Ep 52: Miranda’s Birth Story – Why You Must Learn About Childbirth, Even if You Can’t Predict It

We're back with another birth story for you today! This is an extra special one because this is the first time I'm having someone on who used my Birth Preparation Course as part of their childbirth education. 

Miranda is an emergency veterinarian and self-described data-driven person. She learned as much as she could before giving birth to her daughter, who was only 11 weeks old when we did this interview. 

I really appreciate Miranda's honesty in this episode about how scary her birth felt, why she's so proud of how she handled it, and what she did when she was dealing with postpartum anxiety in the weeks after her daughter's birth. She also shares the huge positive impact that her doulas had both during the birth and afterward.

We also chat a little bit about the Birth Preparation Course, what Miranda felt was the most helpful about it, and other great resources for childbirth education.

In this Episode, You’ll Learn About:

  • What resources Miranda used to prepare for her birth (including the Birth Preparation Course), and some of the most important things she learned
  • Why you can't know exactly what you need during your birth until you're in it
  • What Miranda's birth was like and why it was harder than she imagined it would be
  • Why she and her team decided to use forceps during delivery 
  • How a childbirth doula and postpartum doula made a huge difference in Miranda's birth experience and postpartum transition
  • What her mental health was like in the weeks after her baby arrived
  • Why consent absolutely must be received before a provider conducts an episiotomy



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Transcript

Speaker 1: It is a birth story episode and this one is a special one.

Speaker 2: Welcome to the All About Pregnancy & Birth podcast. I'm your host, Dr. Nicole Calloway Rankins, a board certified Ob Gyn physician, certified integrative health coach and creator of The Birth Preparation Course, an online childbirth education class that will leave you feeling knowledgeable, prepared, confident, and empowered going into your birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. You can see the full disclaimer at www.ncrcoaching.com/disclaimer.

Speaker 1: Hello and welcome to another episode of the podcast. This is episode number 52. Thank you so much for being here today. Now today's episode of the podcast is a birth story episode and if you've been listening to the podcast for awhile, you know that birth stories are some of my very favorite episodes and today's birth story episode is no exception. Today's episode is actually even a bit more special because it's a birth story from one of the members of my signature online childbirth education class, The Birth Preparation Course. Miranda comes on to share her story, and Miranda is an emergency veterinarian who lives in New York. And at the time that we recorded this, her baby was just 11 weeks old. Miranda and I talk about all of the resources she used to get ready for her birth, including of course, The Birth Preparation Course.

Speaker 1: We talk about her birth and how hard and scary it was at times. We also discuss what really helped her to get through it and how ultimately she feels great about her birth experience as she felt like it was really an enormous achievement for her. Now, before we get to the episode, I gotta be honest, I was actually a little bit nervous having Miranda come on because although her birth was ultimately satisfying, it was not like she imagined it was going to be and she definitely had some challenges during her birth and as silly as this sounds, I was worried that you would somehow interpret her challenges as like, a negative reflection on my course. I know that sounds silly, but that's kind of what I was thinking. But I had to remind myself of something that I say all the time to you, and that is that no one can plan birth and no childbirth education course is going to guarantee a specific outcome for birth, because birth is an unpredictable process.

Speaker 1: However, a comprehensive childbirth education course can definitely help you be prepared to really weather that unpredictability and manage it well. And the Birth Preparation Course did that for Miranda. She actually emailed me after our interview to say that she hopes she was complimentary enough in the interview and she hopes that she made it clear that she thinks I'm really gifted at explaining things clearly and that I'm very kind and compassionate in how I deliver information. Well, thank you for that Miranda, and thank you again for coming on and sharing your story and experience. So without further ado, let's get to Miranda Hilliard's birth story.

: Nicole: Thank you so much, Miranda, for agreeing to be on the podcast. I'm super excited to have you here and share your story.

Speaker 3: Miranda: Great. It's my pleasure.

Speaker 1: Nicole: Yeah. So why don't you start off by telling us a bit about yourself and your family.

Speaker 3: Miranda: I am a veterinarian. I work in emergency veterinary medicine and I live in New York City with my husband. I'm from Massachusetts originally. My husband is a New Yorker through and through and he works in health care research. We have been married for, we got married last summer.

: Nicole: Oh you're newlyweds.

: Miranda: So we are newlyweds. We've been together longer than that but, but recently married and we live in a small apartment with our dog and now with our 11 week old daughter.

Speaker 1: Nicole: Awesome. Awesome. So let's go ahead and talk about, I know we'll get to what your birth was like and how, you went through The Birth Preparation Course in getting ready for your birth. But first let's just give a little bit of background of what was your prenatal care like.

