Birth Matters Podcast, Ep 90 - A Runner’s Fast Labor

Kaley did everything she could to maintain a healthy, active lifestyle throughout her pregnancy. She continued her running habit, then around 20 weeks she needed to shift to swimming and also did prenatal yoga. Toward the end of her healthy pregnancy, she’s told that her cervix is already 4 centimeters dilated and 90% effaced, yet her labor doesn’t start for another 3 weeks. When she experiences some bleeding at nearly 40 weeks, she checked into the hospital to get checked out. They tell her they’d like to induce, but before they can start the induction, her water breaks with a big gush. She buys a bit of time, and is grateful that her contractions started on their own about an hour later. Kaley shares all of these details and how both fast and positive her labor was, but what very scary complications she experienced after the birth, and how it has helped her to separate the birth from the 3rd stage into distinct events in order to protect the memory of her baby’s birth as a positive one. She also shares a bit about the experience of being a bit disoriented in her postpartum physical body, as well as some of the breastfeeding challenges she faced due to low milk supply caused by having lost so much blood. As always, please curate for yourself which episodes you feel will be helpful for building your confidence and knowledge base about birth. If you prefer to avoid the more potentially stressful parts, in this particular episode you’ll want to just listen through the baby’s birth and weighing the baby and stop when she mentions the placenta.

mother in glider kissing newborn baby's head

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Episode Topics:

  • Moving at around 36-37 weeks from Upper East Side to Clinton Hill, Brooklyn

  • Doing lots of reading and finding lots of prep very empowering

  • Staying active during pregnancy - kept running until 20 weeks, then swimming a lot, prenatal yoga – great for physical health as well as mental health

  • Choosing to take Lisa’s birth class in person

  • Not focusing on weight gain, just healthy lifestyle

  • Walking around 3 weeks 4cm dilated, 90% effaced

  • 39 weeks, 6 days starts having spotting

  • Went into hospital after having some dinner and hydrating

  • They almost send her home as nothing seemed wrong with the bleeding

  • They say they’re about to start induction

  • Immediately after, her water breaks with a big gush

  • She requests some time so they don’t induce

  • Contractions start within an hour and are very strong

  • Requests the epidural and it takes very well

  • Quick progress; labor only 4.5 hours long from time water broke

  • Pushing - directed pushing but whenever she feels the urge to push, goes fast

  • Baby doesn’t cry right away, so they do light suctioning

  • Delivering the placenta and bleeding quite a bit, manually extracting the placenta

  • Goes to OR to have the placenta removed as it was coming out in pieces because she had lost 2 liters of blood – they put a balloon inside the uterus to stop the bleeding

  • Was stuck in recovery room for 20 hours before getting a private room

  • Stayed at the hospital around 2½ days

  • Coming home and feeling a bit disoriented in her body after birth

  • Breastfeeding - low milk supply due to blood loss, working with lactation consultant to build up supply, finally as of yesterday baby is exclusively on her milk

  • Finding the positive, cognitively breaking up her birth story separately (positive) from the 3rd stage complications (far more challenging)

Interview Transcript

Lisa: Welcome to the Birth Matters Podcast. And good morning or good afternoon, I should say, Kaley, how are you today?

Kaley: I'm good. Good afternoon. How are you?

Lisa: I am doing great, thanks. I'm so thankful that you were willing to come on so early in your parenthood journey. And we might see Adam at some point. He's taking care of the baby right now.

Kaley: He is, he may pop in and out, but he is on baby duty.

Lisa: Yay for involved supportive partners, that's awesome.

Kaley: Absolutely.

Introductions

So Kaley, would you just take a few moments to just introduce yourselves, maybe share how long ago you gave birth and maybe the neighborhood you live in? Just anything you'd like to share with us?

Kaley: Yeah. My name's Kaley and I have an almost six-week-old baby. He'll be six weeks tomorrow. I live in Clinton Hill in Brooklyn, and I delivered at the Upper East Side Mount Sinai location. And that was about six weeks ago.

Lisa: And did you move during your pregnancy?

Kaley: I did. At like 37 weeks we moved from, we were on the Upper East Side.

Lisa: Upper East Side, right? Yeah, that's what I thought.

Kaley: We were incredibly close to the hospital, and it was very convenient because my OB was also there. And then we moved to Clinton Hill, which we love our new neighborhood, but I don't recommend moving at 37 weeks. That it was very stressful.

Lisa: And yet many New Yorkers do it, and probably people all over, but I noticed that a lot of my clients move, either like right before birth or like right after, and it's challenging. Moving ever is challenging.

Kaley: I was happy we moved beforehand, as hard as it was to be limited and like what I could personally do just from lifting and things like that. I cannot imagine doing that with a newborn baby.

Yeah. Yeah. Agreed. Great. thank you.

Preparation for pregnancy

Lisa: So why don't we start with your pregnancy, if you'd like to share anything about your pregnancy and how you prepared for the journey into parenthood.

Kaley: Yeah, absolutely. I think for me, I'm very much a planner.

Did a lot of reading

Kaley: So the way I started to think about getting pregnant and throughout my pregnancy, I did a lot of just reading, and reading of different people's experiences and reading on what to expect, and for me that was really grounding.

