TRANSCRIPT EPISODE 68 – All About Pregnancy & Birth With Dr. Nicole C. Rankins

Transcript episode #68: Jessica's Birth Story - Choosing To Induce Labor During The COVID-19 Pandemic

Transcript

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(00:00):

This is a birth story from Jessica. She gave birth right at the beginning of the COVID-19 pandemic.

(00:12):

Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, competent, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at www.ncrcoaching.com/disclaimer. Now let's get to it.

(00:51):

Hello, welcome to another episode of the podcast. This is episode number 68 thank you. Thank you. Thank you for spending a bit of your time with me today. So today's episode is a birth story episode and it's from Jessica. Jessica gave birth right at the beginning of the COVID-19 pandemic and Jessica has been kind enough to come on and share her story of her vaginal birth and she talks about how she actually pushed a bit for induction in part because of the uncertainty surrounding it. She talks about how she's so glad she did some research about techniques for coping with pain without medication because although she had an epidural, it did not work. And then she also touches upon how the hospital staff was really very supportive even throughout the ever changing policies. Jessica has a really calm demeanor and I enjoyed our conversation and I know you will too.

(01:55):

I actually learned a couple things that I hadn't really thought about in terms of how this pandemic is changing giving birth and really becoming a mother. So really great stuff in this episode. Now before we get into the episode, let me give a quick listener shout out. This is to Seattle Erin and the title of the review is so good and the review itself says, "I am a first time mom currently 28 weeks and I have found Nicole's podcast to be very informative." Well thank you so much for that review, Seattle Erin. I have a special place in my heart for first time moms because I know how nervous you can be and how scary things can be. So I really appreciate that you find the information helpful. I know something that a lot of first time moms and second time moms, all moms really will also find helpful is my free online class on how to make a birth plan that works.

(02:55):

This is a one hour on demand online class which covers information to help you have a birth plan that works to help you have that beautiful birth you deserve. I think now more than ever with all of the things that are going on and not being able to have the same amount of support with you in the hospital, that's going to be around for a while because of this pandemic. It's really important that you have a strategy for communicating your wishes for your birth to your care team and that is exactly what you will learn in this class. So it includes information on how to adapt your birth wishes in light of COVID, how to approach the process, questions to ask, how to get your doctors and nurses to pay attention to your birth plan, what to include, so really great information. They're completely free. You can go to www.ncrcoaching.com/register and sign up for a spot.

(03:52):

All right, so without further ado, let's get into this birth story episode of giving birth during the COVID pandemic with Jessica.

(04:08):

Nicole: Thank you so much Jessica for agreeing to come on to the podcast. I think it's going to be so, so helpful to hear the experience of someone giving birth in the middle of this whole pandemic.

(04:20):

Jessica: Thank you for having me. It definitely made it interesting with everything going on and the uncertainty, especially since my experience was at the beginning of this, there was even more, it was more volatile at that time, so.

(04:34):

Nicole: I'm sure. I'm sure you were. I'm excited to hear, hear all about it.

(04:38):

Jessica: Yes, definitely threw a curve ball in an already unpredictable process.

(04:43):

Nicole: Well, why don't we have you start off by just telling us a little bit about yourself and your family.

(04:48):

Jessica: Sure. So my son was born into a very large blended family. We live with my boyfriend. He has four kids from his previous marriage and they range in age from 12 to four. And then we have my daughter, my biological daughter from my previous marriage. And now we have our son who was our first child together.

(05:12):

Nicole: Alrighty. That is a big family. Yes. Yeah. I admire people who have lots of kids. I don't, I don't think I could do it.

(05:20):

Jessica: Well they rotate in and out of the house at various times based on our custody agreement. So there's really only a couple of nights a month that everybody's here in the house.

(05:29):

Nicole: Okay. Okay. Okay, gotcha, gotcha.

(05:31):

Jessica: But it's fun. It's really fun to see the siblings interact with the baby, especially the little girls, cause this is the first time they are getting to be the big sisters.

(05:41):

Nicole: That's really cool. Yeah. So what was your pregnancy and prenatal care like? I think in order to understand how the birth went, it's nice to understand a little bit about your pregnancy and prenatal care. So what was that like for you?

(05:57):

Jessica: So this one was a little bit difficult, as far as the pregnancy goes. I'm a restaurant manager, so I'm on my feet, you know, 10 hours a day. I have really long shifts. I found out I was pregnant in the summer last summer and it was really, really hot. So I was going through all the morning sickness and stuff like that in the middle of summer and I would just get in my car every day and bless the air conditioning and just sit there for a minute after my shift and just like try to unwind and like relax a little bit before I drove home cause it was just really strenuous. But I didn't really have any major problems in the beginning. Morning sickness was, it was there but it wasn't really intense or it wasn't anything that I couldn't function around. And I actually, they told me to take that B6 and Unisom combo and I started taking that really early on and that was really, really helpful for me to try to combat the nausea a little bit. So that was a good remedy. I took that the entire time I was pregnant.

