that recovery felt at least three times as quick, if not moreso.

Bryan:

54:33

Later that afternoon, our pastor's wife came over to our house having received the news that Ella had arrived, and she cooked us a meal in our kitchen, which was a beautiful gift. And if you have ever received a meal from someone in a time of sickness or a time of where you just needed another set of hands, you know what a beautiful gift that is, what a big help that is, and it can be an opportunity to just sit and catch up with someone in a moment where it's good to have some company. We really appreciated receiving meals from our church. Our church at the time had a meals ministry. They had a schedule where people would sign up to bring meals to those who needed them. That's something that we continue to participate in today. In our current church, Lisa organizes that for other people and I would encourage you to participate in that kind of thing. You know, through some kind of group that you're a part of wherever possible.

Lisa:

55:34

Yeah. If you have family or friends or a faith community who can support you in that way, there are great websites that allow you to do that. Takethemameal.com is what I use. They're free. You just set up a webpage for the recipient and you can highly customize the dates and you can put all the dietary instructions in there and that is the top thing I always recommend requesting and it's the best time in your life to ask for help. You just need help. We're not meant to do this alone and the meals are golden -- beyond golden.

Bryan:

56:06

And you can also feel free to say to people, "Thank you so much for bringing a meal; we can't visit. We're going to enjoy this food. Thank you so much." You know, it's fine. People get it, they're happy to help and if you need some time and if they need to go on their way, that's cool. This is a, this is a time where you can ask for that and expect them to willingly grant you that and they're going to be happy to, to contribute in any way that they can.

Lisa:

56:37

A lot of people I talked to who decide to give birth at home have a lot of concerned friends and family and we had, I think we just had one. I think most of our family kept their thoughts to themselves unless you protected me from certain things. But we did have one friend who is a physician's assistant and has worked in ERs and you know, emergency situations a lot and has seen a lot of scary things. So she expressed to us that she was really, really, really scared that we had chosen to give birth at home and it was hard to know how to respond to that in a loving way. And you know, show appreciation for her concern but not change our minds. You know, because we were quite confident. It was a very thoughtful decision. It wasn't a rash decision at all. It took months for us to change our minds about where we were giving birth.

Bryan:

57:35

Right. And it wasn't just based on an abstract principle. This was a decision that was only made after we had -- and particularly you -- had done a lot of research looking at the information and talking through our specific situation with care providers we trusted and coming to a decision about what was going to be best for you and for our baby.

Lisa:

57:59

Right. So all that to say that especially if you do choose to give birth at home, you may want to be cautious, proceed with caution in who you share that with, just knowing that you may get a lot of judgment and a lot of scared people and a lot of people trying to change your mind a lot or just one in our case, thankfully, but that's a very common thing that I hear from people who've chosen to give birth at home is, sometimes there are family or friends who are very, very against it and are very scared and really usually not with any evidence-based reason. You know, it's just a very emotional reaction because our culture is so set around the medicalized form of birth. So I just wanted to mention that. Do you remember how you felt about my changing views on where we should give birth and with whom we should give birth.

Bryan:

58:53

I don't. I mean, I remembered vividly the story that our birthing class teacher had told us of her catching her own baby in her home, which when I heard the story I thought was bonkers. But you know that along with everything that I learned after that about the birthing process and about how people, you know, around the world give birth and how that compares to our typical view of, of, of birth here in the United States. All of that plus, you know, my trust in, in you and I knew that this was not something that you were taking lightly and this was not something that you were going to enter into without really thinking through it that allowed me to be excited about it.

Lisa:

59:43

I feel really fortunate to have a partner who was so supportive of that because it's not always the case. You know, sometimes couples clash on this topic and I think it's really important when you're making a choice to give birth in a setting that's not traditional, it's really important to be on the same page as much as you can, you know. But I feel like the involved parties need to be onboard with it as much as possible. And I think that some midwives might not even work with someone who, if they're both not onboard with it, because it's just setting things up to not go very well. If there's any stress or strife over that decision.