Speaker 3: Miranda: So we gave birth at one of the large hospitals here in Manhattan and our prenatal care was at that hospital with a doctor's group, the OB doctor practice at the hospital. I am advanced maternal age. I was 39 when we got pregnant. I was 40 when we delivered and so I had pretty frequent visits throughout the pregnancy. Also had pretty frequent ultrasound scans. But for the most part my pregnancy was complication free.

Speaker 1: Nicole: Okay. Do you feel like you were supported during your prenatal care, that you got information that you were looking for?

Speaker 3: Miranda: I definitely feel that way. We chose our doctor, he was the doctor who did the prenatal care for my sister in law and she was really happy. Personal recommendation meant a lot to us and I felt very well supported and I felt that he explained and we went through the blood genetic testing initially and all the steps always felt like it was very well explained why we were making certain choices.

Speaker 1: Nicole: Awesome. Awesome. That's good to know. It makes me feel good when I hear that people are happy with the care they receive.

Speaker 3: Miranda: I think also because I'm a veterinarian and therefore had medical training, you know, my OB thought that was really fun. And so he loved to talk about how things are different in people compared to animals giving birth. So that was really fun.

Speaker 1: Nicole: And as veterinarians you have to know like a lot more than we know, like one body system. You have to know like many...

Speaker 3: Miranda: Fair. But I mostly just do dogs and cats, so it's not, I no longer do all of them.

Speaker 1: Nicole: All right. So when you were thinking about, you know, heading towards your birth, were there some specific things that you wanted for your experience?

Speaker 3: Miranda: So there definitely were, it really meant a lot to me. I really wanted to have a vaginal delivery. I know of course that C-section saves babies lives, saves women's lives, and that women who have C-sections recover and it can be a beautiful birth experience. But that was something that was important to me. I also got really excited about the idea of avoiding having an epidural for my birth. I got there, you know, I had read that many women who don't have an epidural, they have a shorter recovery period. And I liked the idea of being able to move around during the pushing stage and it just seemed to make sense to me. I think it definitely became a bit of a, like leaving myself believing I could do it thing. So yeah, so going into it, that was another thing that was important to me. And then the other things like delayed cord clamping and immediate skin to skin are all standard of care at the hospital I was delivering it. So there it wasn't, you know, I didn't really have to advocate strongly for those things.

Speaker 1: Nicole: That's good. I'm glad to hear that. That is a fairly recent thing. I think that it's standard of care at most hospitals. So that's great that you didn't have to really think about that.

Speaker 3: Miranda: Exactly. Yeah.

Speaker 1: Nicole: So when you were getting ready for your birth, what kind of resources did you look into or use? I mean, I know you used The Birth Preparation Course, but certainly I'd love to hear what other resources you considered or thought about and ended up using.

Speaker 3: Miranda: Well, I'm definitely an analytical and data driven person, so I think I overdid it. I bought a lot of books, so my husband and I did the childbirth prep course offered at the hospital together and it actually was a childbirth educator who had, you know, an association with the hospital. She was a really excellent educator. We chose for scheduling to do the one day, eight hour session and that was really great. I think he especially benefited a lot from it. It was a lot of information that I had already known from my own research I was doing, but was great to hear it in person. I read a lot of books. I really loved the Mayo clinic guide to pregnancy.

Speaker 1: Nicole: I haven't read that.

Speaker 3: Miranda: It's very similar to your course and your podcast. It's sort of the facts without too much, you know, opinion or dogma in it. I thought it was great information. And then I, because I was interested in avoiding an epidural, I looked at birthing from within. I looked at the hypnobirthing book and then I also listened to a lot of birth related podcasts including breast stories, including your podcasts.

Speaker 1: Nicole: Okay. All right. So you did what I think is fairly typical for a lot of first time moms in particular is that you gathered information from lots of different sources so you can hear different opinions and thoughts and kind of take what resonates with you.

Speaker 3: Miranda: Yeah, I'd say that's exactly right.

Speaker 1: Nicole: Yeah. Yeah. So how did you come to choose my course?

Speaker 3: Miranda: I heard you interviewed on another podcast I'd been listening to. So that's how I found your podcast at first.

Speaker 1: Nicole: Okay, let me guess. Either Birth Queens or Evidence Based Birth.

Speaker 3: Miranda: It was Birth Queen. Yeah, and then I guess through them and through you, then I found Evidence Based Birth and I'll listen to that podcast. So then I went and listened back over your back catalog and I've really appreciated your approach to explaining things, that you're an obstetrician, so have the firsthand clinical knowledge and are able to just summarize what seems daunting and scary to those of us who are the patient and summarize it and make it just sound like it makes sense.