I know that everyone is different in that respect, and for some people, information overload is not a good thing. For me, I found it something that I took a lot of comfort in throughout pregnancy. It empowered me and made me feel like the more that I knew in some respects, the more that I would be able to ask questions and, I don't want to say control my own experience, because you're not in control of your experience in some ways.

What to Expect When You're Expecting

Kaley: So I did a lot of reading. I mean, I had, What to Expect When You're Expecting, just the standard reference book that, has some positives and some negatives, but that was a good, just on-hand resource for me.

Expecting Better by Emily Oster

Kaley: And then one that I really enjoyed was, Expecting Better by Emily Oster. It's really an evidence-based look at a lot of common pregnancy advice or procedures or just things that you'll go through.

And essentially, just you know, something such as the food restrictions that you have during pregnancy, she just takes a look at one, what's the science behind these restrictions? Why are they advised? And then two, what is the actual kind of likelihood of severity of something happening to you, severity of something happening to your baby, if you were to not necessarily follow with the restrictions or things like that.

And so, I highly recommend that book. To me, that just gave me a sense of calm, because when you get pregnant and you go to the doctor, you come home with a list of, here's all the things you cannot do. And it feels like a lot at first, and that helped me just take it on at a more bite-sized level.

Lisa: Nice. Yeah. It's funny, those two books that you mentioned are the two most common ones that my clients say they read, and your commentary on both of them is what I hear constantly from clients. Expecting Better was definitely my favorite. What to Expect? Okay, but like, often it's kind scary for a lot of first-time parents.

Kaley: Very much so, yeah.

Lisa: So I don't usually recommend that one, even though it's like the classic, and pretty much everybody reads it. I think there are some things that are more empowering and more confidence-building out there.

Staying active during pregnancy

Kaley: Yeah, absolutely. I think the other big thing for me through my pregnancy was just really trying to maintain control of being active, and that changed throughout pregnancy, but that's something that's always a big part of my life. I'm a runner, I do a variety of other sports, but that's my core thing.

I also do, just HIIT and weight training normally, so I knew when I became pregnant, that maintaining kind of physical activity throughout would be important. And it was so critical for just managing my stress throughout.

Kaley: So I was able to run about half the pregnancy. I ended up having to stop around 20 weeks because I was having a lot of pain in like my tailbone and pelvis area.

But I was amazed by how much I was still able to do. It was just about shifting things. So I ended up swimming a lot, the second half of my pregnancy, which was amazing. I highly recommend that for anyone.

The only challenge is just finding swimsuits that work for you throughout as you're growing and growing. And yeah, just doing a lot of prenatal yoga was a constant for me as well. And so I just can't speak enough to how important finding some sort of routine was for me, both mentally and physically from just a management perspective of everything you're going through and your mental health too.

Lisa: Thank you so much for sharing that because I'm a big believer in that. And, having done this work for around 12 years, I see that when people do stay active, it really bodes well for helping their body to be able to more efficiently give birth in many cases, more often than not. So I love prenatal yoga, awesome. Swimming, awesome. Running until you can't, it's great.

Kaley: Yes.

Yeah, those are wonderful things. I'm so glad you were able to keep doing that.

Lisa: And did you just listen to your body or how did you decide what was okay to keep doing or how to modify?

Kaley: Yeah. I mean, in the beginning, I almost wasn't confident in how to listen to my body. Even in the first trimester, when I was running, I constantly would stop and be like, oh, this is okay, but you start to get a feel for what is normal. As you progress in your pregnancy, you get more comfortable in your pregnant body, and so for me, I just use the rule of thumb that you should be able to carry a conversation when you're working out. I was always by myself, but I would literally try and talk to myself for a little bit sometimes, just to make sure I was okay. Yeah, and there are a few mantras, just different YouTube videos of people that I watched said, and one of them that always stuck with me is, the goal in pregnancy is to stay active.

That's the goal, you're not trying to set a personal record on anything. It's just keeping in mind what your goal is. Healthy baby healthy mother, and that's it.

 It sounds to me like the staying active was just really beneficial and a positive thing. Did you ever feel any bit of frustration or sadness about the limitations, and needing to really adjust things and not be quite so vigorous?

Kaley: I felt that when I lost running, when I wasn't able to run anymore. Because that was always my beloved activity. But then, once I found something else and was able to feel myself, not progressing at it, but getting comfortable at it, that kind of helped relieve that for me.

Great. Yeah. I just had someone recently who trying to remember, I think she's a dancer in class, and as we were doing the bodywork and the hands-on comfort measures and the partner supported squatting positions, she was brought to tears because she was so frustrated, and she felt like her body was suddenly foreign to her.

Lisa: And my heart just broke for her, because for someone who is so in tune with their body and knows their body, it can be very disorienting for some people, as our body is changing and adjusting for this growing new life inside of us, so that's what caused me to ask you that question.

Kaley: Well, I absolutely feel that now, more so in the postpartum period, because I'm really not able to do much at all, and so I think being so in tune with my body during pregnancy, because I was doing a lot of different activities, and really enjoying kind of the process of being super in tune with myself and understanding what's changing, what's happening, and then going to postpartum, and then feeling a little bit unsure of what's happening with my body and also just not in control of it.

