Ep 195: Claudia’s Birth Story – 52 Hours from Induction to Vaginal Birth

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This is a delightful birth story episode from a fellow physician! Claudia is an orthopedic sports surgeon, currently stationed with the Air Force in Anchorage, Alaska. She gave birth at the same military facility where she works and loved her experience. Even though she went into pregnancy at a (barely) advanced maternal age and with pre-existing borderline hypertension, she was still able to have the vaginal birth she wanted.

Being in the “at risk” category doesn’t necessarily predict how your birth will go. A different hospital might have pushed for a c-section instead of waiting for interventions to work. Induction can be long!! Hers was Tuesday to Thursday. You have to be patient with the process and fortunately her care team was.

I love how one of the doctors in the practice asked if she had birth wishes. This is how it should be done. Fortunately Claudia came prepared with a birth plan she’d made the right way (using The Birth Preparation Course) and went over it with her team before she went into labor. If she hadn’t done that she may not have gotten the outcome she did.

This story goes so many places and I know you’re going to learn a lot!

In this Episode, You’ll Learn About:

  • How Claudia and her partner got pregnant without any treatment right after visiting an infertility specialist
  • How her experience as a physician influenced her expectations of birth
  • How she felt about giving birth in the military overall
  • Why she and her care team opted for induction
  • Which pain management option she liked and which one she hated
  • When and why her team decided to implement different interventions to move her labor along
  • How she felt when her doctor said they needed to consider a c-section after she’d been trying for vaginal for so long
  • How well she recovered after a 3rd degree tear by immediately requesting pelvic floor physical therapy
  • How her baby’s latching issues were resolved
  • What she wished she’d have known about the postpartum “baby blues”

Links Mentioned in the Episode

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Dr. Nicole (00:00): This is a delightful birth story episode from a fellow physician. Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway, Rankins a board certified OBGYN, 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 drnicolerankins.com/disclaimer. Now, let's get to it.

(00:49): Hello there. Welcome to another episode of the podcast. This is episode number 195. As always, I'm so glad that you are with me today. Whether you are a new listener or you have been on me with this journey for a while. In today's episode of the podcast, we have Dr. Claudia Thomas. Claudia is an orthopedic sports surgeon, and her orthopedics training has taken her to many places, Chicago, Seattle, Pittsburgh, where right now she is stationed with the Air Force in Anchorage, Alaska. She and her husband Chris, welcomed their first baby boy in June of 2022. His name is Stellan, and now he joins their two cats and one dog in their adventures around Alaska. Claudia joins us to share her birth story, including how they tried to get pregnant for 12 months and then got pregnant without any treatment, right after visiting an infertility specialist, how she really enjoyed her prenatal care that involved midwives and physicians, including a set of twin OB male doctors.

(01:52): How rare is that? We talk about her lengthy induction that lasted 52 hours, but ended very well, and then some of the challenges that she had postpartum and how she was greatly helped by pelvic physical therapy. You're going to love this episode for ashore. Now, Claudia is also a member of the Birth Preparation Course. It is part of what she used to get ready for her birth. I would love to have you inside the Birth Preparation Course. If you don't know, the Birth Preparation Course is my signature online childbirth education class that will get you calm, confident, and empowered to have the beautiful birth you deserve. You can check out all the details of the Birth Preparation Course and come join me at drnicolerankins.com/enroll. All right, let's get into the conversation with Dr. Claudia Thomas. Well, thank you so much, Claudia, Dr. Thomas, for agreeing to come onto the podcast. I'm so excited to have you share your story.

Claudia (02:58): Oh, thanks for having me. I'm excited to be here.

Dr. Nicole (03:00): Yes. So why don't you tell us a bit about yourself and your family?

Claudia (03:04): Okay. Well, I am currently living in Anchorage, Alaska but we got here by way of Pittsburgh and Seattle and Chicago. So I'm originally from northern California in the Bay Area, and then I went to medical school in Chicago at the University of Illinois, and that's where I met my husband who was also in school for education. So he's a teacher, and so it makes him easy for him to travel around for work as well. So then we moved to Seattle for my orthopedic surgery residency at the University of Washington, which was five years, and then to Pittsburgh for a year for my sports medicine fellowship and then up to Alaska, since I am in the Air Force, they paid for my medical school. So we'll be here probably for six years. We've been here two and a half so far. And then we had our first son Stellan in June, so he's now five months old, and so it's the three of us and our dog and our two cats.

Dr. Nicole (04:10): Love it. Love it. So how do you like Alaska?

Claudia (04:13): It's awesome. Yeah, it's really cool. We chose it because we liked Seattle in the Pacific Northwest so much, and so it's a lot Washington on steroids, in terms of just weather and outdoor activities. So we're into winter now. It's snow on the ground, and we had snow in early October, but yeah, it's awesome.