Speaker 1: Nicole: Well thank you because that is certainly what I aim to do, because I know that this can certainly feel sort of overwhelming and guys, I don't, this isn't intended to be like a commercial for my course, promise, and I'm actually going to ask Miranda to give some feedback. If there's a thing she would have liked to see that we do, you know differently. But I do want to give a sense that people can understand firsthand what it's like to go through it. I think I certainly have my perspective as an OB GYN, but it's helpful to hear actual stories as they go through all kinds of different materials in order to get ready for birth. So how did you approach going through the course? Did you kind of binge through it or did you do a little bit at a time?

Speaker 3: Miranda: Definitely binge through it. I think I had signed up for the course and then not really done the modules and then in my eighth month I think of pregnancy, I did the whole course over I think two weekends.

Speaker 1: Nicole: Okay. Okay. All right. I'm curious for the birth wishes piece. Did you decide to make a birth plan and talk about it with your doctor at all?

Speaker 3: Miranda: So yes, I did. We also hired a birth doula who was present our birth live with us and part of her service was she helped us make a visual birth plan. Which I think you said you recommended where there's those images because so much of it aligned with the standard of care practices. You know, my doctor knew that I wanted to avoid an epidural, knew that it was important to me to have a vaginal delivery, but the rest of the birth plan, since it fit into their standard of care, I think actually in hindsight, the birth plan paper, I don't remember it ever actually showing up at our actual delivery and birth.

Speaker 1: Nicole: You know, honestly, I think ideally that would be the way that it goes, because you already know ahead of time that you're fairly confident that the person and the team that you're working with is going to support what you want. It doesn't have to be any sort of, you know, big discussion or fight or anything like that.

Speaker 3: Miranda: Exactly. I think that worked out really well. I did the separate session that you offer, the birth plan preparation and I really liked that. It broke it down into the top things that you should think of. You know, when you Google birth plan, it gets a bit overwhelming with all the different information that's out there.

Speaker 1: Nicole: Right, right, right. So did your partner go through the course too, or did he only do the in person class with you?

Speaker 3: Miranda: He, yeah, he only did the in person. I had planned for him to do it with me, but you know, best laid plans. But I did share the information that I thought was relevant to our situation I shared with him.

Speaker 1: Nicole: Got it. Okay. So let's talk about what was your, actually let's talk about what were things that you liked about the course and maybe things that you wish you would have liked to see included?

Speaker 3: Miranda: So because I was advanced maternal age, I knew that the plan would be, it was a strong recommendation of my doctor, to have a labor induction at 40 weeks. You know, I was very worried about having induced labor, worried about it affecting my two goals of vaginal delivery and avoiding epidural. And so I really focused on your sections on labor induction. It was really comforting to learn about how long induction can last, that it's normal for it to be longer than 24 hours and it's not stalled labor, you know, the criteria that you, the information you gave on what defined stalled labor. So I really enjoyed those. I really liked the first few sections when you talk about your mental state and how mental state plays such an enormous role and your birth experience. And I very much found that to be true.

Speaker 1: Nicole: Yeah. That's something that I honestly, sad to say, didn't really appreciate until I've been in practice for a bit, but it is so important to start the game, so to speak, but the right mindset.

: Miranda: And I'll say, my doctor said to me, you know, somewhere around 36 or 37 weeks, he said, Miranda, you're gonna, I know you're going to have a great birth experience because you are so calm and knowledgeable and you know what you want but you are able to, you know, go with the punches or whatever he said. And that was very comforting and I think having done all this education helped me get to that place that I felt pretty calm about everything.

Speaker 1: Nicole: Yeah. And you sound calm, even now you sound calm.

: Miranda: There's a part of this story that stopped being calm.

: Nicole: Oh I guess we'll get to that point and then I did you know it, was there anything that you would have liked to see more of in the course or included?

Speaker 3: Miranda: I don't think so. I think, you know, that's the benefit of sort of using different resources that everyone has a different focus. And I think it was a great amount of total time. You know, there's more, there are other courses like hypnobirthing or something like that, they have much more focus on non-medication pain management. But that wasn't what I was looking for in your course. And you certainly addressed, you had a whole long section talking about avoiding epidural.

Speaker 1: Nicole: Yeah. Yeah. So, okay, so enough about my course. Let's talk about your, let's talk about your birth. So what was your birth like?

Speaker 3: Miranda: Well, so I did all this preparation and had my idea of what I wanted it to be and I paid attention to everyone saying that you can't plan your birth and thank goodness I did because you can't plan your birth. And, and it really didn't go, it didn't go badly, but nothing went sort of the way I had pictured it. So I was, I did have labor induction performed. The hospital I delivered at only uses the foley catheter for cervical ripening. They don't use cervadil. And so the way it worked is I went and in the evening had an IV placed, started on Pitocin, had the foley catheter placed and then just waited overnight. You know, everyone says that's a great time to take a nap. I definitely found that with the monitoring strapped around you that flips out of place so quickly and the nurses having to come in and adjust your monitors, it really meant that I didn't sleep pretty much overnight.

