Ep 105: Emilie’s Birth Story – Every Birth is Different

It’s another birth story episode today and this one is a completely unmedicated hospital birth in a military hospital.

Emilie is a registered nurse and military spouse currently living in Guam. She and her husband Chris have been married for 5 years and have two precious babies, Liam who is 2 and baby Adeleine whose birth story we are going to hear today.  She is taking a break from full time nursing to stay home with her kids and soak up the sunny Pacific. She and her family enjoy hiking, traveling (before the pandemic), and splashing at the beach.

In this episode Emilie shares how different her two births have been, her experience with postpartum preeclampsia, and the excellent care she received in a military hospital.

In this Episode, You’ll Learn About:

  • What makes prenatal care and giving birth in a military system unique
  • How Emilie’s husband served as her “dude-la” when she couldn’t have a doula present due to Covid
  • How Emilie’s background as a nurse informed her pregnancy and birth
  • Why you can’t predict how a birth is going to go
  • What her experience of postpartum preeclampsia was like and how it was treated
  • Why it’s important to listen to your body and advocate for the care you need

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Transcript

Ep 105: Emilie’s Birth Story -- Every Birth is Different

Nicole: Well, this is a birth story episode of firsts. Today, we are talking about giving birth in a military facility. You're also going to hear about postpartum preeclampsia.

Nicole: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB GYN who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, 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 drnicoleankins.com/disclaimer. Now let's get to it.

Nicole: Hello. Hello. Welcome to another episode of the podcast. This is episode number 105. Thank you. Thank you. Thank you for spending a bit of your time with me today as always. I appreciate it. This is another birth story episode today, and this one is a completely unmedicated hospital birth in a military facility. We have Emilie. Emilie is a registered nurse and a military spouse. They currently live in Guam. She and her husband, Chris have been married for five years and have two precious babies, Liam, who is two and baby Adelina, whose birth story we're going to hear today. Emilie is taking a break from full-time nursing to stay at home with her sweet kiddos and soak up the sunny Pacific. She and her family enjoy hiking, traveling of course, outside of the pandemic, and then splashing at the beach. This is a great episode for a number of reasons.

Nicole: You'll learn about prenatal care and giving birth in a military system. And there are actually some lessons to take away from that that apply to giving birth outside of a military system. Emily shares about what is her second unmedicated hospital birth, and actually how different it was from the first unmedicated hospital birth she had. And then finally we learn about her experience with postpartum preeclampsia. So there is definitely something in this episode for everyone. Before we get into the episode, I have a quick question. Have you taken my free online class on How To Make A Birth Plan That Works? See the thing about making a birth plan is that most people think that it's about what you want for your birth, and that is certainly part of it, but there's more to it than that. The process of making a birth plan really needs to include understanding two of the most influential factors in your birth, your doctor's approach to birth and how the hospital approaches birth.

Nicole: When you understand those two factors, that is how you have the best chances of having your birth wishes fulfilled. Okay? So in my free online class, I take you through a step by step process and give you questions to ask in order to understand how your doctor and how your hospital approach birth. So you know that the team of people who are with you are ready to support you and the birth experience that you want. You'll also learn some tips on how to get them to pay attention to your birth plan, how to get your doctors and nurses to pay attention that is, and what to include. Tons of good, great information in this one hour class, you can sign up for the class at drnicolerankins.com/register. It is totally free. It's an on demand class offered several times a day. So do check that out at drnicolerankins.com/register. All right, let's get into the birth story episode with Emilie.

Nicole: Thank you so much, Emilie, for agreeing to come onto the podcast.

Emilie: Thank you so much. I'm so excited to be here.

Nicole: And I know when you initially submitted, you were going to talk about maybe your son's birth, your first child, but just in chatting beforehand, we decided that it's maybe better, or I shouldn't say better, but definitely provides a new, like, perspective to talk about your second.

Emilie: Absolutely. Yes. I'm happy to.

Nicole: Yeah. Yeah. So why don't you start off by telling us a bit about you and your family?

Emilie: Sure. Um, well, my name's Emilie and I'm married to my husband, Chris. We've been married for five years and I'm a registered nurse. I'm currently taking a little break to raise my kiddos and we live in Guam. My husband is an engineer in the air force, and so we have been here for about a year and a half. So I had my first son in the States and then I just recently had my daughter about seven weeks ago here in Guam.

Nicole: Gotcha. And how long have you been a nurse?

Emilie: Um, about six years.

Nicole: Okay. And you said all of that time, you've been in L and D?

Emilie: No. So I, my first two years were, um, maternal child health, OB, um, newborn nursery, that kind of thing in the hospital. And then the last three years I worked at a military clinic, uh, doing family health and women's health.

Nicole: Oh, gotcha. Okay. Okay. Gotcha. All right. So how about we talk about, and I'm, I'm really excited to have you on, because you're going to talk about, um, prenatal care from like a military perspective in like navigating that system and potentially like how it's different, how it's the same. So I'm really curious to learn more about this.

Emilie: Yeah. So, and it looks a little bit differently, uh, for everyone depending on where you're stationed and what kind of military care is available near you. Um, so my first pregnancy, I was seen by a civilian provider because there wasn't a military hospital nearby. Gotcha. Um, but with my daughter, we, although my husband is in the air force, there's a Naval hospital, that's about 30, 45 minutes from us. So I was seen initially up until 20 weeks at our air force clinic by just a family practice, a doctor, physician. And then at around 20 weeks, they transferred me down to the Naval hospital to be seen by the OB clinic for the rest of my care. And that's pretty standard for everyone on the Island here.