So that's been a lot harder for me. I get more frustrated with my limitations now rather than when I was actually pregnant.

Getting back to normality

Lisa: That makes a lot of sense, because I think psychologically, a lot of us can make peace with, okay, there's this growing life inside of me, so that makes sense that it's going to be very different. Whereas after we've given birth, it feels especially culturally-speaking, like we're supposed to just bounce back and feel like ourselves immediately and that's just not realistic or true.

 So thanks for sharing that. It can just take a little time and you know, it hasn't been long since you gave birth, but it is a sort of a gradual thing.

Lisa: And another one of my clients who shared earlier on, I think in the first season of the podcast, was a marathon runner, really athletic, and she found that she tried to start running again a little too soon and she very quickly was like, whoa, no, this is not happening, it's too soon, I can't do this. And it was frustrating for her because she's so used to just running all the time.

Kaley: Yeah. I was literally googling that in the middle of the night, last night, like how to return to running after delivering a baby, because I have my six-week appointment this week, and so I'm just starting to think about wanting to move forward in some strength exercises and getting back on pace to what I used to do more. And I know it's a long journey, but I was reading all these different things last night, so I definitely relate to that.

Lisa: Yeah, and I actually am thinking of a pelvic PT here locally, who specializes in working with runners and specializes in the perinatal period. So I'll be sure to send you that information. I'll also link it in the show notes. I'll link it for anybody else who might find it helpful. And I'll also just send you some of the other online programs that might also be really helpful, that are just really customized for this time in life and getting you prepped to, in a very healthy, protective way, get back to that physical activity.

Prenatal yoga

Lisa: I wanted to ask you, because you were pregnant during the pandemic, prenatal yoga. Was that virtual? Was it in-person?

Kaley: Yeah, it was all virtual. I used to do yoga in-person pre-pandemic, and then I had been doing just kind of an online service, prior to getting pregnant during the pandemic.

And then I ended up just finding a couple of YouTube instructors that I liked and just watching their videos on repeat, because for me, normally it's nice to have kind of variability in the yoga routines, but I actually ended up just gravitating towards having six different videos that I could rotate through. Because it was nice to know I could do the moves, I knew the modifications and all of that.

Lisa: Nice. Yeah, you know, my first baby was born 16 years ago, so it was like pre-Zoom and like having as many YouTube resources and things, but I had prenatal yoga videos and I just like, repeat, repeat, repeat, it was great. You just see that familiarity. Yeah, so thanks for sharing that.

Birth class

Lisa: How did you decide you wanted to take birth class?

Kaley: Yeah, I don't know. I just thought that it was something that everyone did and would want to do. And the more I talked to people after I took my class, like a lot of people don't take a class, so it was just always something I had on my mind, frankly, probably from like television shows. There's the Friends episode when they're in the birthing class and it was just always something I thought I would do.

And then when I was seeking out a class, yours just appealed to me because there's a lot that are offered kind of very much just through the hospital directly or in that sort of setting. Just based on some of the reading I had done, personally throughout pregnancy, I knew that I wanted a class that was a little bit more all-encompassing, just on what the labor journey can be from a number of different perspectives. That was really big for me, as far as taking the class.

Don't stress too much over weight gain

So anything else about pregnancy?

Kaley: I guess one thing I would add, because I know it's something that a lot of people struggle with, from a stress standpoint and pregnancy is like the weight gain. And I talked about how important exercise was for me, and I think one of the ways that it was important for me is it helped me not worry as much about the weight gain, and the specific numbers, because I had this sense of self-empowerment that I know I'm taking care of my body along with diet choices. And I know I'm exercising, and I don't need to stress week to week or visit to visit, unless it's something the doctor is I was lucky, my doctors were not super-obsessed with it. It wasn't the topic of conversation generally, but yeah, I gained on the higher end of the range. I think they say like 25 to 35 pounds.

Generally, there's a huge variation, but that's kind of common, and I think I gained 33, 34 pounds. And it just wasn't a stressor for me.

And so I think I would just encourage people, unless your doctor is telling you this is a big medical issue, know that you're controlling the things that you control, whether it's through exercise or walking and eating, and just be okay with that.

Lisa: Yes. I'm so glad you brought that up. I was just listening recently to a couple of podcast episodes that a doula in our collective recommended about this. We were having a conversation about, you don't have to be weighed at your prenatal visits, and especially for anyone who might have disordered eating or an eating disorder, it can be triggering. It can be challenging. And there's such an over-focus on the numbers. We need to not focus on that. That is not evidence based in terms of effectiveness and pressuring people. We really need to focus on exactly what you were talking about, our nutrition and our healthy lifestyle, our activity, and all of that.

When we focus on those things, like you said, we don't have to worry about weight gain, and looking at those numbers. So I'm so glad you brought that up. Thank you.

And I might link to a couple of those episodes that this doula friend of mine recommended, because that can also be just interesting and informative to hear about that and hear how you don't have to be weighed or you can turn your back to the scale.

Kaley: Yeah, that would be really interesting.

The birth story

Lisa: Yeah. Great. do you want to go ahead and go into your birth story? Is this a good time?