(06:57):

Nicole: Okay.

(07:00):

Jessica: As far as the prenatal care goes, everything up until the very end was really routine. We did at the 20 week anatomy scan, they found a couple, what they called soft markers for some of the genetic diseases. So they wanted to explore a little bit further. So they sent us to the perinatologist to get some more in depth ultrasounds and we went to two appointments with a perinatologist, just to kind of get their opinion and see how everything looked. And, we also decided to do the nip testing at that point, and that came back as low risk. So that was good. And then by the second visit to the perinatologist, all the markers had disappeared. So, you know, we felt like everything was on track. They did mention all along that the baby was big. So once I had my diabetes screening, up until that point, I was nervous that it could have been gestational diabetes. And then when I had the diabetes screening, that came back just fine. So in general, there was no issues with the pregnancy until the very end.

(08:10):

Nicole: Okay. Okay. But that, all that stuff is, is still sort of, it can be anxiety provoking for sure.

(08:17):

Jessica: Yeah. When they mentioned the soft markers and what they had seen in the anatomy scan, of course that was, you know, asking Dr Google, you know, what is it, what's the risk, what you shouldn't do.

(08:32):

Nicole: We all do. We all do. It's like, it's so hard not to do.

(08:35):

Jessica: I know, but everything turned out fine in the end. And it was just nice to have that peace of mind with the nip testing that even though I am considered advanced maternal age, that everything was fine.

(08:48):

Nicole: Gotcha, gotcha. And for the, for those of you all listening, the nip testing is noninvasive prenatal testing and it tests for DNA. I talked about it in another episode. I can't remember off the top of my head, but I'll link it in the show notes now. Did you have a physician or a midwife for your care?

(09:04):

Jessica: I have a physician for my care. She's a part of a very large practice here in Atlanta. So I'd seen her for years and years and years. And she primarily manages my care, but her office that she sees patients at is a bit further from my house and there's another office that's closer. So especially for those appointments at the end, I didn't feel like driving all the way across town in Atlanta.

(09:28):

Nicole: Yeah, Atlanta is a hot mess.

(09:31):

Jessica: I went to the office that was closer and I saw a mix of the different physicians at that office and then a midwife that practices over there as well.

(09:40):

Nicole: Okay. Okay. Did anything change about your prenatal care once COVID happened?

(09:46):

Jessica: Yes. My last appointment, my 36 week appointment was on St Patrick's Day and that was a few days after they had closed the schools. COVID had just become really like newsworthy and it was really uncertain about what was happening. So at my 36 week visit, I was still allowed to bring my boyfriend at that visit. I went to the office and they had the chairs all spaced out and you were starting to see the nurses and the staff wearing masks. They had removed the pens from the front desk and just various other precautions that they were starting to take in that visit. We started to talk about procedures that might change because of the COVID as far as the birth goes and the rest of the office visits and everything that was going to happen from here on out. So that was when it started to get a little bit interesting. With my first pregnancy I had preeclampsia, so I was very on alert with my blood pressure during this pregnancy. And at the end, at 36 weeks was when it started to get high again. And then just because of the anxiety and everything, like going into that waiting room and seeing the chairs removed and starting to understand the magnitude of what was happening at that visit, my blood pressure was sky high.

(11:07):

Nicole: So was it, do you remember what the number was?

(11:10):

Jessica: Oh gosh. It was like 160 over 90. It was super high, so she hooked me up to the monitor for a while and I sat there for 30 minutes while they monitored the baby, and just kind of came in every, you know, 10 or 15 minutes to check my blood pressure again. And it did go back down into the one thirties, but it was just a combination of me already being vigilant about the hypertension at the end of my pregnancy from last time. And then the uncertainty and the scariness of everything that was happening in the world. It was very anxiety inducing.

(11:44):

Nicole: I can only imagine. Absolutely. So then she decided to let, I mean obviously I, she let you go from that appointment or you went home from that appointment, is that correct?

(11:56):

Jessica: I went home and I scheduled an appointment at the office by my house for the next day and at that appointment they did an ultrasound to see basically if the baby was finished. So they checked the weights, they checked like all the organs and everything just to give one final scan in case I did have to be induced before 37 weeks. I just wanted to make sure that we were in a good place to do that. And that all came back fine again. My blood pressure at that appointment was super high. It was, I think it was in the one fifties, for the top number. But at that appointment she said, okay, she's like, go home and pack your stuff. You need to go to labor and delivery right now. So I called my boyfriend. He was on his way to work. I said, um, we're going to go have a baby. So turn around.

(12:49):

Nicole: And then before we get into what happened, when you got to the hospital, what had you done beforehand to prepare for your birth and what are some things that you, that you wanted?

