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June 19, 2023

Arya Pretlow, MSN, CNM, IBCLC, C-IAYT: Healing Through Pregnancy Loss and Empowering Others

Arya Pretlow, MSN, CNM, IBCLC, C-IAYT: Healing Through Pregnancy Loss and Empowering Others
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Season 1

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What if your personal journey through pregnancy loss, ectopic pregnancies, and a home birth could empower others facing similar struggles? That's exactly what Arya Pretlow, a certified nurse, midwife, lactation consultant, yoga therapist, and soon-to-be doctor-of-nursing practice, shares with us in this enlightening episode. We delve into Arya's rollercoaster experiences, from infertility heartaches to a successful home birth, and how these moments have shaped her career, and helped her connect with patients on a deeper level.

Arya shares her pregnancy journey and the strategies she used, like acupuncture, to improve pregnancy symptoms and promote natural labor.  We also touch on the importance of increased monitoring in late pregnancy, relying on clinical evidence to make informed decisions, having a plan for a safe delivery if there are unexpected challenges in the home birth, and the significance of trusting one's intuition during this process.

We explore how Arya navigated her delightfully unexpected pregnancy and planned home birth with the help of her husband and midwife. We discuss the safety parameters for a successful out-of-hospital birth, effective pushing techniques, and anatomy awareness during labor. Additionally, we emphasize the importance of sharing personal experiences and navigating conversations around pregnancy loss to foster understanding and support. Arya's resilience and openness to unexpected outcomes serves as a powerful reminder for all of us to trust our bodies and advocate for ourselves in our healthcare journeys.

You can connect with Arya at www.apwellnessservices.com

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Medical Disclaimer:
This podcast is intended as a safe space for women to share their birth experiences. It is not intended to provide medical advice. Each woman’s medical course of action is individual and may not appropriately transfer to another similar situation. Please speak to your medical provider before making any medical decisions. Additionally, it is important to keep in mind that evidence based practice evolves as our knowledge of science improves. To the best of my ability I will attempt to present the most current ACOG and AWHONN recommendations at the time the podcast is recorded, but that may not necessarily reflect the best practices at the time the podcast is heard. Additionally, guests sharing their stories have the right to autonomy in their medical decisions, and may share their choice to go against current practice recommendations. I intend to hold space for people to share their decisions. I will attempt to share the current recommendations so that my audience is informed, but it is up to each individual to choose what is best for them.

Chapters

00:00 - A Midwife's Journey Through Pregnancy Loss

10:04 - Struggles With Conception and Ectopic Pregnancy

19:24 - Pregnancy, Fertility, and Home Birth

25:58 - Overdue Pregnancy and Induction

41:21 - Trusting Intuition in Labor

52:04 - Home Birth Experience

57:00 - Benefits of Out-of-Hospital Birth

01:03:51 - Effective Pushing Techniques and Anatomy Awareness

01:15:25 - Navigating Pregnancy Loss Conversations

01:22:11 - Pregnancy Loss and Bodily Autonomy

Transcript
WEBVTT

00:00:00.100 --> 00:00:02.488
This episode depicts pregnancy loss.

00:00:02.488 --> 00:00:06.831
Listeners who are sensitive to this topic may prefer to skip this episode.

00:00:06.831 --> 00:00:11.111
Hello, Today I have with me Aria Pretlow.

00:00:11.111 --> 00:00:19.967
Aria is a certified nurse, midwife, an international board certified lactation consultant and a certified yoga therapist.

00:00:19.967 --> 00:00:25.551
On top of that, she is a mom and she is in the process of getting her doctor of nursing practice.

00:00:25.551 --> 00:00:39.209
Today she's going to talk about her birth journey, and if you want to work with Aria, you can go to apwellnessservicescom and message her, And that will also be in the show notes, so you don't have to remember that.

00:00:39.209 --> 00:00:42.348
Aria welcome and thank you for joining me.

00:00:42.348 --> 00:00:43.362
Thanks, Kelly.

00:00:43.362 --> 00:00:45.069
I'm very happy to be here again.

00:00:46.064 --> 00:00:53.158
Me too, I'm excited that I have not heard this full story, so Oh, we never had enough time hanging out at the nurses station to go into detail.

00:00:53.621 --> 00:00:55.045
After like six years.

00:00:55.045 --> 00:00:59.380
I've heard bits and pieces, but not the full story.

00:00:59.581 --> 00:01:05.649
Yeah, well, it all started Upon a time a girl in a ballroom.

00:01:07.421 --> 00:01:08.787
Exactly like that.

00:01:08.787 --> 00:01:53.290
First of all, i love being able to share this story because I think it's in my experience as a provider, both at the bedside on labor and delivery and definitely as a nurse midwife it has been so helpful to you know, have a reasonable amount of sharing personal information, like you never want it to become about you, but sometimes the patient very much appreciates knowing that the person caring for them has experienced something similar, and so whenever I work with people who have had like a long journey to get that sticky embryo that they can carry all the way through to birth and then have a healthy life, birth After loss, that's always been really useful.

00:01:53.290 --> 00:02:10.719
So being able to relate to patients and share a little bit about my own experience so that they can feel even more understood and heard and seen in the care that I provide, that has, for better or for worse, as far as my own personal history goes.

00:02:10.719 --> 00:02:36.808
That includes difficulties conceiving, it includes early pregnancy loss, it includes not one but two ectopic pregnancies And then finally, an unplanned conception that resulted in a healthy all the way term almost 42 weeks gestation and a home birth an on-purpose home birth and this healthy, amazing, now nine-year-old.

00:02:36.808 --> 00:02:56.031
So thank you for asking me to come and talk about it, because it's not just kind of a triumphant story but also one of really it's just human-ing right, like we're just going through trying to deal with each new situation we have to face, whether it was one that we on purpose chose or not.

00:02:56.031 --> 00:02:58.246
We just are always doing the best we can.

00:02:58.659 --> 00:03:11.800
So my first pregnancy I guess we could say that I know of, because all of us technically have probably had some pregnancies that were such early losses we didn't even necessarily know it happened.

00:03:11.800 --> 00:03:17.733
But the first planned I want to get pregnant happened really easily for us.

00:03:17.733 --> 00:03:24.430
We had been married five or six years, we had just gotten out of the military, settled in.

00:03:24.430 --> 00:03:40.911
I really had that like what we think of for our for me at least, my grandparents' generation of like you get home from war and you just want like white picket fences and your 2.3 children and your cute little dog chasing the kids or whatever.

00:03:40.911 --> 00:03:49.479
I very, very much wanted that when I got home from serving overseas in the war And we wanted to get like settled into civilian life first.

00:03:49.479 --> 00:04:00.020
And so then when we felt ready, we basically it was like, okay, we didn't really have to like chart, we didn't know, i didn't even know about any of that kind of stuff.

00:04:00.020 --> 00:04:03.711
We just, you know, had a bunch of sex and made a baby.

00:04:04.360 --> 00:04:07.106
At that time I was late 20s, you know.

00:04:07.106 --> 00:04:23.434
So that helped, i'm sure, and I already was very enthusiastic about living in a part of the country where I knew that home birth was a feasible, relatively common and safe option in Seattle.

00:04:23.434 --> 00:04:37.589
And so I, you know, i think I was like four weeks and three days pregnant, like I had just peed on the stick The stick it was like still hadn't gone out in the trash yet, probably and I was calling midwives and being like will you be my midwife?

00:04:37.589 --> 00:04:38.391
I am pregnant.

00:04:38.391 --> 00:04:52.872
And it turned out that, even though, as a midwife, a lot of people do that, of course you're very excited and I totally get wanting to start care, but for most people there's really nothing for us to do that early.

00:04:52.872 --> 00:05:02.512
There's really except meet you, like having meet and greet, and like we could run some labs, but there's nothing to do really in the care until a little bit further along.

00:05:02.512 --> 00:05:12.180
So I connected with a midwife and she was like, yeah, come on in and we can like confirm the pregnancy, we'll do the blood tests and everything.

00:05:12.180 --> 00:05:17.291
And so I went in and those initial labs were fine.

00:05:17.291 --> 00:05:21.050
By the time I got in to see her I was maybe like six weeks or something.

00:05:21.050 --> 00:05:22.744
So the initial labs were fine.

00:05:22.744 --> 00:05:31.591
And then the next you do the like serum quantitative to see Did your HCG go up the way it should And how's your progesterone looking, and all those things.

00:05:31.591 --> 00:05:36.172
And I got a phone call on Friday that said this isn't looking good.

00:05:36.172 --> 00:05:46.153
And I just want to let you know, especially as we go into the weekend, that this is not a viable pregnancy and you should prepare yourself for having a loss.

00:05:46.740 --> 00:06:00.882
And I did all the things people do, i think I, you know, took long walks and cried and yelled and bargained and started bleeding by Monday And so I had what we all thought was just a, an early pregnancy loss, just a miscarriage.

00:06:00.882 --> 00:06:18.053
But about two weeks later I had a horrible pain And I had had this kind of pain in my lower abdomen throughout, like since I really early on, and you know people are just like, oh, it's growing pains.

00:06:18.053 --> 00:06:23.495
It's kind of doing that thing people do to try to be reassuring but really it ends up dismissing the concern.

00:06:23.495 --> 00:06:25.521
And so it wasn't investigated.

00:06:25.521 --> 00:06:29.050
And knowing now what I know.

00:06:29.050 --> 00:06:36.274
I wish that I had had an early dating ultrasound because it would have identified that in fact all along.

00:06:36.394 --> 00:06:40.004
I had an ectopic pregnancy and we could have treated that condition early.

00:06:40.004 --> 00:06:56.646
But instead, because that wasn't what was done then, or perhaps with the practice I chose, about two weeks later I had this terrible, terrible pain, ended up the short-ish version of it in being diagnosed with an ectopic pregnancy And the embryo, of course, had died.

00:06:56.646 --> 00:07:01.947
It can't keep growing, but the placenta is dumb, placentas are not smart, and so it just keeps growing.

00:07:01.947 --> 00:07:11.353
And the radiologist was like you don't have to go to the emergency department, but you absolutely have to get this treated today, which was a Friday.

00:07:11.353 --> 00:07:15.607
So we were just like what does that mean?

00:07:15.607 --> 00:07:22.348
So we called the midwife and the midwife was like well, it's not in my scope to treat it, but I'm going to send you over to this OB-GYN.

00:07:22.348 --> 00:07:25.122
So I go to the OB-GYN.

00:07:25.122 --> 00:07:34.815
It's the office full of pregnant people, all the awful things, and I was treated with something called methotrexate because I didn't want to have surgery I have.

00:07:35.257 --> 00:07:48.012
The interesting thing with ectopics is, while any kind of pelvic inflammatory disease or surgery in the pelvis increases your risk of having one most people who have one have never had either of those things.

00:07:48.012 --> 00:07:55.204
So I had never had an STI, i had never had a procedure, i had no risk factors, except just being a person who got pregnant.

00:07:55.204 --> 00:07:57.875
And so I was like, oh, you can't take my tube.

00:07:57.875 --> 00:08:00.062
I feel like I might need that.

00:08:00.062 --> 00:08:17.990
So I chose to get methotrexate, which is a medication some people may be familiar with because we use it to treat other conditions, but it's basically chemotherapy to kill the placenta, and if I had to go back and do it again, i would have had surgery instead, because it was like two months of recovery for me because it was.

00:08:18.331 --> 00:08:45.149
It's so slow to break down the placenta And the fallopian tube is it has a little tiny bit of like diastasis action, like your guts do, and so all the way I envision it is like chunks of placenta are kind of deteriorating and it and it still has to move through the tube, and that was imagine kidney stones, right, i mean it's like it was excruciating and it would happen randomly.

00:08:45.149 --> 00:08:49.903
So I couldn't drive and I couldn't until all of that was done and had wrapped up.

00:08:49.903 --> 00:09:07.384
So that was my entree into pregnancy And so, you know, the follow up was basically like we're going to look at your blood and make sure you know that it worked so that you don't have to get a second treatment or possibly surgery if for some reason it wasn't responsive to this drug.