Kaley: Sure. Yeah. For me, I was lucky as far as having a pretty non-complicated pregnancy, and so I was expecting, hopefully that I would be giving birth in that kind of 37-to-42-week range. I didn't have any pre-existing conditions or anything like that.

4 centimeters dilated

Kaley: And when I had my 37-week checkup, I was almost four centimeters dilated at that point and 90% effaced.

Lisa: Oh, my goodness.

Kaley: The doctors were careful in their wording, but my father-in-law's an OB-GYN too, and he's oh my God, you're going to go into labor any day now.

And so I left that 37-week appointment. We had literally just moved, being like, oh my God, I'm going to give birth tomorrow. And as one hears, I did not, of course. Three weeks went by, and I still had not had the baby.

Lisa: Three weeks at four centimeters?

Kaley: Yes.

Lisa: Oh my goodness. That is surprising, because usually people are only up to three or so before they actually are noticing they're laboring and contracting and everything.

Kaley: No, I was just having, Braxton Hicks contractions, but nothing particularly strong or regular. So that made for kind of a long three weeks, because every time I would have some Braxton Hicks, I would start timing them and think it was, you know, and it wasn't. But I was pretty comfortable during that time.

39 weeks bleeding

Kaley: It was just a long three weeks, but on, I guess it was 39 weeks and six days, I just started having some red spotting and a little light bleeding. That was a little concerning to me, because I thought I had already lost my mucus plug a while before. And so I reached out to the doctor, and they said, oh, it's probably okay, you had an exam yesterday, so it could just be the aftermath of that exam. But it continued throughout the day, and it just felt a little wrong to me. they had said it should be okay, but I don't know, I was concerned about it. I'm not really sure why. Everything I had read and was led to expect, it seemed a little bit off.

Called the hospital

Kaley: And so I called again at the end of the day, because it had been going on since first thing in the morning, and the on-call doctor said, why don't you come in? And this was around like 5:00 PM.

Lisa: Can I ask you a question? At the prenatal visit that you mentioned, I think you said the day before, do you remember if that pelvic exam was like more uncomfortable or more painful than normal?

Kaley: It wasn't at all, and I didn't have any bleeding that day.

Lisa: Okay. I was just wondering if maybe they stripped your membranes, but I guess not, if it wasn't uncomfortable.

Kaley: No, they said they weren't. Yeah, and I didn't feel anything different that day at all.

Lisa: Okay.

Kaley: So I ended up heading into the hospital that night and of course it was rush hour, so it took us forever to get there.

But one of the things we talked about in your class a lot was like, don't sprint to the hospital unless you have to. And that was helpful, because at 5:00 PM they're like, yeah, why don't you come in?

And we sat down, we had dinner, made sure I was well-fed and drank a lot of water. Got all our stuff together, and so we probably didn't get to the hospital given rush hour, until eight o'clock or so.

Arrived at hospital

Kaley: And yeah, when I was there and they took a look, they were thinking about sending me home. Yeah, they said it seems okay, they were going back and forth. But then when my actual practice doctor, the on-call doctor came, she said, given where you're at 39 weeks and six days, and the fact that your baby's measuring very large and a few other factors, we're going to go ahead and admit you and induce you.

Water broke

Kaley: And literally, like a minute after we had that conversation, when I was processing kind of all those mixed feelings, I stood up to go to the bathroom and my water spontaneously broke right there.

So I was ready, and that was shocking, having my water break. It wasn't anything like I had thought it would be. It's so much liquid.

Lisa: So you had the big gush, like in the movies.

Kaley: Yeah, it was crazy. but that was a huge relief for me. Because I was feeling just very conflicted about if I wanted to be induced or not. And then, right after it broke, they still recommended giving me Pitocin because I wasn't having contractions or anything at that point. And that is where I said, I'd like to wait a little bit. And they said, okay, it's your decision.

They respected that and said, "we'll give you two hours, and we'll check back in two hours."

Lisa: Two hours. This is so interesting with somebody who is like four centimeters dilation and like you're so ripe and ready, why do we need to rush to induce? That's so odd, it's not surprising because that's our medical system's tendency, but like really? That's interesting. So go ahead.

Kaley: No, absolutely. Because my thought is, labor had started, my water had just broken, so I really just wanted to give it a little longer to progress on its own. And I was glad that I did, because yeah, I got set up in a room, and probably within an hour or so, just out of nowhere, I just boom, like these incredibly strong contractions started. I went from nothing to just being like completely doubled over with these very strong contractions.

So that was different than I expected. My labor progressed very quickly as I'll outline in a minute.

Lisa: And often when you're that dilated and that effaced, it shaves off a lot of time of the early labor. So we are expecting-- I has anybody given you a heads up that it's likely?

Kaley: They had, that's why it was a stressful three weeks. Because they had said, "as soon as you get contractions, you should call us and probably head to the hospital, because you live so far away."

Short labor

Kaley: So in total, I went from my water breaking at 9:00 PM, to the baby being delivered at 1:20 AM.

