TRANSCRIPT EPISODE 11 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #11: 
Birth Stories - Giving Birth In A Rural Area With Tarynn Saling 

Transcript

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00:00                                It's a birth story episode. Today I'm talking to Tarynn Saling about her experiences giving birth in a rural part of America, but don't be fooled. You're going to learn from Tarynn's experiences no matter where you're giving birth.

00:21                                Welcome to the All About Pregnancy and Birth podcast. I'm doctor Nicole Calloway Rankins, a board certified Ob Gyn physician and certified integrative health coach. Every week I break down topics, share birth stories or interview experts to help you have your very best pregnancy and birth. Quick note, the information is for educational purposes only and is not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:50                                Nicole: Hello. Hello, hello, hello. Welcome to another episode of the podcast. Thank you for being here. I love spending this time with you sharing information to help you have your very best pregnancy and birth. So today we have a birth story episode. I kind of think these episodes are my favorite. I really enjoy hearing and learning from women's stories and today's episode, most definitely delivers. Tarynn Saling is a mom to three kiddos and she is also a Virtual Assistant. She happens to be my Virtual Assistant. She does my graphics. She helps me with emails, social media, podcast production, and I asked Tarynn to come on today to talk about her experiences giving birth in a rural area.

01:36                                Nicole: Tarynn lives in a rural part of Kentucky. Now, even though Tarynn is talking about birth in rural America, you're still going to get something out of listening to her stories. She talks about the struggles with advocating for herself during her first birth, how she was able to do it differently for her second birth and whoa, whoa, whoa, whoa, whoa, the third birth, you have got to hear that story that really exemplifies what could happen when you don't have a hospital near you that delivers babies.

02:11                                Nicole: Now, before we get into the episode, I have a quick question for you. Are you on my email list? Because being on my email list is actually the best way to stay in touch with me. I only send emails about once a week and never do any spam. I don't sell your information. I use email to let you know about new podcast episodes, any special opportunities that I come across, and then once a month or so I share some behind the scenes information about what I'm doing in my life. Like books I'm reading, the podcasts I'm listening to, music I'm listening to. I give a sneak peek about upcoming episodes of the podcast, so definitely hop on to my email list.

02:54                                Nicole: You can sign up at www.ncrcoaching.com/email-signup and I will put that link in the show notes. Now real quick, let me give a listener shout out. This is to MollyR02. Molly says "love the podcast, lots of solid evidence based information with a down to earth delivery. Can't wait to hear more from the podcast". Well thank you Molly. I appreciate that review and I can't wait to give you more information through the podcast. So with that being said, why don't we go ahead and get right into the show and this awesome interview with Tarynn Saling. Hey Tarynn, thank you so much for being a guest on the podcast. I'm super excited that you're here.

03:45                                Tarynn: Thank you for having me. I am very excited to be here.

03:49                                Nicole: Yeah. So let's start off with having you tell us a little bit about yourself and your family.

03:57                                Tarynn: Okay. I am 34. I live in Kentucky and I have three children. My oldest is a boy. He just turned 13 in December. And I have two daughters, one of which is about to be 11 and the other just turned 8 yesterday actually. I'm a virtual assistant.

04:21                                Nicole: And you're my awesome virtual assistant.

04:26                                Tarynn: And basically me in a nutshell, I read, I am a caffeine addict and I love to do anything outdoors.

04:38                                Nicole: Okay. Awesome. I like it. I like it. I'm a caffeine addict as well. A minimum of two cups of coffee a day.

04:43                                Tarynn: Oh yes. Yes.

04:46                                Nicole: All right. So we are here to talk about your unique experiences giving birth, particularly living in a more rural area. So why don't we just start with your oldest and we'll just go through each pregnancy and each birth and you'll, you know, share your story. So let's just go for it. Alright. So with your oldest, let's start with what was your prenatal care like and how did you feel about the care you received during pregnancy? And I ask, because I feel like in order to understand about people's births, we got to know a little bit about how their pregnancy went.

05:20                                Tarynn: Oh absolutely. Well, prior to getting pregnant with my oldest, my ex husband and I, which is my kid's Dad, we actually had a miscarriage several months before that. So I feel like that really influenced a lot about that pregnancy. I was very anxious, you know, very, very nervous for sure. Very much wanting to do everything possible, you know, with that pregnancy to make sure that everything went well. So I ate, you know, everything that I was supposed to and actually avoided caffeine the entire pregnancy, which is amazing to me. Now looking back, so my doctor, I do as you mentioned, live in more rural area and we at the time didn't have any OB's in my county. So I had to to go about 40 minutes away to an OB.

06:20                                Nicole: Oh, wow, so for every appointment you had to drive 40 minutes?

06:24                                Tarynn: Yes. And actually that will, that will come into play with my third. My third, which I will explain it in a minute. But yes, we, our county no longer delivers babies in our hospital, so we don't have OBs here. They haven't for quite some time. But so basically I went with suggestions, you know, people that I was friends with and had known, what, you know, their experiences were with different OBs. So that was how I chose that one. And honestly my prenatal care was really good. The only issue I ever had, I just felt like I didn't get enough time with the actual doctor during appointments.

