Birth Matters Podcast, Ep 91 - Arriving to Hospital Just in Time to Push

asian dad kneeling next to white mom holding newborn baby. All sitting on floor in front of Christmas tree in matching red and white deer and tree festive pajamas. Their small dog sits in front sitting and wearing a coordinating bandana

Kelly eagerly educated herself and prepared for giving birth in all the ways – prenatal yoga, hiring doulas and a midwife, taking birth class, strategic nutrition, acupuncture, seeing a pelvic floor therapist. Because of her experiences working in the medical field, she knew it was really important to make very intentional choices surrounding her care provider and support team. Kelly’s surprised when, just before her due date, her water breaks during a prenatal visit with her midwife. From there, listen to hear how quickly Kelly’s labor progresses after her midwife sends her home, how instinctively she labors, and how showing up just in time to push contributed to an easier-than-she-expected birthing process. Kelly also shares a bit about her early breastfeeding experience and how getting her daughter’s tongue-tie oral restrictions released helped lead to gradual improvements.

new parents in hospital gazing down and smiling while mother holds their newborn

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Episode Topics:

  • Lots of prep for birth early on and developed her birth preferences

  • Knew she wanted to hire a doula and find a supportive provider

  • Settled on an OB practice with a midwife who right after that left the practice

  • Finding a new midwife from listening to this podcast who would be almost guaranteed to attend her birth

  • Had heard about Astoria Doula Collective - she attended a Meet the Doulas and immediately connected with and hired Sarah-Grace & Beth, loved Sarah-Grace’s prenatal yoga being part of the package

  • Chicken - protein early in pregnancy and supplementing with B12 & unisom

  • Pelvic floor PT

  • Lots of walking

  • Around 37 weeks went for acupuncture weekly at advice of doulas

  • 39 weeks, 6 days - Did a nonstress test, and then her water breaks

  • had declined cervical checks through her entire pregnancy, 2-3 cm dilated, 100% effaced, midwife sends her home

  • Texted doulas, who give them some suggestions for promoting progress

  • Things get stronger while they’ve having lunch

  • Come home and drapes herself over ball, rocking

  • Contractions get quickly quite frequent and strong, communicating with Sarah-Grace

  • Doula suggests some different positions via text

  • Goes to sidelying with hiked up leg

  • Moves to shower on hands and knees but fairly quickly feels too intense so she goes into semi-reclined

  • She felt nauseated most of labor

  • At 3pm, 2 min apart, 90 seconds long - doula heads to them

  • 4:30pm doula arrives, they head to the car in rush hour, takes 35 min

  • 5:05 pull to hospital entrance, doula goes with her, Phil goes to park car (NYU LI Hospital, used to be Winthrop)

  • Midwife meets her out in waiting room and says she’ll skip triage

  • Sits on toilet giving a urine sample – soon after, rest of waters released and midwife says she’s 10 cm

  • Getting urge to push, pushing on her side

  • Sarah-Grace up by her head

  • Request for them to turn off the lights

  • Taking sips of Hydro Flask in between pushes

  • Felt the ring of fire very briefly

  • Baby born quickly

  • Placenta delivery was fine

  • A bit of delayed clamping, short cord

  • Phil cuts cord

  • They did give her a bag of pitocin after delivery (she had a hep lock)

  • Skin to skin for a few minutes before newborn protocols

  • Stayed in L&D room for a few hours while waiting for Covid negative test results

  • Going home after 24 hours (at their request)

  • Seeing a lactation consultant with the Nest Collaborative

  • Identifying a tongue tie  and getting it corrected with a laser (frenectomy/frenotomy) by Dr. Siegel on Long Island

  • Didn’t fix things immediately, but more gradually

  • Didn’t feel instantly bonded with baby, grew into it

  • Adjusting to Phil going back to work around 6 weeks

  • Remembering it’s not forever in the moments that are hard in early parenthood and remember they will get to be more interactive

  • Final thoughts 

Interview Transcript

Lisa: Hi Kelly, welcome to the Birth Matters Podcast.

Kelly: Hi, Lisa. Thank you so much for having me. So excited to be here.

Lisa: Yes. Kelly took my birth class back in July, I think. So welcome.

Introduction

Lisa: Would you please just take a few moments to introduce yourself?

Kelly: Sure. So my name is Kelly. I'm married to my husband, Phil. We live in Bayside in Queens, and we have a furry baby named Lola and our daughter, Nora, who is just about 12 weeks old.

Aside from being a new mom, still only for a few more months, I'm happy to say, but I'm also a speech pathologist and I work in a hospital setting, mostly with geriatrics. Babies are a whole 'nother world for me.

Lisa: The other end of the spectrum.

Kelly: Exactly. Exactly.

Lisa: And are you back to working yet? Are you still in maternity?

Kelly: No, I'm very lucky that I was able to take a six month leave from work, so I won't be going back until this Spring.

Lisa: Oh, good, if that's like the minimum we should get.

Absolutely.

That's so great. Wonderful.

The Pregnancy Journey

so why don't we start with your pregnancy journey and the different ways you prepared for the journey into parenthood, how your pregnancy went, just anything to note?

Kelly: Yeah, sure. I've always been really interested in birth. So I had done a lot of independent reading and learning through social media, podcasts, including yours, et cetera. So I had a lot of knowledge and ideas about physiologic birth and my goals for my own birth experience, even before I became pregnant.