(12:59):

Jessica: Well, I did your podcast, obviously it was my...

(13:01):

Nicole: Oh, thank you.

(13:02):

Jessica: Yes, that was my primary refresher on labor and delivery preparation. I did a little bit of research on hypnobirthing. I wasn't set on having an unmedicated birth, just because I knew, I know how unpredictable it is. And since I had been through it before the epidural worked great with my first birth. That was my plan going into it. But I did want to kind of explore the options and see how far I could get on my own. So I did a little bit of hypnobirthing. I listened to some episodes of Evidence Based Birth which you recommended on your podcasts. And that was pretty much it. It was just refreshing on what happened, exploring a little bit of the unmedicated route just to see, you know, see what that was like and get a little bit of understanding in case I needed it.

(13:51):

Nicole: Gotcha. Gotcha. And what are some things, did you have anything in particular that you wanted for your birth experience?

(13:56):

Jessica: I was pretty flexible with this one just knowing how unpredictable it was. But a few things that I really wanted was, I wanted my partner to reveal the gender cause we had a gender surprise.

(14:09):

Nicole: Oh nice.

(14:10):

Jessica: So that was fun and it made it really interesting and all the nurses came at the end cause they wanted to know if it was a boy or a girl, so I had him do that. I wanted him to cut the cord and I asked them to put the baby straight on me. As soon as it came out, I just wanted the baby straight on my chest. I didn't care if it was clean, nothing like that. I just wanted immediate skin to skin. And I did ask to see the placenta. This time with my first one, I declined to see it, but I started to understand the importance of this organ that my body grew just for this purpose. So I wanted to see what it looked like.

(14:44):

Nicole: Awesome.

(14:45):

Jessica: That was pretty much it. Everything else was, I was go with the flow and we'll see what happens.

(14:50):

Nicole: Gotcha, gotcha. So, and I guess I should ask, how was your first birth experience? Was that a good experience for you and did that influence how you felt about things?

(15:00):

Jessica: Yes, it was a good experience. That one was an induction as well at 37 weeks due to the preeclampsia. And with that one they called it full blown preeclampsia. So I was having the migraines and everything like that. So they got her out really quickly. That one I had a Pitocin induction, so I went in the night before I had the Pitocin and my body responded really well to it. I had the epidural, which it was able to help me relax and dilate really quickly. I pushed for a while cause she at 37 weeks, she hadn't calmed down enough. So I pushed for probably about two hours when I had her.

(15:38):

Nicole: That's actually not bad for a first time mom.

(15:40):

Jessica: It wasn't bad and I was, I was mostly numb for the experience so it wasn't quite as painful.

(15:47):

Nicole: Okay. So that's good that you had a good experience the first time around, so you didn't feel like, you know, you knew that that was possible.

(15:55):

Jessica: Yeah, my body tolerated everything really well. It tolerated the Pitocin, it tolerated the epidural, the baby did great with all of those things. So I felt pretty confident if I had to go down that path again, I was going to be fine.

(16:07):

Nicole: Got it, got it. Now when you wrote to me, you actually said that you sort of pushed to be induced. Why was that?

(16:16):

Jessica: So that was because of the, first of all the hypertension and then the anxiety surrounding COVID. I could see where it was headed. I knew that if I waited a couple more weeks, I was going to be in that full blown preeclampsia again. I could feel it starting just the same way that it did with my first pregnancy. And the anxiety surrounding everything at the hospital was really starting to peak. So I didn't know if my partner was going to be able to go. I didn't know what the environment was going to be like and I really just wanted to get in and out of there as quickly as possible.

(16:45):

Nicole: Gotcha. Gotcha. And do you feel like your doctor was, it sounds like she was supportive of that.

(16:52):

Jessica: Yeah, we were on the same page and when she told me to go to the labor and delivery at 36 weeks, I was like, okay, let's just go and get this over with.

(17:03):

Nicole: So then what was your induction like this time? What was your labor and birth like?

(17:08):

Jessica: So this time, the first time I went to the hospital, they put me on the monitor. They kept me there for about two hours, I was 36 weeks and four days. And at that point my blood pressure stabilized while I was there. They did not want to deliver the baby before 37 weeks. So they actually sent me home. So sent me home for bed rest, which I did the best I could with that with my four year old daughter.

(17:33):

Nicole: Yeah. I don't know why we, I mean there's not a whole lot of evidence that it works and then it's nearly impossible when you have the responsibilities. So you do the best you can.

(17:43):

Jessica: Exactly. We just took it easy that day. She got to watch a lot of movies. So this was my experience with having to wait for the hospital to call me for my induction. They scheduled it for the next Sunday, which was 37 weeks and zero days, and I had to wait around that day to get the call from the hospital that was like, Hey, come in, we're ready for you. They called me about three o'clock and she said, can you be here in an hour? And I was like, well, I have to, you know, make arrangements for my child, but we'll get there as soon as we can. And so we got there relatively quickly and they got us checked in and got us settled into the room and everything. And this time I wasn't as, my cervix wasn't as dilated as it was the first time, so they decided to go ahead and place the Cervidil.