00:09:07.384 --> 00:09:15.518
And then the nurses literally said things like oh you know, i just know we're going to see you in here pregnant in a few months.

00:09:15.518 --> 00:09:17.283
And I was just like how do you know?

00:09:17.283 --> 00:09:18.907
I'd like to know how you know that.

00:09:18.907 --> 00:09:19.808
I don't know that.

00:09:19.808 --> 00:09:27.120
It didn't feel good to be told that when you're still in the throes of like a very painful, physically and otherwise loss.

00:09:27.120 --> 00:09:35.931
So that was one of those things that when I think in my practice, the things you learn not to do, you know it's like don't don't say those things You don't know, you don't know that.

00:09:36.211 --> 00:09:39.746
So it took us two more years to conceive.

00:09:39.746 --> 00:09:42.092
Again, not for lack of trying.

00:09:42.092 --> 00:09:46.226
We started temping and using taking charge of your fertility.

00:09:46.226 --> 00:09:48.095
You know, old school paper style.

00:09:48.095 --> 00:09:49.522
There weren't apps and stuff for that.

00:09:49.522 --> 00:09:59.721
This was the early odds And so I would do tofully take my basal body temperature every morning and track all the cervical mucus and all the signs and all the things, and I clearly was ovulating.

00:09:59.721 --> 00:10:02.307
It just took us like two years to do it.

00:10:02.768 --> 00:10:08.144
So we finally conceived again, had a very early loss again, so it's like 2008.

00:10:08.144 --> 00:10:16.427
And I remember for that one it was like the Friday before Memorial Day when I started bleeding.

00:10:16.427 --> 00:10:32.322
So I had like had a positive at home pregnancy test, i don't know on like Tuesday or Wednesday, and Friday started bleeding And a given that I had quote unquote miscarried with the first one before I found out it was an ectopic, i was like, oh my God, this time I'm going to die.

00:10:32.322 --> 00:10:34.548
So we went to the emergency department.

00:10:34.548 --> 00:10:53.855
I didn't have a provider or anything, so we go to the ED and that was its own kind of wretched experience And they determined that it was not an ectopic And so it was like, okay, well, just go home, and you know you're already miscarrying, so just go home and continue with self care.

00:10:53.855 --> 00:11:10.958
So we did that And then it was three more years until I conceived again And all along that time for me I just never wanted to do reproductive endocrinology, like I didn't want to go to fertility treatment.

00:11:11.119 --> 00:11:18.823
I just had for me this very strong feeling that either I can just do this like I don't think there's something wrong with me.

00:11:18.823 --> 00:11:21.634
I think it's either timing or I don't even know what.

00:11:21.634 --> 00:11:25.486
But I don't want to go and engineer it, i didn't want to.

00:11:25.486 --> 00:11:28.538
So and I was still in my early 30s.

00:11:28.538 --> 00:11:32.105
You know, i was kind of like it's not, i'm a healthy, youngish person.

00:11:32.105 --> 00:11:33.669
This should eventually work out.

00:11:33.850 --> 00:11:38.229
And so the third pregnancy was a surprise.

00:11:38.229 --> 00:11:39.614
We had been trying.

00:11:39.614 --> 00:11:54.721
We would kind of go through cycles of like doing all the tracking And at some point you're like, oh my God, if I have to hear that, that fucking thermometer one more time beeping at like stupid o'clock in the morning because you got to take your temperature or you got to bed, i was like I'm just going to throw it out the window, like I'm so over it.

00:11:54.721 --> 00:11:58.892
So for our health and wellness, we would take breaks from like on purpose trying.

00:11:58.892 --> 00:12:02.491
So I think we might have even been taking a break from trying.

00:12:02.491 --> 00:12:05.000
And I had a famous last word.

00:12:05.240 --> 00:12:08.214
Again, i had a period and it was a little bit of a weird period.

00:12:08.214 --> 00:12:11.946
I can't remember specifically how, but it just was a little strange.

00:12:11.946 --> 00:12:25.673
But I remember being very relieved to have my period because we were going on a family trip to Ireland And, as a person of Irish descent, this was the first time our family was going to Ireland And it was like a pilgrimage.

00:12:25.673 --> 00:12:36.162
We were so excited And I was like there will be fresh Guinness and there will be Like there are things that need to happen in Ireland.

00:12:36.162 --> 00:12:39.469
So I was like, Oh well, i got my period but you know, okay.

00:12:39.469 --> 00:12:51.171
And so I went and had a lovely time in Ireland and came home And I remember I was a doula at the time And I was also enrolling in midwifery school at Bastier University.

00:12:51.171 --> 00:12:59.149
So I was, i was preparing to become a licensed midwife And I went to a birth as a doula, some kind of long but lovely birth.

00:12:59.932 --> 00:13:22.418
And like the next morning it was a Saturday I woke up and I was like I feel terrible And not just like strung out from a long birth, you know, and my husband was like making some bacon we're gonna have Saturday morning breakfast And I was like I think I'm just like really hungry, like that kind of weird low blood sugar, but I feel kind of nauseous And maybe I just need to eat a little bit.

00:13:22.418 --> 00:13:29.668
And I tried to eat just a little bit of like a muffin and threw up all over the place And I was like that's not normal.

00:13:29.668 --> 00:13:31.975
And so then I was like I don't understand what's wrong.

00:13:31.975 --> 00:13:48.404
Then my pelvis started hurting, so this really on the same side right side was my messed up side So my lower right abdomen really, really painful And I have a history of some food intolerances that cause terrible colicky gas.

00:13:49.225 --> 00:13:54.769
I have before in college, like call the hospital, been like I just don't know what to do.

00:13:54.769 --> 00:13:56.759
When they were like well, we can't tell you what to do.

00:13:56.759 --> 00:13:59.664
I mean I was in college, i didn't know.

00:13:59.664 --> 00:14:02.551
So I was like it's just gas.

00:14:02.551 --> 00:14:07.033
And my husband was like I don't feel like gas usually makes you throw up like this.

00:14:07.033 --> 00:14:07.956
Like what's going on?

00:14:07.956 --> 00:14:12.409
I was like I don't know, but I'm not going to the hospital for gas, like that's so embarrassing.

00:14:12.409 --> 00:14:14.988
So I was like just let me take a bath, i'm just gonna take a bath.

00:14:15.330 --> 00:14:22.586
Well, now, like my cats have started following me around the house and staring at me and that way the animals doing they're like something's wrong, what's going on?

00:14:22.586 --> 00:14:30.436
And he comes up to check on me And he's like having this conversation with me of like I really think we should probably just go the hospitals.

00:14:30.436 --> 00:14:35.942
Like a mile away, it's Saturday morning is not going to be that bad, it's not like the downtown hospital, so it's gonna be fine.

00:14:35.942 --> 00:14:39.793
And I was like I just don't want to go for gas.

00:14:39.793 --> 00:14:41.519
And I compromised.

00:14:41.519 --> 00:14:42.806
I was like let's call the nurse line.

00:14:42.806 --> 00:14:46.201
I was like we'll call the nurse line through our insurance and see what they say.

00:14:46.201 --> 00:14:56.471
And so he brings me the phone and I am in the midst of telling the nurse what I'm feeling when my last period was and she says have you ever had an ectopic pregnancy?

00:14:56.471 --> 00:15:01.769
at the same time that I'm like, oh my God, what if it's another ectopic pregnancy?

00:15:01.769 --> 00:15:05.331
And she's like, yeah, i'm going to suggest that you go into the emergency department right now.

00:15:05.331 --> 00:15:08.001
I was like, oh my God, i have to go.

00:15:08.783 --> 00:15:10.547
So we managed to get me.

00:15:10.547 --> 00:15:12.090
We didn't even call 911.

00:15:12.090 --> 00:15:17.489
We just like got in the car, me with a barf bowl, and my husband like gunning it right, like don't do that.

00:15:17.489 --> 00:15:19.822
People, people at home, just call.

00:15:19.822 --> 00:15:22.794
Like I didn't know, i didn't work in healthcare at the time.

00:15:22.794 --> 00:15:33.268
If you call 911, they can prepare the hospital to receive you And if you are in shock because you are hemorrhaging inside of your body, that's a way to help you stay alive.

00:15:33.268 --> 00:15:34.149
We didn't know that.

00:15:34.149 --> 00:15:43.595
So we just sped and broke all the laws And we got there, got me in nothing gets you seen faster than you know, not really being able to walk and then barfing all over the waiting room.

00:15:43.875 --> 00:15:45.322
So they took me back.

00:15:45.322 --> 00:15:47.505
Of course I was hypotensive.

00:15:47.505 --> 00:15:51.602
Everything was a mess And they ran the pregnancy test And I turned.

00:15:51.602 --> 00:15:54.756
I remember that was the first time I had a symptom of pregnancy.

00:15:54.756 --> 00:16:03.745
I turned my head and, like to my husband, i got that smell of like hospital gurney, like like the cleaning products, right, that super person smell you get when you're pregnant.

00:16:03.745 --> 00:16:09.226
And I was like, if I'm pregnant I am not doing method trixate again.

00:16:09.226 --> 00:16:10.472
They are taking that goddamn tube.

00:16:10.472 --> 00:16:12.120
They can add it.

00:16:12.120 --> 00:16:14.532
All it causes me is trouble.

00:16:14.532 --> 00:16:23.765
So, sure enough, ectopic pregnancy has ruptured, my tube is blasted, i am hemorrhaging inside.

00:16:23.765 --> 00:16:31.799
They have called the OB who's like as soon as I'm finished with the cesarean I can come and save you.

00:16:31.799 --> 00:16:45.807
And I was like I'm alive, i'm in a small hospital So they pump me full of fluids to keep me stable and do emergency surgery And basically you sign away all the things.

00:16:45.807 --> 00:16:46.581
They're like we.

00:16:46.741 --> 00:16:52.052
Honestly, what we saw was like there's a mass over your ovary.

00:16:52.052 --> 00:16:54.908
We don't even know how much of you we need to take out.

00:16:54.908 --> 00:16:59.105
It looks like it's just a hot mess in there And we might have to take the ovary.

00:16:59.105 --> 00:17:00.846
We definitely have to take the tube.

00:17:00.846 --> 00:17:07.086
I mean it's ruined And we're not sure how much of your uterus we'll be able to preserve, because we just can't know until we open you up.

00:17:07.086 --> 00:17:09.111
Sign here, please.

00:17:09.111 --> 00:17:11.480
Okay.

00:17:12.642 --> 00:17:23.236
So it turned out that the fallopian tube was twisted, kinked and wrapped around.

00:17:23.236 --> 00:17:25.788
It had pulled the ovary over.

00:17:25.788 --> 00:17:30.142
So the ovary was fine And I got to keep it And the tube was.

00:17:30.142 --> 00:17:33.405
I mean, there was no saving the tube, so I got to keep my whole uterus.

00:17:33.405 --> 00:17:35.949
It didn't mess up the horn where the tube comes out.

00:17:35.949 --> 00:17:50.765
But they said you know, the thing is is we can never know if this ectopic pregnancy caused your tube to be malformed like that, or if that's a result of damage from the first ectopic pregnancy, or if you just developed that way.

00:17:50.765 --> 00:17:51.386
No idea.

00:17:51.386 --> 00:17:54.963
So good luck seeing when you're pregnant.

00:17:55.085 --> 00:17:58.451
Basically It's funny.

00:17:58.451 --> 00:18:01.605
No, it wasn't funny, but basically it was like okay, well, we've done our work.

00:18:01.605 --> 00:18:04.486
You know, surgeons especially, they tend to be like, okay, well, i did great.

00:18:04.486 --> 00:18:08.329
So see you in six weeks to reassure all of us that I really did great.

00:18:08.329 --> 00:18:10.125
And then, you know, do whatever.

00:18:10.125 --> 00:18:15.028
So, okay, the recovery from that was laparoscopic surgery.

00:18:15.028 --> 00:18:18.470
The recovery from that was exponentially easier for me than the methotrexate.

00:18:18.470 --> 00:18:21.529
I'm still awful, but it was way better than the methotrexate.

00:18:21.700 --> 00:18:30.548
So you know, we go through all of the mourning and the shock and trauma of waking up and going into shock and this knowledge that your pregnancy almost killed you.