For example, I knew I wanted to hire a doula. I knew I wanted to minimize interventions, hopefully avoid an epidural. And I personally would have considered a home birth, but it was not something my husband was comfortable with at all. So we agreed to aim for a natural, low-intervention birth, with a hospital delivery.

Researching providers

Kelly: And with that in mind, I knew it was going to be really important, first of all, to find a provider who was going to be supportive of my plans. And when I first found out I was pregnant, I spent a lot of time researching local providers and figuring out which hospital I wanted to deliver at.

And I really wanted to work with a midwife, but where we live in Eastern Queens, I had very few options for midwives that had hospital privileges.

So I finally settled on an OB practice that was close by that had a midwife. She attended all of her own deliveries and I was really pleased after our first appointment.

First midwife left practice

Kelly: She was great, but I found out a few weeks later that she left the practice for unspecified reasons.

So after that, they just transferred my care to a physician assistant and she provided prenatal care, but she didn't attend deliveries.

So she told me, oh, you can schedule an appointment with one or more of the attending OBS if you want to. And like most private practices, their OBs rotate coverage for deliveries, so there was really no way to predict which doctor was going to be delivering my baby. But another thing I found really strange was that I went to a number of visits, and I was never actually examined by a provider. So they would do an ultrasound at every visit, they drew my blood or took urine samples, and then I would just briefly meet with the PA in her office, but no one ever like actually examined me, which I thought was really weird.

So it really wasn't comfortable there continuing, but I also was just feeling so disappointed and overwhelmed at the idea of going back to the drawing board in terms of choosing a provider. So I kept going to appointments there for a while we tried to figure out what to do.

Switched Practice

Kelly: And I actually was listening to your podcast, and I heard one of your guests talk about her midwife on Long Island who delivered at the same hospital I had chosen, so I immediately looked her up and I wound up switching my care to her practice at 20 weeks.

Lisa: I don't think I knew that that's so cool.

Kelly: Yeah. Yeah. I feel so lucky that I heard about her, because truly, my internet searches had not really yielded much.

Lisa: It's hard, it's really hard.

She liked her new midwife

Kelly: Yeah. So at our first meeting, I really liked her whole approach and her personality. She said, "Most of my patients are seeking low intervention births."

Very supportive and said like, "These are all the things that I do standard, you can let me know if you want to do anything different," and it was pretty much everything that I had in mind. She also confirmed she attends all of her own deliveries, so pretty much guaranteed she was going to be the one at my birth. And I also liked my prenatal care much better. She did an exam every visit, she took time to answer my questions. She really didn't use ultrasound, she used the Doppler instead, so I think I only had one additional ultrasound between 20 weeks and when I delivered.

Lisa: That's really standard with a lot of midwives, especially ones in birthing centers and home births, but in some hospitals, they'll also do far fewer internal checks and sonograms and things, which because we don't really need to do all that stuff.

Exactly. Yeah. So that was a really good move.

Also loved her doula team

Kelly: But aside from working with a midwife, I also had a doula team that I totally adored. I think because I work in healthcare and especially in a hospital setting, I'm a little jaded, for better or worse.

And I knew I was going to need to be prepared and a little strategic in order to have the birth I wanted in a hospital.

Kelly: But my husband is just very inclined to trust doctors and go along with whatever they recommend, which is fine. But I knew I was going to need a doula in my corner to help navigate if things got a little complicated and we needed to make decisions.

So before we bought our house in Bayside and we moved, in March 2020, right at the start of the pandemic, we had lived in Astoria for four years.

Had heard about Astoria Doula Collective

Kelly: So I had heard about the Astoria Doula Collective [now East River Doula Collective], and it was very much on my radar. And I attended one of the virtual "Meet the Doulas" events, and I was so lucky to connect with Beth and Sarah-Grace, at that event because after talking to them for a few minutes, I could tell they were exactly the kind of energy I was looking for.

Very calm, confident, supportive of whatever my goals were, but also pretty savvy to the ways that hospitals can sometimes disrupt the natural birth process. And they had a lot of tips for how to preempt some of those challenges.

Lisa: Great.

Prenatal Yoga Sessions

Kelly: Other thing that was great, was Sarah-Grace was offering weekly prenatal yoga sessions, and we hired them when I was about five months pregnant. So I really got to take advantage of those yoga classes all through the second half of my pregnancy, which was awesome.

Lisa: And that's part of their package, as I understand it.

Kelly: Yeah, she recently switched to doing the classes once a month and also offering it up to previous clients for kind of a postnatal yoga as well. So I'm really excited to be doing the first one next weekend.

Lisa: Oh, wonderful!

Started birth classes

So once we had our team kind of assembled, we also did your birth class. I, like I said, had done a lot of research, so there was a lot of stuff in the class that I was already familiar with, but my husband had very little prior exposure to pregnancy, birth, infant care. It was all new to him, so I knew something interactive was going to be helpful for us, to kind of get on the same page. So we took the live class over Zoom when I was about six months pregnant. We decided to do it a little earlier to give us more time to digest, which I thought was a good move.

Kelly: And I think what I loved about your classes, it's just such a balanced perspective about all the different interventions you might encounter, just so you can make informed decisions, not really pushing that you should do one thing or another, but here's all the information so that you feel prepared, should you be called upon to make choices about these things.