(18:34):

Jessica: So I had that this time. I didn't have that with the first one, so I was a little nervous about what to expect with that. But they placed it around six o'clock at night. And when you have that you can't move or get up from the bed for a couple hours cause they want to make sure that it stays in place. So she told me that oftentimes Cervidil will go ahead and start labor, which it did for me. So I had the Cervidil around six and just kind of laid there for a while. After a couple of hours I was able to get up and use the bathroom or walk around a little bit if I wanted to. So I did that until about midnight and around midnight they started coming in and checking the baby's heart rate because it was starting to drop a little bit.

(19:15):

Jessica: So they made the decision to go ahead and remove the Cervidil and let my body kind of take over and just see what happened over the next couple hours. So they took it out around midnight and I just labored by myself. At night I was having some contractions but they weren't anything that I couldn't really handle on my own. So I just got on the peanut ball and kind of bounce up and down a little bit and sat in the bed and put some music in my headphones and worked through the contractions and I got myself to about four centimeters dilated.

(19:48):

Nicole: Okay. Was your boyfriend there at the time?

(19:50):

Jessica: He was there, he was sleeping during that part. It wasn't, I didn't really need any support. I just kind of went in to my zone and worked through everything. And um, they came in around six in the morning and she was talking about breaking my water and asking if I wanted the epidural.

(20:08):

Jessica: And I said, sure, let's go ahead and get that epidural right now. And that way you guys can break my water and do everything like that and I won't even know you can just go ahead and do your exams and whatever you need down there. So we called the anesthesiologist and he came in around seven and place the epidural, which was fine. And then they broke my water shortly after that. So then the contractions really started to ramp up and then it was probably around noon, maybe a little earlier than that. She came back in and she was checking everything. They had been coming in a little bit and they wanted me to lay on one side just because when I flipped to the other side of the baby's heart rate would drop. So come in and push me over to the other side.

(20:50):

Jessica: But everything was going fine at that point. And she came back in and I said, you know, I can, I can move my legs by myself. Like I could flip myself in the bed. And she was like, okay, that happens sometimes, but you shouldn't feel anything in your belly. You shouldn't be feeling any of the contractions. And I was like, okay, for the most part, I can't feel anything. I can feel a little pressure. And she said, just call me back if you start feeling any pain in your belly. So I waited about 30 minutes, I started feeling the contractions. Little by little I was feeling them more and more. So I called her back in and I said, you know, I think that I need to, um, we need to like do something with the epidural cause I can feel everything right now.

(21:30):

Jessica: And at that point I was about six centimeters dilated. So I went from four to six in a couple hours without really having any pain. And then the pain started back up. So she gave me a little bit more of the medication through the epidural to keep it coming and I still was feeling the contractions. She made a little bit more medication after that and I was still feeling the contractions. So she called anesthesiologist back and he came back down and he gave me another mix of drugs through that epidural to try to numb my mid section again. He said, wait about 20 or 30 minutes and you shouldn't be feeling anything. So at that point the contractions were starting to get really intense. I knew I was getting close to transition and that felt like a really long 30 minutes. But I was, I was still feeling pain.

(22:22):

Jessica: So I called him back and he gave me another mix of drugs to try to get the epidural back working again. And he said, okay, this is what we give people when we're giving them C-sections. So this would definitely work. So I was like, okay, please, you know, let it work. So he gave me that and I could feel my legs going numb, but I could still feel every contraction in my midsection. So at this point I was probably around eight centimeters dilated and it was getting very, very, very intense. I couldn't talk through the contractions. I was getting really upset when I would see the contraction starting to build on the monitor and he's, the anesthesiologist came back and he said, well, sometimes we have to move the needle or replace the epidural altogether at this point. But there was no way I was going to be able to sit still while that was happening.

(23:18):

Jessica: It was just too intense. The contractions were coming too fast. So I kind of looked at my nurse for guidance and she was like, we can try it if you want to. And I was like, no, I can't, you know, I'm too far into this now we're just going to finish it off. So that was about, I was still about eight centimeters dilated, but the problem was the baby was still really high. Was at like negative two station. So I still had a long way to go before I was going to be ready to push the baby out and she, she was like, okay. You know, she helped me work through the contractions. She was just, she was checking me pretty frequently just because I was in so much pain. She really wanted, we both really wanted me to start pushing to try to get it over with.

(24:02):

Jessica: So I did, you know, I did labor down until I got through that 10 centimeters and she called the doctor in and it was very, very, very intense. And this was the point where I was, I was having to pull everything that I researched and learned from my memory to try to make it through these contractions. So I was really glad that even though my intention wasn't to have an unmedicated birth, I was so glad that I had studied a little bit. Some of the techniques to try to make it through an unmedicated birth cause I had to pull those out and use them even though I didn't expect it.