07:09                                Nicole: It's a common issue.

07:10                                Tarynn: But I had a lot of time with the staff and nurses, and they did have an actual in office ultrasound and tech. So because of my previous miscarriage they were really understanding, you know, we did an ultrasound the first visit. We did an ultrasound, we actually had like four ultrasounds just to I think alleviate my concerns to make sure that the baby was okay.

07:40                                Nicole: Right, right.

07:41                                Tarynn: That was really nice. As far as that went, other than just the time, you know, it, everything went really well as far as my prenatal care.

07:52                                Nicole: Okay. All right. Well that's, well that's good. Good to hear. So then when it came time to get ready to give birth, what did you do to prepare, if anything, to get ready to give birth?

08:04                                Tarynn: I did and, and I'm a bit of a nerd and now back in those days Google was not a thing. I'm the Google Queen today and I am the Google Queen, but back in those days I didn't have a smart phone. It was a flip phone and we had a dial up internet connection. I was in college at the time.

08:26                                Nicole: You really are taking it back with the dial up internet connection.

08:29                                Tarynn: I feel really old right now. I don't know if that's just because I'm older or because of where I live.

08:34                                Nicole: Oh, well if you're old, then I'm definitely old cause I'm 10 years older than you.

08:43                                Tarynn: Like I did, I had the what to expect when you're expecting book. I had a friend to loan me her copy of, it was the Mayo Clinic's book about pregnancy and childbirth and labor and all of that.

08:56                                Tarynn: So I read everything and I went online, read a lot of things and I did decide for two reasons actually that I was not going to have an epidural.

09:08                                Nicole: Okay. And why was that?

09:11                                Tarynn: The first reason was from my research just because for myself, first of all, I have low blood pressure anyway. And during that first miscarriage, my body didn't exactly do what it was supposed to do, I had to have a D&C because it didn't expel the fetus and all of that during that time. And they acted like it was a huge deal. Like my blood pressure dropped really low. I didn't notice, like I didn't feel anything, but they didn't even want to let me out of bed after the procedure because my blood pressure was so low, and all of these things. So when I was researching, that was one of the things that stood out to me that it could possibly drop your blood pressure and I don't even want to, you know, cause any issues or have anything to go bad if I can help it.

10:07                                Tarynn: And then the second reason, a very close friend of mine, when she had her baby about six months before I had Jagger, who's my oldest, and I got to be in the room with her, And because her husband had just stepped out to go to the cafeteria, I was in there with her when she had her epidural.

10:30                                Nicole: Okay.

10:32                                Tarynn: I'm not usually a big baby when it comes to needles, but that one's pretty big. I watched and I was like, uh uh, I ain't doing it, no. So I had decided early on I didn't want to have an epidural. I wanted to, and probably just, and this is such a silly reason, looking back, just being able to say I did it without one.

11:04                                Nicole: That's not a silly reason. You know, a lot of women do do that. Um, but you know, there's nothing wrong with that at all. So you read read books, you had made the decision, you didn't want the epidural. Did you do anything else besides read books? Like take any classes or anything?

11:19                                Tarynn: I did. The hospital that I delivered at during that first pregnancy, my husband and I did go to a childbirth delivery class and you know, they taught the breathing and the things like that. So we did do that as well.

11:35                                Nicole: Okay. Okay. So then what was Jagger's birth actually like? Tell us about that,

11:42                                Tarynn: Well, it was 37 weeks and 3 days. I remember that because my first two children were that day exactly. I went to my OB appointment and it was the first time they checked, you know, to see if I was dilated, and I was three centimeters and 50% thinned. So I was a first time mom, I was very excited. I wanted to get this going right? So I went home and he told me like, how many minutes to wait and you know, all of that before I came to the hospital. Well, I went home and I guess looking back, it was kind of the nesting instinct. I got a little ridiculous. I took down all of the curtains in my entire house.

12:27                                Nicole: Oh, okay.

12:29                                Tarynn: Yeah. Yeah. My ex husband still laughs about this. I took them all down. I washed them all, and then I went to Jagger's room. And of course I already washed all of his clothes and put them up. They were hanging up, they were in their drawers, they were organized. I rewashed everything.

12:48                                Nicole: Oh my gosh.

12:49                                Tarynn: Yeah. So I did that. And then about two or three hours later, the contractions were starting to get a little intense.

12:57                                Nicoe: Oh is that somebody saying "hi" beside you?

12:57                                Tarynn: Yes. So these contractions are very, very strong and I really think that we need to go ahead and go to the hospital. And he was like, they're not as close together as the doctors said they should be. And I said, well, they're really hurting. You know, and I was so excited. I just wanted to, so we did go. And one of the things that my doctor found very funny was that on the way, because this hospital would not let you eat after you came in.