Dr. Nicole (04:37): Are there really days where it's dark most of the day? Yeah,

Claudia (04:42): I mean, in Anchorage, luckily we're kind of halfway through the latitude of the state, so our longest days are getting on 14 to 15 hours, and then the shortest days are about six hours of daylight, but the sun does come up and Okay. Yeah. So sunrise today was, I think nine 30 and sunset will be about four.

Dr. Nicole (05:07): Okay. All right. Well, we didn't come to talk about Alaska. I was just curious. Yeah. We're supposed to be talking about your birth. So I wanted to start off with the fact that you are a physician, but when you went into your pregnancy, what were kind of your expectations of pregnancy and birth based on your medical training and experience?

Claudia (05:31): So I mean, it had been many years. It was my third year rotation pretty much was my last experience with, and so I fully expected to have a hospital birth and have all the things that go along with that in terms of the prenatal care and that's what I was familiar with. And also being in the military, that's what is provided. So I expected that. And other than that honestly, a lot of the details of prenatal care and of birth I had just forgotten from med school.

Dr. Nicole (06:11): Of course.

Claudia (06:12): Yeah. So I definitely went into it kind of with the enough medical knowledge to be able to scare myself about certain things, but not enough to be able to talk myself out of those gotcha anxieties.

Dr. Nicole (06:25): Gotcha, gotcha. So what made you then, well, we'll get to what the things you did to prepare. Let's start off with what your pregnancy and your prenatal care was like. I know that your active duty military, so that was different. You were also considered advanced maternal age, so maybe that was colored your care. So what was your pregnancy and prenatal care?

Claudia (06:44): And we had also just started an infertility workup. So my husband and I had been technically trying without my birth control for about a year. And so we had gone to see an infertility specialist off base, and we had literally just started labs hadn't started any treatment, and then a couple weeks after that found out we were pregnant. So we joked that there was something in the air in his office that helped us. So we had technically started that treatment or that workup.

Dr. Nicole (07:22): That's stress and that's stressful.

Claudia (07:24): And it was especially, yeah, the labs that I had had so far had come back normal, and so we had started adventure kind of deeper down that path. We felt lucky that we didn't have to go any further into that workup. But

Dr. Nicole (07:43): Did you feel like when you're a physician maybe, and especially a orthopedic surgeon, which is a highly competitive field, attracts the best of the best, did you feel like any sense of failure or up because you weren't getting pregnant?

Claudia (08:02): That's a good question. I would say not yet. Okay. Again, because it had only been a year, which can feel like a long time, but because we weren't really stressing about the timeline of it yet. No, I'd say I gotcha

Dr. Nicole (08:21): That. Okay, cool. Yeah I was a nut case after six months of not getting pregnant, so I was like, I don't want to see a pregnant person. And just, I'm embarrassed to say that six months I was a nut case. But at any rate so you had just started the infertility, found out you were pregnant, and then what happened from there?

Claudia (08:44): So the prenatal care on at base for us is awesome. I loved our clinic. They have a model with midwives and MDs as well as some nurse practitioners, and they definitely encourage you to see everyone, or they don't make a point to schedule one of your prenatal visits with the same person. I could have chosen to schedule with a particular person each time, but I kind of like the idea of meeting everyone. So my first visit was with midwife then a couple visits were with some of the MDs. And yeah, overall I'd say the prenatal care was really great and you know, can definitely hear things about the military pluses and minuses of Sure. Military medicine. But I think overall I was very, almost pleasantly surprised with how great the care was. Yeah. Well,

Dr. Nicole (09:47): That's good. That's good. Yeah. Do you feel like you noticed a difference between the midwives and the physicians?

Claudia (09:54): I actually wouldn't say that I did. Okay. Yeah. In terms of time spent, questions answered, things focused on, they were actually pretty similar. That's good. And then I ended up because I was advanced maternal age, I had some of my ultrasounds and things off base, so my 20 week anatomy scan, because I guess they needed the level three

Dr. Nicole (10:22): Scan more detail. Yeah. Yeah.

Claudia (10:24): I went off base for that. And then when I started I again started ultrasounds, I guess it was every four weeks after 28 weeks did some of those off base as well.

Dr. Nicole (10:40): Okay. So they didn't have, I guess, mil having maternal fetal medicine specialist isn't really common in the military. I don't know.

Claudia (10:53): And that there probably are some, who have done fellowships and are some of the bigger military centers, but Right. Yeah, we certainly don't have them. Gotcha. Yeah. So for that 20 week, I had the scan and then met with the M F M.

Dr. Nicole (11:06): Okay. Okay. So then what did you do to prepare for your birth?

Claudia (11:11): So I definitely, I started listening to your podcast, and I will admit, I focused more so on the interviews with specialists early on, because I didn't think that the birth stories would necessarily apply to me or that I wouldn't find them interesting. But those were really my favorites, actually.

Dr. Nicole (11:32): I swear everybody says that.

Claudia (11:34): Yeah. I mean, because you can find something in common with everyone, and you learn something from every single story. Right? Yeah. So I definitely went back and listened to those sort of in a binge listen style. But yeah. So I listened to your podcast and we also did your prenatal course.