00:18:30.548 --> 00:18:31.411
That was a big one.

00:18:31.411 --> 00:18:37.772
So we at some point are like, okay, well, look, this may or may not be a very good idea.

00:18:37.772 --> 00:18:42.884
How about if we don't on purpose try, but we're not necessarily on purpose going to try to prevent either?

00:18:42.884 --> 00:18:46.388
So I'm like 36, almost 37.

00:18:46.388 --> 00:18:55.907
And I was like I mean, i still feel like I'm fine, but at some point I'm going to know in my bones that like, oh, i'm your pregnant, like I'm going to go do other things now.

00:18:56.299 --> 00:19:08.491
So I decided for the first time to get a hysterial subpingogram to see if my remaining tube was fine or not, cause I was like if maybe my tube grew that way, then what's going on with the other side?

00:19:08.491 --> 00:19:11.127
It just happens that both that topics were in the same side.

00:19:11.127 --> 00:19:16.951
And so I got the hysterial subpingogram, which you know, you can Google it, look it up.

00:19:16.951 --> 00:19:18.644
It's, in my experience.

00:19:18.644 --> 00:19:22.141
As awful as every story says it is, it's not.

00:19:22.141 --> 00:19:24.189
It was not a delightful experience.

00:19:24.189 --> 00:19:34.849
However, it did show that my left tube was patent, was fine, it looks straight, it looks open, it should be fine, but you will always have a higher risk of ectopic pregnancy.

00:19:34.849 --> 00:19:40.625
So I was like I mean, maybe my right tube was fine until it wasn't like I'm kind of reassured, but not super reassured.

00:19:40.779 --> 00:19:46.359
So there's a part of me that was like, yeah, you could bypass all of that and just do like IVF, right And.

00:19:46.359 --> 00:19:54.645
Or you could just do intrauterine and like there's all kinds of things you could do and just kind of bypass the whole part where the embryo has to like travel for the little blastocystals to make its way.

00:19:54.645 --> 00:19:57.628
But I just wasn't prepared to to consider all of that.

00:19:57.628 --> 00:20:03.641
So I still very much felt like either it's a thing that will somehow work out or it's not.

00:20:03.641 --> 00:20:15.991
And so at some point we were like, yeah, we're just not even trying anymore, and if we can't have kids, i guess we're going to have money and time.

00:20:15.991 --> 00:20:17.765
So what do you want to do?

00:20:19.884 --> 00:20:37.112
So I made a few changes to my education plan and was in the midst of like doing this really hardcore chemistry with lab in an eight week summer term because I was going to shift and do not just midwifery but kind of shift to like naturopathic position I needed more chemistry.

00:20:37.112 --> 00:20:44.107
So in the middle of that of like eight hours a day of chemistry Monday through Friday for eight weeks, i was like I feel really weird.

00:20:44.107 --> 00:20:48.240
I remember calling a friend of mine who was a midwife and I was like what if I'm pregnant?

00:20:48.240 --> 00:20:50.327
And she's like well, you should find out if you're pregnant.

00:20:50.327 --> 00:20:51.625
And I'm like but what if I am?

00:20:51.625 --> 00:20:53.705
She's like well, first, maybe you should find out.

00:20:53.705 --> 00:20:55.605
And I was like but oh my God, what if I'm pregnant?

00:20:57.380 --> 00:21:07.047
And so we had a plan which was I had maintained care with the midwife, who was also a naturopathic physician, and so she was the person I saw for my PAPs and everything.

00:21:07.047 --> 00:21:15.185
So we had already agreed that if I ever conceived again, we would get the earliest possible ultrasound, like get a dating ultrasound, make sure it's in the right place.

00:21:15.185 --> 00:21:17.070
You know, do all of the labs?

00:21:17.070 --> 00:21:19.505
And the labs aren't predictive of ectopic.

00:21:19.505 --> 00:21:24.028
But the labs look weird And so you suspect an ectopic, right?

00:21:24.028 --> 00:21:29.028
So that is what happens with ectopics You can't diagnose based on the labs, but they don't look ripe.

00:21:29.028 --> 00:21:32.801
So my labs looked beautiful And we're like okay.

00:21:32.801 --> 00:21:39.186
And then the follow up labs still looked beautiful And we're like that seems good.

00:21:39.186 --> 00:21:43.470
And then I didn't have any of the pain that I had had before.

00:21:43.740 --> 00:21:51.588
So they were like well, we could do this five week ultrasound and just get dating and make sure it's in the right place, or you could wait another week or so and actually see the heartbeat.

00:21:51.588 --> 00:21:54.508
And I was like I want to see the heartbeat.

00:21:54.508 --> 00:22:04.372
If I felt bad or the labs had been weird, i wouldn't have waited And we had a very short threshold for like eject, eject, eject, go to the hospital.

00:22:04.372 --> 00:22:08.789
But I was like, yeah, let's just see how viable it is.

00:22:08.789 --> 00:22:20.673
And so we went and it was, sure enough, it was an intrauterine pregnancy And that sonographer was probably the weirdest appointment that they had had in a while at least, because I just kept looking at it and being like so that's my uterus?

00:22:20.673 --> 00:22:22.220
And she was like mm-hmm.

00:22:22.220 --> 00:22:26.430
And I was like and that is the embryo is in my uterus.

00:22:26.430 --> 00:22:27.311
And she's like mm-hmm.

00:22:27.311 --> 00:22:29.207
I was like so it's not in my tube.

00:22:29.207 --> 00:22:33.029
She's like nope, or anywhere else except my uterus.

00:22:33.029 --> 00:22:41.547
She's like you're correct, and so it's going to be staying in my uterus, just like trying to process that.

00:22:41.547 --> 00:22:43.230
It was like in the right place and not trying to kill me.

00:22:43.230 --> 00:22:51.007
So from that point on once it was like this is an intrauterine pregnancy And once we got through the, is it sticky?

00:22:51.007 --> 00:22:51.903
Is it not sticky?

00:22:51.903 --> 00:22:56.477
Just knowing it wasn't in a location that would end in a loss again.

00:22:56.738 --> 00:23:00.269
The rest of the pregnancy was completely vanilla.

00:23:00.269 --> 00:23:01.704
I was 37.

00:23:01.704 --> 00:23:19.626
So whatever some extra monitoring, i was a very healthy 37 year old and was like eh, okay, but there was nothing interesting about the pregnancy at all clinically, because the big part for me was like, can it make it down the superhigh way of your tube to actually get to the uterus and be where it needs to be?

00:23:19.626 --> 00:23:22.420
And this one did So.

00:23:22.420 --> 00:23:23.926
Then I just waited and grew.

00:23:23.926 --> 00:23:33.770
I was horribly sick for like 17 weeks And then one day was like oh, the clouds parted and I was like kind of functional again.

00:23:33.770 --> 00:23:39.625
So that was good And I had a feeling it would probably be my only pregnancy, even what I had experienced.

00:23:39.625 --> 00:23:46.529
I was like I don't see us having the stamina to work through all of that trauma of the early stages in particular again.

00:23:46.529 --> 00:23:50.685
So I just wanted to be pregnant and enjoy it, and so that's what I enjoy.

00:23:50.685 --> 00:23:53.287
Quote, air quotes, huge air quotes for enjoy.

00:23:53.287 --> 00:24:00.022
I am not an I love being pregnant person, but I loved being pregnant that one time because things were working.

00:24:00.022 --> 00:24:02.103
And then finally, finally.

00:24:02.163 --> 00:24:13.789
So I hired the midwives that I had trained with as a community midwife, because I knew them, i knew their risk level was similar to mine.

00:24:13.789 --> 00:24:16.046
I knew their tone of voice.

00:24:16.046 --> 00:24:26.288
I knew if she looked at me a certain way or used a certain voice like, oh, that's it, you know, i just I knew them, i trusted them, i love them And so and they were like, yes, us too.

00:24:26.288 --> 00:24:27.744
So let's do this thing.

00:24:27.744 --> 00:24:29.404
And I wanted a home birth.

00:24:29.404 --> 00:24:35.711
I had always wanted a home birth from early in my academic career.

00:24:36.380 --> 00:24:41.451
One of the first papers I wrote for a college class was the dangers of the medicalization of childbirth.

00:24:41.451 --> 00:24:43.144
That was before there was internet.

00:24:43.144 --> 00:24:53.031
I had to do all my research like at the library, with textbooks and everything, and I was like for healthy, low risk people, it's not an illness.

00:24:53.031 --> 00:24:55.548
I also am a survivor of sexual trauma.

00:24:55.548 --> 00:25:06.671
I was like I am not going and being stuck in some weird ass gown in some weird ass bed with some strangers I don't know, putting their hands up inside of me without asking.

00:25:06.671 --> 00:25:08.526
You know like I'm not about that.

00:25:08.526 --> 00:25:14.711
So hashtag not all nurses, but a lot of them.

00:25:14.711 --> 00:25:25.471
And so it's like I'm not, i'm not willing to relinquish my bodily autonomy And I'm a perfectly capable adult who can make decisions for myself and my baby.

00:25:25.471 --> 00:25:30.010
And so I was like this is what we're doing, as long as it remains healthy and low risk.

00:25:30.279 --> 00:25:35.666
My husband was very supportive, on board, educated, i mean, as comfortable as anybody is with anybody.

00:25:35.666 --> 00:25:36.911
They love having a baby.

00:25:36.911 --> 00:25:39.648
You know, it was like okay, as long as you feel safe and cared for.

00:25:39.648 --> 00:25:47.946
And so then my due date came And I was totally that person who was like you're healthy and things are good, i wouldn't be surprised if I go early.

00:25:47.946 --> 00:25:51.885
No, so 40 weeks go by.

00:25:51.885 --> 00:26:01.963
Now we know that the average length of gestation for a first time full term baby is 10 days past your due date.

00:26:01.963 --> 00:26:03.375
That's if your dates are even good.

00:26:03.375 --> 00:26:15.809
If your dates are good and you have a really good idea of when you conceive, so you shouldn't really expect to go into labor before 41 weeks and a half ish, but also at 37, moving on toward 38.

00:26:15.910 --> 00:26:22.589
At that time I was like I don't want to hit the mark where, just because I'm old, i'm going to have to go get induced.

00:26:22.589 --> 00:26:30.243
I'm like the worst person to send for an injection, just personality wise.

00:26:30.243 --> 00:26:33.268
Finally, at like 41, 41 weeks.

00:26:33.268 --> 00:26:35.163
So she was due on like the fifth.

00:26:35.163 --> 00:26:41.970
For the record, the child did not decide to arrive until the 18th.

00:26:41.970 --> 00:26:48.571
She was born 10 minutes before we would have been 42 weeks gestation.

00:26:48.571 --> 00:27:02.010
So like on Monday of that week I start having prodromal labor And so every night I would have labor, early labor, regular.

00:27:02.010 --> 00:27:02.951
It would wake me up.

00:27:02.951 --> 00:27:03.913
It was painful.

00:27:03.913 --> 00:27:05.845
I could stay in bed, but it was.

00:27:05.845 --> 00:27:10.347
I couldn't sleep, except in between, and every morning when the sun came up it would stop.

00:27:10.347 --> 00:27:12.306
I'd be like can you get me right now?

00:27:12.306 --> 00:27:17.911
By about day three I was like I'm never going to have this baby.

00:27:19.303 --> 00:27:21.769
Can I just pause and say that's why I had an induction.

00:27:21.769 --> 00:27:29.184
You're like maybe you could have been induced, But I didn't want to find out, So I was like just give me a minute.

00:27:29.226 --> 00:27:45.210
Yeah, yeah, i was like you know, i still have time, i still have time, and so I didn't love it, but it's not like I wasn't working at the time, so I would sleep during the day, when the sun was keeping me out of labor anyway, and then every night I'd be like maybe this is the night it'll stick, and it never did So.

00:27:45.210 --> 00:27:53.931
Annoying So then it's really the moon It just wasn't the right time, I wonder I'll have to go back and look at the calendars and see what was the moon doing?

00:27:54.059 --> 00:27:59.066
Because we all know it's the moon, it's the barometric pressure, it's all the things that the earth and gravity are doing.

