TRANSCRIPT EPISODE 38 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #38:RACHAEL’S BIRTH STORY: PREPARING FOR AN
AMAZING UNMEDICATED HOSPITAL BIRTH

Transcript

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00:00                                     This is an awesome birth story episode about an unmedicated hospital birth.

00:06                                     Welcome to the All About Pregnancy & Birth podcast. I'm your host, Dr. Nicole Calloway Rankins. A board certified ob gyn physician, certified integrative health coach and creator of The Birth Preparation Course, an online childbirth education class that will leave you feeling knowledgeable, prepared, confident, and empowered going into your birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. See the full disclaimer at www.ncrcoaching.com/disclaimer.

00:43                                     Hello and welcome to another episode of the podcast. This is episode number 38 and as always I am so glad that you are here. On today's episode of the podcast I have Rachael McKinney. Rachael is a license clinical social worker. She currently works with preschool age children and their families to help promote positive and age appropriate development using tools like mindfulness, yoga and play based interventions. Since becoming pregnant, Rachael has had an increased interest in learning how to help support women throughout their pregnancy journey and beyond and that's why she is on the show today. While she was pregnant, she herself used yoga and mindfulness strategies as well as some other things that she'll discuss. She used those throughout her pregnancy as well as during labor and delivery in order to deliver her son unmedicated and with very little medical intervention in the hospital. She shares her really empowering story today.

01:49                                     I'm so glad she came on and at the time we recorded this, she was just six weeks postpartum, so that made it even more special. Now before we get into the episode, let me give a quick shout out to Victoria Esperanza. She left me this review in Apple podcast and it says, "I am so thankful to Dr. Rankins for this informative podcast. I am a 27 year old, first time mom and I'm 25 weeks pregnant. I discovered this podcast last week and I'm just obsessed. Dr. Rankins presents so much information on all topics related to pregnancy, labor and delivery in such a clear and concise way and has such a soothing manner of speaking. I just can't get enough. I really enjoy her diverse variety of guests. She features on the show from fellow doctors to regular women and their incredible birth stories. 10 out of 10 I recommend this podcast to anyone interested in being more informed on all aspects of pregnancy and birth."

02:55                                     Well, Victoria Esperanza, you've got me over here, blushing. Girl, thank you so much for that really kind of review. I am so glad you love the show. I love bringing it to you. Also, let me take a minute and remind you about my free live online class on how to make a birth plan that works. I take all the confusion out of making a birth plan, give you a super clear process on how to make a birth plan that works, to help you have the birth that you want. Women really love this class. I only do it about three or four times a month. So you can go to www.ncrcoaching.com/register to sign up for the next class and that link will of course be in the show notes.

03:38                                     And if you want to go even deeper with me helping you get ready for your birth, then check out my online childbirth education class, The Birth Preparation Course. This amazing class gives you all the information you need to be knowledgeable, prepared, confident, and empowered to have the birth you want. It's a very comprehensive class. You learn everything from getting in the right mindset, to all the stuff you need to know about labor or pushing a baby out, the truth about things like pitocin and c-sections as well as some information to help you get off to a good start as a new mom. So you can check out everything that's included in the course at www.ncrcoaching.com/enroll. The free birth plan class is a great way to kind of get a flavor for The Birth Preparation Course. So again, if you want to check that out, first the free classes, www.ncrcoaching.com/register or if you're ready to hop right into The Birth Preparation Course, it's www.ncrcoaching.com/enroll.

04:33                                     Okay. Without further ado, let's get to the birth story episode with Rachael.

04:41                                     Nicole: Hey Rachael, thank you so much for agreeing to be on the podcast, especially considering you are like, a very brand new mom.

04:49                                     Rachael: Yes, Nicole, thank you so much for having me.

04:52                                     Nicole: Yeah, so tell us about you and your family.

04:55                                     Rachael: So I live in the Chicago area with my husband and my son, Nicholas will be six weeks on Friday.

05:03                                     Nicole: Wow. So a brand new baby! I can't say that I miss those days to be honest with you.

05:11                                     Rachael: Yeah. All those people that say to you like enjoy every minute and you're like, whoa, there's minutes that are really hard.

05:17                                     Nicole: Exactly. For sure. For sure. Now you came on to talk about your birth story and we'll get into that. But before we talk about the birth, I think we need to understand a bit about what your prenatal care was like. So what was your prenatal care like? Did you see a physician and midwife? How'd you feel about the care you received?

05:38                                     Rachael: We're part of a very large medical group in our area and there's six ob gyn's that we're linked to through our insurance. Unfortunately, midwives are not available with our current plan. And so they encourage you to visit with all of the physicians because whomever is on call that day at the hospital, that physician is going to deliver your baby. That was a little bit challenging for me because I had this vision of, oh, I'm going to have the same doctor I did for all of my appointments. So that was something that I had to kind of grieve and move forward with that. I think that I had some hiccups with my prenatal care just because I had some pretty specific birth preferences. And at one of my prenatal appointments I had shared a couple of them with him and he said, well you know what, this is kind of hospital policy and people deliver in hospitals to avoid complications or else everyone would deliver at home. And it kind of felt like he was dismissing my preferences and how I wanted to birth my baby. At that point I had a very tearful conversation with my husband about our care and it wasn't really an option to switch providers but with talking with some friends and family, we decided well we're going to stay and really the physician is there to catch the baby. So let's talk about other things we can do within labor and delivery and kind of kick that physician concern out the window.