Dr. Nicole (11:52): Well, thank you. I hope you found it helpful.

Claudia (11:54): We did, and my husband actually, he loved it. He, he's the kind of guy who, you know, have to drag him into things like prenatal courses or birth courses grumbling, but he found it really interesting and yeah, definitely found it helpful. Good,

Dr. Nicole (12:10): Good, good.

Claudia (12:12): And then I read a couple books. I did get what to Expect When You're Expecting, which is, it's just got a lot of info and it's great. It can definitely, I think, be a little dated at times or a little black and white, but it does have a lot of information. And then I read Expecting Better by Emily Austin, which I know a lot of other ladies have mentioned as well. Yeah. And I'm actually reading crib Sheet right now, which is her, the book about yeah, I guess Infancy in Toddlerhood.

Dr. Nicole (12:45): Right, right.

Claudia (12:47): And then I had a book called Pregnancy Childbirth in the Newborn, the Complete Guide, which it was good. It was kind of like what to expect when you're Expecting but a little more about, they spent more time on the labor and childbirth process and some of the techniques for pain control

Dr. Nicole (13:08): And Gotcha.

Claudia (13:10): And things like that. It was a little more focused, I think, on either home births or midwife center births.

Dr. Nicole (13:18): Okay.

Claudia (13:20): So some of it didn't apply so much to my situation, but it was still Right. Good techniques. Yeah.

Dr. Nicole (13:26): Okay. How did you come to Emily O's book? I've had a lot of, sometimes I hear physicians in particular push back against her because Oh, really? That's interesting. Well, she says, so says some things in there like, oh, it's okay to have a few drinks, or that kind of thing. So

Claudia (13:44): Yeah, it's okay to eat deli meat.

Dr. Nicole (13:45): Yeah. Yeah. Which I, I've read the book I think is great. I think it's very balanced and everything, so yeah. It sounds like you didn't know that there was some sort of controversy, but some OBGYNs in our field. Oh, yeah.

Claudia (13:59): I could see physicians still liking it just because it is very data-driven and Yeah. Lets you make your own decisions, whereas what to expect is a lot more, or do this, don't do this, never do that. Right,

Dr. Nicole (14:11): Right. Yeah. Maybe it's just OB B GYNs who have the problem with the , the book and not necessarily like, yes.

Claudia (14:19): And then I can see in the same vein, sleep trained specialist or lactation consultants having issues with crib sheet, which is more about the infant.

Dr. Nicole (14:30): Yeah, I haven't read that one. Okay. So what are some things that you wanted for your birth?

Claudia (14:36): So at first I thought I am going to be the epidural lady. I'm the second I hit the door, I want an epidural. I know myself, I know some of the risks and I'm definitely going to do an epidural. And then the more I listened to other ladies' birth stories and read a little more I thought, okay, maybe I could try at least start labor without it. But then, especially as it became clear that I was going to be induced, then I kind of went back to I do want an epidural. So that was one of the things I knew I wanted to do.

(15:15): Other than that a lot of the things you mentioned in your Birth Preparation Course that I think are our gold standard, but I just wanted to be sure that the military hospital was going to do them, so . Delayed cord CLA clamping. Yeah. Immediate skin to skin. Yeah. Those were the main ones. And then I really wanted to try to have a vaginal birth, and as we talk more, I guess about the actual birth process, there was definitely a time where that might not be possible. So I appreciated the team allowing me to continue with that, that desire. Yeah. So overall, I'd say I did make a list or birth wishes list. I fought back against it at first of not wanting to do it, but then one of the MDs actually at one of my prenatal visits, asked me if I had made a birth wishes list. Yeah. It was actually one of the male MDs, and I was like, wow, okay. Wait. Yeah. Birth stereotypes. I liked it. Yes. So I went home and made one. Okay.

Dr. Nicole (16:25): Well, cool. Yeah, I mean, we really should, because it really should be a conversation. A lot of it, I think is just reassuring people that we're like, we're going to do the things that we should be doing. Unfortunately, in some places it's not the case, but it sounds like you gave birth in a place with the group and in the hospital. That was great. So what was your labor and birth?

Claudia (16:51): As? We came towards the end of my pregnancy my blood pressure had always been something they were keeping an eye on. Before pregnancy. I was someone who kind of lived in the one forties over nineties, but was never medicated. And so I was sort of labeled as gestational hypertension because mm-hmm. Those blood pressures sort of stuck through the beginning of my pregnancy. They actually got a little better just by being pregnant.