Nicole: Okay. So you start off close by and then transfer later on, correct? Yes. Okay. Okay. And if you are in the military, are you required to get, or if you have military insurance and there's a place nearby, do you have to have care in the military?

Emilie: You do. Yeah. So that's the, the that's yeah. Well, that's what they want you to do. Um, unless there's, you know, really severe high-risk type things that they feel they can't handle, but especially here on Guam, um, because there's not a lot of other civilian options, everyone is required to get their care for them from the military providers, if something high-risk does come up, they would potentially have to fly you to either Hawaii or Korea. So, uh, the military hospital is definitely the place to go.

Nicole: Oh, wow. Wow. Okay. Okay. But when you were in South Dakota, you didn't have another option, so then you went to-

Emilie: Correct. Yeah. I just, um, they would refer you out to, uh, a civilian provider. Right.

Nicole: Okay. Okay, great. So I don't know why I have this. It's probably a total misperception of like the military being like regimented and I don't know. So tell me about what your, your prenatal care was like.

Emilie: Yeah. I think that's a totally understandable, um, process. I think most, a lot of people and I have no military background prior to meeting my husband. So I was definitely apprehensive having worked in the civilian healthcare. And I had loved my OB from my first pregnancy. And I was definitely just a little bit worried about, you know, what if I have concerns, is there going to be like any kind of repercussions that my husband could face? Like if I don't get along with a provider, you know, you just never know. Sure. So it was, I will say overall, I had a really, really positive experience and that's from all the other moms that I've talked to that have delivered here. They've also had really great experiences. It is different, um, because you have no set provider, you really just see who is in clinic that day.

Emilie: And when you go into deliver you see who's on call that day and you may have seen them in clinic, or you may not. So that for me was the kind of the biggest hurdle to wrap my brain around is that I wasn't going to be a hundred percent sure of who my care team was. Gotcha. But I just really tried at every appointment to list out or any questions I had addressed those with the provider and kind of get a feel for how each provider would feel about what my birth wishes were and if they had any red flags or anything like that. I really just tried to get as much information from each person so that I could be prepared as, as well as I could be for what would come.

Nicole: Gotcha. So did you know, like how many potential people it could have been?

Emilie: So I believe, I don't know the exact numbers, but I believe there's about six or seven OBs, but then the family practice providers do also take calls. So it could have been up to 10, maybe 12 different providers. And then there was also a nurse midwife who actually is who I ended up delivering with.

Nicole: Oh, okay. Okay. Okay. And then did you ever encounter any people who you were like, eh, I don't know about this.

Emilie: Um, so I did, um, overall I had really great care. Um, I felt really heard and understood, but there was one provider that I saw for a couple appointments when I brought up my birth wishes with this provider. Um, just, you know, asking things about maybe just having an, a saline lock instead of fluids running, uh, movement during labor. Could I get in the shower, that kind of thing, just, you know, see where they were at. Um, this provider, when I initially said, what are your thoughts on the birth plan? Because I've worked on a unit, I know that sometimes they can get eye rolls and, you know, the perception of what birth plans can be, you know? Yup, yup. Absolutely. So I said, I don't want to bring one, um, if it's not going to be received or, you know, if, if it's just going to get me those, eye-rolls, I'll just discuss it with the providers when we get there. And this provider said, well, you can absolutely bring a birth plan, but I don't want to see anything on there. That makes me question, what's your, where's your medical degree from?

Emilie: So that, that initially I would set me back for sure. And, um, just as I kind of tried to discuss further with this provider and, and get into some more of the specifics, it was every everything that I would ask it was, well, that's fine. But, and, and then there was, you know, a dot dot dot to everything. So that was a concern for me, definitely, but it really, I came home from that appointment and I just told my husband, Hey, this was my experience. I'm not excited about it. So I need you to be my advocate. Like this is your job. Now you have to jump in and, and this is just what we're going to have to do.

Nicole: Gotcha. Gotcha. And, and we should also mention that you're coming from a background of your first pregnancy. You described it as a dream physiologic birth, where you had both your husband and your doula supporting you. So I'm guessing you wanted a similar experience, but actually, could you maybe not have a doula this time?

Emilie: Right. So because of COVID, um, I couldn't ordinarily, they, there is, um, a couple of doulas on the Island that are also military spouses. I think there's some civilian, uh, doulas as well, but because of COVID, there's only one support person allowed now. Gotcha. So it was my husband, but my husband actually, he, my doula team was like my husband and my mom, my mom had done some doula training that I had given her because I went through doula training when I was in nursing school. So they were my doula team for my first birth, which really allowed my husband a lot of learning. And I think once we had talked through it and kind of refreshed on the comfort measures and, and things like that for my second birth, my husband was just ready to jump in and he felt super confident and he was amazing. I call him like my dude-la because he was amazing. Like he did everything I could've wanted.

Nicole: That is awesome. That is awesome. So we'll get to your, um, labor and birth for sure. But how did things change in your prenatal care? Because of COVID?

Emilie: Sure. So I, I really only had maybe one or two in-person visits up until 20 weeks. Um, there was two or three virtual visits, and then I had an ultrasound, but any other, you know, just routine visits were just virtual. So it was a little strange because I felt like man, it's been, how long since I've seen a provider. Um, but I mean, that's just, that's what had to be done. And then when I switched down to the Naval hospital, the appointments were still every four weeks up until 36 and then just went into every two. I never did ever switch to just every once a week appointments.

Nicole: Got it. Okay. So they just kind of, they kind of spaced them out of it because you were low risk. I assume the rest of it. It's okay. To space them out. Okay. Yeah.