And I also liked that we were able just to practice different coping techniques together, even though funny enough, we didn't actually use all that many of them. But it was a nice experience to be able to practice different supportive positions and stuff together.

Lisa: Sure, and you never know it might've played out in a different, or maybe even for a future birth, maybe you'll use some of those things.

Kelly: Definitely, definitely.

Self-advocacy is handy

Lisa: Yeah, and one thing I wanted to ask you is, given you said Phil, as many do in our culture, tend to think, doctor knows best, let's trust that. Coming to my class, I know that I kind of rock that boat a little bit or a lot, of when you look at the data and see that we have some of the worst outcomes for birthing people of all of the developed nations.

That means that we have some work to do, and that that self-advocacy piece comes in really handy and helping our care provider to abide by best evidence, and/or just really hiring someone who is abiding by best current evidence and will provide patient-centered care.

Anyway, I'm digressing a bit, but my question is just like, how did that land with him? Was he like, who does she thinks she is, or...?

Kelly: No, not at all. I think it was things that I had already been saying to him. So it was just an opportunity to continue the discussion and him to understand where I was coming from about some of the things I felt really strongly about. So it was good.

Oh, good. So as far as my pregnancy goes, I was very fortunate that I had a pretty easy, comfortable pregnancy and overall, I actually really enjoyed being pregnant.

First trimester

Kelly: First trimester was rough. I was so tired. I fell asleep at my desk a few times. I think my coworkers were like, what's wrong with her?

I'm pretty sure they knew something was up.

Kelly: And I was pretty nauseous. I ate a lot of plain chicken fingers, would come home from the city commuting and fall asleep at 5:30.

But by about 12 weeks that went up, and then after that it was pretty smooth.

The need for protein

Lisa: And can I ask you something real quick, about the chicken, I just noticed that you said chicken fingers and so many people are like, crackers. Had you in all of your reading, because I know you read up and really were very prepared much earlier than many people are, had you read the need for protein?

Kelly: Yeah.

Lisa: A lot of protein, yeah.

Kelly: Yeah, and I'm a pretty balanced eater in general. So I had this sense that I needed something with sustenance, but it needed to be very plain and nothing with any, intense flavors. So that was my go-to.

Lisa: Yeah, and a lot of people aren't aware of how much protein our bodies need when we're building a baby. So I just wanted to ask about that since I know you said chicken.

Kelly: I also learned through trial and error that if I let myself get hungry, then nausea would get much worse. So I made a point of eating kind of every three hours just to make sure that I had something in my stomach, and that worked well.

I also actually did take B12 and Unisom and that I do think made a big difference. Actually continued taking it for my whole pregnancy, because at one point I stopped taking it thinking like, oh, maybe I don't need this anymore, and I started to feel a little queasy, so I just stuck with it.

Yeah, that's good. We found out pretty early on we were having a girl, but it wasn't really important to us to keep that a secret, so we did share that, but we decided to keep her name to ourselves until she was born. That was a nice little surprise for our families.

Prenatal sessions with a pelvic floor physical therapist

Kelly: In terms of preparing physically for birth, knowing that I wanted kind of minimal pain management, I had a few sessions with a pelvic floor physical therapist, kind of has a proactive measure, just to check things out and learn a little bit about what I could do proactively and then also after birth. So that was great, I learned some exercises for strengthening, but also relaxing. That was something I learned that it's not always about strengthening your pelvic floor, it's also about learning to relax those muscles. And then, like I said, I was also doing prenatal yoga about once a week, and I was commuting to Manhattan this whole time. So my commute involved two to three miles of walking round trip, I take the Long Island Railroad from where I live and that helped keep me moving even when I was otherwise slowing down and not really motivated to exercise, at least I was getting lots of walking time in which I think definitely helped.

Acupuncture

Kelly: And then around 37 weeks, I started going for acupuncture once a week on my doula's recommendation, and I loved it. Wouldn't have been something I considered otherwise, but I found it so relaxing. I think all of the things added up to prepare my body for birth, but there was definitely an element of luck for me.

The baby was head down, she was in the left occiput anterior position for weeks. Pretty low in my pelvis for most of the end of pregnancy. So she was ready to go. We didn't have to do too much extra work to get her in position. Before you move on, I just wanted to ask, if you remember right now and would like to share, or you can share it with me after the fact for the show notes page, your pelvic floor PT and the acupuncturist. Do you happen to remember who you saw?

I'll have to look up the name of the practice for pelvic PT. I will say, the provider I was seeing has since left that practice and I only met them in person once, so I can't say too much about her.

Lisa: OK, then it doesn't make sense to list them.

Lisa: But for acupuncture, it was a referral from my doula.

Kelly:  Again, I'll look up the name, but she was awesome. Would highly recommend her and she's in Manhattan.

Lisa: Okay, great. Thank you.

Kelly: Sure.

Birth story

Kelly: So I think we'll jump into the birth story.

Lisa: Go right ahead. Yeah.

Kelly:  I was commuting to Manhattan. I'd been planning to work up until a few days before my due date, but those last few weeks, it wasn't working that was the problem, it was the commute; it just started to feel like too much. So thankfully, my department is super flexible, and they let me move my last day up by a week. And my husband actually had also taken that week off.