13:40                                Tarynn: So I'm an eater, I like food. So I made him stop. We have a dairy freeze about halfway between where we lived and in the hospital and, and I made him stop and get me a grilled cheese cheese sticks and milkshakes. And we get to the hospital, and I know for a fact it was 7:00 PM when I got there because Gilmore Girls was on the air at the time. And during triage that was what was on. And they were like, well, you're contracting fairly regularly, you know, we'll go ahead and keep you.

14:22                                Tarynn: So they kept me. And it was a very long labor. Honestly it was not bad until they broke my water. And that was about like, I got to the hospital at 7:00 PM and I had Jagger at 10:23 AM the next morning. It was really about, I think 8:00 AM that next morning when they broke my water and I was about seven centimeters and that was really the point that it got really bad at that point, honestly everything I had learned, everything I had been taught in the classes and reading the books just kind of went out the door.

14:59                                Tarynn: I don't have a lot of recollection about it. I just remember holding onto the side rail and being really internal, you know, just really in my head and really just trying to make it through everything. And I can remember Sam, my husband was being really sweet and he was like, okay, you need to remember to breathe. And he was practicing these breaths and in my head I was just like, shut up. Just stop talking to me. I'm doing this. I'm doing it in my way just quit.

15:32                                Tarynn: Now as far as the issues I had with that, and a lot of it falls on me. I had a very clear picture of how I wanted things to go and what interventions I wanted to have or not have.

15:46                                Nicole: Right.

15:47                                Tarynn: But I didn't communicate that very well to my doctor and we didn't really have that conversation. So first of all, when I had only been there for like an hour, they started pitocin. That was not anything I had been really prepared for.

16:03                                Nicoe: Right.

16:05                                Tarynn: I had read that was just more for like if it wasn't progressing or things like that. So it wasn't really prepared for that, but I didn't question it, which again was on me. I didn't really say, you know, why are you doing this? I don't need it. Blah, blah, blah.

16:19                                Nicole: Well, yeah, I mean I'm like, okay. So yes, you could have asked, but we also should explain why the medication is being done. That's on us as healthcare providers to have a discussion about why pitocin is being started. It shouldn't just be started without any type of discussion.

16:36                                Tarynn: And yes, and I agree with that too. I just, I've always felt like I should've pushed a little, you know, asked and found out why. And then the rest of the actual delivery and looking back now, I realize and I really can see that he was more concerned with getting out of there quickly.

17:03                                Nicole: Okay.

17:03                                Tarynn: As opposed to what actually needed to be done. And I say that because I had two children after that. And so the experiences I had, I realized that some of the things that happened weren't necessary. They did do an episiotomy and didn't tell me what they were doing until they were doing it. And I had read a little bit even back then.

17:30                                Nicole: Wait, I'm sorry. And you didn't have any anesthesia?

17:34                                Tarynn: Well, when they did the episiotomy, they did what they told me was a pudental block.

17:40                                Nicole: Okay. Yep.

17:42                                Tarynn: Because she told me she was putting a shot there and I asked what it was, and she told me. And I asked why, and she said, because he's going to do an episiotomy. Well at that time I had read a lot that episiotomies were kind of going out of the norm. But again, I was 20, you know, when I had him. So I was young and I wasn't very assertive and I just kinda went with it. And then I literally only pushed once before he used the vacuum extraction.

18:23                                Nicole: What?

18:24                                Tarynn: Yeah. Yeah.

18:26                                Nicole: Was the heartrate low?

18:26                                Tarynn: No, no, there was nothing. And that's why I say that I realized later because I delivered two more babies and not to brag, because I have nothing to do with this, but my second doctor, she told me, she said, your body is just made for babies.

18:48                                Tarynn: Like I just pushed that kid out in like two pushes. And I did the same with the third one, actually one push with the third one. And that's why I feel like he was just very rushed and just didn't want to be there. So that experience was very disheartening for me. But you know, Jagger came out healthy. He was fine. I wasn't super happy with the whole process up until having him, but I mean, I have a healthy son, he's 13 years old. So I tried to look at it that way. I will say that I'm a strong believer in everything that I've read about how episiotomy recovery is so much worse than just tearing, because I did tear with the other two and the recovery was so much better with the last two as opposed to the first. It was a long recovery period for me.

19:49                                Nicole: Right. Well, let me say a couple things. One folks, ladies, we should not do a episiotomies routinely. That's just not something that should be done. So Tarynn is exactly correct about that. And number two, you have the right to be both happy that you had a healthy baby, but upset with the experience. I mean, it didn't go exactly how you would have liked and it sounds like some things were done to you that you didn't really get a good explanation for it. And it's perfectly okay to be upset about that.

20:21                                Tarynn: Well, that's a good point. I hadn't really thought about it like that, but that's a really good point.

20:26                                Nicole: Yeah. Okay, so that's, that's baby number one. So how are things different with baby number two?