Emilie: Yup. And then my husband was allowed to come to the anatomy scan ultrasound, but I had another two additional ultrasounds just to check baby's size, which he then was not allowed to come to. Um, of course we had to wear masks and it's been really interesting being here on Guam. We've been because it is such a pretty small Island. They have the ability to really lock down. And so we've had no tourism. There is a mandatory 14 day quarantine in a government facility. So, um, dang, okay. It's, it's serious. Um, but coming from South Dakota, which really has had no lockdowns, um, my family still lives there. So just talking to them about just the differences has been really, really interesting. Um, but so we were, you have, there is a mask mandate here. Um, there was a period during my pregnancy where for about two months, you could only see the members of your household.

Emilie: Um, you were not allowed to do anything except like go to the grocery store, you know, essential activities. So it was, it was pretty locked down. My husband did have to go on a, uh, military trip away. So it was just me and my toddler and it, that, you know, for my mental health was a little bit difficult. Wow. I bet being so isolated, but I thank God for technology and, you know, FaceTime and all of that, we were able to talk to him every day and talk to family in the States. So that made it a lot more bearable.

Nicole: Oh, good. Good, good, good. So what did you do to prepare for your birth?

Emilie: So I had done a lot of preparation for my first birth that then we carried over to my second. So the doula training that I took in just in nursing school was largely shaped, you know, kind of how I wanted my birth to go. And it helps with just a lot of information and, and things like that. Um, of course I watched The Business Of Being Born a couple of times. I think when I was in nursing school, um, I did have my husband watch that as well, and that really helped him understand why I wanted, what I wanted. He'd never questioned the kind of birth that I was planning for, but, um, I think that really helped get him on board and, and understand. And then he also, we read together, we read The Birth Partner by Penny Simkins and that was a great book for, to help the birth partner. Um, no, not only the comfort measures, but also, you know, goes through the stages of labor. And then what I really liked is it talks about, okay, during this stage of labor, this is what your partner is going to be feeling. This is what they might be thinking. So it really helps them get like a whole body mind kind of concept going on. And I think he really responded to that book as well.

Nicole: Gotcha. Gotcha. Gotcha. So did you do any formal, did you do anything like, I know you did unmedicated birth, did you do like hypnobirthing or, um, anything like that?

Emilie: Did not. Um, I did do some just, um, kind of guided imagery with this pregnancy. Um, when my toddler was taking a nap, I would just sit on the couch and, and listen to my birth playlist and just try and relax, focus every day on having at least 10 minutes where I could really, really just focus on relaxing and what that would look like in my labor as well.

Nicole: So much of labor is about mindset. And I don't think we emphasize enough how you can start preparing your mindset, like while you're still pregnant.

Emilie: Absolutely. I think that's, that was so huge for me. And I found when going into my first pregnancy, because it was so unknown, what birth would be like for me. Um, you know, even though I'd been in tons and tons of births, but you don't know what it's going to feel like until you go through it. So it was a lot more just open-ended whereas this one I'd already gone through an unmedicated birth. So while I was really excited about that, I did find that I was having a little bit of fear, um, towards just the pain, because it is painful, no matter how magical and wonderful it is, it's painful. So I, I did have to kind of take some time and work through that fear that I was having towards that.

Nicole: Oh, this is interesting. I guess you felt like you knew that that pain was coming, but did you also like tell yourself, but I also, like I did it before, like, did that give you some reassurance that you could do it again?

Emilie: Absolutely. Yup. I, and you'll, you'll hear in my birth story. I didn't think I could do it again. Um, I really had to talk myself out of it, but it was that, that helped me. Yeah, I, yeah. I tried to talk to myself about not, not focusing on the pain and how I remembered from my first, once I, as soon as I had my baby on my chest, I said, I remember that hurt so bad, but I don't remember how it felt, how it goes away. And I tried to just focus on that and, and know that I could absolutely. If I've done it before I've done other hard things, I can do this hard thing.

Nicole: Gotcha. Gotcha. So other than wanting an unmedicated birth, is there anything else that you particularly wanted for your birth experience?

Emilie: My main, uh, I would say just overarching theme for my birth. I just wanted to feel heard. Um, and so that's, I really, I listened to your podcast. I found it during my second pregnancy, um, when you were on Dr. Rebecca Decker's podcast and that's how I found you. And so I, I loved all of your episodes. I love the birth stories, but even just the, all of your topic based information, I listened to all of those because it was so great to get a refresher and, and just, you know, learn new things. And so your episode on episiotomy, that was one thing that I'd heard from a couple moms here that maybe there hadn't, they hadn't gotten what I would consider to be fully informed consent if episiotomy was going to be happening. So I felt like carrying over into all of my birth. I just wanted to really make sure that I was heard and that if anything was going to be happening, that there was a full informed conversation going on around that.

Nicole: Absolutely. Yeah. And, and that is not like asking for a lot in our system. Like when I'm thinking back to the doctor, who's like, Oh, your birth plan and this and that. I was like, well, you're not asking for a lot. It's just like, just respect me before you like, and talk to me before you do anything, that's it? It's absolutely. Yes. Yes. So what was your labor and birth like?

Emilie: So I woke up on around 5:00 AM when I was 39 and five. So just right before my due date, my first son was born at 39 and one. So I was so anxious because I thought of course she would come before he did. And she didn't. Um, but really it, it was fine. Um, so I woke up about 5:00 AM with just, you know, the mild period like contractions, um, that I told my husband, Hey, I don't know if you should be going to work today. He did. And to have to end up going in, um, just for a couple of hours in the morning, but that was fine. So I got up and got my toddler up. We kind of had breakfast and throughout that, I was just sitting on the birth ball, just bouncing. Um, I really didn't need to breathe or, I mean, I was breathing, but like really focused through them at that point, they weren't grabbing your attention at that.