07:15                                     Nicole: Yes, absolutely. Okay, so we have to unpack this a little bit cause I think this is really important to discuss. So you initially, were you thinking that you wanted to have a midwife for your care?

07:25                                     Rachael: Yes, yes. I really liked their philosophy of care versus a more medical physician type setting or, but it wasn't available to us through our insurance.

07:36                                     Nicole: And that is the reality, folks listening, that sometimes your insurance can be a barrier in terms of getting the things that you want and it's not easy to pay for this stuff out of pocket. It's not cheap. So you do have to check with your insurance and work within those guidelines. That's one of the things that I recommend you check for sure is a certain practice and a certain hospital covered by your insurance. Yeah. Yeah. So then you made peace with that and then you're having to meet the six different doctors. Did you just kinda rotate between them or like one here, one there. How is that experience for you? Because I know a lot of practices use that approach.

08:16                                     Rachael: It was somewhat convenient because they had several different offices within our area and so I was able to meet all of them. However, they added five new physicians to that group about two weeks before my due date, and they had already scheduled my other appointments with the previous five or six, so that was another tearful conversation. But I kind of had to go through that same process like okay, I'll meet them if they're there and then everyone will be okay like we will be.

08:53                                     Nicole: Gotcha. So you met the six I guess, and then was it just one of the six who gave you some pushback about your preferences?

09:00                                     Rachael: So it was one and then after that appointment I told myself, you know what, I have these preferences when I show up at the hospital, I'm going to talk, or my husband will talk to the nurses about our preferences. I kinda didn't really bring it up at any other prenatal appointments.

09:16                                     Nicole: Okay. So you only brought it up with that one person and then from there did you feel like you didn't want to face that disappointment again or you were just like, I'm just going to deal with this a different way?

09:27                                     Rachael: I think a little bit of both. Like I don't want to put myself in that position again to feel kind of discounted or feel so small. So I just, yeah.

09:39                                     Nicole: No. Yeah, totally. I totally understand. It makes me sad actually. So you have to tell us, if you don't mind, I'm curious, what exactly were the preferences that you wanted that caused this reaction from the physician?

09:51                                     Rachael: Of course. So I had been wanting to have an unmedicated birth. I did not want to have IV fluids throughout my labor. That was one of the things where it's kind of a hard line for me just doing a whole lot of research about why do women have IV fluids? I wasn't going to have an epidural. I wasn't going to have pitocin. Why do I need it? I can ingest fluids orally.

10:16                                     Nicole: Where are you opposed to getting what's called a saline lock where it just sits there.

10:20                                     Rachael: Oh no, no, I wasn't. Actually ended up having that. So it was like a compromise like I don 't want the fluids, but feel free to put it in the lock. I totally understand.

10:30                                     Nicole: Exactly. So for the listeners guys, this is so reasonable. If you do an unmedicated birth, you do not need IV fluids. Rachel is spot on when you can drink to hydrate yourself, you don't need IV fluids. So it's disappointing to hear that. And the saline lock is the perfect compromise because it's not hooked up to anything, but it's there in that rare instance if it's an emergency. So it's disappointing to hear that you got some pushback about that because there is no reason for it to be. And what else? What other things did you want?

11:06                                     Rachael: The other one that I brought up with him was to have intermittent fetal monitoring, not to be hooked up and attached to a bed. And he was not a fan of that either. But later in my story, it didn't even really matter because I was in the bed the whole time at the hospital anyway. But that was another thing he said like, well, we have this for safety and we need to keep it on the baby. Whereas my rationale is I'm very low risk. If we had establish the heart rate for however many minutes they wanted to establish, then why do we need to have it?

11:44                                     Nicole: Right, right. So again, you said you're low risk, so you didn't have any health problems, no medications, no issues, nothing. Yes, again, intermittent monitoring and this is backed by ACOG. The American College of obstetricians and gynecologists is totally reasonable in your situation. And I will say that it's true that not a lot of ob gyn are necessarily on board with that and sometimes the hospitals and nurses don't even know how to do it properly so you can run into some concerns. It just makes me feel sad though because you're not asking you because you're not asking anything unreasonable. They're both like totally reasonable, safe things that are perfectly fine. But you decided that, okay, I'm going to approach this a different way by having a strong support team around me. Is that what it's fair to say?

12:39                                     Rachael: Yes.

12:39                                     Nicole: Okay, so who was part of your support team?

12:41                                     Rachael: That's a good question. So I had my husband of course, and then I had my mom and she is a former floor nurse turned utilization management nurse. She helps people with insurance, with things I don't understand in the hospital. And then my aunt is a certified nurse midwife and she has been delivering babies for over 30 years. So she kind of acted as a communication between my husband and my mom and me and the medical staff at the hospital. She wasn't hands on of course, because she doesn't practice in the hospital. But she acted as an in between and also an advocate for sure. Yes. And had so many labor support like activities for us to do and suggestions and we met with her before the labor, like while I was still pregnant and then she came to the hospital and met us there for the labor and delivery.