A little unwind before the baby arriving

Kelly: So we were able to spend a lot of time together. We went on dates; we got the house ready.

And I think that really helped me mentally prepare, kind of unwind in preparation for the baby arriving. So that was really awesome. You can't always plan it, but I would definitely recommend doing that if you can. So when I was 39 weeks and six days, I had an appointment at my midwife's office and I was going for weekly appointments at this point, but I had not had any signs of labor yet.

And I had also declined cervical checks pretty much throughout my pregnancy. I think I only had one the entire time. Since I was just about full term, the midwife wanted to do a check at this visit, which I agreed to, and she also did a non-stress test, which was totally normal.

Water broke

Kelly: But while I was waiting for her to come in for the exam, I went to use the bathroom and all of a sudden, I had this kind of continuing trickle of fluid. So I realized my water had broken. So ironic that it happened right in the midwife's office.

But this was around 11:30 in the morning. And she didn't even bother testing the fluid. She was like, oh yeah, that's definitely your water. She checked me, she said I was two to three centimeters dilated and a hundred percent effaced, and said go home, rest, but I'll probably see you at the hospital later tonight.

And we had previously discussed the plan to call her when my contractions were 5-1-1, meaning five minutes apart, lasting at least one minute and consistent for at least an hour. So we had her personal cell phone number, that's how she handles her patients.

So I texted our doulas to let them know things were happening and they gave me some additional suggestions for alternating movement and rest to try and get contractions going and keep them going steadily in the right direction.

And we left the office, stopped for lunch on the way home.

Doula's suggestions

Kelly: Do you happen to remember any of the suggestions that the doulas gave you?

Yeah. The Miles Circuit, taking walks, they said, like 30 minutes, once contraction start, aim for 30 minutes of movement and 30 minutes of rest, you want to conserve your energy, but keep your body moving.

Lisa: Great. Thanks.

Kelly: Yeah. So we left the office, we stopped for lunch on the way home, knew that was going to be a priority is to get some good sustenance in me before labor started. And even within the hour sitting there eating lunch, I started to notice some contractions and they started getting stronger pretty quickly.

So by the time we got home around one o'clock, I was really uncomfortable, like made a beeline from the car to the house and set up on the living room floor with my birth ball. It was already at the point that I couldn't really do anything else. I could still talk in between contractions, but I definitely was not, watching a movie or doing the puzzle that we thought we were going to be doing in early labor. All these things that we planned. So I was draped over the birth ball on my knees, I was just breathing, kind of rocking side to side through the contractions.

Contractions increased

Kelly: And then at around two o'clock, I texted the doulas again that things had really progressed. The contractions were between three and five minutes apart and lasting anywhere from 90 seconds to two minutes.

And shortly after that, I stopped really being able to kind of text or hold the conversations. My husband took over and he was texting with Sarah-Grace, who we knew was going to be the one attending my birth. And I was feeling like I needed to just change up my position and do something different.

And I was already in my head and didn't have the wherewithal to think through what my position options were, so she gave us some good suggestions. And I really had no sense of time from this point on because I was just fully focused inward on breathing, I started vocalizing, which I found really helpful to get through the peaks of the contractions.

And because this was my first time in labor, and because things went so much more quickly than I had expected based on everything I had learned about first-time labors, I really had no sense of where I was in terms of stages of labor, either. So things felt really intense, really quickly. Part of my brain was a little panicky, thinking if this is early labor, I don't know how I'm going to make it.

Lisa: Those mind games are real, aren't they?

Kelly: Definitely.

Let the body do its work

Kelly: But at the same time, there's this very calm inner voice, that was like, you know what? This is happening, your body's doing the work, all you have to do is just surrender and let your body do its thing. And that was really my intention for labor all along. That was my motivation for not wanting interventions. I really wanted my body to lead the way.

But it's funny and kind of a reflection on my personality I think that I'm a very type A person. So I had done all this preparation and research, so that I could feel in control and have tools to manage my labor, and really all I needed to do was just let go and let it happen.

Lisa: But maybe that prep really helped you to let go and let it happen.

Kelly: I think so, too. I have no regrets about all of the preparation I did. I think that it all added up to having the experience that I wanted.

Vocalization description

Lisa: Can you elaborate a little bit, if you don't mind, on the vocalization piece? What was that like, as part of the vocalization, was it just like primitive groaning? Was it counting? Was it saying something like an affirmation or a word? Anything?

Kelly: Yeah, it was just that primitive moaning sound. I was consciously thinking about keeping it very low and relaxed because I knew that was going to help my body stay relaxed. And it was funny how once I remembered to start doing it, because I had been breathing, that was something that seemed very natural. I was like, oh, people always say that like moaning can really help them. And I was amazed at how effective it was and it feels a little weird and embarrassing, even though you're caught up in labor. You're like, oh, I'm making all these weird sounds.

But truly, it was so helpful. And as soon as I started doing it, I was like, oh, that, let's keep doing that. That's good.

Lisa: Great. I'm glad that helped.

Kelly: So that continued all the way through.

Trying other positions

 Around two I texted the doulas, they gave me some ideas for other positions. So I moved first to sidelying in bed with one knee all the way up, that worked for a little while. And then I moved to the shower on my hands and knees, which I remember when I first got in felt amazing, but the relief didn't last that long.