Emilie: No, it was just like, okay. Yep. There's one. And they were anywhere from 10 to 20 minutes apart about that point. And then around 9:00 AM, I texted my husband and I said, Hey, I need you to come home by 10. Because by then it was like, they were four to five minutes apart and I was just struggling to keep the toddler entertained. Gotcha. So I was like, I need to focus on this. I need you to come home by 10. And then he got home and I immediately got in the bathtub, which was great. I hadn't really used a lot of water therapy with my first birth. Um, so that was phenomenal. Just the, the hot water to take away the tension between the contractions was really nice. Um, just the pressure that it took off, you know, my joints and all of that was great.

Emilie: So our, the person who was going to be taking our son, um, was just running her kids to school. So we're just sort of waiting for her to get home. And then around 11:30, she got home. And I was like, I think we need to go because I started throwing up. And for me with my first, that was transition. So they were three to four minutes apart. I was throwing up, but I was a little bit too in my head. I was really logical about it, which should have told me that I was not as far as I hoped I was, but I think having my toddler there knowing, okay, I have to get him to the babysitter's house. And then we had, depending on traffic, a 30 to 45 minute drive to the hospital, I was very apprehensive about that. So I really just wanted to get to the hospital. I didn't want to have that in front of us. So we dropped my son off around 11:30 and headed into the hospital. And I was definitely breathing very deeply through contractions, but then when the contraction would get over, I would tell my husband, okay, when we get there, make sure you do this, this and this, which you know, that was still too logical. I think.

Emilie: So we got to the hospital and with COVID. So we walked onto the unit and then they asked if I had had a recent COVID test, which I had not, the plan was to just test me when I got there. And that's for everyone that's standard. But because I hadn't had a test, my husband had to leave. So he, which we were just not quite prepared for. We thought he could stay with us with me. Um, so he kinda just turned around and left and was like, okay, I don't know where to go, but I'll see you later.

Emilie: He was so confused. Um, so they checked me and I was a three and 90% effaced, which when we were leaving our house, I said, okay, we're hoping for a five. So I was like, Oh, I was so embarrassed. I thought, Oh, I'm a second time, mom, how could I not have known that I was not this far along? Yeah.

Nicole: Aw. Yes.

Emilie: So that was discouraging. But, um, the nurse was great because she said, you know what? I see that you want an unmedicated birth, your best option is going to be to go home. We don't want to keep you here. And, you know, just risk the fact that you're going to get more intervention. She was like, if you want an unmedicated birth, you should go home. Um, which I was, I appreciated that. That's what they said. They did check if my water had broken. Cause I wasn't sure if, if maybe I'd had a trickle in the bath, but it was not, it was still intact. Um, so they did the COVID test. They said that should be back, um, within a couple hours. So they recommended that we go home for two hours, walk around and do what we needed to do and then come back and be checked and see how far I progressed.

Emilie: Okay. So we drove back home, which was disappointing, but getting back here was really nice because it was just my husband and I got immediately back in the bathtub. My husband got, he put the birth playlist on, he got my diffuser going in the bathroom. He got me water, he got a cold rag. Like he was on it. I didn't have to ask any of these things. He was just on it. And then he took over timing and I was having, um, definitely some bloody show and I was losing my mucus plug. So I felt encouraged by that. And so I just stayed in the bathtub, moved. I was on my hands and knees a lot. And I was doing a lot of cat cow, um, stretches, which I felt really, really helped. My son was OP for a good part of, um, my labor with him.

Emilie: So I was really trying to avoid that back pain, uh, which I did not really have. I did not need that constant counter pressure on my back. So I was really glad for that. Um, so I started throwing up again a little bit more and around three o'clock. I told my husband, all right, we need to, it's time to go back. I, I don't want to be home anymore. Right. So by then traffic had picked up, um, and our roads here are not great. There's a lot of potholes. And I just really felt like every pothole would like start a contraction. And so in the car, we were probably probably 10 minutes from the hospital. And I said, I'm getting an epidural and I must have sounded so serious because my husband, he didn't even question me. He said, okay. We had, you know, like a plan, to like talk me out of it, remind me what I wanted. He was okay.

Nicole: You clearly either had the look or the sound or both. And he was like, ain't no way I'm questioning what she's saying right now.

Emilie: Absolutely. And with my first birth, I had never actually said epidural. I said a couple of times in transition, you know, I don't think I can do this. This is really hard. I don't think I can do it, but I was serious, I guess. So we got back to the hospital. My COVID test was back and was negative. So he could, my husband could stay with me in triage and they checked me real quick and I was a six. And so they, they don't admit till a 6 at that hospital. So they said, okay, we can go ahead and admit you, which was great. And I said, at that point I want an epidural to the nurse. And she was like, okay, that's fine. But you know, we have to, um, we have to do some labs. We have to get your IV in. So it's going to be a little while.

Emilie: And I was like, okay. But I think for me, that was just the mental hurdle of like relief is coming. Right. So we got into the room, she said, do you want to sit on the, on, go to the bathroom? And I said, yes. Um, and on the, when I was sitting on the toilet, you know, that position really, really helped. And I, but I started feeling a lot of pressure, which in my mind, I was like, Oh my goodness, I'm only a six, but I'm feeling so much pressure. I absolutely have to get an epidural because I can't handle this pressure for, for, in my, I was going, okay, it's a centimeter an hour. There's going to be four more hours of this. Right.