So it was less than a three-and-a-half-hour labor. It was very quickly. And so, yeah, I was set up in the room when I started having contractions and I hadn't started the epidural at that point. And I waited a little bit, I didn't do it the minute I started having contractions, but I did decide to have an epidural. And I asked for it relatively quickly after contractions had started, because I was aware that, given how fast things seem to be progressing, that if I waited too long, I might miss out a window of opportunity. And I was glad I did, because next time they checked me, I was seven centimeters already. So they're like, all yeah, essentially, I had a decent amount of time, just kind of me and my husband in the room, just to go through the contractions and have some us time. But I guess I had a lot less time than most people do because, they checked me, and I was seven centimeters. I want to say that was around 11:00 PM.

And they said, we'll check you again in two hours, but let us know if you feel like you have this constant need to push. And a little over an hour later, I was like, I think you need to take another look, and I was 10 centimeters.

Lisa: Wow.

Kaley: It all went very quick.

Lisa: What an efficient labor. That's amazing. So the epidural worked its magic, and like totally took away the pain?

Kaley: It did. It worked very well. For me, it was a really good choice. I had really been on the fence about if I would want one, my mom hadn't had one and so I had always heard growing up, she had very positive labor experiences and she hadn't had epidurals.

And obviously, there was no pressure on me in that respect, but I had kind of been on the fence, but for me it turned out to be the right decision and I was happy I did.

And anything to note about the epidural administration itself? Was Adam able to stay in the room or not?

Kaley: Yeah, he actually was able to stay in the room with us.

Lisa: Nice.

 It was a pretty good process for me, as far as getting it administered and everything went pretty smoothly on that front.

The pushing stage

Lisa: Great. Anything to note about, you want to talk about pushing a little bit? It sounds like everything was very fast so that I don't know how much detail you can provide, but.

I had spent a lot of time thinking about early labor management strategies with that, and I haven't spent a lot of time reading about the pushing stage and, I didn't feel that I needed to have done that, but it was a bit of a surprise to me.

Kaley: I didn't realize how one pushed, and so the way they had us do it is, know, when you feel a contraction coming on, basically I would do three, 10-second pushes each time. So they would have me hold my breath for 10 seconds.

Lisa: The directed pushing.

Kaley: Yeah, as they counted to 10, And then I would push during that time when I was holding my breath. And we did that three times per contraction.

Lisa: And were you pretty numb at this point?

I was, yeah, I wasn't having a lot of pain. I was able to feel the urge to push.

Lisa: You were, oh, good.

Kaley: Yeah, I was totally dictating when we pushed. So they would just tell me to wait until I felt the need, and then they would start counting at that point.

Lisa: Okay. And did you find that you were okay with holding your breath that long? Or did you like release it before they got to the 10? Or what did that look like?

Kaley: I did, my husband was teasing me after, because he's like, you're so competitive. Like you were holding it to 11 every time. Like you would always hold like a bit longer.

Lisa: You're like, I'm gonna do more than what they're asking me to do.

Kaley: So apparently, I was being a little self-competitive.

Lisa: Interesting.

It was challenging, but it was just a very unusual breathing technique for me.

Kaley: It's funny, my sister who doesn't have any kids, my younger sister, I was explaining kind of the pushing stage to her, what I went through. And she was like, oh, that makes so much sense. Because she does CrossFit, and she's like, "when we're doing squats, we do a similar, we're breathing out when we're doing like the harder exertion of some of the exercises." So for her as that type of athlete, she had experienced that kind of exertion before.

Interesting.

But yeah, the pushing stage for me, it was like I said, just very different than I expected in the feeling of pushing as well.

Kaley: I don't know quite how to describe it, but it's just such an unfamiliar sensation, like how you're pushing. And not bad, but it's just such a totally different use of your muscles. And I was really happy just with the doctor and nurse team that I had in that, I just felt very kind of supported as far as every time I was doing it, it was a lot of you're doing great, you're making progress. we can see X, and I guess for me again, I was very lucky in that it did go so quickly.

So I was making progress every time I pushed.

Red hair!

Kaley: And the big shock for me is, so I have red hair, and as the baby was starting to crown but not fully out yet, they told me that like, he has red hair.

Lisa: Oh my goodness!

Kaley: I was so shocked because my husband doesn't have red hair, he has very dark brown hair. So I was certain the baby would not have red hair. I almost stopped pushing for a minute. I was so surprised. That was a very cool surprise.

Ring of fire?

Lisa: That's fun. And when Owen was crowning, did they bring your attention to it or did you realize it, did you feel that ring of fire at all?

I can't say I really remember feeling that. I guess I did, to some extent, as he was crowning and they pointed that out, it certainly felt a little different down there. But I almost didn't believe it to be honest, because I had expected to be pushing for longer.

Kaley: And so they're telling you're making progress, but for me, I just didn't actually think the baby was like about to come out when it did. I didn't have a mirror or anything. I think they may have offered, and I had declined, I don't remember.

Baby is here!

Kaley: But it just went so fast that it was a little bit like, oh wow, the baby was here now.

Lisa: And so when baby was born, did he come straight up to your chest?

Kaley: He did. Yeah, he came straight up to my chest, and he wasn't like immediately screaming. And I just thought when babies come out, they're like always screaming immediately, and I was so scared. I feel like that moment, I didn't even appreciate having him on me because I just would be like, is he, okay?

He's fine, they just did a very little suction, I think, of his mouth, but he was totally fine. And he came to my chest briefly, but then pretty quickly, they took him away to the little table they have with the baby scale and all of that.