Speaker 3: Miranda: We had planned with our birth doula that she would meet us at the hospital the following morning when things would really sort of start kicking into gear. And that's definitely what happened over night. The contractions that the Pitocin was causing were very manageable. And then by morning time is when it really started to be much less comfortable. And so having the birth doula there with us was great. She did a great job of sort of coaching me through it. It turned out that I very much didn't want to be touched in any way. So, all of our plan for possible massage and counter pressure kind of didn't work out because of how I felt.

Speaker 1: Nicole: That's very interesting. And something that I think a lot of times you see in like Facebook posts, Instagram posts like, Oh, you need massage. Oh, you need this or you need that. Honest to goodness until you are in it, you really don't know what you'll need.

Speaker 3: Miranda: Right? You don't know. You know, she had brought aromatherapy and had a little towel next to me and it was, you know, the worst thing possible that I could have had. She had to get that aromatherapy out of there immediately. So you don't know, you really don't know until you're there. Right? So everything was progressing well. We were doing well through the day. And so this was, you know, 18 hours or so of being in labor or being in the medically induced labor. And the plan was to check me, I was going to have a cervical check again at some point that evening. And so I had this time in my mind and you know, as the day was progressing, as the contractions were getting harder and harder, I kept thinking about this time and telling myself, well, as long as everything's looking good, as long as you're well dilated, you can keep going, it's going to be fine.

Speaker 3: Miranda: So that check came and at that point I was, if I remember correctly, I was effaced at 80 or 90%, but I wasn't very dilated. I was at 5 or 6 centimeters. And so that's when the doubts and my mindset end. So I spend the next two hours thinking I can't do another five centimeters of this. This is only the beginning of active labor, thinking a lot about having the epidural placed. And so we chose as a team, but mostly my decision, to have the epidural placed. And, and you know, both my husband and the doula were of course very supportive of that, and that went really well. I actually, I've had herniated disc problems in the past and had epidural steroid injections that were a very bad experience. And so that was also part of my concern.

Speaker 3: Miranda: But this was, you know, nothing like having those injections. It was a very, it was a totally painless experience, but I had an epidural that then only worked on one side of my body was being affected. You know, after an hour or so, the left side wore off. So twice I was given boluses of additional medication and one of those times it caused my blood pressure to drop significantly. And so having the epidural placed sort of started this cascade of, and not the true cascade of the interventions, but it just started things being much more complicated and having more problems and I will say, you know, the epidural is just incredibly effective when it's working on both sides. And I had gone from being silent and really just closed into myself to chatting with my doula about her pets. It's amazing the difference that happened.

Speaker 1: Nicole: Yes, it is. It is effective, very effective when it works for sure. I've had women have that had that lopsided feeling. I can't imagine what that feels like.

Speaker 3: Miranda: Well, I just started feeling the contraction pain mildly, but it was very much only on the left side. I could, it was only on the left side and then over the course of half an hour or so, it just got more and more intense to the point that the contractions were as intense as they had been just on the one side, but just on the one side. So it just really feels like cramps or contractions on the left side. And you know, once the epidural was placed, they had turned up the Pitocin and it kind of was, it was mentally very discouraging because it had been a little bit of a hard decision to decide. I definitely didn't feel like I had failed in any way, but it was a big decision to go forward and a big procedure and then to think, Oh man, I did all that and it's not even working.

Speaker 3: Miranda: But again, they were able to make it work again, the having my blood pressure dropped though, was a really unpleasant experience. You just feel so nauseous and weak and terrible when that happens.

: Nicole: Did it make your baby's heart rate drop also?

: Miranda: No.

: Nicole: Okay, great.

: Miranda: The baby did great through the whole thing. You know, I got a whole lot of fluids bolus and they have blood pressure medication given. One of the things that was important to us to have was to have calm lighting and we had brought in, I think this was your suggestion. Oh you suggested the Christmas lights, we brought in led candles.

: Nicole: Oh nice.

: Miranda: And it was really nice having the calm lighting. But whenever, you know, when the epidural was placed, when they were coming in to treat my low blood pressure, they had to turn on all the bright fluorescent overhead lights and it just really, really changed the feel of being in there.

Speaker 1: Nicole: Yeah, I hate those things. They are so awful. I mean they're just so like bright and sunny.

Speaker 3: Miranda: They're terrible. The nurses and the OBs, they were all, they were like, Oh, it's so nice in here with your candles. But the anesthesia team were not as impressed.

Speaker 1: Nicole: All right, so you got your epidural around six centimeters or so. So what happened from there once you got comfortable?