13:42                                     Nicole: Okay. So she happens to be obviously a very well qualified, well trained provider who's delivered babies for a long time. But it sounds like she kind of acted like what a Doula may.

13:53                                     Rachael: Yeah, yeah. Yeah.

13:55                                     Nicole: Except you didn't have to pay for it.

13:57                                     Rachael: Nope. She was thrilled to help.

14:01                                     Nicole: I'm sure she was. I am sure she was. So what kind of things did you do to prepare for your birth? You said you met with your aunt ahead of time. How many times did you talk to her? Did you and your husband kinda chat with her?

14:13                                     Rachael: We met with her probably two or three times. And then I had talked to her on the phone a couple of times too. And our conversation centered around kind of what does labor and delivery look like. We know it's different for every woman and for every baby, what are some things that we can do beforehand? And she asked very pointed questions of how can I support you and your husband during that time? Like what do you want from me? So we had a lot of conversations about like expectations, which was really helpful. So she knows what to expect, we know what to expect. And then she has this very calm meditative presence and something that I very much appreciate about her. And then this wealth of knowledge and all this experience from delivering so many babies for such a long time.

15:04                                     Nicole: Yeah, for sure. So what other things, did you read any books or take any classes?

15:08                                     Rachael: Oh boy. Yes I read books.

15:10                                     Nicole: Oh tell us all about it.

15:15                                     Rachael: So I took a hypnobirthing class. Which was with a very well known and well respected Doula in our area. And so that was for Chris as well, my husband and that was a five week course, two hours each time and I really think it increased both my confidence and my husband's confidence in what is birth, like what does labor look like, what are our options for intervention? And also helped us consider our birth preferences and talk those through in a group setting with someone who has been birthing babies in this area for a very long time or assisting as a Doula with babies for a very long time.

15:55                                     Nicole: Okay. Okay. I hear you keep saying birth preferences, so clearly somebody got to you early and letting you know that we cannot plan birth.

16:04                                     Rachael: And I really tried to be very careful about words and how we use them and how powerful they can be because plan can be very misleading to people. It's like, oh, this isn't in my plan. This isn't what I wanted.

16:16                                     Nicole: Exactly. Yeah. You know, I use birth plan just because that's what's commonly used, but you are right, words have meaning and you cannot plan birth. The doctors can't plan birth, you can't plan birth. Babies are the ones who are in most control of it and they don't tell us what their plans are, so.

16:32                                     Rachael: Right. Yeah.

16:34                                     Nicole: So you took the hypnobirthing class. Any other classes or...

16:38                                     Rachael: So along with the hypnobirthing, I made a point to listen to those birth affirmations as well as kind of write my own and look at them and think about them so they're in my brain as I was pregnant. And then I took the hospital birthing class.

16:55                                     Nicole: Okay. How did you find that?

16:57                                     Rachael: I found it to be very intervention based, so she did show a lot of videos of birth and talking about, he spent some time on comfort measures, but mostly it was here's the interventions that you might expect or you might participate in. I had a very strong negative reaction when she passed around all of the instruments that might be used, like forceps or the little crochet hooks, to break your waters. Oh, I don't want anything to do with all that.

17:30                                     Nicole: Yeah. Okay. That's why I tell people there are some great hospital birthing classes, but sometimes hospital birthing classes are geared towards getting you in that hospital birth system of interventions. But you sat through it and like, okay...

17:48                                     Rachael: I'm like, this is what I didn't want.

17:50                                     Nicole: And then what other things did you do any other classes or books?

17:56                                     Rachael: I did a lot of prenatal yoga. I did that about once or twice a week, which really helps. I had a yoga background before getting pregnant, so that was kind of a really cool experience to do yoga in a different way. And it also helped me find a pregnant lady community. We've kept in touch, we've met up with all our babies and that's nice. That was really, really, really, really beneficial. I read the What to Expect book, which again kind of paralleled the hospital experience. So some information was helpful and some I just kind of glossed over. I also read a ton from the Evidence Based Birth website and also listen to her podcasts, which I found incredibly helpful to help me understand interventions, the evidence behind them. It helped me understand and give me the power to say like, well, no, I don't really want any fluids for that. It's helped me have the words to say if that were to come up.

19:05                                     Nicole: Exactly. Rebecca's website is great. I'm talking about Rebecca Dekker guys and Evidence Based Birth. That's a great website for really like non-biased information about pregnancy. She does really thorough research reviews, so great source of information.

19:21                                     Rachael: Yeah, she is wonderful.

19:23                                     Nicole: Yeah, and she's actually been on the podcast and I will link to her episode where she came on my podcast and I'll link to that in the show notes so you guys can check that out. I was really grateful that she came on and I've been on her podcast too, so.

19:36                                     Rachael: That is so cool.