Emilie: Which I should have. Should've known. And I also got really emotional. I got really weepy to my husband. I said, is it okay that I'm getting it epidural? And he, he was so encouraging and so supportive and that I could do whatever I wanted, that he was here to support me, but whatever I wanted was going to be okay. So I got to the bed, um, my husband went to move the car and then they came in to give me the IVs, which in my mind felt like it took 30 minutes. I think it probably only took about five minutes, but did have a couple attempts and tries and through contractions. And that was, I hated that part.

Nicole: And you're a nurse too. So you were like, dang it. Why can't you get this IV?

Emilie: Nurses are terrible patients, I know.

Emilie: So they finally got it. And then the nurse said, okay, well we've got your labs. Um, but it's going to take a while. And, and she was like, honestly, when I checked you, you were probably more like a seven. I don't think it's going to take that long. Are you sure? Do you want me to call the anesthesiologists? And I looked at her and I looked at my husband and I said, okay, no, let's wait. I don't want it. Okay. And then I, because I had heard her as they were getting the IV and you know, there's just a flurry of, of activity. I'd heard her say, is there a delivery table ready? And I thought, man, does that mean she thinks I'm close. So I really, I really started to feel the pressure right after I said, no, I don't want an epidural. And I said, but I'm feeling so much pressure. And she said, well, do you want me to check you again? And so I said, yes. And she was like, yep, you are right. You were, you were pretty much ready. You just have a little bit of a cervical lip. So that had only, I had gone from a six to seven to 10 with a cervical lip in about 30 minutes. Okay. Um, so I felt like I was there. I just needed my body to catch up.

Nicole: Yup, yup. Yup.

Emilie: She said, okay. You know, you just have a little bit of a cervical lip. We're just going to have you pant for a couple contractions. I'm going to go out and get some things and be back. So I rolled over to my right side, um, which felt like that gave me a little bit more control. Um, and I could kind of clutch the bedrail, which helped me breathe. So I did one contraction that way and felt like, okay, I can do this. And then with the next contraction, there was the uncontrollable urge that my body was absolutely bearing down. And I told my husband, get them in here now. I'm pushing, I can't pant anymore. There's no panting through this. This ss happening. Yup. So he runs out to the hall, calls them all in. And, um, the, the midwife came in and I had seen her for a couple of my prenatal appointments.

Emilie: And I had really, really liked her, really responded to her, um, you know, the care that she gave. And so they came in and the nurse, this is a, just have to shout out to my husband for being such an amazing advocate. So when we first got there and we're going through, you know, birth wishes and things like that, the nurse had asked my husband if he wanted to cut the cord. And he said, yes. Um, but we do also want delayed cord clamping. And she said, yeah, that's standard practice here. No problem. We do about 30 seconds. And my husband said, okay, that's, that's fantastic. Could we do a little bit longer? If there's no issues? She said, well, you know, it just really depends on the provider and what's going on with the baby. And a lot of times we need, we need to cut the cord to move on to things.

Emilie: Um, and my husband said, okay, you know, but we we'd like it a little bit longer if possible. So I just, I was so proud of him in that moment for, for just being so onboard with this and, and for stepping up and advocating. He's not the medical person, he's an engineer, but he, he really felt like empowered that this was his baby also, and his wife. And he felt empowered to say the words that he needed to say, love it, love it. Um, so they came in and I was, I was bearing down. Um, but I really felt so much rectal pressure, which I had not felt with my, my first pregnancy or my first birth at all. It was, it was in my butt.

Emilie: This was where I felt the pressure like crazy. And my water was still not broken at this point. Um, so the nurse said, okay, we need to break down the bed and can you roll over on your back? And the midwife said, she's doing great on her side. Let's just leave her on her side, which I was so grateful for because that's, that's where I felt comfortable. And that's, that was what was working for me. So I so appreciated that they didn't make me move. And so my husband picked my leg up because I couldn't hold my leg up and I was pushing. And then I felt so much pressure in my rectum. And I S I asked the midwife, I said, is your hand on my butt? And she said, no, no one's touching your baby. But it was such a different sensation that I had ever felt before. Right.

Emilie: Um, so I felt then with the next contraction, the pressure moved through into my vagina. And then I felt like the ring of fire, then I started to feel the burning. And with my son, he was little itty-bitty. He was small for gestational age. He was six pounds, one ounce. So he just, he slid right out. I felt the ring of fire. And then with one push, his whole body came out. So that's kind of what I was prepared for this time. But this time I felt the ring of fire. And then when the check contraction ended, I felt her slide back, um, back to my butt again, which I was so discouraged, I was like, ah, she slipped back. And the midwife was like, no, that's what we want. She's helping you stretch. It's okay. You're, you're going to get her out. Right. Right. Um, and so she said, do you want me to guide you to push? And I said, yes, please help me remember to pant. But what I really want is informed consent. If you need to do an episiotomy.

Emilie: And there was like a pause in the room. I could tell everyone was like looking at each other. And she said, did you need an episiotomy with your first? And I said, no. And she goes, okay. I don't think we're going to need one, I think you're going to be fine

Emilie: For whatever event though. I love

Emilie: That. That's what I say in that moment.