20:33                                Tarynn: Well, baby number two, I was in nursing school actually at the time that I had her and originally I was going to have her at a different hospital. So to be clear where I live, we have pretty much two options. We have one hospital that's 30 minutes to the north and one hospital that is 30 minutes to the south. So when I was in nursing school, when I found out I was pregnant, I was in the mother baby unit of my nursing classes at this hospital to the south. So I was planning on having her there, to be quite honest. I don't even remember why I changed my mind, but I decided to go back with the original hospital. I think it's just because it was more known to me and that's where the majority of people around here have their babies.

21:29                                Nicole: Okay.

21:30                                Tarynn: So against my better judgment, I did go back to the original OB that I had and I was more clear with him that time. He knew that I wanted as little intervention as possible, and only if it was necessary, you know, medically necessary.

21:50                                Nicole: Now I'm curious, did you have any other options for other OBs that you could have gone to or did you just know him and you kind of felt like, well, for the most part he was okay or a little bit of both.

22:03                                Tarynn: There is not an abundance of options here and so a lot of the other doctors, I didn't know anyone that had been to them.

22:12                                Nicole: Gotcha.

22:12                                Tarynn: So they were kind of an unknown. So I did go back to him and I was very, I guess more emboldened that time, you know. I knew what to expect, so I was more vocal about what I wanted with this one. I think that it would have made a difference. But honestly, I actually did not get the chance to find out because...

22:36                                Nicole: Oh, and let me ask before you go on, before you tell us, was he receptive when you were telling him about the things that you wanted?

22:42                                Tarynn: Yes.

22:42                                Nicole: Okay.

22:42                                Tarynn: Yes, he was.

22:43                                Nicole: Okay. Okay. So then you said you didn't have a chance because what happened?

22:49                                Tarynn: Actually, she was born just like my first one at 37 weeks and 3 days and he was on vacation because it was spring break. So I actually had the on call OB.

23:04                                Nicole: Okay.

23:04                                Tarynn: Now this particular labor and delivery, again, I had the very strange nesting the night before. I had decided, I guess in my crazy nesting phase here, that I was going to go ahead and make sure that we had everything set up for her, even though it was a few weeks before. So my husband worked third shift and I apparently rearranged all of our master bedroom furniture and painted, and painted. I don't recommend any of this, just a disclaimer. I don't recommend it, but I painted the entire room, rearranged it, set it up where she could be in there with us. You know, the play yard, changing table, all of that. And then at 5:00 AM the next morning I woke up and I was like, oh, oh, you know, this is hurting, you know, there's real contractions going on.

24:05                                Tarynn: And she was actually born at 11:23am, so it was a very fast labor with her. When I got to the hospital, they informed me that my doctor was on vacation because it was spring break, and they told me who the doctor was that was on call. And she came in and talked to me and I asked her all the questions. I asked her do you just routinely do pitocin? And she was like, no, only if it's an emergency, only if you're not progressing, dah, dah, dah, dah, dah. I asked her all of it, the episiotomy, the vacuum, and she was very much in line with what I wanted.

24:43                                Nicole: And good for you for asking.

24:45                                Tarynn: I had learned. That labor and delivery went well. I was not in labor very long and the only point that I got a little frustrated, they had inserted something to measure the fluid and the pressure.

25:03                                Tarynn: I could be wrong about that. Maybe it's a strength of the contractions.

25:07                                Nicole: We either use something called a fetal heart rate monitor or intrauterine pressure catheter to measure the strength of the contractions.

25:16                                Tarynn: The second one sounds accurate and because of that they would not let me get up. So when I had to use the restroom, I was very aggravated because I couldn't get out of the bed. And I actually, it's a funny story. My daughter finds this hilarious when I tell her. They brought me a bed pan. I had never used one and I was like, I can't do this. I cannot use this. And she was like, Oh yeah, it'll be fine. And my ex husband Sam, he laughs about this to this day. He's like, you were so comical trying to find a way.

25:53                                Tarynn: Like I ended up trying by like squatting on the bed just to pee. And I ended up just getting really frustrated during a contraction and I just threw the bed pan. It was empty, it was empty.

26:12                                Tarynn: And it was actually just a few minutes later that I was telling the nurse, I said, I really need to push. And she was like, no, you were just seven. You know, you were just seven, it's still a while. And I was like, no, trust me. Trust me. I need to push. Okay, I've done this. I recognize this feeling it's going to happen. Because she kept saying, just wait, just wait till the doctor gets in here. She's on her way. And I was like, I can't wait and wait.

26:40                                Tarynn: And the doctor actually was only able to come in and throw her gloves on, because the nurse finally believed me and checked me and she was like, Oh yeah, yeah, you're about to have a baby. The doctor threw her gloves on, she actually broke the light, the light that comes down out of the ceiling at the hospital. So she was trying to get it down in time and it actually broke. She wasn't able to put on her her gown or anything. She just put gloves on and then the baby came out. And that's why she told me, she said your body was just made to have babies, I don't know what to tell you. So that delivery went very well. I was really happy with it.