19:37                                     Nicole: Yeah, I'll link to both of those in the show notes.

19:40                                     Rachael: And unfortunately Nicole, I didn't find your content until I was probably two weeks out from delivery. I would listened to more of yours.

19:48                                     Nicole: Oh, that's okay. Thank you. I really appreciate it. You can tell your friends though. How about that?

19:55                                     Rachael: All of that is still so interesting to me, so I found myself listening to more pregnancy and postpartum podcasts and things like that.

20:03                                     Nicole: Right. Yeah, for sure. For sure. Did you happen to read the book Birthing From Within? That's a book that I like.

20:09                                     Rachael: So my aunt brought probably eight or nine books over when she found out I was pregnant and we asked her to help with labor and delivery and Birthing From Within was one of them and I did read a fair amount of it but I didn't finish it. But that is a good one.

20:25                                     Nicole: Gotcha. Yeah, yeah, yeah. Okay, good. It really takes away the medical side and says birth is natural, your body is meant to do this. So you were obviously very prepared to going into this, which I love. It's really important to be prepared. You're not going to get it in your doctor's office. You know you have quick like five minute visits if that and it's just not set up to give you the information that you need and if you want to have the best chances of having the birth that you want, you have to do something to prepare yourself, whether it's books or a class or both. So you obviously did your work and hopefully we'll hear that it paid off.

21:12                                     Rachael: I found a therapist who specializes in prenatal and postpartum care and we talked a lot about normalizing uncertainties. And one of the things that stuck with me that we did together was we made a little t chart and across the top it was that important and not important. And along the side vertically it's like control and not control. And we talked about all the different aspects of labor and delivery on whether or not I would rate that as something that is important and I can control versus any of the other boxes in the diagram if that makes sense.

21:46                                     Nicole: No, totally. And I think it's great that you are bringing up that you worked with a therapist and how that mental health piece can be so important as well.

21:56                                     Rachael: Yeah. I'm a social worker, so like mental health. Those are my people. Like I want it to be out there. It's all okay if you find somebody that helps you talk through things. Especially making a transition from being a pregnant person to having a baby.

22:11                                     Nicole: It's a big transition.

22:13                                     Rachael: Yeah. Yeah.

22:14                                     Nicole: You can't understand what it's like until you go through it.

22:18                                     Rachael: Oh yeah.

22:18                                     Nicole: Yeah. I mean you can be prepared, but it's just like every mother will tell you like you're prepared and then it happens and then you're like, what am I doing?

22:27                                     Rachael: Yeah. Who said it was okay for me to take a baby. Right.

22:33                                     Nicole: Well, I think you raise a really important point that we focus a lot on things like postpartum depression and that's important, but we don't always necessarily focus on mom's mental health during pregnancy.

22:46                                     Rachael: Hmm. That's a really good point.

22:49                                     Nicole: So yeah, so I think that's great that you bring that up. So let's talk about your labor and your birth. So let's give us all the details from start to finish.

22:58                                     Rachael: Okay. So I woke up at four in the morning when I was 38 weeks a long, so I was right in that, I feel like it's a sweet spot, 38 weeks and feeling kind of different sensations, some tightening, thinking, okay, this is it. My husband woke up, I didn't really want to tell him what was going on. So I just said, hey, I can't sleep hoping that he would go back to bed. But he didn't. And so I said, you know, I'm pretty sure I'm in labor. We'll just kinda see where this goes. Like don't tell anybody, like I don't wanna freak anybody out or anything. So he went to work for a couple hours during that time. Very inconsistent, mild contractions. So I ate breakfast, take a shower, walked my dog, right. Did all those things.

23:45                                     Nicole: All great things to do in that early part of the Labor. Kind of distract yourself from it. Do a little activity. Yep.

23:52                                     Rachael: Trying to clean a little bit around 10 in the morning. I called my aunt and she said, Oh, when's your next ob appointment? Which it happened to be the next day. So she said, okay, well just relax, like hang out and see what your ob says tomorrow and keep me updated. And in my mind I'm going, no, no, this baby is coming. Like we are not having an ob appointment tomorrow. Is that okay? I'll let you know like what happened. So during that time my husband got home from work. He went in for a couple of hours just to kind of wrap some things up and then the contractions got more consistent. So we took some other things we learned in hypnobirthing class and did like the exercise ball, hands and knees. When they got more consistent, I had gone down and I was listening to the hypnobirthing affirmation in between and we kinda hung out, watched a little TV, I would track and put my headphones back.

24:49                                     Rachael: It went on that way for quite some time. Then they got a little stronger, anyways, my husband was massaging my hips during the contractor. That really helped and he was tracking them with an app on his phone and communicating with both my mom and my aunt to say kinda tell them what was going on. Right. I think around 7:00 PM they were really, really close together and by really, really, I mean like five or seven minutes apart and it had been that way for quite some time. I will tell you one of my biggest fears was going to the hospital and being sent home. I was really motivated to stay at home. My husband was very anxious about us getting there in time, which this was my first baby. I didn't think I was going to have a baby in the car at home.

25:37                                     Nicole: That's very true. It's not likely that you're going to have your baby in the car. Yeah.