Emilie: So, um, she said, no, you're really controlled. And you're pushing, I don't think we're going to need anything. Um, so with the next push, I felt her slide through, again, there was some slight burning, but the, the, my body was doing so much of the pushing. I really didn't have to do much. Um, it was so out of my control. And so I felt her slide out and I was prepared for, you know, the head and then the rest of the body. But I did have to push for her head, her shoulders, and then like her hips almost, um, which we found out later, or my husband could see my eyes were closed, but she was born, um, en caul. So her water never did break. So that's why there was so much more pressure. There is such a bigger surface area. Yep, yep. Yep. Um, so her

Nicole: That's considered good luck. So

Emilie: I've said, and you know, I, I'd also heard that it's called a mermaid birth, which being in the Naval hospital, like it's like good luck for sailors. So that was super fun. Um, so when, uh, her head was born, my husband, you could see the cord was wrapped around her neck. And I heard the midwife say, okay, there's a nuchal cord. And then my husband said, you could see the cord around her neck and then through her legs. And, but he said, it was just so cool to see in the, in the bag of water, you could see everything just floating. And then when she got out about to her hips is when the bag broke. Um, but they just released the nuchal cord really quickly. There was no issues there. And then she came right up to my chest. She had a nice long cord, so she could come all the way up to my chest and she wasn't really crying.

Emilie: Um, but she wasn't, she wasn't even purple. She was already had pretty good color. So they just wiped her off a little bit. Um, and then she, she did just kind of start making some sweet little sounds and clear new lungs out. And I was, of course just sobbing. Like there's no, I think I just kept saying over and over again, my baby that's my baby. Oh, that's my, um, and it's just, so it's such a, an amazing feeling to see, you know, this, somebody that has been inside you for so long and then, and then she's here, but you can't really see her little face because they're on your chest, but just feel that little body was, is so amazing. Um, so they wiped her off and she cried a little bit. And then a little while later, then the midwife said, okay, it's been about four minutes. It doesn't look like the color cord is pulsing anymore. Is it okay if we cut it? Which I so appreciated that, that consent as well. Absolutely. And so we cut the cord, they dried her off and she never left my chest for the first hour. We got, um, you know, that golden hour or so. Um, she had a little bit of just gunky lungs. Um, so they had to clean her out, but they did that right on my chest. And, um, and that was pretty much the, the birth.

Nicole: That is beautiful. That is so beautiful. So you had to unmedicated birth and it sounds like they were pretty different.

Emilie: They, they overall looking at them. I think, you know, just from the outside, they were pretty similar, but the actual labor and, and the birth part was completely different from my first. Absolutely so different.

Nicole: That just goes to, to say like every, every pregnancy, every labor, every birth is different.

Emilie: Absolutely. Yep. And you can't predict, I kept trying to compare to my first and I think that was part of, you know, just that mental block that I had to get over. Is I, okay, well, this is what happened before. Why isn't it happening again? And I had to just accept that this is her own birth and she's going to have the birth that she needs to have. And that's, I mean, I feel like that carries through, through to parenting because she's such a different baby.

Nicole: Uh, now I know you said after your son's birth, you had a postpartum hemorrhage where you worried that that was going to happen again?

Emilie: I w I definitely was. Um, and so I had talked about it in my prenatal care and kind of how they would handle that. So they were super aware of it and super prepared. Um, so I did get just a bag of Pitocin afterwards, and I had had really, really minimal bleeding with delivery. Um, but I continued to have more significant bleeding then for the next three hours. Um, so they gave, did give me a second bag of Pitocin and then a couple other meds. Um, and I had every 15 minute fundal massages for, for three hours, which was not awesome, but, you know, just being, being on the other side of it, I've pushed on mom's tummies. I know how much that hurts. So I really, I kept saying, I'm so sorry, like it's so hard not to pull your, your body away, which I just wanted to like, put a say to like other moms, like it's okay. Like the nurses know you're not doing this on purpose. We know that it hurts. So like don't feel bad.

Nicole: Yeah.

Emilie: Um, but yeah, they handled it really well. So while I did have longer bleeding than they were happy about, right. At the three hour mark, she came back in and she said, okay, if your next check, you still have this much bleeding, I'm going to have to go in manually and see if maybe there's like a clot in your cervix or something. That's, that's not stopping the bleeding. But then by my next check, everything was fine. So they did not have to do that, which I was really grateful.

Nicole: Okay. Good. Good, good, good. So, is there anything that you weren't happy about with your experience? It sounds like you had a great experience

Emilie: Overall. Yeah, my labor, I was so happy with it. It was, it really was exactly how I could have wanted, but I didn't even know. I couldn't have prepared for it because I didn't know what to expect really, you know, just the different atmosphere type of thing.

Nicole: Gotcha. Gotcha. Is there anything that you weren't happy about?

Emilie: Um, well really just more in my, my postpartum care or not even my, my care was fantastic, but what happened in postpartum, which I can get into that if you'd like. Sure. Yeah. Okay. So, um, our, our stay postpartum was great. Um, they, the nurses were fantastic. Uh, all the providers that we saw, the pediatrician and everything. So we got to go home at 24 hours, um, which was great. And just coming home and introducing my son to his little sister was so special and it was right before Thanksgiving. So we were just looking forward to, um, you know, preparing for that. Um, but on, so with my son, my first pregnancy, I had had never a diagnosis of gestational hypertension or anything like that. But around 34 weeks, my pressures had started to creep up a little bit. So because I was only being seen every two weeks with this pregnancy, I was monitoring my blood pressure at home.

Emilie: Um, just the, I just couldn't shake. There was just something in me that told me I should be checking it. Um, which throughout my pregnancy, it was so low. It was hundreds over sixties, every single day. It never did get high, which I was really grateful for. I was like, okay, that was just something with my first pregnancy. Um, but around day four, um, I started checking it and it, it was just a little higher one thirties, one forties. Um, so I called the clinic just to check in with them and they said, yeah, why don't you come in for just a blood pressure check? They did some labs, my labs were all fine. And they said, you know, it's probably just a little, a little bit of lingering. You'll be okay. And so I was, I was comfortable with that. Um, the day before Thanksgiving, I woke up with 102 degree fever and a swollen, hot red breast.