Kelly: One thing that was really challenging was I didn't feel like I was getting a break between contractions. So, there were waves or peaks, but then in-between I was still feeling pretty strong pain. And when I first got in the shower, I had total relief between contractions and it felt so good, but it really didn't last that long, unfortunately. At some point being on my hands and knees started to feel too intense and I flipped over, I was sitting in a kind of reclined position. And I really think instinctually, my body was trying to slow things down a little bit, because it was moving so fast. I stayed in that position until we left for the hospital.

So this whole time, like I said, I was really in my own head. I wasn't looking for hands-on support. I felt like I was coping pretty well with what I was doing, but I felt nauseous the whole time. I wanted my husband near me, and I just kept telling him to bring the trash can every time I moved just in case I needed to throw up.

Doula was on her way

Kelly: So he stayed with me, and he was in touch with Sarah-Grace. Some of their text messages, looking back, helped me figure out the timeline of things. So at three o'clock, my contractions were two minutes apart, lasting about 90 seconds each, and Sarah-Grace talked to me on the phone briefly and she could tell I sounded different.

So she said, I'm going to pack up and head to you. But she was coming from Brooklyn and we're pretty far east in Queens. So she was at least an hour away.

And then he called the midwife around this time too. And she definitely said, come to the hospital now. But I was really in denial about how fast things were progressing. And I felt so strongly about staying out of the hospital for as long as possible, that I insisted that we wait for Sarah-Grace to get there. Because I was really afraid that we were going to get to the hospital, I was going to find out I still have so long to go, and it was just going to be like a really tough blow.

So we had our bags packed, we were prepared, there's one of those last-minute things. You're like, oh, I'll get them together when labor starts. So he's frantically trying to run around and get those things. And I'm like, just come back, I just need you to sit here and be next to me. So there were things that just never made it into the bag, but we made it.

Doula arrived

And then at 4:30 is when Sarah-Grace arrived and she pretty much helped me get dressed and then turn right around and headed to the car, to go to the hospital.

Headed to the hospital

Kelly: Unfortunately, we were heading out on a Friday afternoon into rush hour traffic. So yeah, it would normally be a 15-minute drive any other time, but it was more like 35 minutes.

Phil was very calm, took all the side roads and I was sitting in the back seat. And I know everyone says the car ride and labor is the absolute worst, but I honestly didn't think it was any worse than anything else. Again, because I was sitting in this semi-reclined position, I think my body was just like, let's slow it down a little.

 So I was able to stay in that position in the car, kept my eyes closed, kept moaning through contractions and it was fine.

Arrived at hospital

Kelly: And then we pulled up to the hospital entrance at 5:05. And I looked out the window and I was like, how am I going to get up and walk inside? It felt so impossible. But then I was like, okay, guess we're doing this.

And I did it. It's a pretty short walk. I had one contraction on the way and just kinda leaned against the wall and waited it out. And then of course, security was like, do you want a wheelchair? But I wanted to just walk. So we walked all the way up. Sarah-Grace came in with me and Phil went to park the car.

So when you get to the entrance of Labor and Delivery, I don't think I mentioned, this is NYU Long Island Hospital, which used to be Winthrop. When you get to the entrance outside of the actual doors that lead you in, there's a receptionist who just does registration paperwork. And there was a couple ahead of me who are clearly not in active labor, and I was just standing there and making so much noise.

But for some reason, the receptionist is not really moving with any urgency. So I was just trying to wait my turn, and then my midwife came out and she was like, there you are, I've been waiting for you. Because she had gotten a phone call two hours earlier that my contractions were two minutes apart, so I think she was a little nervous.

Lisa: Like, you need to cut the line.

Skipped triage

Kelly: So she told her receptionist that I was going to skip triage and be admitted directly to L & D. I had to wait another minute or two, she brought us, their forms are all electronic, so you just scroll through. Thank goodness Sarah-Grace was there, she just swiped through and said, sign here.

And I have actually like a record of the time. It was only 10 minutes that we were waiting there, but it felt like forever.

Lisa: Like who likes to have paperwork shoved in your face.

Kelly: So about 5:15, I walked back to the delivery room and the nurse was just going about her usual process for prepping for an admission. And I think, because I was so calm, she didn't realize quite how progressed I actually was. And of course, I didn't know.

So I told her, I felt like I needed to pee, and she said, oh great, I need a urine sample. So she gives me the cup and I sit on the toilet for a minute, I'm only getting a trickle. Phil came in briefly and when he saw me just sitting there, he was like, oh, I have time. And he went back out to the car to go get some stuff that he hadn't brought in.

Bloody Show & Pushing

Kelly: But when I went to stand up, that's when I had the bloody show.

Everybody had been asking me, do you have any blood this whole time? And I had not. And then suddenly I did. So the midwife came in and she was like, all right, time to go. She hustled me onto the bed. Checked me, said I was 10 centimeters, and when she checked me, the rest of my waters came gushing out. This whole time, it had just been like a little bit of a trickle. And so it was a big gush. So, I was laying on my side on the bed with my knees bent, and almost immediately after that release of the waters, I started bearing down completely and voluntarily. It was such a crazy feeling. It felt like my body was wringing itself out from the middle down and up.

So I thought for sure, I was going to throw up, they gave me like a little bag, but I never did. It just felt just so intense.