00:27:59.066 --> 00:28:00.449
It's all of that Working against me.

00:28:00.449 --> 00:28:00.970
It is.

00:28:02.180 --> 00:28:11.772
So you know, when you go past, especially when you're older, but really for everyone, when you go past 40 weeks, we highly recommend and the standard of care is increased monitoring.

00:28:11.772 --> 00:28:23.749
So you go for a non-stress test and you go for a BPP, and is your amniotic fluid still okay And is your baby doing the things we hope to see them do, or are they starting to like slow down?

00:28:23.749 --> 00:28:29.868
So because in that case perhaps we should just expedite this whole situation and create an exit strategy.

00:28:29.868 --> 00:28:31.180
No-transcript.

00:28:31.180 --> 00:28:44.355
I go on Thursday for my NST and BPP and everything was great except the child would not do the full body movement.

00:28:44.355 --> 00:28:47.738
I could feel her moving inside of me.

00:28:47.738 --> 00:28:49.555
I could feel her move, but it was never.

00:28:49.555 --> 00:28:53.436
When the sonographer was like measuring that And so or it wouldn't, it didn't.

00:28:53.436 --> 00:29:02.200
It's very specific about like how how big the movement is and how long, how many seconds it lasts, and it never quite met what they were looking for.

00:29:02.200 --> 00:29:12.558
And so she she got like a passing BPP, except that it was like a zero for full body movement And my midwives were like, yeah, that's weird.

00:29:12.558 --> 00:29:18.942
So we've consulted with our friend over at the hospital who was like yeah, that's weird.

00:29:18.942 --> 00:29:22.118
But also, you know, she's almost 42 weeks and 38.

00:29:22.118 --> 00:29:23.251
So really, how about?

00:29:23.251 --> 00:29:27.181
if she doesn't have her baby by Friday, she comes in for an induction.

00:29:27.181 --> 00:29:38.637
And I was like, yes, i hear you, i believe you, i agree with you, and that gives me like 36 hours to get the show on the road, like if I'm in labor before then I'll do it.

00:29:38.637 --> 00:29:43.240
So I was like, yeah, we'll make that plan, we'll do that tomorrow.

00:29:43.240 --> 00:29:47.740
It was like do another NST BPP and see how it is and then also plan an induction.

00:29:48.009 --> 00:29:50.378
So I was like, in the meantime I'm going to see my acupuncturist.

00:29:50.378 --> 00:29:51.795
A word about acupuncture.

00:29:51.795 --> 00:29:53.714
I do not care how it works.

00:29:53.714 --> 00:30:15.559
All I know is that, like I don't have to understand it with my medical background and my Western science background as a yoga therapist and practitioner, there is a whole body of knowledge that that scientific method, as we know it, does not seem to be able to assess.

00:30:15.559 --> 00:30:16.373
How about that?

00:30:16.373 --> 00:30:21.039
And I'm not trained in the Eastern methods for that assessment.

00:30:21.329 --> 00:30:34.554
All I know is that every time I went for acupuncture my nausea felt better, my whatever was going on was improved, and so the acupuncturist that I worked with she was also a certified professional midwife, and so she just was.

00:30:34.554 --> 00:30:40.499
She was like I'm done with the baby catching, but I use all that knowledge to specifically help pregnant people.

00:30:40.499 --> 00:30:45.820
And so I was like Jasmine, jasmine, i need to go in and see you.

00:30:45.820 --> 00:30:49.038
So she's like, okay, come on in.

00:30:49.038 --> 00:30:50.711
She did all.

00:30:50.711 --> 00:30:53.980
She did moxibustion, and she did like all the little things.

00:30:53.980 --> 00:31:00.161
And all I know is that night, when the pro-dramal labor started, it kept going.

00:31:00.161 --> 00:31:01.182
I stayed in labor.

00:31:01.182 --> 00:31:07.529
She even treated my husband He doesn't actually remember it, but yeah, she was like how about if I do some things to help with your stress?

00:31:07.529 --> 00:31:11.720
And he was like she did some little, whatever she did.

00:31:11.720 --> 00:31:17.878
So that time I stayed laboring, and so it was like hot diggity, this is awesome.

00:31:17.878 --> 00:31:21.880
So, okay, that was like the big hurdle to cross.

00:31:21.880 --> 00:31:24.740
And so I had my midwife come out.

00:31:24.740 --> 00:31:30.359
You know, after, like, okay, the son is up, i've stayed in labor, send Rob back to bed to get some sleep.

00:31:30.809 --> 00:31:38.776
My mom had been visiting during this time because I had invited her to be there for the birth, and then I just kept not giving birth, and so finally, she like had to go home.

00:31:38.776 --> 00:31:44.781
So she actually was like leaving and I was finally in labor, whatever.

00:31:44.781 --> 00:31:46.595
So what are you going to do?

00:31:46.595 --> 00:32:08.661
So so we had the midwives come out, so when you're doing a home birth, we didn't have to figure out, like, when to go to the birth center, right, the whole plan was like I am not leaving here in labor, you're not getting me in a car unless something is wrong, and I have requested a change of scene and society, otherwise, no, no, it is so uncomfortable.

00:32:08.661 --> 00:32:11.298
So I was still certainly an early labor.

00:32:11.490 --> 00:32:12.815
They came out assessed.

00:32:12.815 --> 00:32:13.778
I will never forget.

00:32:13.778 --> 00:32:28.059
I was totally like you know, had the lights dim and like all the nice like super labor e vibe, and she was like this is lovely And also too early for all this labor e stuff.

00:32:28.059 --> 00:32:30.044
I love them so much.

00:32:30.044 --> 00:32:44.596
It was like, just, you know it's very early, yet Just go do something else, go distract yourself, go go take walks, go do it's daytime, you don't need to be in here like huffing and puffing, like you're in the full blown labor when it's still very early.

00:32:44.596 --> 00:32:46.451
And I was like Oh, right, yeah, okay.

00:32:46.451 --> 00:32:52.497
It's like I had forgotten all the things and I was trying very hard not to midwife myself And so I was just like yes, okay, okay, cool.

00:32:53.250 --> 00:33:04.435
So I call my doula, who is one of my classmates and a very dear friend And we figure out when she's going to come, and Rob makes a quick trip to the store because I was like all I want is playing.

00:33:04.435 --> 00:33:07.779
And then we figure out a time like when is the midwife going to come back to do a check?

00:33:07.779 --> 00:33:10.971
They don't need to sit there and watch you be an early labor, it's not.

00:33:10.971 --> 00:33:17.058
It's very unusual for someone to pre-sip and be like, wow, my first baby came in three hours, you know, but it happens.

00:33:17.058 --> 00:33:20.474
But I'd already been in labor for more than three hours, so it clearly wasn't happening.

00:33:20.474 --> 00:33:24.820
So at some point they came back to administer.

00:33:24.820 --> 00:33:37.619
I was GBS positive And so they came back to administer my antibiotics and we're kind of like, okay, well, we're going to go do a couple of home visits, see a couple more people, and then we'll plan on coming back and we're probably just going to hang out here all evening until this baby comes.

00:33:37.619 --> 00:33:59.958
And I was like, yeah, okay, and so we I remember going for a walk with Alyssa, with my friends and Dula, going for a walk up and down the street and hanging out and just passing the time, having to do those annoying things like go up and down the stairs sideways to help the baby move like, which is all great And it works.

00:34:00.490 --> 00:34:06.394
But wow, now I totally get why everybody moans and groans when the Dula suggests it, because it's like I don't want to.

00:34:06.394 --> 00:34:08.599
I just want to stand here and like sway my hips.

00:34:08.599 --> 00:34:11.983
My husband was an A plus hip squeezer.

00:34:11.983 --> 00:34:15.998
Oh man, yeah, it was excellent.

00:34:15.998 --> 00:34:21.260
And I remember just taking I had a really like stupid labor pattern.

00:34:21.489 --> 00:34:26.894
If I had been in the hospital someone would have pretty quickly put me on pit to just to manage and regulate it.

00:34:26.894 --> 00:34:32.255
Not that that would have changed, i mean, it would have just regulated it.

00:34:32.255 --> 00:34:35.722
But because it was an effective labor pattern It just isn't textbook.

00:34:35.722 --> 00:34:37.250
It would have made the providers feel better.

00:34:37.250 --> 00:34:45.291
It would have made the providers feel better Like you're not just hogging a bed right, like okay, we're doing something and this baby will eventually come out, as if it wouldn't on its own.

00:34:45.291 --> 00:34:53.659
So that was another reason why I was like I do trust my body in the process and I'm very high degree appropriate assumption.

00:34:53.659 --> 00:34:57.137
And so I was like between me and the midwife, i feel confident.

00:34:57.217 --> 00:35:02.791
If something is going sideways, we're going to make the transfer, like I'm not the person who's going to argue that transfer, i will.

00:35:02.791 --> 00:35:06.701
I don't want to be an emergency transfer, anything weird.

00:35:06.701 --> 00:35:39.291
I don't want to get out of here and be in a place that's more appropriate for the change in my status, but until that time comes, or unless I ain't leaving, so in and out from the backyard, we have some awesome pictures of me like eating popsicles, standing in the backyard, swaying like just trying to pass the time, because it is ultimately, if we average again, when it's not an induction, and average 24 ish hours, it's a day of hard work, even a poo poo anybody's experience of it being like way worse than that by any means For me.

00:35:39.291 --> 00:35:49.960
I was not scared of the pain and I had excellent coping tools that were already proven because of the things I had experienced previously.

00:35:49.960 --> 00:35:59.480
So I was like I know how to help my mind deal with the biggest issue, which is like how much longer and how much more can I handle?

00:35:59.480 --> 00:36:01.389
I just don't go down that path.

00:36:01.389 --> 00:36:16.157
I was like it's one at a time And all I did was accepted that it was coming and there was nothing I could do about it, and I would count up to 10 and then back down to zero And by the time I was done so was the contraction.

00:36:16.289 --> 00:36:22.615
I just lengthened it as the contractions got longer, but that way it was like okay, that one's done.

00:36:22.615 --> 00:36:27.141
That was my primary coping tool was just like oh okay, here it comes.

00:36:27.141 --> 00:36:30.059
And then I would count and get pissed at people if they try to count with me.

00:36:30.059 --> 00:36:31.313
I was like I do know how to count.

00:36:31.313 --> 00:36:38.295
I get so mad Like you're messing up my flow, shut it Shut up, shut up, shut up, shut up shut up.

00:36:39.489 --> 00:36:43.181
So at some point I was like I have been awake for a very long time.

00:36:43.181 --> 00:36:45.297
It was probably like two in the afternoon or something.

00:36:45.297 --> 00:36:46.554
I was like I'm going to go lie down.

00:36:46.554 --> 00:36:54.900
And so everyone did the appropriate thing, which was have the conversation with me about how, if I lie down now, things might slow down.

00:36:54.900 --> 00:36:59.094
And I was like I don't give a fuck, i am tired.

00:36:59.094 --> 00:37:02.157
I am talking about like a 20 minute catnap.

00:37:02.157 --> 00:37:06.170
It's not like I'm going to go and like sleep for four hours, right, like.

00:37:06.170 --> 00:37:10.117
I wasn't that kind of tired, i just needed to like, i just needed a little downtime.

00:37:10.690 --> 00:37:18.538
So I remember I went and laid down on we had a futon, like in a sunny office room, and I laid down on the futon just to like rest.

00:37:18.538 --> 00:37:28.119
And then Rob came in and he spooned up behind me and like gave me a snuggle And I had this surge of oxytocin.

00:37:28.119 --> 00:37:30.438
I felt the huge contraction.

00:37:30.438 --> 00:37:41.028
I heard a pop and was like my water brush And I love that story, clooney, snuggle with your you know, sweet, supportive person.

00:37:41.028 --> 00:37:45.565
I just it was like so amazing to actually experience that process.

00:37:45.815 --> 00:37:59.048
It was like feeling loved, held, safe, bonded, and then, bam, water broke You were 42 weeks And it wasn't very much water, like she just went bloop and plugged it, but it was clear.