Emilie: Um, and so I had developed mastitis, so that was a bummer, but the clinic was great. They got me right in, got me on antibiotics. Um, I had not dealt with that with my first pregnancy. So that was just a little bit of a bummer for sure. So, but, but the antibiotics did take care of it. I pumped a little bit just to help relieve that pressure and that got better. Um, but then on day 10 postpartum, I started to get just a dull headache, um, in the evening. And I thought, ah, I don't know. I, I'm not really a headache person. I don't, I just feel a little off, I'm going to check my pressure again. Um, and it was high again, high you're, like one fifties. Um, so I said, okay, I'm going to keep an eye on it through the night.

Emilie: Um, the next day it was 160, I think it was like 164 over 98. And I, I was at that point, I was not comfortable, um, with that. So I called the clinic and they said, yep, let's go ahead and have you come in for another check. So I did. And it was just a walk-in check, the check, the tech technician, um, checked it and it was high first. It was like 164, um, over 94, but then she said, you know, we'll have you hang out. And then she rechecked it and it came down to like 138 over 90. So she said, yeah, I think they'll let you go. I think it was probably, you're probably distressed from the traffic and they'll probably let you go. And I was okay. So then our doctor came in and talked to me and he said, you know, it looks like your pressure got better.

Emilie: I think what we'll probably just send you home and have you come back for another check. And I said, that's fine, but here's what has been at home. And I gave him, I had been checking it, you know, a couple of times over the last 24 hours. And, and that made him pause and he said, you're having a headache. And I said, yep. Um, and he just, I don't know what about it, but he talked, looked at me for about five minutes and he said, I'd like to walk you upstairs and, and just admit you, um, just for a little bit, uh, but just to keep an eye on you. And I said, okay, okay, that's fine. Um, he said, I don't think we need to do magnesium at this point, but I just want to keep an eye on you, which, um, I'm so grateful.

Emilie: I I'm going to get emotional, just thinking about, um, a lot of moms that this happens too, that aren't heard by their providers or that aren't, um, especially moms of color I know are dismissed. Um, but I was so, so grateful that he didn't hesitate. He didn't question me. Um, he, he just erred on the side of caution. So he walked me upstairs himself to the unit and they admitted me. Um, and within an hour of being there, my pressure has started to really, really get really high. Um, they went 160's 170's and eighties. Um, so within an hour of being there, they did go ahead and start me on magnesium. Um, so I was on that for 24 hours. My husband of course, had to come stay because I had my baby with me and my husband at that point was home with our son.

Emilie: Um, and that's just a shout out to the military community. Um, our military family just stepped up. Um, w he called our friends and they came immediately to stay with my son. Um, it, you know, it's, of course we would have loved to be around family when, and have family come and stay with our son that we, but we just don't have that luxury. Um, so our military family just, just came and took our son and my husband came with me to the hospital and overall the magnesium was fine. I felt the really hot flush right when they started it. But then I, I felt good. My headache went away and my pressures came down. They did also give me, uh, nephedamine. And so my, my blood pressure responded really well to that. And so I was like, okay, we're just going to be here for 24 hours, and then we can go home.

Emilie: Um, but around 16 hours on the medication, I started to get some, some yucky magnesium side effects. Um, I got a horrible headache and my, I couldn't see really, um, I could hardly lift up my arms to like feed my daughter. My husband, um, had to do everything for her. And so, um, my, I couldn't see, my eyes were really, really painful, like to turn my eyes and things like that. So I, I just, it didn't feel good. My reflexes did decrease a little bit. It was really, um, I had been able to get up and go to the bathroom and then I, I just really couldn't get out of bed. I felt like my kneecaps were going to fall off. It was just yucky. So, um, you know, I, Oh, magnesium looks differently for everybody, but that was just what my experience on it was.

Emilie: Um, but as soon as they turned it off at 24 hours, I started to feel a lot better. So we spent another night. So we totally think we were there for about three days, um, another night and then into the next day. And then they let me go home on a, ephedamine um, just for a couple of weeks, they said, and then, but it still, unfortunately my blood pressure has just been hanging out higher than it should on the medication. So I have follow-up today, um, I'm now seven weeks postpartum today. Um, but I'm seeing my regular family practice provider to see if, um, maybe I need a different medication or what, so that's been really just the only thing I've been dissatisfied with about my postpartum care. It was not care, postpartum experience. The care was phenomenal. Um, but just a little bit of a, a hiccup in what would otherwise be such a, a blissful, you know, baby snuggling time. Yeah,

Nicole: Yeah, yeah. But it's so important that you listen to your intuition. Um, and, and, and you're right. It's something that I, I struggle with in the sense that, like you had somebody on the other side, thankfully who paid attention to what you were saying and not all moms have that, and it's hard. Like I can't fix that piece. Um, so the best I can say is like, when you feel like something is off, just continue to press until, you know, something, you know, you get something resolved cause it could have been a totally different outcome for you with your blood pressure's going up that quickly.