Dr. Nicole (17:20): That happens. Yeah,

Claudia (17:22): For sure. I got relatively hypotensive but as we got into LA later weeks it started to creep back up. And so I was doing weekly. Is it PPPs or the, yep. Yeah. And so then we had started to talk about induction pretty much as soon as I had the diagnosis of gestational hypertension and with my age as well. And so they talked to me about the timeline of when to do it, the risks of potentially waiting past 40 weeks. And I'm definitely a pretty risk averse person. And I had, unfortunately, a few pretty close family friends who had had late term stillbirths. Oh my God. Yeah, it, it's unfortunate. But that definitely, I think clouded or not clouded, but impacted my, my decisions about induction. And so I was totally on board for being induced at 39 weeks. So I came into the hospital 39 plus one, and to check me in and I essentially was starting from complete ground zero. Not at all ripe cervix, not at all favorable. So they checked me and decided to start with the Doris with a dose of the oral.

Dr. Nicole (19:06): Yeah, yeah.

Claudia (19:09): So they gave me one dose of that. Didn't even try the Foley catheter right away, just because it was So, if you were closed,

Dr. Nicole (19:16): I probably couldn't have put it in.

Claudia (19:17): Yeah, exactly. So let that simmer for about six hours. And then when they checked me again I'd started to ripe in a little enough that they thought they could put the catheter in Foley catheter. So yeah, about six hours in of that first night, I got a second dose of oral, and then they put the Foley catheter in. Okay.

Dr. Nicole (19:43): Was that painful?

Claudia (19:45): It was, yeah. It was pretty painful. And so they did that at about midnight. And so consequently, that first night was pretty horrendous in terms of Okay. Discomfort. And it was, it was pain, but it was also nausea and just GI upset. I felt like I was running the bathroom every 15 minutes and because of that discomfort, my blood pressure shot way up to 200 over one 10. Oh, yeah. So there was an hour or two there where they were treating me for, concerning for preeclampsia. So I got a couple doses of I think it was Nife Aine. Okay. But something for my blood pressure, and that helped a little bit. What really helped was actually getting a dose of fentanyl and controlling my pain, and that then my blood pressure was totally normal. I didn't love that the fentanyl it I mean, it makes me feel totally high allowed me to get some sleep especially because that we weren't going to be able to do the epidural until the anesthesiologist got in that morning. They could have called him in, but I was okay with sure with waiting.

Dr. Nicole (21:11): Sure. Sure.

Claudia (21:12): But yeah, so consequently that the first night had its rough spots in terms of the blood pressure and the discomfort of the

Dr. Nicole (21:19): Right,

Claudia (21:21): The opiates. But then I guess first morning was able to get an epidural and it was great. I felt like I felt like a good epidural. I know there can be good epidurals and bad epidurals. I was able to move around in bed. I couldn't get up out of bed but I could at least power myself around, around the bed turnover. But my pain control was still great.

Dr. Nicole (21:56): Gotcha. And did you still have the catheter in at that point? The balloon in? Oh,

Claudia (22:00): Yeah. So at that point I want to say it fell out slash They pulled it out at the check where I got to about three to four centimeters.

Dr. Nicole (22:14): Okay.

Claudia (22:15): So I think it was probably in about a total of 12 hours would be my guess.

Dr. Nicole (22:18): Okay. Yeah. So wasn't like they said you have to be a certain number of centimeters or anything before you got the epidural. It was just like when you wanted it, you got it, correct, yeah. As it should be, yes. Okay.

Claudia (22:28): Yeah. And so then consequently, the next I guess if that was Wednesday morning, so the next 36 hours really till Thursday night that was actually pretty comfortable. I was just sort of coasting very slowly, dilating

Dr. Nicole (22:50): I, okay. So yeah, let's talk through that. Cause I'm doing the math in my head now. I was like, wait a minute. You were already three to four centimeters dilated, and then how long, what happened in that? Yeah.

Claudia (23:02): So then I think it was about three to four Wednesday morning, and then by the time they checked me again Wednesday afternoon so I'd had the epidural for 12 hours. I was still at four. And

Dr. Nicole (23:26): They were probably doing Pitocin, I'm guessing, at that point? Oh, yes.

Claudia (23:29): Yeah. We had start Pitocin pretty much when we started the epidural.

Dr. Nicole (23:32): Yeah. Okay.

Claudia (23:35): So because I hadn't really dilated much more, they decided, I should say, we decided to break my water. So that would've been Wednesday afternoon. And that went fine because of that epidural. It was not uncomfortable when he came out. He definitely had a little nick on his scalp

Dr. Nicole (24:00): From

Claudia (24:00): Where they little, it's like the little, a little crochet hook, which I mean was fine. He healed fine. So that happened Wednesday afternoon, and then just kept trucking through Wednesday night. I don't really think they checked me that much more until the next morning. Okay. Yeah. Cause again, I wasn't feeling any urge to push at that point. Sure. And so I assumed there wasn't really much to check for overnight. So I just essentially could rest and

Dr. Nicole (24:40): Okay. Were you able to get some rest? I

Claudia (24:44): Was. Okay. For sure. Okay. Yeah. Okay. And then my husband was there and my mom was also there, and so they were kind of swapping, so they were allowed to, or they had the ability to also go home and rest. Gotcha. Which was nice. Gotcha.