Complications after delivery

Kaley: And then I returned to focus on delivering the placenta.

And for me, this is where things shifted for me because the entire delivery process was very positive and just from a pain management perspective, it was very positive for me. But then I had a lot of complications after the delivery and that's where things got just a little bit more overwhelming for me.

So I think of these as two very distinct phases in my delivery experience.

Emergency operation

Basically, as I turned my attention away from the baby, because I had in my mind, I have to deliver the placenta as well. I don't remember the exact timing, but the doctor explained that I was having more bleeding than she expected. And so they wanted to basically manually extract the placenta.

Kaley: So I think that I'm just trying to see here, I've written down kind of the word of what they suspected.

Lisa: Accreta, maybe? So the doctor explained that they suspected that I might have placental abruption. I don't remember how much of this was explained in detail at the time, but afterwards, when we were recapping everything. But I do remember her explaining that for some reason, she wanted to manually go in and extract the placenta because I was having some bleeding.

Kaley: So obviously, I was like, yeah, sure, do what you think. I don't really know anything at this stage. but when she did that, I started hemorrhaging pretty significantly to the point where even with the epidural, I could literally feel blood pulsing down there. It was a very significant hemorrhage, like I lost over two liters of blood in the delivery room. So pretty quickly, as soon as that started happening, I was rushed to the OR. And from there, everything's crazy because I was awake and conscious throughout the whole thing, and they really wanted me to stay awake, as I was feeling lightheaded from the blood loss, like no, stay awake, stay conscious.

And so yeah, in the operating room, what they ended up doing is the DNC procedure, to try and remove the rest of the placenta. Because it basically came out in pieces. It was morbidly adherent, is what it ended up being. So it just wasn't detaching from the uterine wall. So yeah, I had that kind of emergency operation there where there were two objectives, one to remove the remaining pieces of the placenta and then two, to stop the bleeding that had occurred when the placenta had initially been manually removed.

So what they did for that is, they inserted, basically like a balloon almost, into my uterus that was blown up and it stayed there for about, I think, like 20 hours or so actually, to just act as a pressure in the inside of my uterus, to stop the bleeding.

Lisa: This sounds so much like another story that was shared earlier in the podcast. It was a client of mine whose water broke in class, while we were doing a relaxation exercise. And she had a very fast, she had a very fast labor as well, and then had this exact same thing happen afterwards. And they told her like, it's a lot for your body to do all of that birthing process condensed into such a small window of time that it, for some reason, makes it more likely for this kind of thing to happen. Because the body is just whoa, slow down a little bit, this is too much for me to have to do all at once.

That was the kind of thing that they communicated to her. And I'm just reminded of that, in your sharing such a similar story, in that the balloon that had to be put in. I'm sorry you had to go through that after such an otherwise positive birthing experience.

Kaley: Yeah, it was definitely scary. And I think it was, obviously it was scary for me as I was going through it, but my poor husband was there too. And I don't want to speak too much for him since he's not here, he's taking care of the baby right now. But I know, for him, all of a sudden, I'm whisked out of the room, and he's left there essentially alone. And no one was really, they weren't taking the time to let him know what was going on because they were focusing on me. But I know that was also very traumatic for him. It's a very scary thing, overall. It all ended up positive, I was able to get a couple of blood transfusions in the OR.

20 hours in triage

Kaley: And I ended up spending about 20 hours in the, I don't know if maybe people who are listening probably haven't experienced this unless they've had a kid before.

But in like the triage area in the hospital, there's the smaller triage area in the hospital where there's a number of different beds, and people in there evaluating like incoming patients, generally speaking or people who've had a C-section and are there briefly for recovery, before they get brought up to their own rooms.

There are the rooms, which are on second floor, which are just more designed for, post-birth recovery and those are private or somewhere private. But I was placed in the triage area for about 20 hours, and I was just in this little bed in the side and there's all these people coming and going, and the beds aren't electric in that area, so every time I wanted to shift my position, I had to ask for someone to move the bed up and down. So that was horrible, it was such a long, long day there.

Lisa: 20 hours.

Kaley: Yeah, it was very long. And that was just because they have more sophisticated monitoring equipment there than they have in the individual rooms.

And because I was still higher risk at that point, they wanted me there, but that was a very long day of zero sleep.

 

Little corner in triage

Lisa: And was Adam allowed to be in there at all?

Kaley: He was, yeah, Adam and the baby were allowed to be in there. We just had a little corner of the room with a little curtain that we could sometimes close. And we were able to be there, and the baby was doing amazing. And he basically just slept and slept and slept. And the hard part for me was because I had the surgery right after, they had done more anesthesia, and so I was basically numb from, almost like my breasts downward. And so I really wasn't able to breastfeed him right away, or hold him, really, because I wasn't really able to trust myself to hold him right away.

That wore off relatively quickly within a few hours, but I really just didn't have the strength or encouragement at that point to try breastfeeding him. So I did hold him to my chest a few times that first day, but it was hard because I did feel very disconnected from him in a sense, because I wasn't able to have all that like kind of skin to skin and cuddle time with him initially. And so that was really hard.

Sure, and I'm sure with that kind of amount of blood loss, you felt weak, I would think.