00:37:59.048 --> 00:38:01.298
Exactly, there wasn't a whole lot left.

00:38:02.135 --> 00:38:08.121
My BPP but, my FI was fine, just to be clear, and she wasn't a big baby.

00:38:08.121 --> 00:38:11.422
So she just kind of went bloop and settled down in there.

00:38:11.422 --> 00:38:14.378
I know she just plugged it, i guess Thankfully it wasn't, it wasn't.

00:38:14.378 --> 00:38:15.059
There was no Mac, you know.

00:38:15.059 --> 00:38:16.945
It was like, hey, well, we're just going to keep doing this.

00:38:16.945 --> 00:38:23.744
But then of course, as you would expect, things picked up And so now it's like a better labor pattern, more effective.

00:38:24.375 --> 00:38:34.697
I have not had a cervical check since earlier because it doesn't do anything And I was like A I want your hands up inside of me, i love you And I do not give you permission.

00:38:34.697 --> 00:38:38.284
B I am a trained midwife.

00:38:38.284 --> 00:38:45.686
I already know that it's not necessary and it's not going to change the plan And you can tell that things like there is a labor pattern, it is shifting.

00:38:45.686 --> 00:38:50.367
I said they offered to check me at some point.

00:38:50.367 --> 00:38:53.043
I was, i think, at this point I was like laboring in the tub.

00:38:53.454 --> 00:38:54.701
I did not want to have a water birth.

00:38:54.701 --> 00:39:10.420
I had a wonderful like soaking tub but the edge of the tub was like an inch And, having attended many water births, i was just picturing my poor midwife trying to hang over that tub And I was like, no, and it's so hard, nobody wants to get out of the tub.

00:39:10.420 --> 00:39:15.996
I was like it must feel so nice to stay in that tub And then it's just full of blood Like ew.

00:39:15.996 --> 00:39:19.360
I didn't want to And so I was like I will labor in the tub.

00:39:19.360 --> 00:39:27.021
And then I want I like I know where I want to have my baby And I was like I will labor in this room that I have created, the first thing done The guest bedroom.

00:39:27.155 --> 00:39:30.059
It was like that was the room So that way we could trim.

00:39:30.059 --> 00:39:34.722
Yeah, i mean well, well, that too.

00:39:34.722 --> 00:39:37.237
Yeah, it was like, and I mean I wasn't ruptured yet.

00:39:37.237 --> 00:39:39.382
But when they initially were like do you want to be checked?

00:39:39.382 --> 00:39:42.898
And I was like no, but then yeah, so it was like do you at some point?

00:39:42.898 --> 00:39:45.304
they're coming like regularly, things are good.

00:39:45.954 --> 00:39:52.865
It's been, i don't know because I wasn't paying attention, because I was trying not to midwife myself however many hours, and they're like do you want us to check you?

00:39:52.865 --> 00:39:59.172
And I looked at her and I said the funniest part of this story is that I am.

00:39:59.172 --> 00:40:08.963
I thought I only imagined saying all of these words, but I actually came out of my like you know, between contractions kind of stage and I looked at her and I was.

00:40:08.963 --> 00:40:12.541
I said very coherently no, i do not want you to check me.

00:40:12.541 --> 00:40:16.365
You know, if you check me right now and I'm only four I will die right now.

00:40:16.365 --> 00:40:18.342
I do not want to hear that.

00:40:18.342 --> 00:40:20.824
I would rather not know and just keep doing things.

00:40:20.824 --> 00:40:25.864
When I have a spontaneous urge to push, then we can check and make sure and then we'll proceed.

00:40:25.864 --> 00:40:27.007
But no, i don't want to know.

00:40:27.007 --> 00:40:29.001
I don't want to know what my cervix is doing right now.

00:40:29.001 --> 00:40:31.181
And they were like okay, because nothing was wrong.

00:40:31.181 --> 00:40:32.818
There wasn't anything that was like.

00:40:32.858 --> 00:40:57.722
But so the, the, the, the takeaway from that, clinically speaking, is also I had seen so many people lose their hope when they're on hour 20, you know, and they get checked and they're like maybe I'm nine you know especially people who haven't done it before or been to any births like they don't know about transition, right, so they're like maybe I'm at least a seven, i'm eight, i've got to be close.

00:40:57.722 --> 00:41:08.648
And if they have in their mind like this many hours should have resulted in this many centimeters, and your body doesn't have an algorithm like that, it doesn't.

00:41:08.648 --> 00:41:18.896
And so even if we as clinicians have a concept of an algorithm, we would like to see so many centimeters of change over so many hours of labor, depending on if you've done this before or not.

00:41:18.896 --> 00:41:21.204
Your body didn't get the manual.

00:41:21.204 --> 00:41:31.867
And so I've seen people who are having a perfectly normal course of labor and everyone is well and fine, just lose all hope and change their plans because they lost hope.

00:41:31.867 --> 00:41:36.826
And then it could be that you're seven and within an hour I've seen that have pushed a baby out.

00:41:36.826 --> 00:41:37.675
We also can't.

00:41:37.675 --> 00:41:43.670
It doesn't mean it will take 10 more hours to go, right, yeah, right, it could go so fast.

00:41:43.670 --> 00:41:49.141
So I was like, no, because I'm doing well and I'm coping well, and that's a thing I just don't.

00:41:49.141 --> 00:41:50.184
I don't want that.

00:41:50.184 --> 00:41:52.382
That is not information I require.

00:41:52.382 --> 00:41:57.764
And so they were like, yeah, okay, at some point it must have gotten to be like maybe around 1030 or something.

00:41:57.764 --> 00:41:58.485
So that's nighttime.

00:41:58.485 --> 00:42:00.822
My husband has made coffee for everybody.

00:42:00.822 --> 00:42:01.858
I love coffee.

00:42:01.858 --> 00:42:08.126
And also I was in labor And so two or three people came upstairs with coffee mugs, steaming coffee.

00:42:08.146 --> 00:42:09.619
You know the smell of coffee.

00:42:09.619 --> 00:42:12.983
And I did that thing where I was like falling asleep between contractions.

00:42:12.983 --> 00:42:17.525
I smelled the coffee and was like it smells like fucking coffee.

00:42:17.525 --> 00:42:26.614
And whoever had like walked into the bathroom like I hate it, i hate the smell of coffee, it's.

00:42:26.614 --> 00:42:29.507
I was so mad because it smelled so bad to me.

00:42:29.507 --> 00:42:33.947
Yeah, it's just gross.

00:42:33.947 --> 00:42:39.121
Yeah, they were just like, oh, yep, she's, she's probably transitioning now because she's mad.

00:42:39.121 --> 00:42:53.438
And then at some point I totally did the thing where you're like in between contractions, i love the endorphin rush in between contractions, i love that, like it's a lot of hard work.

00:42:53.438 --> 00:42:59.864
And you're like, wow, i really would love to be done And also clearly I'm not done yet, so let me suck it up for another contraction, just one at a time.

00:42:59.864 --> 00:43:05.875
But then the after is like oh here, let me give you a little something to help you deal until the next one.

00:43:06.076 --> 00:43:07.961
When you're laboring in a functional place.

00:43:09.014 --> 00:43:10.240
When it's a functional labor pattern.

00:43:10.240 --> 00:43:14.403
So again I want to acknowledge that not everybody experiences that.

00:43:14.403 --> 00:43:19.608
Yes, when you're safe, feeling home and loved and things are, you know.

00:43:19.608 --> 00:43:33.923
So I'm in my tub with my peeps not in the tub with me, but like around me, you know, not drinking coffee near me anymore And I go.

00:43:33.923 --> 00:43:36.168
I was like everybody they did that.

00:43:36.168 --> 00:43:37.048
They totally froze.

00:43:37.048 --> 00:43:42.126
I'm like listening and looking at me and then I'm like it's time to get out of the tub.

00:43:42.126 --> 00:43:50.961
So over the course of a couple of contractions we get my very pregnant self And I'm like okay, you can check me.

00:43:50.961 --> 00:43:54.744
So that was the only time I laid on my back the whole labor.

00:43:54.744 --> 00:44:02.248
So now it's probably like it must have been around 1120 or so because I only pushed for 20 minutes.

00:44:02.248 --> 00:44:04.961
So we probably around maybe 11.

00:44:04.961 --> 00:44:06.244
Spontaneous urge to push.

00:44:06.244 --> 00:44:21.282
We start getting me out of the tub onto the guest bed because I wanted to keep our bedroom all night, because that's where we quote unquote transferred to after two hours in the bedroom, So we my postpartum room was my own bedroom.

00:44:24.597 --> 00:44:27.016
That's right Across the hall.

00:44:27.016 --> 00:44:35.778
So they checked me and I was like, oh my God, this is, this is the worst position, this is horrible.

00:44:35.778 --> 00:44:42.047
How like, just get what you need and get out, because I cannot stand being in this position.

00:44:42.047 --> 00:44:46.682
And so, and they did, and everything was great No interior lip, no, no shenanigans.

00:44:46.682 --> 00:44:47.719
It was like, okay, great.

00:44:47.914 --> 00:45:00.898
So I pushed on hands and knees That was just how I ended up and what felt really good And I pushed dear listeners, i love you all And it's not a competition What I'm about to say.

00:45:00.898 --> 00:45:03.445
You can't set a goal like this because it's not in your power.

00:45:03.445 --> 00:45:07.706
I pushed three times over approximately 18 to 20 minutes.

00:45:07.706 --> 00:45:09.701
That's just how it was for me.

00:45:09.701 --> 00:45:14.204
So it helps that I got these good birthing hips.

00:45:14.204 --> 00:45:26.659
Apparently It helps that, even though my baby was an old baby like I totally had an old lady baby with long ass fingernails, like she was all wrinkled and peeling and like old baby She was small.

00:45:26.659 --> 00:45:34.286
She was like six pounds, six and a half ounces And, for the record, my husband is like five, eight and I am five, two and a half.

00:45:34.286 --> 00:45:49.302
We did not expect to have a ginormous baby, but at her gestational age she almost was small enough that we would have had to actually go to the hospital after she was born for low for gestational age size Cause, like a half an ounce or something, and we would have been screwed.

00:45:49.302 --> 00:45:52.181
So so she just wasn't.

00:45:52.181 --> 00:45:56.016
She was not a chunky monkey, she was not a big kid, she.

00:45:56.157 --> 00:46:03.960
I pushed real hard in a position that worked really well for me and I had like zero inhibitions about who was looking.

00:46:03.960 --> 00:46:12.538
No one was going to come walking in the room, what noise I was making, like what was coming out, right, like I didn't care.

00:46:12.538 --> 00:46:17.844
I'd see, i'd already been at so many births and so I wasn't afraid.

00:46:17.844 --> 00:46:23.246
You know, and I had seen plenty of many times in the out of hospital setting.

00:46:23.246 --> 00:46:26.182
It's not the norm to require a repair.

00:46:26.182 --> 00:46:29.724
It happens, but most of the time we don't need it.

00:46:29.724 --> 00:46:35.237
And so I just wasn't, like I wasn't worried about if I tear they'll fix it, and also I just wasn't.

00:46:35.237 --> 00:46:37.043
Those weren't the things I was worried about.

00:46:37.795 --> 00:46:54.646
So well, i guess, after maybe the third push, so maybe it was a total of four And my husband God bless him He's just, like you know, standing back there like for 20 minutes, being like I'm ready, because he was going to be the initial hands on her And at some point my midwife goes, just go ahead and push your baby out.

00:46:54.646 --> 00:46:58.585
And I was like, oh fuck, i don't know what she saw I do now.

00:46:58.585 --> 00:47:02.264
But at the time I was like, oh, that was the change Beast mode.

00:47:02.264 --> 00:47:06.717
And so I was like, okay, and so I did.

00:47:06.717 --> 00:47:11.706
I was like I don't know what's going on, but if she needs out, she's getting out.

00:47:11.706 --> 00:47:15.784
And again it worked out that that was something I was able to do.

00:47:16.594 --> 00:47:21.166
I remember the sound that came out of me, thinking that I sounded like a train.

00:47:21.166 --> 00:47:33.505
And it was again almost midnight And I was like I wonder if the neighbor heard that we live in a city, you know, it was like, like, just like, so loud, like a train.