27:22                                Tarynn: Bella, that is my middle daughter, she did have to spend some time in the NICU. She had some fluid in her lungs and they did notice that really quickly, that she was breathing a little bit rapidly. And the way it was explained to me at that time was just kind of like with the C-section where they don't get squeezed enough. She came out so quickly.

27:44                                Nicole: Yeah.

27:45                                Tarynn: So she spent a little time in there and less than 24 hours and she was good to go. 

27:51                                Nicole: Okay. So overall that experience was better, and again, you did it without an epidural?

27:57                                Tarynn: Yes.

27:57                                Nicole: Okay. And then did you do anything different to prepare, any more books or classes or anything or just the same kind of stuff?

28:03                                Tarynn: I read a little bit more of the books, just kind of a refresher, but I didn't do another class and honestly I kind of feel like I got off a little easy with her. I mean 5:00 AM to 11AM it was just six hours, and honestly, like an hour of that was difficult. The rest of it was just kind of painful, but it wasn't that difficult. It wasn't that hard.

28:28                                Nicole: So how about baby number three?

28:31                                Tarynn: Oh, this is my favorite one to tell. So I do live in a rural community as you mentioned. So they changed a lot of their rules at the hospital I had gone to and they wouldn't let you video tape babies being born anymore. They wouldn't let you have more than two people in the room. Just a lot of things that I was not really happy about because I wanted it to be not so much like a surgical procedure, but more like a normal, natural kind of thing. So we do have a city that's about an hour and a half away and they have a few hospitals that were very much more progressive at the time, toward having babies with low intervention and no medication and making it homey and all of that.

29:26                                Tarynn: So I chose to go there during that time and that's where I had my prenatal care. And so it was an hour and a half drive.

29:34                                Nicole: Wow. Okay.

29:36                                Tarynn: But I loved the doctor, absolutely loved her. I toured the hospital. I loved the hospital, loved the mother baby unit, the delivery rooms, everything. And now I had just had an appointment with my doctor. Everything was fine, you know, the baby was great. There was no signs, which of course they weren't checking me at that time because I was 35 weeks, but everything was good. Looking back now because I should have realized this, but I had the little goofy nesting thing going on, like normal. And I did all kinds of weird stuff. Like I hadn't even had my baby shower. So I just had this really strong pull to just run to the store and get diapers and all of the just absolute necessities for a baby.

30:32                                Tarynn: Like the bedroom wasn't even done yet. Nothing was done.

30:36                                Nicole: But something was telling you to just get necessities.

30:39                                Tarynn: Yes. So that night, my husband worked third shift again, and I had two little kids. I had a five year old and a three year old. Well, she was not even three yet. She was close to three. I put them in bed. My back was hurting very badly and the back was always a big, big thing for me. But of course, you know, I had tiny kids. I was busy, I was doing a lot of things. I was cleaning the house. I was just, you know, going nuts. And I thought, well it's, you know, I'm pregnant, my back hurts. So I went ahead and went to sleep because it didn't feel like contractions. It was just kind of a constant pain. And I woke up at three o'clock that morning and my contractions were bad, like I knew they were contractions and they were very bad.

31:23                                Tarynn: And I was like really alarmed because this is not usually how it feels until right before. So I remember grabbing the clock off the wall and holding it and staring at it. And I was like, these contractions are like three and a half minutes apart and I thought this is bad, this is very bad. So I call my husband. Well I called my doctor first, but of course I got the answering service and they were going to call me back, you know, it's the middle of the night. But I call my husband and he was at work and was 30 minutes away. So I said, I really think you need to come home right now, and I called my parents to come watch my kids. And then so my husband got there and by the time he got home, and he got there very fast, I couldn't walk to the door like it was that bad.

32:14                                Tarynn: And I was like, oh no, and I told him we are not going to make it to the hospital that I had planned to deliver at. I said let's just go to the closest ER and they can take me by ambulance, because I'd rather have this baby in an ambulance than on the side of the road with you, no offense. I do remember he was like put your seatbelt on, put your seatbelt on and I'm having a contraction and I'm like will you shut up please? Just get to the hospital and again, this local hospital, they don't deliver babies at all, haven't in like 15 years now. Me being me, I just assumed that they would be maybe at least a little trained, you know, for emergency situations, but they weren't at all.

33:08                                Nicole: Yeah. And that's something that folks don't realize. The hospitals that don't usually do labor and delivery, I mean, you know, the last time they may have delivered a baby may have been in medical school.

33:19                                Tarynn: It was kind of a shock to me. So we checked in and all of that. And I can recall, and this is such a silly thing, but the nurse that I had, he was a male nurse. And again, I'd been through nursing school and I'de done really well in nursing school. Because of the hormones in my pregnancy, I had quit, but that's a whole other story. But he started an IV, and then he was trying to get my blood pressure and then he was griping at me because that couldn't be still. And I finally, I was like, I'm having a contraction. I'm not going to be still, you're going to have to wait.