Speaker 3: Miranda: So that had been 5 or 6:00 PM I think, around midnight, they checked me again. And at that point I was 100% effaced, and nine centimeters, or eight or nine centimeters. And so they had sort of planned that we would start pushing in one to two hours. You know, it's a busy hospital. There's a lot of women delivering there at any given time. So of course the OBs are doing their best. So I think that one or two hours turned into three hours. So I think around at some point overnight is when we all started pushing together and that's, and that's where it got really hard. You know, certainly the epidural, what I hadn't realized is it doesn't, when it comes to pushing it doesn't, you actually start feeling pain again. Well, at least I started feeling pain again.

Speaker 3: Miranda: Definitely, you know, that's when I found out that pushing is the best way to handle that pain and to get you through it. You know, it had been my goal to be able to move around and of course I couldn't, I had to stay in the bed. But it was great having my husband and the doula there to support my poor husband. He tried counting the pushing for me and I couldn't tolerate any kind of instructions coming from him, it was much better coming from the medical staff. It definitely was not going quickly. The support staff and the medical staff were making a point of not telling us how much time had passed, but it, you know, it definitely felt like it was going for a long time and I was just getting more and more and more exhausted and to the point that I really, really felt like I didn't have anything left.

Speaker 3: Miranda: The hospital I delivered at it actually still uses forceps to deliver there. One of the, I understand not very many hospitals still do that, the Northeast it uses a lot more. There are more doctors who are skilled with these and forceps in the Northeast.

: Nicole: Oh, interesting. That's really interesting.

: Miranda: Yeah. So, my obstetrician who was not the doctor I did prenatal care with, but I had had a few appointments with her, so it was someone I had met before and I had known going into it that that would be the situation. You know, she, at some point she said, Randy, I think we should think about either vacuum assisted or forceps delivery. And I was very much relieved because I was starting to feel like I couldn't see a way out of the situation. My husband was terrified of this. He didn't know much about forceps and thought that it was very dangerous for the baby.

Speaker 3: Miranda: But luckily he actually didn't say anything at the time. But so once the decision was made for it to be a forceps delivery, things changed really fast and got really scary. You know, my eyes had been closed through most of this pushing phase. And at one point I opened my eyes and there were, it had gone from four or five people in the room to 15 or so. There was a resident OB and an intending OB who had shown up and then there was the pediatric team for the baby. And even with the forceps, it still took a couple of rounds of pushing to get her out. And you know, everything suddenly felt really, really scary to me because she came out forceps, I guess this is their standard, is that she was, we were not able to do delayed cord clamping or direct skin to skin cause she was taken right to the warmer to be assessed by the peds team.

Speaker 3: Miranda: She was a little champion and she never had any problems whatsoever. And very soon after, after being delivered, our doula helped my husband do direct skin to skin contact. And meanwhile I had another blood pressure drop and they were worried about how much I was bleeding. And so where I was, things felt very scary and I felt really sick.

: Nicole: Oh my goodness.

: Miranda: So then they told us how long it had been, that we actually had been pushing for three and a half hours. So that is why I was so exhausted. So that was, it turned out to be, everyone tells you, you know, everyone knows that childbirth and delivery is a really hard experience to go through, but I found that it was so much harder than I had anticipated it was going to be and scarier, you know, I never felt in danger and of course, and I felt like I had great care and great support, but it was a lot harder than I thought it was going to be.

Speaker 3: Nicole: Right, right, right. Do you feel like your doula and the medical staff were able to help you manage the fear at all or was it just so much?

: Miranda: I think they definitely, yeah, they absolutely were. You know, having the birth doula was such a good decision that we made. My husband and I both feel like how could we have done that without having her, you know, the labor and delivery nurses were with us really frequently, but they have other patients and our doula was with us permanently and was able to tell us, I've seen this before, this is normal, this is how, you know, this is normal, the way everything's progressing. And that was really reassuring.

: Nicole: And the nurse change shifts. I mean you probably had a couple nurses, or two or three nurses probably.

Speaker 3: Miranda: Well we did, but we had the nurse, we had the first night, came back the second night, so she was with us for delivery and we had thought that nurse was really wonderful. So that was nice to have that continuity.

: Nicole: Okay. That's good. That's good. And how did you find your doula?

: Miranda: I found her through doula match website.

: Nicole: Yup. Okay. Okay. Okay, good, good. So looking back, how do you, how do you feel about your birth experience?

: Miranda: So looking back, I feel really great. I feel like it was a really hard experience that we got through together and that I was able to be tough and get through. I feel like it was an enormous achievement. You know, it makes me really emotional. This is the first time I've talked about it without bursting into tears. I guess that's to be expected. Nothing went badly and we had the vaginal delivery, it's a really big deal. Delivering a baby.

Speaker 1: Nicole: It is a big deal. It is a big deal. And like you said, it can be unpredictable. And even though like overall, you know, you had a vaginal delivery, there's still some elements that can sometimes feel hard or maybe even a little bit traumatic to some degree.