Bryan:

60:21

And as the decision was made and as we were approaching the due date, we kept an open line of communication about, "What are we both going to need in order to feel as prepared as we can be? You know, how much planning do we need to have in place? How many, how many people do we need to be able to call on?" So that we both felt good about what we were getting into.

Lisa:

60:45

One of the things that our midwife, Cara said after the birth was that she really thought that somewhere in my psyche that I just wanted this to be a family-only affair. And I don't know if that's true or not. I was like, "No it's not." I don't know that I said that to her, but I was thinking, "I don't think so." I'm like, I'm not sure I had that confidence level or -- you know, I wasn't a doula yet, I wasn't a - and even if I was a doula, a doula is not a clinical expert. But I just thought that was a funny observation thought that she had.

Bryan:

61:27

If we were to have another home birth, would you do anything differently this time?

Lisa:

61:34

I haven't thought about that at all since we decided we were done after two. And our third baby so to speak is our adopted dog. Well, I mean I would hire a homebirth midwife from the get-go. That's not really what you were asking, but wow. I would have loved to have that care through the whole pregnancy. That would have been amazing. And I probably would call somebody earlier. But the thing is I have no regrets because I love our story. You know, I absolutely love our story.

Bryan:

62:13

Tell them about the gift from your work.

Lisa:

62:15

Within about a week of Ella's birth, we received a package in the mail, a gift, and it was from my workplace, which was a nonprofit called Hope for New York. And we unwrapped it and it was this sweet little pink catcher's mitt. And they had written on it, Ella's name, her birth date, birth time, birth weight, all of those things. And then it said safe at home and the card was addressed, "To the best catcher!" So that's our birth story, our second birth story.

Bryan:

62:51

You did it!

Lisa:

62:51

You did it, too.

Bryan:

62:55

I was there.

Bryan:

62:58

One other thing I might throw in is one or both of you -- either the mother or the partner -- try to write down these details soon after they happen. Because looking back over this, there are many details that I had just completely forgotten and, or changed in my mind. And it's great to be able to look back. Lisa journaled this and I made a few notes here and there at the time and you saved some emails that you had sent around this time and that's a, a great way to, to look back and be reacquainted with these smaller moments that otherwise would get lost in the stream of time.

Lisa:

63:39

Definitely. Yeah.

Bryan:

63:41

Anything else you want to say?

Lisa:

63:42

I think that does it. Thanks for coming on the show again, Mr. Bryan Taylor.

Bryan:

63:47

It was my pleasure. Thank you for having me. I feel right at home here.

Lisa:

63:52

In our bedroom where we're recording this. Alright, signing off.

Lisa:

64:01

So there is our second crazy birth story -- or bonkers as Bryan put it. For the first time expectant parents out there, please remember this was not a first birth but a second one, which just tends to progress more quickly and unpredictably. I want to be sure to give our doula, Ellen Farhi props and all the credit for the fact that we ended up giving birth at home. I will be forever grateful for the education, support and encouragement she provided both in our first pregnancy and labor and then in our second pregnancy. In our next episode -- and oh, the irony of my having just told you this story wasn't indicative of a first labor -- you're going to hear another kind of crazy story in which one of my birth class students' first labor starts when her water breaks during a class meditation exercise on my classroom floor and she meets her baby only five hours later. So be sure to tune in next week. Here's a sneak preview.

Student:

65:01

While we were laying there and I was very relaxed and that was, you know, enjoying the soothing music you put on and just feeling very, very comfortable. My, I felt a very, very -- what felt like the strongest kick that I had had up until that point. And then as soon as that passed, I just felt a warm flood.

Lisa:

65:23

Thank you so much for listening to the Birth Matters podcast. We'd love to hear from you. So please feel free to shoot us an email to podcast@birthmattersnyc.com and as always, please subscribe, like, and review this podcast wherever you're listening. See you next time. And remember, you are stronger than you likely think. And you've got this.