33:58                                Tarynn: So my husband had gone out to move the car, because of course he pulled up right to the door and then went to go put the car back. The doctor at the EE had told me that I was only five centimeters. Now, I'd had two babies without epidurals. I knew he was lying. And my husband on his way back in, heard him on the phone with the hospital that delivers babies, the one that's 30 minutes away and he was saying she's eight to nine and we need to get her there. So he knew I was about to have a baby, but they didn't know what to do. So he was trying to get me to there. So my husband came back and he told me what he said and I was like, I could've told you that.

34:42                                Tarynn: I know I'm about to have this baby. I know. And they called for an ambulance. And again, I'm five weeks early at this point, she's considered a preemie, and this had only been a couple hours from when the contractions started. I woke up to contractions at 3:00 AM and she was born at 5:00 AM.

35:03                                Nicole: Dang. Okay.

35:04                                Tarynn: It was very fast. They called the ambulance to come get me and they put me on the gurney. Now, I didn't want an epidural, but I tell them, if I'm going to ride all the way to Owensboro, which is the city with the hospital, can I not have something for pain? And they're like, no, we can't give you anything. Dah, Dah, Dah, Dah. I was already really irritated about that and they put me on the gurey to put me in the ambulance and I felt the need to push and I didn't say a word, I didn't tell them anything.

35:36                                Tarynn: I pushed and I broke my water all over the gurney. And you've never seen so many people freaked out. They were all like put her back on the bed, put her back on the bed, get her back on the bed. And I literally just grabbed my legs and I pushed one more time and she just came out on the bed. No one caught her. No one, and the emergency room Physician's face is forever etched in my brain becaue he looked so freaked out. It was like, oh my goodness!

36:09                                Tarynn: There was an EMT there, he was going to take me and I knew him really well. When I did a lot of health education classes at our vocational school in high school, and the clubs and all of that, he was always there teaching us CPR, going with us to competitions and all of this.

36:30                                Tarynn: And while the emergency room doctor was just kind of standing there staring at her, he, and his name is Ralph, he ran over to her, didn't even pause. He just grabbed her and he took off with her. And I remember seeing her, she was really blue. But he just grabbed her and took off across the hall and later, come to find out, they didn't even have any type of suction for infants in the hospital. So he worked on her with a bulb syringe. Like the bulb syringe. I know you know what I mean.

37:03                                Nicole: I mean it's just like literally this little bulb.

37:07                                Tarynn: The kind you clean babies noses with. And he worked on her until she was breathing. She didn't cry, but she was breathing and then he took her in the ambulance and my husband went with them.

37:25                                Tarynn: Later, my husband said that Ralph held her the whole time and made sure she kept breathing and he was crying the entire time. When I did get to the hospital and we pulled up to the ER, Ralph had sat there and waited for me to tell me that as soon as the NICU got her, they got her crying within 30 seconds and she was fine.

37:48                                Nicole: Oh Wow.

37:49                                Tarynn: He sat there for probably an hour and a half by the time I got there just to make sure I knew. And it did take so long because bless his heart, that ER doctor did not know how to deliver a placenta. I had torn, I had torn before with my second child and I knew what it felt like. And he was trying to deliver the placenta and I kept flashing back to nursing school.

38:17                                Tarynn: And I was like, no, you're not supposed to pull, stop, stop. You know, like this is not, you're not doing it right. Don't do it. And so after like 30 minutes of him attempting to do that, he just finally was like, you're just going to have to wait till you get to Owensboro. So I rode in the back of the ambulance, strapped down to the gurney, with my placenta still in my uterus, the umbilical cord, you know, hanging out. And I had torn and had no pain meds. They wouldn't even give me anything for pain at that point.

38:51                                Nicole: Wait, wait, wait, wait, wait. So just had a baby? Torn, with the placenta still there. And you got this long ambulance ride and they wouldn't give you any pain medicine?

39:04                                Tarynn: No, they wouldn't give me anything. They said that I needed to wait until I got there to be assessed.

39:11                                Nicole: Oh my gosh.

39:13                                Tarynn: Yes. It was the longest ride ever and it was raining. It was raining so hard that night. And it wasn't an emergency, you know, so they didn't have their lights on or their sirens on. They weren't going like, you know, super fast. It was a horrible ride.

39:29                                Nicole: Oh my God.

39:31                                Tarynn: It was horrendous. Now, once I did get there, the on call doctor took care of that very quickly. So that was not a big deal, but I was not a happy person on the ride to the hospital. I was not happy.

39:46                                Nicole: Oh my gosh. I can't even imagine what that must've been like for you.

39:53                                Tarynn: It was a horrible, but it's an entertaining story. And my daughter who just turned, the daughter that this occurred to, she turned eight yesterday, and every year on her birthday, I tell her the story. We see Ralph in Walmart, she knows who he is, introduced them. This is the man. And he did, he saved her life. If it wasn't for him, she wouldn't be here. I really believe that. I don't think anyone else there had what it took to take care of her and get her breathing and all of that.