Speaker 3: Miranda: And I think if our baby had been having any problems during it, if she had any changes in her heart rate, we would have been sent straight for C-section. The fact that she was doing so well is the reason we had the outcome that we did. But it's also amazing how quickly the difficulty and the pain fade from your memory. You know, within a few days it really felt like a distant memory. And at this point she's now, this was almost 11 weeks ago and that it feels like a lifetime ago.

Speaker 1: Nicole: Right, right, right. So when you say you, you know, before you would talk about it and you would kind of get teary about it, what do you think made you feel teary?

Speaker 3: Miranda: I think it just was, it's an overwhelming experience, but I also felt tremendously proud that we, that we had gotten through it or that I had gotten through it. And, you know, ending up with your baby is an incredibly emotional experience and you have all these postpartum hormones making you cry about everything. So I think the love for your baby just makes you very emotional.

Speaker 1: Nicole: Yeah. Yeah. Yeah. And then do you feel like your OB, and I'm sure your doula, probably checked in with you after birth, but did you have any, did you have like a six week visit or did you see the doctor before then? Like what was your postpartum that like immediate first couple months support?

Speaker 3: Miranda: So I saw, I had seen my primary OB who I'd done the prenatal care with several times in the hospital before we were discharged. So that was nice to be checked on by him frequently. When the decision was made to use the forceps, they had to do an episiotomy, which of course was another thing that I was helping to avoid. And this hospital that I delivered at, they're actually trying making lateral incision.

: Nicole: So at the side of the vulva they're a little less painful maybe.

: Miranda: Yeah, maybe. But what happened to me is a few days after going home from the hospital, it got really painful and they went back in and it had become infected. And so I had several extra visits to follow up due to that.

Speaker 1: Nicole: Okay. Okay. All right. And that can be a process and again, not something that you would necessarily expect.

Speaker 3: Miranda: No, I hadn't. I guess of course that can happen, but you don't really, you don't really plan for that. And it became painful over the weekend when they only have emergency staff. Yeah, of course.

Speaker 1: Nicole: Oh, well hopefully that wasn't too like involved.

Speaker 3: Miranda: It wasn't, no, I just needed a course of antibiotics and you know, the healing went much more slowly than I expected, but I guess that's normal. You know, when you're breastfeeding and changes your hormones and you just don't heal the same way.

Speaker 1: Nicole: Right, right. Do you feel like anybody ever helped you address some of the emotional aspects or asked about some of the emotional aspects afterwards?

: Miranda: They definitely did. It didn't come up at those extra visits, but at the six week visit, I filled out the survey and my doctor has to make sure I was feeling okay. I definitely had some pretty significant postpartum anxiety. I guess that was also a surprise of just how intense I was worried about her and whether or not we were doing the right things and if she was okay. And it was something that I felt comfortable talking openly about. I talked to my husband about it. I was having some intrusive thoughts about her being hurt or injured. And I would tell him about them and it made me feel a lot better. I talked to my mom about it, so it was something that I never felt like I needed to seek care, but it definitely got to the point that it was affecting my ability to enjoy her. But after about three weeks, it really faded off and I stopped feeling that overwhelming anxiety and just felt pretty normal level of worrying about her.

Speaker 1: Nicole: Right, right, right. And that is totally normal and I don't think we emphasize enough like how normal that is. I was an anxious basket case after my first one, cause she was a preemie and she was going to get sick. I remember driving her in the middle of a snow storm to the doctor because she threw up like a quarter size amount and it freaked me out. So yeah. So I don't think we do a good enough job of it, so I hope you understand that. Like that was, that was totally, totally normal.

Speaker 3: Miranda: I actually disagree. I think at least the resources I was using to learn about childbirth and delivery, were talking a lot about postpartum depression and postpartum anxiety. So I knew that the majority of women suffer from postpartum anxiety and that, you know, I started, had in my mind criteria for when I was gonna say, I think I need to go talk to someone.

Speaker 1: Nicole: Well, that's amazing. Yes. I'm very glad to hear that.

Speaker 3: Miranda: Yeah. One of my closest friends is a therapist, and so I had reached out to her and say, does this sound okay? Do you think I should go talk to someone? Of course her answer was always yes, of course.

: Nicole: Of course. So looking back, is there anything that you would change or do differently?

Speaker 3: Miranda:No, there really isn't. I hadn't wanted to have an induced labor and I think probably things would have very differently if I had had a labor start naturally. But you know, my doctor had talked to me a lot about, I think it's, you know, the different research for it. And, then when the time came it felt like it was the right, the right choice to make. There isn't really anything that I would do differently.

Speaker 1: Nicole: Okay. Okay. And I hope, you know, like with the forceps, like it's just helping, you still do the vast majority of the work. It just adds a little bit of extra to it. You still have to push at the end. Even with forceps, I can imagine that is exhausting after three and a half hours of pushing.