(24:41):

Nicole: Gotcha.

(24:41):

Jessica: So I use some of the hypnobirthing techniques I used a focus object and the contractions where I was able to find a focus object and just like stare at it until the contraction was over, that was helpful. You know, some contractions where I just cried through it. But we finally got to that point where we could start pushing and so I started pushing and that helped at first. It helps make the contractions, you know, since you're able to push through it, you can work through the contraction a little bit more and kind of, you start to see an end in sight, I guess when you get to that point. So I pushed for a long time. The good thing about not having an epidural was I was able to do some different techniques. I didn't just have to lay there on my back. I was able to use the squat bar. They brought in another nurse who had a bed sheet and we did the tug of war for a little while. So I told her, I was like, I'm sorry if I throw you against the wall.

(25:42):

Jessica: But she was great and the nursing staff and the doctor were really, really great. And my birth partner as well, there was so many times when I was just like, I can't do this, I can't do this. And they were like, you're going to do it. You're almost there. At one point, the nurse looked at me in the eye and she said, you are going to deliver this baby through your vagina. And I was like, okay, okay. And we finally got to the end of it and my boyfriend was like, look, the doctor he's putting on the gown, there's the tray of tools is over there. The baby team is coming in. We're almost there. You can do it, you can do it. And there was just so much encouragement coming through. And finally he, the doctor, like really was helpful in getting me in any position or any technique he could think of to try to help get the baby out.

(26:28):

Jessica: And finally I pushed a few more times and he was like, the baby's coming to more pushes than the baby's going to be out. And the baby was almost out. And finally I saw the baby coming out and he held the baby up and I saw my baby boy and I just started sobbing. I just, it was uncontrollable just because I was so excited to see my baby and I was so relieved that it was over and I couldn't believe that I had done this, you know, unexpected unmedicated birth. So it was a very, very emotional moment for me. And they placed my little boy on my chest and I was just so, I just couldn't stop sobbing.

(27:07):

Nicole: That's really beautiful. Yeah, yeah, yeah. So then, even though he was a little bit early, he was, he was fine. I presume.

(27:17):

Jessica: He was fine. He was eight pounds on the dot when he came out.

(27:21):

Nicole: Eight pounds at 37 weeks??? Yes, girl, he was on his way to being near 10 pounds.

(27:28):

Jessica: I know. I was so glad I didn't go full term. I wouldn't have been able to here. But they did take him to the NICU just because the delivery was so rough that he had a really bad bruise on his head. So it was bleeding on his head and they took him for a CT just to make sure there wasn't any bleeding in his brain. And then he also, his lungs were a little bit underdeveloped I guess. So he was making these grunting sounds.

(27:55):

Nicole: Yeah. Yeah.

(27:57):

Jessica: So they took him to the NICU. And he was only there for a couple hours. I think he went there and probably about six at night or five in that evening. And then they brought them back to us in the room at midnight. So they just wanted to check. Yeah.

(28:11):

Nicole: Yeah. Sometimes babies at 37 weeks, they're right on the border of being able... Breathing is the last thing that babies kind of get the hang of. And that's not uncommon that at 37 weeks they may have a little bit of trouble with the grunting and then it just sounds like he had a rough road coming out. So...

(28:30):

Jessica: He did, it was rough for both of us. But other than that he was fine and they said particularly for some reason with baby boys when they're born early, there's a higher chance that they'll need some more special care.

(28:43):

Nicole: That is very true. Girls do better when they're born earlier than boys for sure. Yeah. Yeah. So how do you think things were different for your birth because of COVID or do you think anything was different?

(28:57):

Jessica: They were definitely starting to take more precautions at that point. At my last visit at the doctor's office, she had mentioned that they were, she thought they were allowing one person to come in with the laboring mom. She also mentioned that it was possible that they weren't allowing any, so that was very panic inducing. And was, that was the point when I was like, okay, let's get this show on the road before that happens. So they were allowing one and when we came for the induction to get checked in, they were taking our temperature. They were giving us the questionnaire if we had been exposed to anybody that had tested positive or if we had been exposed to anybody that was experiencing the symptoms or if we were experiencing the symptoms ourselves.

(29:37):

Nicole: Got it. Got it. And do you feel like the staff was still attend to, it sounds like they were still attentive to your needs and the mood of the staff at the time was okay.

(29:46):

Jessica: Yeah, they were for sure. I delivered at a, like a satellite location, a suburban satellite location of our big hospital here in Atlanta and there was not a lot going on in the hospital when I was there, in general. So there was a lot of nurses on staff and they came to the room for my birth. I think just because there wasn't a lot going on, so there was a lot of them in there. But some of them were wearing masks at that point. Some of them weren't. But it definitely wasn't the social distancing that we would see now.