Dr. Nicole (24:57): And were you being cared for by a physician or midwives in the hospital?

Claudia (25:02): Both, essentially. Yeah. Whoever was on call for that time.

Dr. Nicole (25:07): So they just really, just whoever

Claudia (25:10): Was there. Yeah. It was really just a team. Okay. Team effort. Okay. Okay. Yeah. So I ended up seeing mostly everyone.

Dr. Nicole (25:16): Gotcha. I was going to say, how'd you like your nurses?

Claudia (25:18): Oh my gosh. My nurses were amazing. Yeah. There was one who, she made it her goal to have me move as much as I could. And so we were doing all sorts of exercises on my knees with sheets, trying to shake the baby, not shake the baby.

Dr. Nicole (25:39): Yeah. Get the baby, shake

Claudia (25:40): The belly to get the baby moving. Yeah. Yeah. So yeah, they were totally awesome.

Dr. Nicole (25:45): Nice. Good, good, good. So then you got to, was it went Thursday morning by

Claudia (25:53): Then? Yes. I got to Thursday morning, and by then I really had not dilated anymore. We had a couple people checking. So there was that measurement standard of error but I was pretty solidly like five or six and not more than that. And so then they decided to do,

Dr. Nicole (26:18): Where was your head space? Where were you mentally then?

Claudia (26:21): Yeah, I was still fine because I was so comfortable. I did know, I guess at that point though, we were going to start backing up against the amount of time my water had been broken. But the team wasn't really stressing about that yet. And so I wasn't stressing about it. I was definitely a little frustrated that my body wasn't responding to the Pitocin and everything else that we were trying. And so at that point, we did a Pitocin holiday. Okay. Yep.

Dr. Nicole (26:56): We do that sometimes a little break.

Claudia (26:58): So I think it was off for what would make sense, maybe two to four hours, couple hours or so. So Thursday morning I had that break, and then they restarted it back at the low dose, kind of Thursday midday, but pretty quickly got back up to the max dose just because I was tolerating it in this entire time. Stellan was tolerating everything fine. He never, I'm good. Right. Concerning, nothing concerning. So that was also reassuring for me this entire time, was that right? His patterns always look great. So finally Thursday evening, by that point, my water had been broken more than 24 hours. And so they started to talk to me about risks of that. And if I'm remembering what they told me correctly, the data would start to talk about risks at 24 hours. But getting towards 28 30 was okay to them. But again, with every hour is a little more risk in terms of infection.

(28:19): But I had started to start to move in terms of my dilation. So I was starting to get consistently seven, eight centimeter checks. Yeah. So then Thursday evening, then we had that talk of, if you don't dilate more and we're getting close to 28 hours water broken, we'll have to start thinking about doing the C-section. Okay. And so the first time we talked about that, I was pretty upset. I mean, I lost it and I was crying and Okay. Just because it wasn't so much that I'd be upset that I had to have a, but just that I'd been there so long Sure. Working towards a vaginal birth and then to, to then have to have a C-section. Right. Right. So that's where the MD, who was on call at that point, and who delivered me eventually, she was awesome because she said, we can give you another two hours.

(29:24): I'm comfortable with that. We'll check you then you're at eight centimeters now. If you haven't moved at all in those next two hours, we really should do a C-section. Okay. And so then after that, I felt things really quickly progressed. So half an hour later I was asking my nerve, I was like, I really think, I really feel something even through this epidural. I feel I'm feeling an urge. I need to be moving. Right. I feel like I need to push. I don't know necessarily what that's supposed to feel like it a first time mom, but I think this is what

Dr. Nicole (29:58): Something is happening. Yes.

Claudia (30:02): So they did check me about an hour after that conversation. I was at nine and a half completely. She said there was just a teeny little lip that was still there. And she's like, we can push through that if you want. There risks. I think she told me that, that there would be a risk of some injury to the cervix by trying to push through that,

Dr. Nicole (30:29): But

Claudia (30:31): That if I wanted to, that we could. And so I felt the urge to push and that was ready to do that. Okay. All right. Yeah. But then I pushed for two hours. So

Dr. Nicole (30:44): Were you feeling better at that point? Yes. It's a little bit of emotional rollercoaster. Literally just an hour before you were, since you might have deception. Right. And then it's like, okay, I'm back in the game. Yeah,

Claudia (30:57): Yeah. Yeah. So then I definitely felt a huge relief and. Definitely had people tell me pushing actually does feel better than the stages right before that. And I agree with that to an extent. Yeah. So we were changing positions. I tried being on my hands and knees. Sometimes I tried being on my side, but he was just stubborn, and I think I was getting tired. So it definitely, it took two hours,

Dr. Nicole (31:27): And two hours is not bad at all For a first time baby. For a first time. It really is not. So, I mean, I can say that because I actually haven't pushed a baby since I had two C-sections. But in the grand scheme of things, I know it can feel like a long time, but I hope you're not like, oh my God, it took me two hours. It just

Claudia (31:46): Actually didn't feel like that long until the end where I just felt like I was getting fatigued. And at one point the doctor was, she's like, okay, I think you're pushing with your face. You need to take all that energy and put it down right down there and push from there. So that actually, that advice helped. But yeah, so eventually he came out. I did have, and we did immediate skin to skin.