25:41                                     Rachael: Right. So my husband kind of made the executive decision like, okay, we're going to go to the hospital. They're like, let's get ready and go. So we lived fairly close. They're only 15 minutes.

25:50                                     Nicole: Okay. In fairness, it can be challenging for people, especially who don't have experience watching someone go through labor seeing you go through that and then like it can make people nervous.

26:03                                     Rachael: Yes. I will tell you that that hypnobirthing class, like he was a champ, like birth partner. So that really, really helped. So I had a couple of contractions in the car and then my mom, she met us at the hospital and of course they started, I was crying and got very scared and like I saw her face and I'm like, oh gosh, like this is happening. And then when we got to triage, they checked me and I was seven centimeters. I hugged some nurse. So that was the best news ever. And here we are thinking like, oh, this baby's gonna be here a couple of hours. Just feeling very excited. But also the contractions were getting stronger and more consistent. And Lo and behold, the physician on call was on the night before, of course, which didn't matter. Like honestly when I was there, it did not matter. I said, okay, nice to meet you. And I didn't see him for probably another couple of hours.

27:12                                     Nicole: Okay. Did he make any effort to like understand your birth preferences or was he just like, hey, I'm doctor such and such and I'm here?

27:21                                     Rachael: You know, I remember him asking me how long have your contractions then this close together? And I didn't have an answer because my sense of time was very much out of whack. So my husband kind of stepped in and said, oh, maybe like an hour, an hour and a half. I don't even know. And then that was kind of all I remember about our interaction together. But then the nurse said, oh, do you want the epidural? And I said, no, thank you. And she said, okay. And that was it. But then when we went down to the labor realm, the nurse assigned to me asked again about the epidural and I said no. And her response, I respect so much because she said Rachael, I'm totally cool with that, but you just need to tell me. She's like, I'm not going to bring it up and I'm not going to ask you if you want anything. It's all on you. Like, yeah, I want you to be the one to tell me. And I said deal.

28:11                                     Nicole: That's how it should be. That's awesome.

28:13                                     Rachael: Yeah. So that was really, really nice.

28:15                                     Nicole: Okay. Did you have written birth preferences at all?

28:18                                     Rachael: I did, but we left them in the car.

28:20                                     Nicole: Oh, of course.

28:22                                     Rachael: So my husband had them pretty much memorized, so he was able to tell them. And then I asked for no IV fluids and I think it kinda, the nurse was taken aback by that and she said, well let me go check with the doctor. And she did and he was fine with it. But they did put the lock in. Yeah. Which was fine. So I think if this plane interactions are really close together and the way that I was coping with them was I would feel it coming and breathing in. I made a humming noise on the way, like throughout the whole contraction. Okay. And then I was also counting backwards, like from the top with my little watch, the contraction monitor and she would help me count backwards or she would say it's fading out, it's almost done. Which I find really, really helpful within the midst of it.

29:07                                     Nicole: Right, right. So do you feel like you took it contraction by contraction?

29:12                                     Rachael: Yes, I definitely did. My husband even asked me like, what do you think of a contractions or something like that. And I said you know what, they end like, they had an ending point. So that was really helpful for me. I made a huge point to keep my hands open and palms up and my jaw relaxed. And that was like one of my main focuses during those contractions cause I didn't want to tense up my jaw or my hand because I wanted my whole body to relax even though the sensations were nothing like ever felt before.

29:42                                     Nicole: Right. It's counterintuitive because like any other time pain is considered like there's something wrong, it's a problem. So in this case it's a different type of pain. It's something you know it's for a good reason. Like you said, each contraction comes to an end, so you just have to get through the next one and the next one and at the very end is your baby.

30:05                                     Rachael: And that's something that my husband continued to tell me throughout the contractions is we get to meet our baby soon and this is not forever. And those are kind of the two that really stuck with us throughout those more intense contractions.

30:18                                     Nicole: What did the hospital policy, how was that about the monitoring? How were you able to work that out?

30:22                                     Rachael: So they suggested that I stay in bed for laboring because they said that my bag of waters was bulging, which at that point I said, I don't care. I want to stay in bed. Like I did not want to be out of bed, if that makes sense.

30:35                                     Nicole: Interesting. Someone recently asked me this on Instagram about like moving versus not moving. And a lot of people recommend, you know, move, move, move when you're doing an unmedicated birth. But there's some women who don't want to, you kind of get however you feel comfortable and you go with it.

30:52                                     Rachael: Most of my time at home laboring was spent moving like rocking side to side or bouncing on the exercise ball. But once I got to the hospital I think I was very far along in that active labor that I just didn't want to move. You know what it probably shouldn't. And I said fine. Then have the continuous fetal monitoring, which I didn't even notice it at that point.

31:16                                     Nicoel: Okay. Well good. So then how long between from when you got there and when you delivered?

31:23                                     Rachael: So it took a while to get from seven to 10. It probably took four or five hours I want to say.

31:31                                     Nicole: Okay. And that's actually not bad for a first time mom.