(30:18):

Nicole: Got ya.

(30:20):

Jessica: We didn't really know at that point that that was going to be so important. So being on the earlier end of it, it was more normal, I guess, than it probably is today. And the time we were there for our postpartum, we spent two nights there and the policies were changing daily. So the first day wasn't really anything different. By the second day they had closed the pantry where you could go and get water or food or anything like that. The nurses themselves became like servers at a restaurant on top of everything else they were doing. And they were more than happy to do it. But anytime we needed water or food or anything from that pantry, they would have to go get it for us. And then they cleared out the fridge so he couldn't, if we brought in any food, he couldn't hold any leftovers there. And they did let my partner leave and they did allow us to accept delivery food throughout the duration of our time there. So I'm assuming now that's probably different.

(31:18):

Nicole: It depends. Some hospitals do let people go in and out. Some don't. It really just depends. I think most people are allowing delivery food though. You just have to meet them down at the, at the front.

(31:29):

Jessica: Yeah. That's what he did. And they did have the policy in place where once he came in, it was only him. I couldn't swap out for another support person or anybody else.

(31:39):

Nicole: Gotcha. Gotcha. Okay. And then so you stay two nights and then you went home, now you're seven weeks out. Now normally you would have a postpartum visit around six weeks.

(31:51):

Jessica: I did. I had one at four weeks, which is my office's standard practice. I really wanted to have my tubes tied, but they said that that wasn't, you know, that's an elective procedure. That wasn't an option right now. So she, we talked a little bit about placing an IUD and she said, you know, this is a little elective procedure as well. I'm really not supposed to schedule, but I'm going to go ahead and call it a postpartum visit and we'll get you in and get your IUD placed. So I'm going to go back this week actually to the office again and get that procedure done.

(32:21):

Nicole: Okay. Okay. But you did actually do that four week visit in the office?

(32:25):

Jessica: Yes, I did.

(32:26):

Nicole: Okay. And what was that visit like? Were there masks?

(32:30):

Jessica: There was more masks. They came out to the waiting room to take my temperature before they brought me back into the office. You can just, the office was more quiet than normal. They, you know, they didn't have everyone coming in for every visit and a lot of things they were putting off. So it was probably me and I saw maybe one other patient while I was there. So, but yeah, it's definitely more quiet.

(32:54):

Nicole: Got in and out fairly quickly.

(32:57):

Jessica: Yeah. And I think I was still having blood pressure issues after the birth. So I think that was one of the reasons why she wanted me to come into the office was to do a check, a blood pressure check there. And then I was on some medication for it. So she wanted to talk about the plan for getting me off the medication.

(33:11):

Nicole: Okay. Okay. Gotcha, gotcha. Cause yeah, often we bring people back with blood pressure issues a week after birth. I don't know if you were probably taking your blood pressures at home?

(33:21):

Jessica: I was, yeah. Yeah. They had me logging in, taking it several times a day.

(33:26):

Nicole: Gotcha. Gotcha. Okay. And then so how, comparing your two experiences of giving birth, were they, um, a whole lot different? A little bit different? How do you feel?

(33:40):

Jessica: I feel like with this pregnancy, I knew what to look for. You know, I knew the signs of preeclampsia, I knew what happened the first time. I knew what to expect, which, you know, as a second time mom you do. So I was more vigilant throughout my whole pregnancy about those issues that came during the first one. And I had a feeling that it was gonna go down the same path. So I was just like very mindful of that throughout my pregnancy. I try to check my blood pressure early in the pregnancy. I would go to the pharmacy and check it. They're on their machines and I was just aware of it throughout which I wasn't really with the first one. And then as far as the birth goes, I knew, you know, if I had the induction that it was going to be fine and I just want to, in my preparations for the second birth, I wanted to explore a little bit further. Some of the other options, not necessarily because I was going to use on which I did end up using them, but because it was interesting to me. So listening to your podcasts and then evidence-based birth was more of just me trying to educate myself because I thought it was interesting.

(34:48):

Nicole: Gotcha. And then it all came in handy, but it sounds like your birth experience, like the actual birth part wasn't that much different because of COVID thing. And that's what I'm finding, that once you get into the hospital and you get settled, that things aren't that much different for the actual birth. Now afterwards, things may be at, you know, like visitors and like you said, the pantry is closed and all of those things. But the actual birth itself seemed to be pretty...

(35:21):

Jessica: Yeah, it was fine. And early on we just didn't know. You know, I was worried about at this hospital was anything going to be different in labor and delivery? Was it going to be overrun with people with coronavirus symptoms? Were the nurses going to be distributed to the ER where they were more needed. There was just no way to know what was going on. But they assured me that, you know, labor and delivery is always going to be separate. They're gonna make sure that the laboring moms are taken care of. Cause that's always going to happen no matter what. So when I got to the hospital, I had a lot of reassurance that security and safety precautions were being taken to limit any type of exposure or anything like that.