40:35                                Nicole: Right, exactly. Oh goodness.

40:38                                Tarynn: And every year I tell her the story and I tell her you came out like a little tornado and she's been that way ever since. And being born that way, and five weeks early, literally the only thing that she had issues with, she had two issues. Her blood glucose was low and so they had to give her a glucose water in the nursery. And I'm assuming, I always assumed it was because she was preemie, she had a very hard time with the sucking reflex.

41:14                                Nicole: Yeah. That's one of the last things that babies get is the ability to suck, swallow and breathe at the same time.

41:20                                Tarynn: So yeah, those were the only things we had an issue with. It was just for a week or so. Just that was it. Everything else, she was great. Her lungs were great, she was preemie and she was jaundice, which all of my kids were and you know, had just a little bit of time under the lights and it resolved itself easily. But I always tell her she looked like a little bird when she was born. She didn't have any fat on her. And she was really tiny and she's gorgeous. She's absolutely gorgeous now. She is a force of nature. Just like she came out.

41:55                                Nicole: Exactly. Exactly. Now I, you know, I listened to your story and the last one in particular obviously highlights some of the challenges that women have when they are in rural areas. And I don't know that, you know, this is something that we struggle with within our profession about how to make sure all women have good access to care. And I wish I had a good answer for this, but, I can't say that, that I do. What are some things that you think women can do who live in rural areas to help them have a great experience both during pregnancy and prenatal care and for giving birth?

42:36                                Tarynn: And I've thought a lot about this over the years. I think there's really two things because again, there's not an ideal option and different hospitals and things like that, but there are two things I can think of. First is to be really informed about what you want and to not be afraid to say so. So you know, if you don't have a lot of options, ideally you know you want to find a doctor that is in line with your beliefs and is comfortable with them. Like for instance, in my case I wanted to have an unmedicated birth, you know, no epidural. Ideally I would have wanted to find a doctor who was very comfortable with that. But if you can't because of where you live and the access, I think it's all the more important to know exactly what you want, to have your birth wishes, to have those conversations with your doctor and even have support people who can advocate for you when you aren't able to speak.

43:41                                Tarynn: You know, if you're in the throes of labor and you're not able to have coherent conversations, to have someone there that is like, okay, this is what she wants. Unless it's an emergency, this is what we need to do. We don't want to have this, we don't want to have that unless you know there's something wrong with the baby. And then I think also one thing, especially with my last one, I think this happens with a lot of first time moms. If you're in a rural area and you don't have a hospital very close, your nearest hospital is 30 40 minutes away. I know it can be very difficult because in my case, a lot of times I thought, I don't know if I'm in labor, I don't know if this is a contraction. I don't want to go and feel stupid. You know what I mean?

44:35                                Nicole: Right.

44:35                                Tarynn: But for instance, with the last one, I really wish that that night, when I was having so much back pain, I had of went and just been checked. You know, to see what was causing the back pain. It could have been a lot different. I could have delivered her in a hospital that delivered babies. So I think just to trust your instincts, just kind of get rid of that embarrassment factor. You know, if you have a hospital five seconds away, it's not so much of an issue. But if you're in a rural area and your hospital is 30 to 40 minutes away, you just really have to just let go of that I'm going to be embarrassed. I mean, the worse they're going to say, is no, you're not in labor. This is Braxton Hicks or you're not in active labor or you know, whatever and send you home. But it's a lot better than the alternative, you know, than delivering in a hospital emergency room that doesn't deliver babies or delivering on the side of the road.

45:40                                Nicole: Yes, yes. Those are both excellent pieces of advice. Don't be afraid to, even if your options are limited, you can still advocate for yourself and go ahead and get checked if you need to. Trust your instincts, go in if you need to. Because you just don't have the luxury of time necessarily. Yeah. Yeah. So are there any other resources that you would recommend for women?

46:06                                Tarynn: I do recommend that every first time mom takes some sort of childbirth education. And, honestly even if you want an epidural, like my sister in law, she was in labor for I think 12 hours before she was able to get an epidural. So the breathing, you know, all of the techniques I teach you, the education you get when you take that course is helpful and it could be a lot more helpful than what you expect, especially if you want an unmedicated birth. So you know what to expect. And it just takes a lot of the fear out of the whole situation. You know when you, when you don't have to deal with the unknown, it helps a lot with your mental state. So I definitely recommend, you know, taking a course of some sort to prepare yourself. And even a refresh, you know, if you're a second time mom and it's been, my children were very close together, you know, if you haven't had the child for five years, things have changed.