00:47:33.505 --> 00:47:40.027
And I remember the feeling of the head during a fire the head, oh my God, the head right, and the head's out.

00:47:40.027 --> 00:47:50.427
And you're like, okay, well then, what we do out of the hospital, but also the CNL It's called the baby out, it's this novel Yank a pen, no The next contraction will birth the body.

00:47:50.655 --> 00:47:52.460
I don't have to pull the baby out.

00:47:52.460 --> 00:47:59.199
It is, oh my God, no, like it's still fine, it's attached to the placenta.

00:47:59.199 --> 00:48:01.485
As long as the placenta is still attached to her, good.

00:48:01.485 --> 00:48:03.059
So you know.

00:48:03.059 --> 00:48:04.155
So of course we're watching.

00:48:04.155 --> 00:48:06.186
It's not like you just say oh, whenever it's going to happen.

00:48:06.266 --> 00:48:15.539
But I remember it being like it didn't take long for the rest of her to come out and it felt the way I describe it It's like a bowl of spaghetti somehow, but like with the biggest noodles in the world.

00:48:15.539 --> 00:48:20.141
But it was like after the head, it was just like like everything else does.

00:48:20.141 --> 00:48:28.480
It was so such a weird feeling, and so she had a really short cord.

00:48:28.480 --> 00:48:31.498
So here's all these things that can happen in retrospect.

00:48:31.498 --> 00:48:42.501
She had a very short cord And that's that perhaps why we needed days and days of pro-dromal labor just to like help somehow shift her down a little bit more.

00:48:42.590 --> 00:48:45.739
It was like she couldn't quite cause the the effacement.

00:48:45.739 --> 00:48:51.262
She just took a really long time for her to apply to the cervix and start getting things going.

00:48:51.262 --> 00:49:04.733
And I wonder if my placenta was funnal, so maybe she just didn't really have the length that would have made it easier for her to do that quickly, and so it was like a little bit over, honestly, that part I don't know.

00:49:04.733 --> 00:49:23.797
But she, so she had a short cord and the placenta kind of practically just fell out after her, and so what the midwife told me after the fact is in her many, many years of practice it was the bloodiest birth that she had seen.

00:49:23.797 --> 00:49:27.873
And this is where, like my husband standing back there, he's like I just thought birth was bloody.

00:49:27.873 --> 00:49:31.255
When you look at pictures of me holding her.

00:49:31.617 --> 00:49:33.481
I'm like no, it's never that.

00:49:33.829 --> 00:49:36.434
It's not no, that was no.

00:49:36.434 --> 00:49:46.996
I think, yes, yes, yep, i think that what happened was there was a gush of separation, and that's when she was like it's you need to push it out.

00:49:47.016 --> 00:49:48.097
Make this happen now, right.

00:49:49.489 --> 00:49:53.804
Like, not that I wasn't, but it was like, yeah, go ahead and get your baby out was how she put it.

00:49:53.804 --> 00:49:55.110
Go ahead and get your baby out, like now, yeah.

00:49:55.110 --> 00:50:04.380
And thankfully I was able to because retrospectively probably I had a partial abruption because again there was no like let's wait around for the placenta to come.

00:50:04.380 --> 00:50:08.778
It was sort of just like plop, if she was out, it needed to come pretty soon.

00:50:08.778 --> 00:50:15.878
It was short enough that when I knelt back up I was on hands and knees and when I knelt back up I could only lift her to my belly button.

00:50:15.878 --> 00:50:17.456
And again, she wasn't a long baby, right.

00:50:17.456 --> 00:50:19.396
So they were like cord, cord, cord, cord, cord.

00:50:19.396 --> 00:50:22.452
I was like, okay, we managed.

00:50:22.452 --> 00:50:30.980
My doula, thankfully, took a little bit of a video I hadn't arranged for, like pictures and videos and stuff, cause again I was like I don't need no strangers up in here messing with my vibe.

00:50:30.980 --> 00:50:47.322
So my doula and friend Alyssa, she took like this beautiful little video of both of us crying, right, we didn't know if it was a boy or a girl, and so Rob laughing and looking around, crying, laughing, and he's like is it a boy or a girl?

00:50:47.322 --> 00:51:11.016
And they were like we don't know, you have to check And I lift her away as a little bit that as I could to look and I was like it's a girl And we both are like first and wholehearted subs of relief that it was done, that everyone was safe and that also, i think, secretly we hoped for a girl but honestly, after everything we'd been through, we didn't want to know the sex cause.

00:51:11.016 --> 00:51:11.559
We didn't care.

00:51:11.559 --> 00:51:13.637
I was like it's a baby, it just needs onesies.

00:51:13.637 --> 00:51:20.778
I don't care about the clothes or anything that people care about, i just want the baby to come out eventually.

00:51:20.778 --> 00:51:30.918
And then it was just all the gentle things of like cut the cord and help her with her first latch And you know, in a home birth they've got like these sweet little.

00:51:30.918 --> 00:51:34.557
We use a fish scale So you hold the fish scale up and you put the baby in.

00:51:34.557 --> 00:51:40.878
So you've got all the little pictures of like her little foot sticking out of the fish scale and the dog like sniffing it.

00:51:40.878 --> 00:51:51.702
She's just like at the foot of the bed and I like getting ready to get her little newborn exam and I'm like rubbing her head with my foot because I'm just we're just in our bed.

00:51:51.849 --> 00:51:59.007
I remember one of the first things once that initial haze passes and you get that elation right And they're like whoa.

00:51:59.007 --> 00:52:01.898
And I was like can I have a sandwich?

00:52:01.898 --> 00:52:03.936
Like I don't know, i'm a sandwich.

00:52:03.936 --> 00:52:05.934
Someone brought me the most amazing sandwich I've ever had.

00:52:05.934 --> 00:52:06.876
I don't even remember what it was.

00:52:06.876 --> 00:52:08.159
It came from my own refrigerator.

00:52:08.159 --> 00:52:09.001
It's probably nothing.

00:52:09.001 --> 00:52:10.896
It's probably like butter and bread Totally.

00:52:10.896 --> 00:52:12.635
I was like I don't know what my like.

00:52:12.989 --> 00:52:37.449
And then it was like okay, usually, assuming everyone is stable, which again the expertise of the community midwife in particular, but I would say midwives in general, but especially those who scope is really just healthy, low risk birth is constantly assessing to rule out anything that's not low risk or healthy so that you can make a transfer before it's an emergency, right, like.

00:52:37.449 --> 00:52:39.175
That's the point as far as I can.

00:52:39.175 --> 00:52:42.878
There are people who specialize in not healthy and not low risk.

00:52:42.878 --> 00:52:50.302
The difference is medicine says you can only determine that it was a healthy, low risk pregnancy retrospectively.

00:52:50.302 --> 00:52:56.500
And midwives say really, i think that you can actually look at this situation right this minute.

00:52:56.500 --> 00:53:06.735
You can't say it will continue to be healthy and low risk, but you can assess them right now, all the factors that we are able to reasonably assess, and you can say at this moment, they are still appropriate for my care.

00:53:06.735 --> 00:53:13.041
It is a healthy, low risk pregnancy and still considered appropriate for out of hospital birth.

00:53:13.041 --> 00:53:24.701
There's nothing pathological happening here, and so that difference in worldview is what makes all the difference in then the experience for the birthing person, but also everyone who's attending them.

00:53:25.269 --> 00:53:28.114
So I mean, then it was just like she latched.

00:53:28.114 --> 00:53:32.523
We snuggled up in our bed all three of us.

00:53:32.523 --> 00:53:39.900
Oh, my gosh, i know, but they showed us it was like all the things to have, like a safe landing pad.

00:53:39.900 --> 00:53:42.117
We already had the mattresses on the floor.

00:53:42.117 --> 00:53:47.271
It was like you just put her here, no pillow, don't let the blankets go up around her face, it just.

00:53:47.271 --> 00:53:50.074
She's right here, i'm not compromised.

00:53:50.074 --> 00:53:57.760
So it was the best sleep of our lives and the last good sleep in the last nine years.

00:53:57.760 --> 00:54:04.777
Not really, it's gotten better in the last couple of years, but she's not a really great sleeper for a long time.

00:54:04.777 --> 00:54:05.840
She's not there yet.

00:54:05.840 --> 00:54:10.318
No, it was until she was like six or seven that she pretty consistently slept well.

00:54:11.230 --> 00:54:13.976
That's been our situation, and I have a four year old, so we've got a way to go.

00:54:14.016 --> 00:54:16.661
It's a long time It is, but it just is that thing.

00:54:16.661 --> 00:54:28.262
I remember working in the hospital and being like they can't get that period of rest because we moved them at two hours and then the postpartum unit they're just like checking and that's what they have to do.

00:54:28.262 --> 00:54:30.757
Like that is the compromise you make when you go to the hospital.

00:54:30.757 --> 00:54:32.355
You do not rest in the hospital.

00:54:32.355 --> 00:54:43.893
I don't know why anybody ever suggested hospitals or places for rest, because they aren't, and most of the time postpartum that's the number one thing you need is rest and privacy and safety.

00:54:43.893 --> 00:54:59.525
And you get safety in a variety of ways, but you don't get privacy and you don't get rest because they have to check you and your baby according to hospital protocol And so you don't get that chunk, that last, final chunk of like.

00:54:59.525 --> 00:55:08.056
Everyone goes to sleep five-ish hours and then you wake up and the rest of your parenting life begins, sometimes when I come off the elevator, the mom and the wheelchair.

00:55:08.077 --> 00:55:11.255
I'm like, okay, And now we are walking into your new life.

00:55:11.275 --> 00:55:15.438
Yeah, it's like the door's open and everything's changed.

00:55:15.438 --> 00:55:16.572
It's just like now.

00:55:16.572 --> 00:55:17.135
It's all you.

00:55:17.135 --> 00:55:21.380
You know you get a few hours here, relatively speaking, and then it's just all you.

00:55:21.380 --> 00:55:50.963
I think with an out-of-hospital birth, you already have the sense that it's all you, because the whole premise of the care is that it's always client-centered from the very beginning, and informed decision-making, a shared decision-making, and like helping people figure out what they want, what their goals are, what they need, and so you, throughout the course of your care, have this sense of I'm in charge of this And at no time or I mean there are certainly our clients who are like just tell me what to do.

00:55:51.405 --> 00:55:56.195
You're kind of like well, Well, but you don't have to go to another room with another patient.

00:55:56.277 --> 00:55:59.842
Yeah, Yeah, all that stuff.

00:55:59.842 --> 00:56:03.952
Yeah, there's no like I'm going to do this now And I'm going to do, or we're going to.

00:56:03.952 --> 00:56:07.221
It's like do you want, do you need?

00:56:07.221 --> 00:56:12.480
it's a question instead of a like sharing information about what's next.

00:56:13.101 --> 00:56:17.074
It's like And not documenting on the script and not doing all the extra stuff.

00:56:17.074 --> 00:56:22.021
Yeah, yeah, wow, okay, i know I have some follow-up questions for you, okay, I'm ready.

00:56:22.021 --> 00:56:32.059
I'm going to be a little relevant, because your baby probably just kind of made her way into the world with, like you said, about 20 minutes, not a whole lot of pushing.

00:56:32.059 --> 00:56:34.858
But what was it that clicked you into being able to push?

00:56:34.858 --> 00:56:37.949
Was it your years of experience and helping moms figure it out?

00:56:37.949 --> 00:56:41.195
Was it the feeling that you like the how?

00:56:41.235 --> 00:56:42.237
to push Yeah.

00:56:42.257 --> 00:56:43.840
Yeah, Yes, Like how.

00:56:43.840 --> 00:56:45.262
Where did you get those muscles?

00:56:45.262 --> 00:56:46.907
How did you coordinate all?

00:56:46.947 --> 00:57:13.380
that This is an interesting question, i know in the hospital we often are like and actually this happens a lot of times out of hospital we are like the first little while it's not that it doesn't count, but the pushing is often so ineffective until somehow they get the hang of it, whether through some verbal coaching or maybe some careful placement of fingers in the vagina to press on that spot in the posterior wall, to be like do you feel this pressure aimed toward that?