(36:03):

Nicole: Gotcha. So how do you feel overall about your birth experience? Is there anything that you weren't happy about?

(36:11):

Jessica: It was definitely interesting. Like I said, just with the anxiety of not knowing what was going to happen. And then the postpartum period has been a little bit more challenging just because we weren't really allowed to have visitors. And the pediatrician just said, you know, nobody should visit the baby right now. And so not being able to have the family around early on has been difficult. And having six kids at home, we did need help. So we did have one of the grandmas come over and then eventually we've had a couple more people come meet the baby, but for the most part of the family really missed out on that newborn stage. Which was, which was hard.

(36:51):

Nicole: Yeah. Yeah. And I think that's one of the things that we haven't thought through as well with mom's coming home with these new babies and you know, we say before this like, get help, get help, get help and now help can't really come to you. So it's definitely a challenge.

(37:09):

Jessica: And early on, when we were just finding out about it, I felt like I almost wanted to keep the baby in cause I knew it was protected from, from COVID. And I thought, you know, if I get it pregnant, the baby at least will be safe inside of me. But once it, once it comes out, there's no way I can protect this little baby from what's going on in the world right now.

(37:33):

Nicole: Right, right, right. So just a lot of ups and downs. Right.

(37:36):

Jessica: Yeah, for sure. But as far as the birth process goes, I really, there wasn't anything that I wasn't unhappy about. You know, I wish my epidural had worked, but there's no way to know that, that anything like that is going to happen. You don't expect it. You just think, you know, I'll get my epidural and I'll just be fine. And especially before. Right. So that threw me for a loop, but we all survived. We made it through a couple of bumps and bruises.

(38:03):

Nicole: Right, right, right. And then how, how are things now, I know you work, you said you work in the restaurant industry, so how is that going to be for you now and going back to work?

(38:17):

Jessica: I think it's going to be interesting. My boyfriend is in the restaurant industry as well and he's been back at work for two weeks now. They've been doing takeout and curbside at his place. So he hasn't really had a lot of interaction with anybody but his coworkers. But this week they're opening the dining room so he'll have a little bit more exposure. And my restaurant is a quick service restaurant, so it's been open the whole time. I'm doing takeout only, but I'm sure they're taking a lot of precautions to try to minimize exposure or, and try to keep the employees and the guests safe just like any restaurant is doing. So I haven't been in contact with them a whole lot. So we'll see. I go back in four weeks. We'll see what it's like.

(39:04):

Nicole: Yeah. Yeah. Are you worried about it at all?

(39:07):

Jessica: I think I'm more worried about the kids being in daycare, the daycare is open and my daughter, she misses her school terribly. She's had a really hard time with not being able to go, but they opened the daycare today and the list of protocols that they have to follow at the daycare is really, really, really intense. So the director said that, you know, if they weren't confident they couldn't meet these protocols, they wouldn't open at all. So I feel pretty good about that, but there's still that anxiety, you know, I have a newborn baby that I'm sending, I'm going to have to send in a daycare really soon. And you know, you just hope that they're doing everything that they can to keep the kids safe and keep themselves safe. And you know, that gives me a little bit of a little bit of pause, but it's just a part of being a working mother.

(39:59):

Nicole: Absolutely. Yeah. Is your baby going to go to the same daycare as your daughter?

(40:04):

Jessica: Yes.

(40:04):

Nicole: Okay. Okay. All right. Well, what advice would you give to other women who are giving birth right now during this pandemic?

(40:15):

Jessica: Just with any birth my advice would be just to keep an open mind and you can, you can plan as much as you, as much as you want, but the expectation and reality might be a lot different when you get in there. So just try to go with the flow and relax. The care providers want you to have the best experience possible and they're going to do everything they can to try to make that happen. So just trust in them as much as you can and just, you know, be positive right now and at the end, no matter what the process is, you're going to have your beautiful baby there soon.

(40:48):

Nicole: Yeah, yeah, absolutely. So where can women connect with you? Are you online anywhere you can say no if you're not or, or if you're in the Facebook group, if you're there. Okay.

(41:00):

Jessica: Yeah, through the Facebook group is probably the best way to connect with me. And even in the last seven weeks postpartum, I still followed a lot of the posts and stuff like that. And since I first joined, I've seen a lot more people joining your group. So it's been fun to see it kind of explode and read some of the different threads and stuff like that.

(41:18):

Nicole: It is a great group and it's very encouraging and supportive, so thank you for being a part of it.

(41:24):

Jessica: Yeah, of course. Thank you. And it's so nice as a, when you're pregnant and as a new mom to just have support of a community like that, everyone's going through the same thing.