31:34                                     Rachael: That's good to know. We were wondering like, oh is the baby in a bad position? Cause he was on the right for a very long time and so I didn't get out of bed to labor, but hospital had the peanut ball. I laid on my side and kind of did a lot of contractions on my side with the peanut ball to open up my head. And then my support people did hip pressure, which felt amazing. And they also put cold washcloths on my head and my feet, kinda rubbed my arms and legs to kind of give that sensory input. But once I got to 10 the nurse that okay we can start pushing. I will tell you, pushing felt so much better than sitting in contractions. So we pushed for probably I think, maybe an hour, an hour and a half.

32:28                                     Nicole: Again, not bad.

32:30                                     Rachael: What kind of amazes me is, so I was pushing through the contractions obviously like waiting for them to peak and then pushing, there were some that were as strong so I didn't push through them. And then nurse Kay said she doesn't have pitocin. Like she doesn't need to push through all the contractions like saying that to my husband cause he wanted me to push through all of them. So it was really interesting to hear that. Like some contractions aren't as strong as other ones. So I kind of like not being medicated I was able to, oh, okay, I don't want to push now. I do want to push.

33:01                                     Nicole: Gotcha. Yeah, for sure. And do you feel like your nurse was supportive and helpful?

33:05                                     Rachael: She was wonderful. She was absolutely wonderful, very supportive. At one point during the pushing phase she said, Rachel get angry. And I said, I don't want to be angry. She was like, okay.

33:21                                     Nicole: We do that and we try like whatever we can think of is going to help people.There's nothing like a great l and d nurse and a great L and D nurse can make up for a bad doctor, you know, cause they're the ones that are with you at the bedside for most of it. When you have a great L and D nurse, it makes a huge difference.

33:44                                     Rachael: Yeah. And she was very transparent. She told me everything she was doing before she turned on the light. She said, oh wait I'm turning on the lights or oh I'm checking your amniotic fluid or when it's time to deliver these other people that are going to be in the room. I really liked that, knowing what to expect and she was very helpful with that.

34:04                                     Nicole: Good, good. Do you ever feel like there was any tension during that phase from when you got there to when you delivered?

34:13                                     Rachael: I don't think so. It seemed like everybody communicated with one another. I mean I was not communicating with anybody at that point. I told my husband like I think I had my eyes closed for three hours because they turned inward, which is what I needed to do to kind of get through that phase.

34:30                                     Nicole: And that's very common and that's why you have to have ladies, if you're doing a medicated birth, you really need people with you who can support you, advocate for you, speak for you because you are so focused on the job of birth and labor that you know that it's hard for you to say much of anything else sometimes.

34:49                                     Rachael: That is so true.

34:50                                     Nicole: Yeah. So then you closed for an hour and a half or so. And then what was the moment like when your son was born?

34:59                                     Rachael: We didn't know the sex of our baby.

35:01                                     Nicole: Oh, I love a surprise.

35:03                                     Rachael: I feel like everybody does. It's pretty cool. Yeah. Cause everybody at the hospital is like, Oh, do you know what you're having? No, it's a surprise. We wanted my husband to announce this back as like we're pushing, I hear my mom say, oh I see like the head and like my eyes are closed. They offered me the mirror and I said, no way.

35:20                                     Nicole: It's interesting to me. We always offer the mirror and I swear most women actually don't want it.

35:25                                     Rachael: I was just like, no, I don't think so. So the doctor came in, all the top people came in again. My sense of time is very cute. But then my mom told me afterwards that the doctor was holding up the baby and says, Dad, and my husband was just kinda like, oh go ahead. And so then he says, oh, it's a boy. And then they put him on my chest. And in that moment it was like everything went away and I was back to being me.

36:02                                     Nicole: Yeah. Yeah.

36:04                                     Rachael: And that hormonal oxytocin is no joke. I was just, wow. My husband had been awake for nearly 24 hours.It's like, okay, this is great. When are they bringing us to our room? Right.

36:24                                     Nicole: And did you do delayed cord clamping?

36:26                                     Rachael: Yes. Yes. My husband, he was good about advocating for that, but I think it's standard practice at this hospital because we said, oh, it's already done pulsating. And so then my mom came in and cut the cord, which is really sweet, and then they kind of did what they needed to do while he was on my test and then took him away and then brought him right back. No complications. So we're very blessed with a healthy a little baby.

36:51                                     Nicole: Yeah. So they really supported him being with you, which is where he should be.

36:56                                     Rachael: Right. That seems to be how they do things there, which was really, really nice.

37:01                                     Nicole: Good. That's great to hear. Great to hear. And how was your postpartum experience, your immediate postpartum course in the hospital?

37:07                                     Rachael: Yeah. So my amazing labor and delivery nurse said, do you want the mom cocktail of sprite and cranberry juice? And I said absolutely. And it was the most glorious drink I've ever had.

37:17                                     Nicole: I've never heard of that before. The mom cocktail?

37:21                                     Rachael: Yeah. Oh it was so good. It was amazing.

37:26                                     Nicole: Interesting. Learn something new every day.