47:15                                Tarynn: There's, you know, there's a lot of differences or you've forgotten, whatever the case may be. I think that being knowledgeable and being prepared is the best thing you can do. And also being really clear about what you want and know whether that be, you know, your birth wishes, talking to your support person. If you don't have a partner getting a Doula or a friend or someone to be there with you who can advocate for you when you're not able to say to the birthing team, hey, I don't want this. I think those are huge assets to have. You know, your wishes explicitly spelled out. And to have people, or at least one person with you who knows them and can say, look, this is what she wants, this is what she needs, this is what we would like for you to do.

48:10                                Nicole: Okay, perfect. So I think that is a great way to end. Make sure you have some childbirth education, educate herself in whatever way you feel it works best for you. You know, whether that's an in person class, online class, of course I'll put a plug in for my own course or whatever books, whatever you want to do, do some type of childbirth education and have somebody there to advocate for yourself. Outstanding advice and things that I've tried to stress with women as well. Okay. So where can women connect with you? Are you on social media or anything at all or?

48:45                                Tarynn: I am. Tarynn Saling on Facebook, on Instagram. So you know, either one of those places is a great place to find me if you have any questions or you want to chat.

48:58                                Nicole: Okay. And Tarynn is also of course in the podcast community Facebook group. So if you have any questions for her after the episode then absolutely post them there and she will get back to you right away. Well thank you so much Tarynn. And this has been really informative. I think you've given some great advice in terms of the things that people do have control over and that is really empowering themselves with knowledge and education and being able to advocate. So I really appreciate you being here today.

49:31                                Tarynn: Thank you so much for having me.

49:32                                Nicole: Okay. And of course I will talk to you later.

49:36                                Tarynn: All right.

49:40                                Nicole: Man, wasn't that something? That third story especially was like, oh my goodness. Now after each episode where I have a guest on, I do something called Nicole's notes where I give just my top three or four takeaways from the episode. So here we go with Nicole's notes from this episode.

49:58                                Nicole: So number one, Tarynn and I talked about how it can be challenging to advocate for yourself. And it can, it can be hard to advocate for yourself, especially against someone who's considered an authority figure like a doctor. But let me tell you, you can do it and it's important that you do do it. Tarynn was able to do it the second time around and she talked about how it made a difference in her birth. So for sure, get comfortable with advocating for yourself. And if you can't, if you feel like it's really hard for you, then find someone who can be with you, who can advocate on your behalf.

50:39                                Nicole: Now to be clear, advocating doesn't mean you have to be mean or nasty or anything like that. Approach it from a place of kindness unless have to take it to a mean and nasty place because they aren't responding to kindness. But start from a place of kindness. Be comfortable with advocating for yourself so you can have the experience that you want and deserve.

50:59                                Nicole: All right number two, talk to your doctor ahead of time about your wishes. This is one of the things that Tarynn said that she wished she would have done is to talk to her doctor about her wishes. This will help you know if you and your doctor are on the same page. Clearly communicate what you want and it gives you the opportunity to know if you need to change to another doctor or hospital that's more in line with what you're looking for.

51:24                                Nicole: This is one of the things that it should be a part of making your birth plan or more appropriately, birth wishes because none of us can plan birth. So I say birth wishes instead of birth plan, but this should be a part of your birth plan, not just like templates and checking off check boxes and that kind of thing. It really should be a discussion with your provider. Now I have a free one hour mini course on how to make your birth plan at www.ncrcoaching.com/birthplan. I'll put that link in the show notes and in that I give you specific questions you can ask to really help facilitate this process and this communication and this discussion.

52:02                                Nicole: All right, number three, there is a little bit of tension, for lack of a better word, between having a healthy baby and how you feel about your experience of your birth. Tarynn almost felt guilty in a way, you know, saying that she didn't have a good experience with her first birth because in the end her baby was healthy. You know, there's a lot of pressure and our society where it's like, oh, you should just be happy that you have a healthy baby and that you are healthy. Well, I'm here to tell you that it is ok, in fact, it's perfectly normal for you to have thoughts and feelings about your experience giving birth. It actually annoys me when people say, Oh, you should just be happy. You have a healthy baby. I feel like it's a manifestation of society's control over how women think, but it's perfectly okay for you to have thoughts about your birth. You can both be happy that you have a healthy baby and not happy with parts of your experience at the same time.

53:08                                Nicole: Now, hopefully you have a great experience, and you're happy with the experience, but if for some reason you're not, that's okay. Just don't let it detract from your experience of being a mother and enjoying your new baby. That's the caveat that I'll give to that. Okay, so what were your takeaways? Let me know in the podcast community Facebook group, that's the All About Pregnancy and Birth podcast community on Facebook, and I'll link to that in the show notes. And also don't forget about joining my email list. Go to www.ncrcoaching.com/email-signup, and that link will also be in the show notes. Next week on the podcast, I have a pediatrician on who's going to give you some great advice on how to choose a pediatrician. So come on back next week. And until then, I wish you a healthy and happy pregnancy and birth.

54:03                                Today's episode is brought to you by Women's Wellness Coaching by Dr. Nicole Calloway Rankins, head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan, as well as my comprehensive online childbirth education class, The Birth Preparation Course with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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