Dr. Nicole (32:15): How much did he weigh?

Claudia (32:16): He weighed seven pounds, one ounce.

Dr. Nicole (32:18): Okay. That's a perfect size.

Claudia (32:19): Yeah. Yeah. It was a very good size. My husband cut the cord, which was kind of fun because he is a little bit of a squeamish guy. Right. But we both wanted him to, and he, yeah, he enjoyed doing that. Nice. And then I ended up having a third degree perennial.

Dr. Nicole (32:39): Okay. Yeah. So what was that like?

Claudia (32:43): That was, yeah, that was some recovery

Dr. Nicole (32:46): Maybe was is,

Claudia (32:49): Yeah. I actually do feel five months now later pretty much completely healed. Okay.

Dr. Nicole (32:55): Okay.

Claudia (32:56): Yeah. So the way she described it, it was barely a third degree, so it barely went into the anal sphincter, but definitely required repair. And so yeah, for sure. The first few weeks were pretty rough.

Dr. Nicole (33:17): Okay. Painful.

Claudia (33:19): Painful. That was taken all sorts of stool softeners. I don't use toilet paper for seven weeks

Dr. Nicole (33:28): Because it was just like, I can't

Claudia (33:30): Do it. The Perry bottle was,

Dr. Nicole (33:31): It was like, I just can't do it. Was

Claudia (33:33): My friend. Yeah. It brought that everywhere. But I think she did a great repair. And then I actually requested to be referred to pelvic floor pt.

Dr. Nicole (33:45): Aren't you smart? Yes.

Claudia (33:46): Immediately. Yeah. So that definitely helped. And I'd say overall, yeah, I do feel like it's pretty much back to normal. I haven't had issues with any sort of incontinence.

Dr. Nicole (34:00): Awesome. How long do you think it, it took you to get back to where you felt more normal?

Claudia (34:08): Yeah, I'd say probably eight to 10 weeks.

Dr. Nicole (34:13): Okay. Okay. Yeah.

Claudia (34:15): So in the grand scheme of things, not that long.

Dr. Nicole (34:17): Gotcha, gotcha. And how often, I guess soon. And how often did you see the pelvic physical therapist?

Claudia (34:23): So I saw, let's see I think I saw her first at four weeks postpartum. I don't think I would've felt comfortable or just felt it would not have been comfortable to try to do it before. And I saw her once a week for about six weeks. And then it was honestly just her schedule and my schedule. I could have gone more sure. But just the timing didn't work out. Okay.

Dr. Nicole (34:56): And you were starting to feel better about things. Yeah. And so what about the postpartum care? From the OB side? I feel like we do such a horrible job, but maybe, yeah. I mean,

Claudia (35:09): In the hospital it was great. So we were there for I guess, three days mostly for my blood pressure. Then he had a little bit of elevated bilirubin, never needed any lights or anything else than just time and eating and pooping. So yes. And then I ended up seeing again, I guess I requested to be seen at two weeks postpartum. Okay. Because I just had my usual six week check, and I was like, I pretty much had a surgical repair of. I,

Dr. Nicole (35:46): I think someone should look at this. Yeah.

Claudia (35:48): Yeah. Exactly. And they were very accommodating. They didn't fight back on that also. Right.

Dr. Nicole (35:53): But you had to ask for it.

Claudia (35:55): I did. Yeah. Yeah. And then similarly to the pre prenatal care, I essentially just saw whoever was available, which is fine again, cause I had seen them all in the hospital.

Dr. Nicole (36:09): I'm surprised they didn't want to see you back sooner for a blood pressure check or anything. No.

Claudia (36:13): That they did actually. So I did get seen at one week to check my blood pressure, and I was actually discharged on Nife Aine because I was still in one 50 over high nineties. Gotcha. Gotcha. When I discharged. So I took Nife Aine for six weeks.

Dr. Nicole (36:32): Okay.

Claudia (36:33): And then was able to come off it pretty

Dr. Nicole (36:34): Easily. Gotcha, gotcha. Yeah. Gotcha. And then how was breastfeeding?