: Miranda: I was hoping that I was off the hook. It's like now, I don't have to do anymore pushing. I mean, thank goodness for medical interventions that, that, that make all the difference.

Speaker 1: Nicole: Right? Yeah, for sure. For sure. So looking back afterwards, I will ask, do you feel like I'm going through the materials and my course was helpful to you and what would you say to someone who's thinking about it?

Speaker 3: Miranda: I definitely felt that your course specifically was really helpful and we actually had printed off your hospital tip sheets to bring with us, you know, when you have an intervention, it's being suggested, here are the things to consider. Of course when it came time to the forceps intervention being suggested, my response was yes, please hurry up and do it, whatever. But I really felt having that sort of hospital based perspective, obstetrician based perspective. I really am really pleased that I did your course. I think it made a big difference to me.

Speaker 1: Nicole: Oh, I'm glad. That makes me, makes me happy to hear. I appreciate that. And guys, I swear I didn't coach her. I wanted her honest opinion.

Speaker 3: Miranda: And the price that you've set it, that is a very reasonable price point. I felt like, you know, there are so many. Our in person course had been I think $500 or something like that. And so it gets overwhelming if you're, if you're doing all this education that can, the cost can add up very quickly.

Speaker 1: Nicole: Yeah, for sure. For sure. So let's end with, if you had to share one your one favorite pieces of advice to share to women as they get ready for their birth, what would that advice be?

Speaker 3: Miranda: I would say hire a doula, hire a birth doula. We also had a postpartum doula come. It was a different woman and the postpartum doula was really instrumental in helping us get breastfeeding going. And so both women I feel so indebted to. They made such a difference in my experience.

Speaker 1: Nicole: Yeah. How long did you have the postpartum doula?

Speaker 3: Miranda: We had her for four to five hour sessions and we spaced them out over two weeks. And then we actually had her back for an additional belly binding ritual that she was trained in and did with me. That was a really sort of like a nice little spa session for me. Yeah it was, and it was really nice doing that extra session. That's kind of honoring what I had been through. So both of those women were fantastic.

Speaker 1: Nicole: Yeah. Yeah. It's one of the things I say, like if you're thinking about things like baby shower gifts, ask for a gift card or a contribution to help with a doula because that will go so much longer than like, you know, 12 packs of onesies.

Speaker 3: Miranda: Exactly. And that's the other thing. Everyone's so focused on what childbirth and delivery is going to be like and it turns out that taking care of a newborn ends up being a much bigger deal and way more significant and much longer a time period. I think you mentioned this on your podcast, I heard it mentioned, but I was just so focused on labor and delivery and that stuff. You know, for the most part you really can trust the hospital to take care of you and to do, I could have done less labor and delivery or childbirth education then maybe a little bit more newborn education.

Speaker 1: Nicole: Right. You are in a fortunate situation. Unfortunately, I get stories, emails, and social media messages every day of people who were in circumstances where they are not quite so supported. So.

Speaker 3: Miranda: Yeah, absolutely. Absolutely. Yeah.

Speaker 1: Nicole: So. All right. Well thank you so much Miranda, for being here and sharing your story. I really, really appreciate it with a brand new baby at that.

Speaker 3: Miranda: Well, thank you for asking me to. It really was a pleasure.

Speaker 1: Nicole: Yeah. Yeah. And I always ask, you know, if you're open, where can women connect with you or are you kinda like not on social media, that sort of thing?

Speaker 3: Miranda: I have a facebook. I'm in the Facebook group for both the class and your podcast.

: Nicole: Oh, perfect. Okay. Probably the only Miranda in there.

: Miranda: But I don't really use Instagram or other social media.

Speaker 1: Nicole: Okay, perfect. Well then if folks have some questions or want to ask about Miranda's experience, then you can connect with her in either one of the groups. All right, well thanks so much Miranda. I really appreciate your time.

Speaker 3: Miranda: Oh, you're so welcome.

: Nicole: Okay. All right. Take care.

: Miranda: Take care.

Speaker 1: All right now, wasn't that a great interview? I just really appreciate how honest Miranda was about her experience and how she was able to find joy in what was a challenging situation, even though she ended up with a vaginal birth like she wanted and how it was a little bit rocky along the process. So again, thank you Miranda for coming on. Now you know, after I have a guest on the show, I do something called Nicole's notes where I talk about my top three or four from the discussion, and here are Nicole's notes from my discussion with Miranda.

: All right, number one, I was excited to hear that she said delayed cord clamping and immediate skin to skin contact were the standard of care at the hospital where she delivered. I know that there are a lot of issues with the way we provide care for pregnant women in this country, but there are some glimmers of hope that we are making progress. We still have a ways to go, but definitely there's progress being made. So I was glad to hear that about the hospital where she was. Those things were standard as they should be. Of course.