37:30                                     Rachael: So my mom and aunt left, they said, okay, like this is your guys' time together. We're going to leave. And it was also three o'clock in the morning. So, and then we kinda hung out in recovery for about two hours and went upstairs to mom and baby and the nurses, every single one was amazing. They're just incredible at this hospital. Cause I felt very cared for. Understood and things like that. So our baby stayed with us. My husband had a little couch for him.

38:02                                     Nicoel: So your baby was in the room with you most of the time, which again is where your baby should be. Not In the nursery. I mean if you want to send your baby to the nursery for sure. Like if you want to get some rest, but the default should be babies with mom. And then were you breastfeeding? How's that going?

38:22                                     Rachael: So lactation consultants, they visited every day. I was there and I helped with positioning and latch and things like that. And then when my milk came in, a couple days later we went and saw lactation again for outpatient visits just to kind of make sure, again, I wanted to be prepared. I mean, he's a champ. He's already 11 pounds right now. Well he was 11 pounds two weeks ago.

38:48                                     Nicole: Okay, so he's eating well.

38:50                                     Rachael: Yeah. Yes. Yeah. Little guy doesn't miss a meal.

38:55                                     Nicole: I always called breastfeeding a labor of love because you know, it takes time and it takes energy and then like you may not be at that point yet, but when you go out of the house you're like, when am I gonna pump? When am I going to feed?

39:06                                     Rachael: Yeah. I breastfed in public for the first time last week and I was like, this is a feat for me like...

39:12                                     Nicole: How was at for you?

39:14                                     Rachael: It was okay. It was with a couple of my mom friends. So they all have little babies. Okay. So they were kind of helping and I had the little cover and they were like, you don't need to color. But for me personally, I want to cover myself. So I think it went okay. And the other girls, you know what? Nobody is in here.

39:35                                     Nicole: Looking back on everything, what are two or three things that you learned that you'd really like to share with other pregnant women?

39:43                                     Rachael: I think that understanding the process of labor and delivery is helpful. Just knowing what's going on with your body can be very empowering because when you don't know, that can be very, very scary. And I think looking at contractions, like you said as this is the way we get to meet our baby, that there's something wrong with my body in any to fight on it. Cause I think that's where I started was I'm so afraid of the pain. I don't know how I'm going to do this. I said okay, I have however many months to figure this out and prepare for it. So that's what really prompted me to seek out the hypnobirthing. It really spoke to kind of my Yoga background and kind of leaning into the discomfort and the sensations rather than being afraid of them.

40:33                                     Nicole: Right. For sure. Is there anything that you kinda wish you would've known beforehand? I don't know if that's kind of a similar question or...

40:42                                     Rachael: I don't think so. I kinda rolled with it then. There were things that I thought I would care about going into it that I didn't in the moment, like going into it is that I'm not wearing a hospital gown. Like I don't wanna wear that like labor and delivery. And they're like, okay, put this on. I said, sure, let's do it. Yeah.

41:03                                     Nicole: Alright.

41:08                                     Rachael: And then the same goes for the doctor. He was there for 20 minutes and he was fast and efficient and he wasn't the one that was there for the whole labor and delivery. It didn't matter like I thought it would matter. Like there's somethings that you might think matter but they might not in the end.

41:30                                     Nicole: Yeah. And I think that's a good point that you can still have a great experience even, and maybe I'm biased because I'm a hospitalist so I just only meet women in labor, but you can still have a great experience even if you don't know the doctor, they may not be like an integral part of the whole thing. And like you said, it just may not end up being as important as you thought it was going to be.

41:53                                     Rachael: And I think if we had maybe some complications, his role would be larger. But yeah, he was a very calm, gentle man and I appreciated that about him. Cause that's kinda how I like to live my life is calm and gentle and I like people around me to be calm and gentle. And he came and checked on me a couple of hours later and just kind of said, hey, how are you doing? Okay, congratulations. Okay. Overall, I think I had a very positive labor and delivery and birth experience.

42:23                                     Nicole: Good. That's good to hear. What were your favorite resources that you like the best?

42:29                                     RachaelL I would say definitely the hypnobirthing. The course was incredible.

42:33                                     Nicole: This was an in person course?

42:35                                     Rachael: Yes. It was an in person course where we live we're just very resource rich in this area. So I think that if women are not in a resource rich area, if you can get the book and kind of make your way through that, but I found that to be very helpful as well as prenatal yoga too. I think that finding a community of women, you don't have to hang out with them, but just like to be in a space with other pregnant women, can make you feel a little bit less alone like in yes.

43:03                                     Nicole: Yeah, for sure. I didn't realize how much of community was a part of Prenatal Yoga until I had a prenatal yoga instructor on the podcast. That's one thing that she talks a lot about, about the community aspect of it and I had another guest when she shared her birth story talk about the community aspect of Prenatal Yoga and how that meant a lot to her as well.

43:23                                     Rachael: I listened to your podcast that the yoga instructor. The whole time I was listening to it, I was like yes. Yeah, yeah, exactly. Because it is a huge part because you take about 10 minutes at the beginning of class to talk about how far along you are or what you're having, any discomfort and can you just commiserate and talk about your experience, which can be very rewarding

43:46                                     Nicole: For sure. Yeah, absolutely. So just to wrap up, what is your favorite piece of advice that you would like to give other women as they get ready for their birth?