Emilie: Absolutely. That's, that's what I, um, I just keep going back to, I, um, I have a really strong faith and so I believe that it was God that still small voice telling me that nudge to keep checking my pressure, even though it had been fine to not let me talk myself out of it. I kept saying, Oh, you just, you're looking for signs where there aren't any, um, you know, things like that. But I just really believe that that's what gave me that intuition to keep checking it, to keep pressing, to tell the doctor when he was going to send me home. Um, okay. But this is what it's been at home, you know, all of that, that, that I had to, I had to talk to them. I had to tell them, and I'm so glad that I did. Yeah, absolutely. Absolutely. And that I was heard that I was looking through and

Nicole: Yeah, for sure. For sure. So as we wrap up, what is the one thing or one piece of advice that you would tell other women as they get ready for their birth?

Emilie: I would, I would say that it is that, that, um, you know, listen to your intuition, whatever, you know, that, that still small voice inside of you that, um, if you feel something isn't right, um, to stand up for yourself to keep pressing, if, um, you need to see another provider or, um, you know, whatever it is, um, to just make sure that you're heard and that, that all your concerns are met, um, because you know, your body, you know, your baby and you know what you need.

Nicole: Yes. 100%, 100%. Well, thank you. So for sharing your story, I really enjoyed hearing it and the different, like how your births were different and unmedicated birth and how you advocated for yourself. So many people are going to find something useful in this episode. So I so appreciate your time and you have a little baby that you, you're only seven weeks postpartum and y'all, it's also like 6:30 in the morning where she is.

Emilie: Thank you so much. I so appreciate it. It's just been an honor to get to share my story.

Nicole: Yeah. Alright, well, you take care. Thank you. All right. That was wonderful.

Nicole: Right? Wasn't that a great episode. I know you learned a lot from that episode because there was a lot to learn in that episode. And I so enjoyed chatting with Emilie and appreciate her coming on. Now, after every episode, when 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 here are my Nicole's Notes from my conversation with Emilie. Number one, when you are uncertain about who is going to be there for your birth, then you need to be more proactive. You need to be really prepared to advocate for yourself, and you need to have good support. One of the best ways to do that, to be ready to advocate for yourself and be prepared to be more proactive is good childbirth education. Of course, I have a wonderful childbirth education option called The Birth Preparation Course.

Nicole: I recently updated the entire course. We re-recorded the entire thing, added almost an additional two hours of content. Do check it out. It's at drnicolerankins.com/enroll. And in relation to unmedicated hospital birth, I actually added like, Oh, 45 minutes or so of content specifically related to that. So do check it out, drnicolerankins.com/enroll. Again, childbirth education is so important, especially it it's important period, but it's especially important when you're uncertain about who's going to be there for your birth. Number two it's really common, especially for your first baby that you think you're in labor and it's not quite time yet. So Emilie's story in this case of going to the hospital and thinking, Hey, it's go time. And it actually wasn't quite go time. That is so, so, so, so common. So do not be surprised or upset or worried if that happens.

Nicole: It is very, very common. And actually it was a great thing that they were like, you know what, why don't you just head back home since things aren't quite there yet, because you're going to be so much more comfortable doing that early part of labor at home. I recommend you stay home as long as possible, especially if you want an unmedicated birth. So it was great for her to go back home, even if it's just for a few hours, walk around, maybe take a bath, those kinds of things before you head back into the hospital, as things get more intense. So how she described things is really, really common, not unusual at all. Number three, every pregnancy, every birth is different. Emilie described very clearly how this birth, even though they were both unmedicated births, how this one felt very different than her first one.

Nicole: And that is really, really the case. Every pregnancy and every birth is going to be different. And you need to be able to kind of ride that fact or be ready to manage those waves and the unpredictability of birth as it presents itself every single time. And another important piece of riding that unpredictability is childbirth education so you're informed about what to expect during the labor and birth process. And as I mentioned, I have a great option, The Birth Preparation Course, drnicolerankins.com/enroll. Okay. That's the last time I'm going to talk about the course. All right. And then the final thing that I want to mention from Nicole's Notes is postpartum preeclampsia. See it, it is not common, but obviously it does happen. And some things that you want to be on the lookout for in terms of postpartum preeclampsia, headaches, vision changes, and actually this is preeclampsia even during pregnancy.

Nicole: And then the final thing that I want to talk about is postpartum preeclampsia and postpartum preeclampsia is not common, but obviously it happens. Emilie's actually not the first guest that I've had on that had postpartum preeclampsia. I had another birth story, Savannah who had postpartum preeclampsia. We can link that in the show notes as well, but it does happen. And some things that you want to be on the lookout for are headaches, vision changes. If you're having swelling, that's getting worse and not better as swelling after birth is fairly common, but it typically gets better and better every day. Also, if you're just not feeling right, something feels off, then go in to be seen and keep pressing until you feel like your concerns are being properly addressed. This is especially important for black women and women of color in general, whose concerns are more likely not to be taken seriously.

Nicole: So if you have things like headaches, vision changes like blurred vision, spots that are new. If you're not feeling well, going to be seeing, keep pressing until you feel like your concerns are being properly addressed. All right. So there you have it. Be sure to subscribe to the podcast in Apple Podcast or wherever you're listening to me right now, Spotify, Google Play, Stitcher, wherever you listening to me. And I would really appreciate that honest review on Apple Podcast in particular, it helps other women to find the show. I also do shout outs from those reviews from time to time as well. Also be sure to check out my free online class on How To Make A Birth Plan That Works. Women love that class, and it's very useful information, totally free, on demand offers several times a day, drnicolerankins.com/register. And that is it for this episode, do come on back next week.

Nicole: And until then, I wish you a beautiful and birth. Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website, drnicolerankins.com to get even more great information, 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 That Works as well as everything you need to know about my signature online childbirth education class, The Birth Preparation Course. Again, that's drnicolerankins.com and I will see you next week.

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