Claudia (36:39): Yeah, it was tough. So

Dr. Nicole (36:43): Labor of love, as I always

Claudia (36:45): Called it, it was so true. I think for many reasons. His latch was not great to begin with. We ended up seeing, so I saw a lactation consultant pretty much day of life five, which was awesome. And she was wonderful. Nice. So we saw her, and then we were referred to essentially physical therapist for his oral facial therapy for him, just because he had a kind of squished little face and a tight latch. So, so they definitely helped with that. He did end up having a tongue tie clipped at about, I guess he was about 10 weeks old, which I think helped. Honestly, I think the thing that helped the most for him was just growing and age and time and practice. But I essentially ended up exclusive pumping for the first couple weeks, which was not how I envisioned it, but I think it actually in the end, worked out the best because my husband could help with feeding him. It established a really good supply for me. I even had a little bit of an oversupply because of pumping so much in the beginning. But that meant that when his latch, it kind of helped with his latch because of the oversupply and the fast letdown and that kind of thing. I think it helped with his breastfeeding. Gotcha.

(38:26): Gotcha. So yeah, it definitely took some work and it took a lot of pumping in the beginning but we're still breastfeeding now and still going

Dr. Nicole (38:38): Well. Okay. Yeah. That's what I was going to ask if you're still breastfeeding. Yeah.

Claudia (38:41): Yeah. We,

Dr. Nicole (38:42): Breastfeeding is obviously you do it, but it's hard to explain how much your world revolves around it for a long time, because you can't like going out to eat, go to the store, when do I pump? When is the next time? So it's

Claudia (39:01): A lot. And pumping is, is no easier. I mean, it respect to the moms who exclusively pump Yeah. For months. It's just, yeah. You have, your whole world revolves around when can I next pump and, yep.

Dr. Nicole (39:14): Yes

Claudia (39:14): Yes.

Dr. Nicole (39:15): Yeah, it's really fun. Do you use the fancy, the ones that you can just stick in there and

Claudia (39:19): Yeah, so I did. I have the

Dr. Nicole (39:21): Hands-free

Claudia (39:21): Ones. Yeah. I have a willow or willows. So my main pump is a spectra, which is great. But then I did also get a pair of willows, which Tricare actually helped pay for it, which was awesome. Oh, nice. Okay. And so I use those on my, or days or really busy clinic days. Gotcha gotcha. I have the liberty to be able to block out time in clinic so I don't have to use the wearable ones just cause I don't feel like they're quite as efficient as the plugin ones. But yeah, I

Dr. Nicole (39:59): Do use 'em. Okay. Okay. All right. And then, oh, how long was your maternity leave? How long is the military maternity leave?

Claudia (40:06): Yeah, so the military I think is actually pretty awesome at their military or their parental leave policies. Policies. So I got three months of paid leave. Oh, nice. We're actually starting, I think January one of 23. It's going to be four months. And for fathers I know it's six weeks now, and I think it might also be going to three or four months for For the non-birth parents as well. Right, right. Okay. Yeah. So I took three. I think I might have been able to take four, but Okay. Yeah, it was

Dr. Nicole (40:47): Nice. All right. Good. So how has the postpartum experience been overall, and how do you feel about your birth experience?

Claudia (40:56): Yeah, so the immediate postpartum period was definitely tough. I had to take my oral boards for orthopedic surgery at essentially five weeks postpartum.

Dr. Nicole (41:13): Ooh. Y'all should see my face right now. Oh my God. That is

Claudia (41:16): Torture. It is. And again, I probably could have asked for some kind of accommodations, but I think the answer may have been, oh, you can take 'em next year. Yeah.

Dr. Nicole (41:25): That's like, I just, I'm going to suck it up and just do it.

Claudia (41:27): Yeah. You know, spend a year collecting cases and Yes. So yes. Yeah. In my mind, the only option was to do it then.

Dr. Nicole (41:34): Oh, do you have to travel to,

Claudia (41:36): Yeah, you do. Okay.

Dr. Nicole (41:38): Where ours are in are in Dallas, in Texas where?

Claudia (41:42): Yeah, ours are in Chicago. Okay. So everyone goes to Chicago. So by myself, Stellan stayed with my husband, and then his parents were here too. Okay. So that in and of itself was actually okay. That travel, I felt okay being away from him. At that point, I was pumping, but the first five weeks of my maternity leave were just horrendous in terms of, I was trying to study my God, and then I definitely was not prepared for just the emotions that come with that immediate postpartum period. I'm definitely a very optimistic class half full person. I felt lucky to never have had to deal with any sort of depression or anxiety. And so just the negative emotions that can come in those first few weeks are Right. Were rough.

Dr. Nicole (42:41): Right. I can imagine.

Claudia (42:46): But yeah, I think getting boards done also, just with time. The second six weeks of my maternity leave for relatively great.

Dr. Nicole (42:54): Okay.

Claudia (42:56): Yeah. And so I definitely dealt with the baby blues for. The first couple weeks, but it did resolve, I'd say by probably by about four weeks. Okay.

Dr. Nicole (43:09): God, I couldn't imagine having to take my oral boards. Right. I had the baby. Well, I'm glad. Well, I assume you passed and got it done. I did, yes. Because then that would be torturous to have to do it all over

Claudia (43:23): Again to do it again. Yeah. Yes,

Dr. Nicole (43:24): Yes, yes. All right, so as we wrap up, what is your one favorite thing or piece of advice that you would give to expecting moms or expecting families?