Lisa: That's one of the most specific physical descriptions I have ever heard. Thank you for that. It's always nice when someone can articulate more specifically what that was like, that was really helpful.

Kelly: Yeah. I'm definitely never going to forget that feeling.

That happened two more times, I think it coincided with contractions, there were short breaks in-between those bearing down episodes, but I don't know how long they were. I think they were only like a minute or two. And of course now there's lots of people in the room, the nurses, there's a midwife, there's a resident physician, everybody's talking and like running around.

Phil made it back in time. He was sitting next to me holding my hand, yeah. And then I'm sure Sarah-Grace like texted him in a panic. Sarah-Grace was standing next to my head and just like talking to me very softly. And even though it wasn't interfering with my labor, obviously at this point, but it was such a vibe shift to come into the hospital and there's bright lights and people running around.

Kelly: So I actually had the wherewithal between pushes to say, hey, can we turn the lights off? It's so bright in here! Which they did. And then they had the purple mood lighting on the wall. So that was nice.

And I was

Lisa: Mood lighting.

Kelly: Yeah. I think it's the NYU colors.

Lisa: Right, yep.

Kelly: I also was taking sips of water from my Hydroflask in-between pushes.

Yay. Hydroflask. Yay. After the third kind of involuntary push, then my body relaxed a little bit, and I was able to more actively push. So the midwife coached me to try to hold out the push a little bit longer during the next two contractions. And that was it, that was all it took.

Baby’s birth

Kelly: She was born at 5:54, five pushes, total.

I guess you gave birth on your side, is that?

Kelly: Yes. Yes. That was the position I wound up in getting on the bed and it was working. So I was like, I don't think I had the energy at that point to change it. But it was perfectly fine. And I remember the midwives saying to the resident, these residents always try, they're so shocked that women can deliver with their knees together. But that's such a revelation to them, but she's of course that's a very natural position to be in. So you're saying you rotated your knees inward?

Pretty much, yeah.

Lisa: Which is what pelvic floor therapists, for anyone who isn't familiar with that because that's not what we see in movies, we see legs splayed open, when pelvic floor therapists will tell us that actually closes the outlet, the bottom of the pelvis.

Kelly: Exactly.

Lisa: Ironically, so yay that you did that. That's great.

Kelly: Yeah.

Lisa: And yay for helping some of the medical staff around you, who aren't used to seeing that.

Kelly: Exactly.

Oh, yeah, the kind of ring of fire, I felt slight burning sensation, but it really wasn't anything too notable. But afterwards, it was just such an immense sense of relief, mostly that it was done. But also just that it wasn't going to get more intense than it had been, because I think that was my fear the whole time.

So, I was so worried that after it was over, I actually said out loud, is it weird that wasn't as bad as I thought it will be? So everyone obviously thought that was hilarious.

Delivered the placenta, delayed cord clamping

Kelly: So I delivered the placenta shortly after, that was totally fine.

We did delay cord clamping a few minutes, I would have loved for it to have been longer, but the cord was not super-long, Nora was really on my belly. She couldn't make it up to my chest. And the midwife was like, can we just cut it so you can have her on your chest?

Baby on the chest

Kelly: So Phil cut the cord. And, at some point when I had first arrived, the nurse put in a hep-lock, which I knew about and had agreed to, and they did give me Pitocin and a bag of IV fluids after delivery, which I think is really standard for them.

Honestly, if they had asked me, I probably would have said, no thanks, but it was too quick for me to say anything, I didn't even realize until later on, especially about the fluids. I knew about the Pitocin, but not about the fluids.

Yeah.

 We had about an hour of skin to skin, then they took her just across the room for a few minutes just to weigh her and measure her.

Kelly: And because I came in so quickly, we did a lot of the administrative stuff after the delivery, I signed a bunch of consent forms for the delivery I already had.

Lisa: Just what you want to do.

Kelly: I know, it's so silly. I had to be tested for COVID. Which they did, again, after she was born. Then I had to wait for the results to come back before I went up to the postpartum unit.

So we actually stayed in delivery room for a few hours waiting for the test results. In the meantime I was able to get out of bed right away, I was able to use the bathroom, and everything was fine. So as soon as the test results came back, I was good to go.

And I did try to get her to latch a few times while we were there, but she was really sleepy. So she would only stay on for a few seconds at a time. But the rest of our hospital stay was very uneventful. We were able to get a private room, which was very nice, Phil stayed with me.

Going home after 24 hours

Kelly: And we opted to be discharged after 24 hours. So by the following evening we were out.

Lisa: Oh, nice.

Kelly: Yeah.

Pelvic exercises

Lisa: Can I ask you a question about, when you were talking about the brief ring a fire that you felt. When you went to see a pelvic PT, did they give you any customized exercises to do, and did they recommend perineal massage prenatally? Or what did that look like if you don't mind?

Kelly: Yeah. The exercises were about coordinating breathing with a pelvic floor kind of tension and relaxation. We talked about perineal massage, but I never actually followed through with getting instructed in how to do it, so I did not do it at all. But I thankfully did not have any tears from this delivery. Hopefully, that'll be true for the next one too.

Lisa: It's more likely if you didn't this time, no guarantees of course, with any of this, but that's fantastic.

Yeah.