: Number two, Miranda's point about you won't know what you want for your birth until you're in it. This is something that I like to remind women of all the time. You may hear stories or see articles that say, you know, you've got to have massage or you have to deliver in a certain position or you need to do this. You need to do that during your birth, and the truth is you really will not know what you want until you get there. She thought she would like massage and she hated anybody touching her. She thought she may like aroma therapy but couldn't stand the smell of it. So really what you need to do is just learn about your options and be open to changing and trying new things. That flexibility is key. You don't want to go into your birth with this rigid sort of way of how you think you should do things or what's going to work or not work. Be open to know the possibilities, try new things, take what works and move on from what doesn't.

: All right. The third thing is Miranda talked about how she had postpartum anxiety and I would just like to bring this up. I think I talked about this in the last episode as well or maybe the last two episodes actually. Anyway, how women don't necessarily just have postpartum depression. Some of the issues that can show up can sometimes show up as anxiety where you're really, really worried or anxious about things despite things going well. So just be mindful for that and be willing to or open to asking for help or ask for help if you experience that.

Speaker 1: And then the final thing that I took away that Miranda talked about two things that are really important that I want you to keep in mind for your own birth. Number one, she talked about how helpful her doula was and I can't say this enough, a good doula can be really, really helpful during your birth. Your doula is there the whole time, whereas your nurse may be in and out of the room, she's going to be the second person who's there the most and then your doctor is not there very frequently actually during your birth. So having a good supportive doula as that constant sort of presence can make a big difference and especially one who has some experience. And then the other thing is the importance of your mindset for your birth. You really need to do some work to get yourself in the right mindset before you go into your birth. That mindset piece makes a big difference.

: All right, so that is it for this episode of the podcast. Be sure to subscribe to the podcast in Apple podcast or wherever you listen to your podcasts, Spotify, Stitcher, Google Play. And if you feel so inclined, you know I would love it if you left a review in iTunes. Always keep it honest. Of course those reviews in iTunes or Apple podcast, I keep saying iTunes, but it's Apple podcast. Those reviews are important for helping the show grow and they help other women find my show. So I really appreciate you taking the time to do so. And then most importantly, I just love reading what you say and I love connecting with folks who listen. And I also give shout outs to folks on the show who leave reviews, so leave me a review in Apple podcast if you're so inclined.

Speaker 1: And then the last thing I'll say is that I know that there are a lot of resources that are available to help women get ready for pregnancy and birth and you ultimately have to find what works for you, but when you're thinking about where to most effectively spend your money and spend your time, especially considering that you probably need to spend some time not just getting ready for pregnancy and birth, but also the postpartum period, Miranda mentioned how she wished maybe she spent a little less time on all of the different things for birth and spent a little more time getting ready for the postpartum period. When you think about where to spend your time, where to spend your money and what's going to be an effective investment for you, The Birth Preparation Course is really an exceptional value for everything you get. I have put a ton of work into this course just to really keep it as tight and concise information packed as possible.

Speaker 1: So it's eight hours of content. It covers everything from how to get in the right mindset for your birth to what labor's like, how to manage pain, how to push, how to avoid tears, what happens with induction, and the immediate postpartum period, and then even some less common things that aren't typically covered in other classes. Like how to have the right support team to make sure you have the right people around you, how to safely approach placenta encapsulation, the risk and the benefits of circumcision and so much more. You also get lifetime access to The Birth Preparation Course, so you enroll once and you have it for all of your future pregnancies. So go to www.ncrcoaching.com/discount to check out the course and grab a big discount on it. There's a 30 day money back guarantee, so if you're not happy with it, just shoot me an email within 30 days and you'll get your money back. No questions asked.

: Or if you want to get a more up close and personal feel for what the course may be like, take my free class on how to make a birth plan that works. The content of that class is taken in part from The Birth Preparation Course. So that free class is a great way to sort of get a feel for my style and the type of information. You know, just kind of check it out and do a test drive, so to speak. So you can go through the free class on how to make a birth plan that works and that's also packed full of information. Go to www.ncrcoaching.com/register to register for that. Okay, so next week on the podcast I am talking about immunizations and pregnancy. This is an important episode, something that you don't want to miss, so come on back next week. And until then, I wish you a healthy and happy pregnancy and birth.

Speaker 2: Today's episode is brought to you by Women's Wellness Coaching by Dr. Nicole Calloway Rankins. Head to www.ncrcoaching.com to check out my free one hour mini course on how to make your birth plan, as well as my comprehensive online childbirth education class, The Birth Preparation Course, with over eight hours of content and a private course community. The Birth Preparation Course will leave you knowledgeable, prepared, confident, and empowered going into your birth. Head to www.ncrcoaching.com to learn more.

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