Claudia (43:33): I think it would be surrounding that postpartum period, and just especially for first time moms and families giving yourself that grace of allowing yourself to feel emotions in those first few weeks and even months and mm-hmm. Let yourself cry talk it out with your partner and your family. And then with that, if you have the ability to have help from family or friends in those first few weeks, definitely. Definitely take it. My mom was here, then my sister came up in the first few days after he was born. And so just to have someone who can cook all your meals for you. Yes. Walk the dog, do your laundry. It is so, so helpful. And even if you don't have family that can literally stay taking advantage of friends who help, and even the little things, if they ask what they can do, make me a lasagna for Walk My dog. Yes. They'll be happy to do it. And it's one item off your checklist and something you don't have to think about. Yeah. Yeah. So definitely taking advantage of that help in the first few weeks and just being prepared to have those ups and downs of emotions. For

Dr. Nicole (45:00): Sure. For sure. For sure. All right. Well, where can women find you? Are you on social media or anything? You can say nowhere. Yeah, I

Claudia (45:07): Am. I so I'm on Instagram and my handle is just CC ski, so CC S K I. Okay. And then I'm also on Facebook. Awesome. Claudia Thomas. Yeah. Okay.

Dr. Nicole (45:19): Do you ski? I presume

Claudia (45:21): I do. Oh, yeah. Yeah. And then my maiden name was also skier, so that went

Dr. Nicole (45:26): Into that. Oh, that. There we go. It. Yeah. Yeah, yeah. All right. Well, thank you so much for coming on to share your story. I know folks are going to find it helpful. I'm already thinking of the things that I want to talk about afterwards in my Doctor Nicole's notes.

Claudia (45:39): Well, thank you so much for having me. It was an honor.

Dr. Nicole (45:49): Wasn't that a great episode? So many things to learn from in her birth story. And after I have a guest on, I do something called Dr. Nicole's notes where I talk about my top takeaways from the conversation. And here are my Doctor Nicole's Notes from my conversation with Claudia. Number one, I really love how one of the doctors in her practice asked her if she had a birth plan or birth wishes. This is really how it should be done. We should be initiating that conversation. However, if that is not happening, and to be honest, that is not very common that that happens, then you absolutely should bring up the conversation. If you have a birth plan or birth wishes, I have a class on making a birth plan the right way. You can definitely check that out. I offer it periodically throughout the year. Just head to my website, drnicolerankins.com, and you can check and see when the next class will be offered.

(46:46): Number two, induction can be a lengthy process. Her induction was Tuesday to Thursday, 52 hours total, she said, and you just have to be patient with the process. You really need doctors who are going to be patient with the process. So be prepared that labor induction can take some time. Not most often it will result in a vaginal birth, but you just again, have to be patient with the process. And keep in mind, even from Tuesday to Thursday morning, like she was five centimeters on Thursday morning. So you just again, have to be patient. You have to know when labor is considered active, when we shouldn't stop. These are all things that I cover in detail, the Birth Preparation Course. So you can, again, definitely check that out, drnicolerankins.com/enroll. Okay. Number three is remember that the anesthesiologist may not be in the hospital.

(47:45): She talked about how there wasn't an anesthesiologist in the hospital, and that is not uncommon that the anesthesiologist may have to be called in during the night for an epidural. So for that reason, you really want to know all of your options for pain management because you may have to wait a little bit before the anesthesiologist can come in, or the anesthesiologist may be doing surgical cases. Epidurals are considered elective. They're not considered something that you have to have. It's more, I don't want to say it's a luxury, but it's something that isn't required for birth. So things that are more urgent are going to take precedence. Like for example, if someone's in surgery for something. So you want to know all of your options for pain management, you can learn all your options. I have a free guide you can download at drnicolerankins.com/pain or episode, I believe it's 1 29 of the podcast also covers all of your options for managing pain and labor.

(48:44): But that guide is great because it lays it all out. The risk, benefits, pros, cons. Actually, the episode is great too, but the guide lets you kind of see it in a visual format. So definitely check that out. And one final plug for the birth preparation course. I cover all of the options for managing pain and labor and even greater detail. Lots of visuals and things that focus on tips for managing labor without pain medications. So you can get more details there. Again, the Birth Preparation Course is drnicolerankins.com/enroll. All right. So there you have it. Do me a sola share this podcast with the friend sharing. It's caring. I would love to reach and serve more people on that. Appreciate your help in doing that. Be sure to subscribe to the podcast so you never miss an episode. So wherever you're listening to me right now, hit that subscribe button. So you always get these episodes automatically downloaded into your podcast feed. And shoot me a note on Instagram. I'm on Instagram at Dr. Nicole Rankins. Let me know what you think about this show. Follow me there. For more information about pregnancy and birth, I love to connect with folks outside of the podcast, and Instagram is my favorite place to do so. So hit me up there, Dr. Nicole Rankins. So that is it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.