00:57:13.380 --> 00:57:28.023
I think because I had already spent so much time at births with people helping them visualize the curve of carouss and being like okay, so you, you push into this point, sort of ish.

00:57:28.023 --> 00:57:30.217
I mean it's like how do you do that?

00:57:30.217 --> 00:57:33.992
It's like saying breathe into your belly, please don't, that's not a thing.

00:57:33.992 --> 00:57:40.280
But like, your belly rises So, um, push into that, because that's what helps them get under the pubis, right.

00:57:41.170 --> 00:57:44.760
So I think the combination of I knew the anatomy and physiology as a clinician.

00:57:45.110 --> 00:58:00.304
I also had already 20 years of yoga practice under my belt, so I had a really good sense of like you know, lift only your pinky toe like that degree of controlling my body and being able to feel and fiddle with things and probably some amount of luck.

00:58:00.304 --> 00:58:03.559
It just I don't like the instruction to push like it's a poop.

00:58:03.559 --> 00:58:13.992
I've I've read quite a bit about how that can injure your pelvic floor And so I had already been for many years giving a pelvic floor before there was so much interest in pelvic floor PT.

00:58:13.992 --> 00:58:26.219
It was sort of left to like yoga teachers, like postpartum yoga teachers, to be like let's relearn pelvic floor stuff right And help people in their postpartum, like mommy and me yoga classes.

00:58:26.219 --> 00:58:38.981
So I also had that sense of what can happen if you push in that kind of way and had read quite a bit, in order to be a better provider, about how to like teach people to push effectively.

00:58:38.981 --> 00:58:47.219
So I think in the moment I wasn't processing any of that, i just pushed the way I had learned to teach people to push.

00:58:47.541 --> 00:58:48.583
So can you share with us?

00:58:48.583 --> 00:59:04.260
I mean cause, here's the thing, like I had never dealt with both, i don't think that I pushed like I was pooping, but then I was told I was pooping And so therefore I was pushing effectively, just based on the anatomy of how your baby goes through.

00:59:04.260 --> 00:59:09.398
You may not be pushing like you have to poop, but you push out the poop Because that's where the poop is.

00:59:09.398 --> 00:59:13.233
Yeah, so, but I've been, i've been the neighboring tube.

00:59:13.695 --> 00:59:16.150
Yeah, exactly, it's like.

00:59:16.150 --> 00:59:26.103
It's like it's like squeezing toothpaste out of it, like if you start here and you squeeze it down, it will come out unless you cap it, yeah, and don't cap it, because then your baby won't come out Come out a different direction.

00:59:26.123 --> 00:59:27.344
It will come out one way or the other.

00:59:27.389 --> 00:59:37.521
Also it'll come out somewhere else and you don't want it to come out, yeah, so I feel like when I had, i was epiduralized with both, but I could feel kind of a little bit with the first.

00:59:37.521 --> 00:59:42.418
Yeah, i was shortening that area and maybe it was because I had a Pilates teacher.

00:59:42.418 --> 00:59:46.597
I was shortening the area between my pubic bone and my belly button.

00:59:46.597 --> 00:59:50.648
Okay, yeah, yeah, and I don't think I puke, i don't really think I poop like that.

00:59:50.648 --> 00:59:52.514
I don't know.

00:59:53.972 --> 00:59:56.237
I mean ideally you don't have to push to poop anyway.

00:59:56.237 --> 00:59:57.097
I feel my poop right now.

00:59:57.117 --> 00:59:57.780
Right Like.

00:59:57.780 --> 01:00:00.164
That is not the life I live.

01:00:00.164 --> 01:00:01.456
That's a whole other conversation.

01:00:01.456 --> 01:00:04.068
perhaps The joy of the squatty?

01:00:04.090 --> 01:00:06.155
time We might need to talk about supplements.

01:00:06.155 --> 01:00:07.739
If that, let's talk about fiber.

01:00:09.056 --> 01:00:10.887
If you've got some ideas on how we can.

01:00:10.887 --> 01:00:16.614
Yeah, yeah, ideally you don't push to poop, so I mean there's the argument that you shouldn't.

01:00:17.697 --> 01:00:19.059
My kids were mal-positioned.

01:00:19.099 --> 01:00:22.954
Yeah, oh yeah, they only have some nerve damage there.

01:00:22.954 --> 01:00:26.541
Yes, yeah, anyway, which also makes pushing harder.

01:00:27.230 --> 01:00:28.235
But it sure does.

01:00:28.235 --> 01:00:34.382
But if someone's pushing, fine and pushing like they want to poop is the way that it's going and whatever, i'm not going to mess with that.

01:00:34.382 --> 01:00:39.356
But what I do tend to say is pretend you have a spring between your belly button and your pubic bone and shorten that spring.

01:00:39.356 --> 01:00:42.054
And that's where your push is, because you're not pushing from up here.

01:00:42.054 --> 01:00:45.998
Right, you're curling around your baby and trying to inject.

01:00:45.998 --> 01:00:47.755
It's like an ejection seat.

01:00:47.755 --> 01:00:50.396
You're injecting that thing from your body, you are.

01:00:50.717 --> 01:00:51.721
But if you have a different.

01:00:51.721 --> 01:00:58.155
Well, i would say one thing is like yes, if you're in a supine position, that makes a lot of sense.

01:00:58.155 --> 01:01:01.996
Yes, right Like, how are you going to get someone who's laying on their back, where I was both times?

01:01:01.996 --> 01:01:08.402
Yeah, so when you're up, yeah, because I've also I've caught babies from people standing up, right Like, oh yeah me too.

01:01:08.481 --> 01:01:10.764
I have no idea how that worked, but I mean I do.

01:01:10.764 --> 01:01:12.764
It seemed to work out a lot better.

01:01:12.784 --> 01:01:27.317
Yes, But So I think there's One thing I would say is that when people don't have an epidural, because you have So much feedback, not just pressure, but like there is so much information that your body is giving you, there's not a ton of instruction.

01:01:27.317 --> 01:01:42.744
That usually needs to happen unless during an assessment we're like we can tell this baby's catawampus, So we can tell they're in malposition and we ought to do something a little different.

01:01:42.744 --> 01:01:48.896
And then it's mainly just like not push differently but be in a different position to facilitate that movement in the pelvis Right.

01:01:48.896 --> 01:01:59.961
So when you're upright, like same thing, if someone is kind of in the throne position right, Like if they stay kind of squatting, you don't necessarily have to curl Right.

01:02:00.849 --> 01:02:11.498
It's more just adjusting the pelvis, it is a lot Like feeling the And that's usually what I try to do with people anyway Yeah, because it's like your baby is going to come through somehow.

01:02:11.498 --> 01:02:17.797
But you got to kind of like just move it around until that head is just like down enough that it's just gonna come out.

01:02:17.817 --> 01:02:22.364
Yeah, and then it's a matter of like You got to be able to curve and do the Yeah, because you also need.

01:02:22.364 --> 01:02:26.277
I mean, we also have to put a fair amount of responsibility on the fetus.

01:02:26.277 --> 01:02:29.653
The fetus also has work to do, right, they have to tuck their Right.

01:02:29.653 --> 01:02:35.873
Well, assuming they're positioned properly, they need to tuck their chin, and that can take them a little while.

01:02:35.873 --> 01:02:43.527
That doesn't necessarily have to do with the pushing, because I think the other thing is I'm not an advocate for, like, never push by any means.

01:02:43.527 --> 01:02:57.119
Because there's a spontaneous urge to push for reasons right, right, but also it doesn't have to be like for a certain You're complete, let's push, yeah, and it definitely shouldn't be purple pushing And you don't, yes.

01:02:57.119 --> 01:03:09.612
The things that we as a society learned needed to be done when people were being given whatever, i was gonna say ether, but not that, because then they weren't following any instructions, whatever they gave.

01:03:09.652 --> 01:03:12.338
Whatever they gave, they would have just come out Right Right.

01:03:12.338 --> 01:03:13.380
But think about that.

01:03:13.380 --> 01:03:26.253
They weren't doing force ups and all kinds of awfulness on the regular, not for just cause, but nobody was pushing, they weren't adding that force, they already Their body was just doing it.

01:03:27.371 --> 01:03:29.496
And babies are delivered to people that are unconscious.

01:03:29.536 --> 01:03:29.777
Yes.

01:03:30.378 --> 01:03:30.880
Exactly.

01:03:31.911 --> 01:03:35.335
Or paralyzed, right, they can also have a baby.

01:03:35.335 --> 01:03:36.855
They're not adding force.

01:03:36.855 --> 01:03:45.003
So adding force can make it more efficient, we could say, but it's not really required.

01:03:45.003 --> 01:03:52.916
But yeah, because they don't have And they have no spontaneous urge to push And if they feel some pressure they still need you to help guide them.

01:03:52.916 --> 01:03:55.442
You go with that, right, yeah, right.

01:03:55.442 --> 01:04:18.293
So in the out of hospital setting, without the epidural, the pushing just tends to be more effective anyway, because people are like I mean, probably also in the hospital, if people don't have an epidural, except even then, oftentimes they still are on their back And that very position prevents the pelvis from opening and moving in the way that it should, because you've locked the sacrum.

01:04:18.293 --> 01:04:20.639
Not my patience, right, thank you, thank you.

01:04:20.639 --> 01:04:27.760
So of course they need more help, but if, like on hands and knees, i was definitely not curling around at all.

01:04:27.760 --> 01:04:30.838
I think when people are supine, that makes sense.

01:04:31.291 --> 01:04:45.380
I can feel what you're talking about And I remember being like Curl, like when like pull Yeah The epiduralized ones, like I'll put their leg in the stirrup and turn them And I still kind of curl because, I'll be like grab onto the handlebar and like focus on that area.

01:04:46.041 --> 01:04:48.757
Yeah, Like I love the squat bar thing.

01:04:48.757 --> 01:04:53.735
The squat bar, yeah, yeah, but I think So I used kind of similar stuff.

01:04:53.735 --> 01:05:00.217
I usually tried to help people, probably because it's always so interesting It's like how different people will do the same math problem.

01:05:00.217 --> 01:05:05.342
I often would get more into like, okay, so here's what's happening inside your body.

01:05:05.342 --> 01:05:13.523
I want you to imagine your pubic bone and imagine it's like a slinky your vagina, right?

01:05:13.911 --> 01:05:27.655
And so your baby needs to get through that last part, and so if you kind of help, aim somehow toward your rectum, it can help the baby make that curve And then all it has to do is just come out.

01:05:27.655 --> 01:05:33.663
And somehow people who are willing to go with me are like, whoa, that totally works.

01:05:33.663 --> 01:05:37.693
And I'm like, shoot, yeah, and a lot of times I also I'll be like.

01:05:37.693 --> 01:05:52.675
The reason it feels like you have to poop is because your baby's head is pressing on the rectum and your rectum isn't smart And so it's just like pressure must be full of poop, and so right, if either you don't actually have any poop in there, it's just baby head squashing your rectum, but go with it.

01:05:52.675 --> 01:05:56.297
And if poop comes up, i don't care, we're going to clean it up.

01:05:56.297 --> 01:05:56.818
It's not a big deal.

01:05:56.818 --> 01:06:00.449
It's not my favorite thing in the world, obviously, and also it's part of labor.

01:06:00.690 --> 01:06:03.534
I have no feelings about poop anymore, just whatever Right, Like don't care.

01:06:04.315 --> 01:06:05.637
Poop is poop just is.

01:06:05.637 --> 01:06:06.880
I love it when it's not diarrhea.

01:06:06.880 --> 01:06:07.481
How about that?

01:06:07.481 --> 01:06:08.623
Like it's just Yes.

01:06:10.030 --> 01:06:11.550
If we're, that's a whole different topic.

01:06:11.550 --> 01:06:22.400
If you could go back and talk to yourself at the beginning of this whole birth journey, when you decided to embark on this process, what would you want to tell yourself?