(41:35):

Nicole: Yeah. Yeah. Well thank you so much for coming on to share your story. I'm so glad everything worked out well and I am wishing you the best through this new normal and going back to work and being a working mom, all that stuff just kind of tugged at my heart when you said that. So you know how it is. Yeah. Yeah. All right. Well, Jessica, thanks so much. You take care. Thank you.

(41:58):

Jessica: You as well.

(42:05):

Wasn't that a great episode? I learned a lot from hearing Jessica's story and I hope that you did too. She also has a really calming demeanor to me, so I hope you find that helpful as well. All right. After every episode where I have a guest on, I do something called Nicole's notes where I talk about my top three or four takeaways from the episode, so let me give you my Nicole's notes from this episode with Jessica about giving birth in the middle of a pandemic. The first thing that I want to say or that jumped out to me is that the staff really wants you to still have a great birth experience. Even in the middle of this pandemic, hospitals and physicians that were good hospitals and physicians before this pandemic are continuing to do that through this pandemic and are really putting in the effort and really care about making sure you still have a great birth experience. That's what I've witnessed at the hospital where I work. That's what so many other people have witnessed at their hospitals and their facilities and what I hear my colleagues saying, so if the hospital and physicians and staff are committed to helping you have a great birth before the pandemic, that is definitely still the case.

(43:28):

The second thing that popped out to me is about that reminder to really listen to your instincts and listen to your body. Jessica was starting to feel that she was going to have issues again with the preeclampsia. It was similar to how it came on during her first pregnancy and her blood pressures were creeping up, so she was able to advocate for herself that, Hey, maybe induction may be the best thing for me. And also with everything that was going on with coveage, she had this instinctual check in with herself that this was what was right for her and her doctor was on the same page as well. So when you have those instincts, when you have those gut feelings about things, pay attention to them. Okay. I'm not saying that they're necessarily going to be right a hundred percent of the time. None of us are, but they deserve some discussion and some thinking about and kind of bringing up, I don't want you to ever ignore those gut instincts or those feelings that you get because those voices that advice, that guidance is important.

(44:42):

All right. The third thing, and this was one of the things that I hadn't really thought about was bringing stuff with you to the hospital. And I've kind of talked about it in the sense that you need to bring clothes for a few days and your partner needs to bring clothes cause you're not going to be able to go in and out of the hospital. You're not going to be able to have people bring things up to you. But I think what really hit me is when she said like you can't even go to the pantry and get like a cup of water. Like you used to be able to just sort of go and get those things yourself. Go to the pantry, grab some whatever's in the refrigerator, any snacks that are there. But those kinds of things aren't possible right now. So you really need to be completely prepared. Maybe I need to do actually do another podcast episode about being prepared when you go to the hospital because of how things have changed. And as an aside, you know, I think I talked about this before, how I thought that COVID was just going to be a short term thing. It's going to be around a little bit longer. So you just really need to think through a little bit more long term in terms of how this is going to affect things. So bring clothes, bring medications, bring food, bring all of the supplies you can with you to the hospital to be there for two or three days.

(46:02):

And then the last thing, and this is also something that I hadn't really thought about, is going back to work and what that means for you and what that means for the safety of your newborn baby and just the challenges of finding daycare and finding a place that is safe for your baby, where you feel comfortable. I mean you're going to have to go back to work in order to make a living and as States and places are beginning to open back up, this is really a serious concern about how you feel good knowing that your baby is being cared for and all of the appropriate precautions are taking place in order to keep your baby safe. So I would really love to continue that conversation about how folks are planning to go back to work in the next few weeks or months after this pandemic because again, it's going to be around for a while.

(47:09):

I would love to continue that conversation in my free Facebook group All About Pregnancy & Birth and just kind of talk through what women are doing there and provide advice and support for each other in that group. If you're not in the group, it's a great group to be in. You can search for it on Facebook. It's called All About Pregnancy and Birth and it's a really supportive and uplifting non-judgment community. So definitely check that out so we can continue that conversation there about how we are going to handle going back to work.

(47:42):

All right, so that is it for this episode of the podcast. Be sure to subscribe to the podcast in Apple podcast or wherever you listen to podcasts. That way you do not miss a single episode and of course I would love it, love it, love it and be so appreciative if you leave a review in Apple podcast. That helps other women to find the show and helps the show to grow and of course you can also subscribe on other platforms. I know a lot of folks listen in Spotify, so just wherever you listen to the podcast subscribe, but it's really an Apple podcast where there's reviews are super duper helpful for me in the growth of the show and helping other women who need the show find it. All right. Next week on the podcast I will have a breastfeeding expert on the show. We had a really great conversation, so come on back next week and until then I wish you a beautiful pregnancy and birth.

(48:41):

Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website at www.ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class on how to make a birth plan, as well as everything you need to know about the birth preparation course. Again, that's www.ncrcoaching.com and I will see you next week.

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