Kaley: Yeah, absolutely.

Lisa: On top of that.

Moved to recovery floor

Kaley: Yeah. But eventually, we did get moved up to the recovery floor and we got our own room, and we were very lucky. My husband's theory is that the hospital felt bad for us being in the triage area for so long, because we ended up, we had a double room, but it was empty the entirety of our three-day stay, which I think is pretty unusual.

Lisa: That's very unusual, yes.

Kaley: Yeah, we were very lucky to have some privacy. So our stay was a little bit longer than usual because with COVID they're typically discharging people have vaginal birth within 24 to 28 hours. But we were there, I delivered like 1:20 AM on a Wednesday, and then we left pretty late on a Friday evening, so about two and a half days.

Lisa: That makes sense with the way things played out.

Kaley: Yeah.

After coming home

Lisa: And so anything we wanted to share about, the transition to coming home and the few weeks that have passed since then?

Kaley: Sure yeah, I think I alluded to it earlier when we were talking about exercise and things like that but certainly, the changes to my body and postpartum for me have been a lot harder than just the pregnancy body changes, because they just feel a little bit more like mysterious, like you don't quite know.

At least for me, I feel like I don't quite know what's happening everywhere and like where I have strength loss or changes yet at this point. Because I have been pretty focused on feeding the baby and resting myself. And so I'm almost a little bit weary to start figuring out like exactly where my body's at right now.

But I did start to do a little bit of just like light yoga and stretching the past week or so. And what I've taken away as a positive from that, is when you leave the hospital and you come home and you're overwhelmed with his baby, and maybe you're feeling very weak and not yourself, like doing the yoga reminded me that while there are definitely a few parts of my body that feel different and I need to explore them and strengthen them and just figure out how they're different.

Kaley: A lot of me felt very normal when I sat down to the yoga, like I could do downward dog, for example, and feel totally fine. And I didn't mentally think that I could, and then when I tried it, I was like, oh, I feel great.

So that, I guess for me is like very much a journey, I guess I need to go on, but I've been, I guess just surprised by the difference in how my body feels pre-birth and post-birth, just from a confidence and understanding perspective.

What was it like after blood loss?

Lisa: With the blood loss that you experienced, what has that looked like in terms of, do you have to do an iron supplement? What does that look like?

Kaley: Yeah. I do take an iron supplement, I was already taking one during pregnancy as well, because I had low iron, so I've just been continuing. But really, that was it. As far as care instructions, it was in the hospital, they ended up giving me, I think, a clotting medicine, just to make sure given the blood transfusions I had, that everything was at the right level on that front.

But then, when I was released, it was pretty much like, you're good to go. So yeah, no specific instructions from that point. struggle for me was just that delay and the starting nursing with the baby and having some decreased milk supply from that initial delay in blood loss.

Lisa: Yeah, understandably, because your milk is made from your blood.

Lactation

Kaley: Yeah, that's been the other huge part of my postpartum journey, is nursing and trying to master that and it's really hard. It's really hard, but it's something I was very committed to trying to figure out as best as I could, to get as close as I could to breastfeeding the baby, and I'm really happy with the progress I've been able to make on that front. I met with a lactation consultant a few days after coming home from the hospital, and they were able to give me some strategies as far as how to utilize pumping to build up my supply, and then from there I've just been doing a lot of work, just constantly trying to bring the baby to the breast and working on different latching techniques and things like that.

And we finally got into a good place. He's basically exclusively breastfeeding at this point. He has pumped milk once or twice a day, but we were able to cut out formula. So that's something I was really proud of. It took a lot of effort.

Lisa: Yeah. I just, we were talking about that before we hit record, but it's such a victory and it feels, it just sounded as you were sharing with me, it's just yay. like you worked for weeks on this. It's been several weeks and it's really exciting.

Kaley: It is, yeah, it's definitely very challenging.

Lisa: Yes. Yeah. It's not just all sunshine and roses from here, of course, but I commend you for really seeking out that support, because our medical system doesn't support us in breastfeeding. And I'm thankful that you had the resources and just the determination and that it required to, especially during the holidays, as you were saying, it's hard to find a lactation consultant who is even available. And you had to do a little patchwork with working with more than one to get that support, in as timely a fashion as possible.

Kaley: And I think just hearing, talking to other women and hearing about individual challenges with breastfeeding was important to me, because I knew it would be very hard. But knowing how many people, very few people can immediately start breastfeeding and not have any issues. Everyone goes through their own unique breastfeeding journey, and there are bumps along the road at different points.

And I don't have a ton of people in my life who do have kids, but I had reached out to a few that I knew had kids and had breastfed, and I was shocked how many of them, almost all of them, had used lactation consultants. And it's just not something that's super known, but even if your baby latches immediately in the hospital and you're having a great journey, I would still recommend it because they have a lot to offer.

Lisa: Yeah, that and pelvic floor PT should be built into the standard of care. I hope that in my lifetime, we will see that become the case, because we could just have so much better outcomes for families, with that support.

One question in terms of that follow-up care and support, with the way things played out for you, did your care provider ask you to come back for a checkup any sooner than the standard six-week checkup?