Kelly: Yeah. And I think it's definitely apparent postpartum that I have some pelvic floor weakness. Definitely had a little bit of incontinence in the first couple of days, that got better, still feel some pressure, especially when baby wearing and stuff like that.

So I'm glad that I learned about the exercises because now I know exactly what to do to try and tone that up and get back to where I was.

Going home and postpartum

Lisa: Great. Thank you. Yeah. So continue on from going home and maybe if you'd like to talk about your initial postpartum and breastfeeding, I know you wanted to talk about.

Kelly: Sure, yeah. Yeah, so I had been planning to breastfeed, but because we were in the hospital for such a short time, I didn't see a lactation consultant at all.

And I had a couple of nurses try to help me, but Nora was very sleepy for that whole, which I think is normal, that whole first night and day. So she would only nurse for a few minutes at a time. But I did notice right away that I was having a lot of nipple pain when she was latching, which was the first red flag that maybe something was off.

Lactation consultation

Kelly: So once I was home, that pain continued, and I decided to do a virtual consultation with a lactation consultant using the Nest Collaborative. And it was a really great experience. I would definitely recommend them. I was able to get an appointment within a day or two. The consultant was excellent, she was really knowledgeable and right away she identified multiple red flags for a tongue tie, which was causing her to have a really shallow latch and kind of just chomp on my nipple, which is what was causing that pain.

So she walked us through all the ways that we could troubleshoot in the meantime, but also really encouraged us to seek out an evaluation and consider getting the tongue tie released.

And luckily, we were still able to continue exclusively breastfeeding through this whole period. I was experiencing a decent amount of pain, which was a bummer, but she was getting enough milk that we didn't need to pump and bottle feed or supplement, which I feel very lucky for. Because I think that really motivated me to persevere through some of the challenges we were having.

I just felt really overwhelmed trying to sort through all of the information out there about tongue tie, which is why I thought it'd be good to bring it up because there's so much conflicting information about when to do a release, whether to do a release, what other kinds of evaluation or pre and post therapy you should get. And it can leave you just feeling so overwhelmed and unsure of what to do.

Kelly: So I spoke with a speech pathologist colleague who works in pediatric feeding. She did a quick assessment and she also encouraged me to just go ahead with the release, and then gave me some tips of things that I could do after to try and strengthen her tongue.

Pediatric dentist frenectomy (oral adjustment) for tongue tie

Kelly: So when Nora was four weeks old, we took her to a pediatric dentist who specializes in tongue ties. He confirmed she had a posterior tongue tie as well as an upper lip tie. And he released them both with a laser. He's out East on Long Island and is purported to be of the best, Scott Siegel.

He was recommended by my doulas as well. Like he's the one to go to. So he was great, it was a good experience, and everything healed well, which is good. We did have to do stretches of the wounds, where you're actually stretching wound open to help it heal the way we want it to. Five times a day for two weeks, which was really torture for all of us, but we made it through. She would get so upset, but I just knew we needed to get through it, and it would be silly to have done the procedure and then not have it heal the right way.

Lisa: Yeah, absolutely.

Kelly: We survived.

Lisa: Thanks for describing, I don't think anyone has ever shared that on the podcast before. I think the topic has come up, but that's good for people to know just in advance that it is necessary to help things heal properly and as we need them to, but that it's not fun.

Kelly: It's not. And I think if you're going to do it, you have to be mentally prepared to just push through that feeling of, I don't think actually that it was that painful for her because once we did the stretch, she would calm down immediately.

I think it was more the discomfort of having fingers shoved in her mouth, is very jarring, but it was okay.

So after the procedure, while things were healing and then even beyond the two-week mark, the improvement in her breastfeeding and her latch was slow and steady. It wasn't a magic bullet, like suddenly everything was fine. And I continued seeing the lactation consultant for a couple of additional sessions because she had learned to latch in a certain way because of the way her tongue was, and now that it was different, she needed to relearn how to do that. So there was some hands-on assistance from me to help her kind of relearn how to use her tongue in a new way.

Chiropractor sessions

Kelly: And then we also did a few sessions with a chiropractor. That's something a lot of people recommend, some kind of bodywork after the procedure, to alleviate any residual tension in her body. But after a few weeks, things were definitely much better, and now I feel like we're really doing great. Still got some hiccups to work through, but compared to where we were to now, I'm really glad that we persevered through those challenges, and we were able to continue breastfeeding.

That's great. And the chiropractor, what were those visits My understanding is that usually, pediatric chiropractors who specialize in working with babies, it's going to be a very gentle technique. Was that your experience?

Kelly: Yeah, it doesn't really look like much.

They're putting like maybe one finger worth of pressure, maybe around the hips or along the spine. He did assess her, having her suck on a finger each time and check her neck to make sure things were symmetrical. But yeah, a visit was really only 5 to 10 minutes. It was pretty quick.

Lisa: Yeah, a chiropractor or a craniosacral therapist, as I understand it would be working with the fascia, which is, this connective layer that it's, everything is connected.

 

Kelly: Right.

Lisa: And some people, when a baby gets a tongue tie or lip tie diagnosis, have found that going for maybe a few sessions, maybe two to four sessions with a cranial sacral therapist or a chiropractor before even having the oral adjustment done, sometimes makes it not even necessary.

That's not going to be the case all of the time, but at some it's one possible course of action that someone could consider if they wanted to. I love that you did that care afterwards.