43:56                                     Rachael: I would say be flexible. My husband and I kind of went into it as like, we have these preferences but we're rational people, right? If we get into it and I say, hey, I want an epidural. That's okay. You don't know until you're in it. So be flexible and then also like there's no prize for birthing a certain way. So just be kind to yourself.

44:16                                     Nicole: Yes, absolutely. Give yourself some grace. Your body grew a human being for goodness sakes.

44:22                                     Rachael: Yeah. And any way baby is born is natural. Like there's no right or wrong. All babies are blessings. So just kind of go into it with knowledge and preparation. And if don't go a certain way, then that's okay.

44:33                                     Nicole: I love it. Perfect advice. Yeah, absolutely. So where can women connect with you? Are you on any social media?

44:38                                     Rachael: Oh, I'm on Instagram and I have email too as most people do.

44:43                                     Nicole: Yeah. Yeah. So what's your Instagram handle?

44:46                                     Rachael: Oh it's @raymck25.

44:52                                     Nicole: Okay. And I will link to your Instagram in the show notes. I'm not going to give out your email address cause I don't want people to spam to suddenly start flooding your inbox. But certainly Instagram posts can connect with you. Well, thank you so much Rachel, for coming onto the podcast. It was really great to hear your story.

45:14                                     Rachael: Thank you, Nicole. I really love what you're doing with your website and your support to women and your knowledge. It's incredible. It's what we need.

45:22                                     Nicole: Oh, thank you so much. I appreciate that. All right, well thanks so much Rachel. You take care.

45:28                                     Rachael: Thank you Nicole.

45:30                                     Wasn't that a great interview? I so appreciate Rachael coming on to share her story. Now, after every episode where I have a guest on I do something called Nicole's notes, and here are my notes about today's episode, my top three or four takeaways from the interview.

45:48                                     So the first thing that I want you to take from this episode is that what Rachael described as a model of care, where you get whatever doctor who is on call, and there may be lots of doctors in a group practice. That is an increasingly common model of care. Where it's going to be a larger practice, you're not necessarily going to have the doctor who was taking care of you, be there for your delivery. That can certainly be unsettling and in Rachael's case, when she met one of the doctors, it was very unsettling. Now the best way to deal with that is to prepare yourself with some good childbirth education. Also have a good support team and Rachael did both of those things. It's the not knowing part that can be scary and as Rachael said, knowledge is power and when you take the time to educate yourself then you can overcome that fear. Of course I'll mention a great option that I've created is The Birth Preparation Course. I'm super proud of that and women really enjoy it and find it helpful so you can check that out at www.ncrcoaching.com/enroll. And then the other thing that Rachel did was have a good support team. Now in her case she had a midwife. You probably are not going to have a midwife who's in your family, but you can certainly have your partner there, a family member there, a doula there to help overcome some of that uncertainty of not knowing who may be there for your birth.

47:20                                     The second thing that I want to point out is that not all physicians may be up to date on evidence-based standards of care, like the issue with the IV fluids as she talked about and how it was like she got pushed back about that. Like really, all women do not need IV fluids during labor. It's just not necessary. If you're low risk and you're doing an unmedicated birth, you can just drink if you want to. Similarly a lack of knowledge about intermittent monitoring and who are appropriate candidates for that. Not all physicians are comfortable with that or understand the evidence or understand that it's even recommended by our specialty society is something that's completely appropriate in certain circumstances. So just be mindful that if you get some pushback about things, you may need to do a little bit of further investigation to find out uptodate evidence-based standards. One good place is Evidence Based Birth has a great website that has information on evidence based care guidelines in obstetrics, so that's a great resource for you. I also focus very heavily on evidence based guidelines in The Birth Preparation Course.

48:29                                     And then the last thing I want to say is that I love how Rachel talked about her mental health during her pregnancy. I know we put a lot of focus and emphasis on postpartum depression, which we should because it's really important, but the conversation also needs to include mental health during pregnancy. I think that's something that we don't talk about a lot, so I really appreciated how she took it upon herself to have a counselor to help her to be in the best shape or best mental health that she could be during her pregnancy.

49:07                                     All right, so that's it for this episode. Be sure to subscribe to the podcast in Apple podcast or wherever you listen to podcast and if you feel so inclined I would love it if you leave an honest review in iTunes. I love giving shout outs on the podcast and it also helps other women find the show. Don't forget about my free live online class on how to make a birth plan that works. The next class is coming up I think in maybe a week, a week or two and you can go to www.ncrcoaching.com/register to sign up for the class spots are limited, so sign up and grab your spot today.

49:44                                     Now next week on the podcast I have an ear, nose and throat doctor coming on to talk about common ear, nose and throat issues that can happen in pregnancy. I think this will be good timing. We're getting into fall and like maybe the fall allergies are starting to kick up, so be sure to come on back next week and until then I wish you a healthy and happy pregnancy.

50:09                                     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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