Kaley: No, I didn't have an earlier checkup. I did reach out to my doctor last week, just because my visit was originally supposed to be last week, and I had to reschedule it. I had just mentioned, as a result of what I went through, I'm still having quite a bit of bleeding and so one of the follow-ups that we have is just a sonogram to confirm kind of the status of any retained placenta that may have still been there. So that's another part of my follow-up visit that I need to do separately, because when they removed the placenta during delivery, it wasn't a clean removal. So that's another thing they're checking in on.

Lisa: Sorry if I missed this, but in the OR, did they need to do a surgical incision in your abdomen or did they do the procedure just vaginally?

Kaley: Yeah, they just did the procedure vaginally.

Lisa: That's what I thought, but I just wanted to be sure that I hadn't missed something there. Okay.

Iron supplement side-effects

Lisa: And totally separate topic, but related, with the iron supplementation, I don't know which one you've been taking, have you seen any side effects that are not great? Because not everybody tolerates all of them equally?

Kaley: Yeah, I had started mine during pregnancy and nothing really significant. Just during pregnancy, you're having all sorts of gastrointestinal fun, fun things going on there, so I'm sure that contributed a little bit. But really, postpartum I haven't felt any downsides to taking it. It's been pretty smooth.

Lisa: And was it just whatever your OB prescribed or recommended?

Kaley: I forget the specific type of iron it is, but yeah, it's what my OB has prescribed earlier, just based on me being borderline anemic.

Lisa: I will put in the show notes just for listeners in case it's useful, a lot of people don't tolerate the just standard things that are recommended, and so there are a couple of things such as MegaFoods Blood Builder, that often tends to be tolerated by the GI system a lot better.

So I'll just for whatever that's worth, put those in the resources. That was what I was curious about is, if you needed to seek out anything alternative. It sounds like you didn't.

Lisa: No, pretty smooth.

Anything else to share?

Lisa: Cool, that's great. All right, anything else that you wanted to share today that you haven't gotten to share and/or just any main themes or tips or insights that you'd like to share with listeners who are largely first-time expectant parents?

Kaley: Yeah, overall, despite having the complications, I still think very positively about my birth experience. And I think that's because I'm trying to focus on the parts that were more in my control to some extent.

For me, because I was able to deliver vaginally, those stages and pushing and managing through the contractions and all of that.

Kaley: And I think it's been helpful for me to think about my labor in different parts, because especially if things don't go exactly the way that you envision them, to still see that usually you can find a positive in what happened. Obviously, everyone goes through very different things, but I have a healthy baby, I was very lucky and I'm healthy now. And so, just trying to separate and understand the different parts of my experience has been helpful for me. And then, I think too, medically for me, I talked about when I was thinking about pregnancy, how important just having information was for me. The doctors explained everything that I experienced in the hospital when I was there, but really, it was helpful to actually go into my MyChart account and really read through the actual-- generally, most people have access to the notes that the doctors are literally inputting throughout your delivery and throughout your hospital stay. And so for me, I really enjoyed actually going through and reading those notes to really understand what they were seeing and indicating, at each part of my experience. So that's not for everyone, but for me, I actually really enjoyed going back and reading that.

Lisa: Yeah, that's a great thing to bring to people's attention, for the people who would find that really helpful and informative. Such as like in the pushing stage, you know, if we have tearing, usually they're not going to tell us what degree tear it was. And that's really helpful information to know and be aware of, especially if you were to ever go to a pelvic PT or even if you don't, but just to know for your body knowledge, what happened down there.

Kaley: That was exactly one of the things I was looking for, is just wanting to understand that as well. Because I think they may have mentioned it, but there's so much going on post-birth that you don't necessarily catch all of that, and it is really important.

Lisa: Yeah. Well, and I hope that you both are having and can continue to have some space and compassion around you to support the traumatic aspect of that third stage of labor. Because that's a lot to go through, especially when you're becoming a parent alone without any complications. That's a lot to just cognitively, emotionally, psychologically process, but then when you layer it with this scary thing that happened, scary for both of you, I just hope that you'll have some space to process that, and just, I’ll send you if you would like, trauma support groups for processing birth and some of the more challenging aspects of it. Sometimes that can be really supportive or helpful, or there's another group that occasionally happens, a fellow doula friend of mine, colleague of mine, who is a writer, leads these birth processing, I forget what they call them, but you're writing your birth story, but it's like a creative writing experiment and a really helpful way to process through however it went, as well.

That just recently happened and one of my clients sent me her story. they actually compiled all the stories and with the permission of everyone, shared it. It's available to people to read, and she said how therapeutic that really was to process, especially some of the more difficult aspects of her birth.

Kaley: Yeah, that sounds really empowering. And I think just talking about it, for me, has been helpful. My biggest takeaway throughout pregnancy and birth and everything is, there's just so much that people don't share and it's totally people's personal choice to share and not any pressure on anyone.

But I have found it very helpful hearing what other women have gone through. And to your point, with like lactation consultants or pelvic floor therapists just not being positions that are well-known in society, there's just a lot of space that needs to be created for, I think, more understanding of just what women go through with birth.

Thank you so much, Kaley. I really am grateful that you were willing to share the joys and the challenges of this journey into parenthood.

Lisa: Have a good one.

Kaley: Alright, thanks Lisa.

Lisa: Bye.