Kelly: But the rest of the postpartum I think was uneventful. It's good and it's hard, in all the normal ways, I think. I definitely was not someone who felt an instant connection when my baby was born. That's something that has built over time for me.

And I was very lucky to have Phil home with me for the first six weeks. And he was such a great emotional support, more than anything. He's very hands-on, but whenever I was feeling overwhelmed, he could talk me down and be like, this is just temporary, things will get better. Because things change so quickly in those early weeks and it's really hard when something new and kind of difficult starts happening, to not feel totally overwhelmed, but definitely what I learned on the best advice I have is that nothing lasts forever.

It feels like it's going to last forever and then in a few days, it's over and you're onto the next thing. So if you're going through something hard, just know keep going and it will pass.

Lisa: Yes. That's one of the things that my husband always said was one of the most valuable things to remind himself.

And I agree, I did this too, of just this is temporary, this too shall pass. And then you're like, oh wait, as soon as you figure something out with the baby that you were like a challenge, then they grow and they keep you on your toes, right?

Then they're like, okay, there's a new challenge, there's a growth spurt, there's a this or that. But yeah, it's all worth it. It's all temporary, and we can cherish it when we can and then, remind ourselves it's not forever when we need to.

Kelly: Yeah, and I think also the first six weeks are especially hard, because the baby's not giving you much. They're not super interactive, they're not smiling yet. So you feel like you're giving everything to caring for this tiny person who's so vulnerable, and then you're not getting much in return. But if you power through it, then suddenly when they start smiling, it's so amazing.

Lisa: Yes. I just got chills thinking about it. When they shift into that phase, it's really fun. Wonderful.

Transition when Phil returned to work

 Oh, actually I wanted to ask you when Phil returned to work around six weeks, was that a smooth transition or did you feel lonely, isolated and any challenging stuff around that time?

Kelly: Yeah.

Lisa: Did you have any extra support?

It's mostly me.

new mom outside in winter wearing a coat and wearing her newborn baby. Standing in front of a house with a tree off to left

Baby wearing

We have family local, which is awesome, but they all work also. So during the week it's just me, and that has definitely been an adjustment. It's something I anticipated would be hard for me, so I did mentally prepare for that, and we talked a little bit before we started recording about babywearing, which has definitely been a game changer for me, because I'm someone who doesn't really like to be idle for long stretches of the day or feel like I'm trapped in the house.

Kelly: And Nora does not love napping anywhere except on me. So, you know, rather than trying to force her to nap in the crib or the bassinet, we said, all right, let's take this nap on the go. And so I can clean the house, take the dog for a walk. I zip her up inside my big coat and so that has just been so awesome for me.

Lisa: And as we're recording this, I know listeners can't see, but we're on a Zoom call. And as soon as she turned her video on, I said Kelly, you're baby wearing, I'm so excited, you have a baby on you. And she's been swaying throughout the time that she's been sharing all of the birth story details.

Kelly: And there are so many carriers now that you can use, right from kind of day one. I used the soft wrap in the first weeks and now I'm using more of a soft, structured carrier, but yeah, definitely, if you can learn a little bit about how to use a carrier and get one before the baby comes, then you'll be ready to kind of jump in and not be overwhelmed by it.

Lisa: Absolutely. And in the show notes, I will post a link, the baby wearing guru in our doula collective, Adriane Stare, just recently created the most awesome tip sheet on some of the top benefits of babywearing, and for anyone who's interested in just taking a peek at that, I will link that in the show notes with her permission.

And that's a nice starting place not everybody, it's not, it kind of rocks the cultural paradigm of babies in cribs, and then we're so surprised that our babies only want to sleep on us, but that's actually so biologically normal, and having a baby, wearing your baby, frees up your arms and your hands as you have found.

And you're snuggling and it's calming you and your baby, there's just so many benefits. So yay for that. Thanks for sharing that. Awesome.

Final insights / advice

Is there anything else that you didn't get to share yet that you'd like to share or any final insights or advice?

Kelly: Sure. First, I just want to say thank you again for giving me the opportunity to share my birth story, because I love listening to birth stories, did before I was pregnant and still do. But also because I remember in the hospital, one of my nurses heard how fast my labor was and that I had no tears and she said, people are going to hate you. And of course she said it in a joking way, but I did really have this apprehension about talking about my quote unquote, easy birth, when so many people have had difficult or traumatic experiences.

But I do think it's important to hear positive stories of all kinds, which is why I loved and still love listening to podcasts like yours.

So I would say, what I want to share most is that it's definitely possible to have a low-intervention birth in a hospital, but it's important to recognize that it's not the default, and you definitely need to choose your provider and your support team wisely, and then also educate yourself, so you're prepared to advocate for your own choices.

I know in your class, you talk about calling it "birth preferences" rather than a birth plan, because the term plan sometimes puts people on edge. But yeah, I think if you are informed, then you're able to navigate whatever unexpected things might come up.

Lisa: Well said, I love it. Thank you so much.

Kelly: Of course.

Lisa: All right, thank you again. I hope we can stay in touch, and I hope that we can finally meet in person sometime.

Kelly: That would be really fun.

Lisa: All right. Have a good one, keep in touch.

Kelly: Thank you.

Lisa: Bye Kelly.

Kelly: Bye.