01:06:22.849 --> 01:06:45.612
Well, if the technology and education I have now had been available, then I would have wanted an early dating ultrasound in my first pregnancy That would have identified right away that I had an ectopic pregnancy In my practice, if I were still doing prenatal and intrapartum, if I were still doing the baby stuff.

01:06:45.612 --> 01:07:03.340
I would recommend that And honestly it's pretty much standard because even though it's a relatively small risk to have an ectopic, the outcomes no one wins And so the sooner you identify it the better, and so much good information to get from like now we know the dates.

01:07:03.340 --> 01:07:05.293
The earlier your ultrasound, the better the dates.

01:07:05.293 --> 01:07:09.829
So, especially if you're like I don't really know when I got pregnant, fabulous You.

01:07:09.849 --> 01:07:18.077
We can just identify if this is actually something that could harm you Or if it's like, okay, things look good.

01:07:18.077 --> 01:07:23.132
Now we just have to wait and see if it stays, because we can't predict that it will end up a viable pregnancy.

01:07:23.132 --> 01:07:25.621
But we can at least say, right this minute it is viable.

01:07:25.621 --> 01:07:31.518
I would have done that And then we would have known when I started bleeding that it wasn't just a miscarriage.

01:07:31.518 --> 01:07:36.552
Yeah, mm.

01:07:38.778 --> 01:07:40.431
Mm Oh.

01:07:47.797 --> 01:08:05.034
I remember how much pain I had related to this feeling of how broken my body felt, and I would encourage my previous self to relinquish that sense of responsibility for every outcome.

01:08:05.034 --> 01:08:10.800
Most people have an early at least one, oftentimes more than one early pregnancy loss.

01:08:10.800 --> 01:08:14.559
It is hardly ever because of anything anyone did.

01:08:14.559 --> 01:08:18.659
It is almost always because of a chromosomal blip.

01:08:18.659 --> 01:08:22.775
Something was not compatible with life And so it stopped growing.

01:08:22.775 --> 01:08:26.500
The embryo dies and your body is smart and it flushes.

01:08:26.500 --> 01:08:28.332
So you can try again Your body.

01:08:28.332 --> 01:08:29.216
We're just mammals.

01:08:29.216 --> 01:08:32.297
We just want to make babies our bodies at least.

01:08:33.510 --> 01:08:35.895
But it's because of our wonderful neocortex.

01:08:35.895 --> 01:08:47.596
We love to try and problem solve and like what could I have done differently And what can I do differently going forward, and how can I make this not happen again And how can I safeguard And how can I protect And how can I And you can't?

01:08:47.596 --> 01:09:02.378
I wasn't doing anything wrong, but it feels like it when you're in the middle of it And I don't know that my now me advice would have even been well received by my then me advice, because it probably would just have felt like more bullshit.

01:09:02.378 --> 01:09:07.858
People say to help themselves feel better when you're suffering, but that's what I wish I could have done.

01:09:07.858 --> 01:09:13.676
It's a horrible thing to experience And also it's not because I'm doing anything wrong.

01:09:13.676 --> 01:09:24.278
Yeah, thank you.

01:09:24.278 --> 01:09:35.280
Great, correct, yup.

01:09:35.280 --> 01:09:37.844
Thanks everyone.

01:09:45.653 --> 01:09:58.372
The only thing that helps potentially is to remain humble and kind of want to say like fact-based, you can say I'm so sorry this is happening.

01:09:58.372 --> 01:10:01.673
That's different from I'm sorry you're having to go through this.

01:10:01.673 --> 01:10:11.556
That almost sounds like but like I was assigned it, like some kind of rewards-based program that I just got the shitty end of the stick.

01:10:11.556 --> 01:10:12.439
Like what do you mean?

01:10:12.439 --> 01:10:17.055
Like I'm sorry you're having to just say I'm sorry this is happening.

01:10:17.055 --> 01:10:20.779
Say you can say I don't know what to say.

01:10:20.779 --> 01:10:27.115
This looks very painful, like that's a fact, it looks like you're in pain and I just want you to know that I'm here.

01:10:27.115 --> 01:10:40.875
I'm just going to sit here quietly so you don't have to be alone, because all the words are just filling the space to make the speaker more comfortable and each of the words is hurting the receiver, who's already in pain.

01:10:40.875 --> 01:10:43.028
That's so much better.

01:10:43.864 --> 01:10:46.694
I would rather there's nothing.

01:10:46.694 --> 01:10:54.429
No, because, and it always just reeks of I just like it's pie in the sky, like, oh, it's going to be fine.

01:10:54.429 --> 01:10:57.913
At least I have someone tell me, at least you know you can get pregnant.

01:10:57.913 --> 01:11:00.533
That was after my at least.

01:11:00.533 --> 01:11:01.506
There's never an at least.

01:11:01.506 --> 01:11:03.713
And just shut up, right.

01:11:04.664 --> 01:11:05.948
And it was because they were.

01:11:05.948 --> 01:11:08.957
They were suffering with not being able to conceive.

01:11:08.957 --> 01:11:10.788
So to them it was like, at least you know.

01:11:10.788 --> 01:11:13.416
And I was like, yeah, but my body killed my baby.

01:11:13.416 --> 01:11:18.731
Like I mean right, i was just like, are you kidding me?

01:11:18.731 --> 01:11:25.416
right now, i also am a proponent of minding your own damn business about whether people have kids.

01:11:25.416 --> 01:11:26.618
What difference does it make?

01:11:26.618 --> 01:11:29.212
It's a way that people try to connect, right.

01:11:29.332 --> 01:11:36.134
But if someone, given how widespread fertility problems are, do you want me to answer truthfully?

01:11:36.134 --> 01:11:45.337
Because there was a period where I would look at people and say all my babies died Because I was so done with people asking me that shit.

01:11:45.337 --> 01:11:48.314
I just was like, what do you want me to tell you?

01:11:48.314 --> 01:11:50.152
I'm a mother of three dead babies.

01:11:50.152 --> 01:11:51.429
Like I didn't.

01:11:51.429 --> 01:12:03.337
I didn't even know what to say anymore, except that I felt all the responsibility that comes with knowing you have created life and also for reason then, that you weren't able to protect it.

01:12:03.337 --> 01:12:13.692
So that was like during my angry phase, which was a few years long, yes, and when you're grieving is ongoing for almost 10 years.

01:12:13.692 --> 01:12:15.886
That's a long time So.

01:12:15.886 --> 01:12:20.515
So I think a lot of it is like don't act like, you can see the future.

01:12:21.425 --> 01:12:26.851
There was one person who said something that was hopeful, that I didn't feel like slapping them, and it was super simple.

01:12:26.851 --> 01:12:40.555
It was, for what it's worth, my sister's first pregnancy was ectopic and she was able to have two healthy babies, and it was just like oh, there are people who survive this and go on to have viable pregnancies.

01:12:40.555 --> 01:12:42.225
Okay, that was like.

01:12:42.225 --> 01:12:46.770
It wasn't like and I know you will too, because that was where it always got me.

01:12:46.770 --> 01:12:47.632
I was like how do you know?

01:12:47.632 --> 01:12:50.092
How do you know that You don't?

01:12:50.092 --> 01:12:54.395
And you and you can say things like I know you're strong and this is painful.

01:12:54.395 --> 01:12:57.811
I trust you, you will somehow find your way through it.

01:12:57.811 --> 01:13:06.115
If I can help with that, please, i'm here Right, which is also different from like oh, this, this will pass and you'll be fine.

01:13:06.115 --> 01:13:11.354
Just like, this is going to be really hard, but you've managed through hard things before.

01:13:11.354 --> 01:13:16.844
Yes, yep, mm-hmm, mm-hmm, oh I'm sorry.

01:13:19.188 --> 01:13:20.350
Mm-hmm, mm-hmm.

01:13:20.350 --> 01:13:25.657
Oh yeah, which could be anybody.

01:13:25.657 --> 01:13:38.078
Yes, right, yeah, tell me about your support system.

01:13:38.078 --> 01:13:39.769
Who's going to be here with you?

01:13:39.769 --> 01:13:40.572
Who's waiting for you?

01:13:40.572 --> 01:13:41.728
Is there any?

01:13:41.728 --> 01:13:42.926
it could be your dog, like I don't know.

01:13:46.113 --> 01:13:46.454
Mm-hmm.

01:13:49.030 --> 01:14:22.427
Yeah, mm-hmm, yeah, yeah, yeah, yeah, yeah, yeah, yeah, ugh, yeah, yeah, they're just waiting for you to stop talking.

01:14:22.427 --> 01:14:29.766
Yeah, yeah, yeah, yeah, yeah.

01:14:33.864 --> 01:14:34.025
Mm-hmm.

01:14:38.426 --> 01:14:51.713
Yeah, i think one thing I've said to people as someone who's experienced these things as well is but also I think anyone just working in the field we work in could say this is I remember one specifically because I saw her twice.

01:14:51.713 --> 01:15:29.824
So the first time was supporting her through a loss And the second time was like a year and a half or two years later with a full term, healthy delivery And so and I got to help her with that And so we were like we were meeting again under different circumstances, But I remember, you know, she commented on remembering what I had told her when I wheeled her out after the loss And I was like we had spent a few days together, so she knew a little bit of that at least, that I had experienced loss as well, and I was like I'm really sorry that now you share this experience.

01:15:29.824 --> 01:15:36.636
It's very lonely, but you are not alone And there's support from other people who've been through it.

01:15:36.636 --> 01:15:52.774
There's support for your partner, because he also has to process his experience, but that you can feel so lonely in your grief that you lose sight of the fact that A you're not the only one to happen to.

01:15:52.774 --> 01:15:54.041
This isn't what I tell people.

01:15:54.041 --> 01:16:10.470
I'm telling you right, and the listeners like A it did happen, not the whole family, it didn't just happen to you, and also that it's happening to hundreds, thousands I don't know, hundreds of thousands of people today, right now around the world And so lonely but not alone.

01:16:10.864 --> 01:16:44.864
This is a horrible club to be part of, but it's also a very large one, and so when we talk about it, we help people also remember that this is like nobody wants to feel the reality of the risk of miscarriage or, you know, it's less common to have an ectopic, but anyway of pregnancy loss, and yet it's a risk we take every time we conceive, and so I think that talking about it is so important to help people understand that it happens.

01:16:44.864 --> 01:16:49.864
It happens frequently And it's not anyone's fault, and I think that's also important.

01:16:49.864 --> 01:17:05.845
It's also important as lawmakers who have no health education make decisions that impact early pregnancy loss experiences, and so it's important for everyone to understand that this is not unusual and it's no one's fault.

01:17:05.845 --> 01:17:26.377
It's a thing that happens because nature and it doesn't mean anyone did anything to cause it, because in some states, i would have just died If my fetus, if my embryo it wasn't even a fetus yet still had a heartbeat, they wouldn't have let me take in the meds to terminate an intratubal ectopic pregnancy.

01:17:26.904 --> 01:17:52.824
I think what I always hope is that gestational parents particularly if they identify as women because we are, in our culture, not encouraged to really embody the strength that we have as fully developed human beings I always hope that stories like mine can help people connect with their own strength that you deserve.

01:17:52.824 --> 01:17:55.713
It is your right to have bodily autonomy.

01:17:55.713 --> 01:17:58.755
It is your right to be in charge of your care.

01:17:58.755 --> 01:18:13.654
It is your right to make decisions about how you want to be treated by the people you have hired to shepherd you through this process of birthing your baby, and that you are always.

01:18:13.654 --> 01:18:20.864
I've never seen anyone who wasn't stronger than they thought they were, and so you can show up for yourself.

01:18:20.864 --> 01:18:24.712
And if you're not sure how to do that, that's what therapy is for.

01:18:24.712 --> 01:18:27.838
Right, because a duel is great.

01:18:27.838 --> 01:18:32.572
I want you to learn how to be strong for yourself And not just like the doula helped me.

01:18:32.572 --> 01:18:39.023
Yes, the doula helps you, but ideally you're helping yourself, right, i love that, aria, thank you for joining me.

01:18:39.063 --> 01:18:39.864
It's my pleasure.

01:18:39.864 --> 01:18:43.208
It's always so much fun to have conversations with you.

01:18:43.208 --> 01:18:44.748
It has been very fun.