Ep 77: Amber’s Birth Story – Having a Beautiful Natural Birth

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Don't Miss An Episode

We have another birth story episode this week! I was very excited to welcome back Amber Manning, who joined us in episode 55 to talk about how she was preparing for childbirth and how she was hoping it would all go. 

Amber is an occupational therapist who lives in Texas with her husband and their 10-week old son. When we spoke last time, she shared her hopes for an intervention-free birth and is back to give us an update on how everything went.

Amber and I talk about why she decided to switch her provider again at 32 weeks and how she knew that the birth center she chose was the perfect place to have her baby. We talk about what she did in the lead up to her birth, including the exercise she kept up with, a few small complications she faced, and why she had two false alarms before ultimately going into labor.

We also walk through Amber's birth and her fantastic birth center experience. She shares how the midwives supported her through the whole process, why she wanted to give birth in the water, and the role her husband played to bring their son into the world. We also talk a bit about the postpartum period and what changes she made after struggling with breastfeeding and some postpartum depression. 

In this Episode, You’ll Learn About:

  • How Amber prepared for her pregnancy and which resources she liked best
  • Why she decided to switch providers for the third time at 32 weeks
  • What she loved about the birth center she ultimately chose and what her experience there was like
  • Why she felt comfortable throwing her birth plan out the window 
  • Her experience with the Foley Balloon induction
  • What her birth was like and why she felt so much more comfortable laboring in the water
  • How the postpartum period has been and what she did to combat postpartum depression
  • How the postpartum period has been and what she did to combat postpartum depression
  • How she and her husband have navigated the postpartum period during COVID-19

Links Mentioned in the Episode

Keywords

birth center, midwife, natural birth, postpartum, pregnancy, water birth

Categories

General Pregnancy, Health & Wellness, Podcast

Keywords

birth center, midwife, natural birth, postpartum, pregnancy, water birth

Categories

General Pregnancy, Health & Wellness, Podcast

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Speaker 1: I am super excited to have this week's guest on the podcast. She is actually a return visitor to the show.

: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, 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 www.ncrcoaching.com/disclaimer. Now let's get to it.

Speaker 1: Well, hello there. Welcome to another episode of the podcast. This is episode number 77. Thank you, thank you for being here with me today. So on today's episode of the podcast, I have Amber Manning. Amber was first on the podcast on episode number 55, where she shared how she was getting ready for her birth. As a first time mom, she was the first pregnant person that I had on the podcast to share their story. And now that she has had her baby boy, she is back to share her birth story. Now, a little bit about Amber. She is a recently married 27 year old first time mama. She loves her career as an occupational therapist, but she is currently enjoying almost every minute of her role as a full time stay at home mom. She and her husband make a great team and are navigating the waters of new marriage and parenthood.

Speaker 1: At the same time, they enjoy craft projects, spending time outdoors and spending time with family. This is such a fun and enjoyable episode that beautifully captures so many things about giving birth and giving birth as a first time mom. We talk about everything from managing early labor at home, to when her water breaks, to having a Foley balloon placed to help move her labor along, how she went from four centimeters to 10 centimeters in a little over an hour, how she gave birth in a tub. We talk about trusting your body, how she almost gave up on breastfeeding and how she struggled a bit with postpartum depression. So there is so much useful information in this episode. I know that you are going to enjoy it.

: Now, before we get into the episode, let me do a quick listener shout out. I should say the person who did the review says labor nurse. That's the name. And the review says, "I love your podcast. I am a new labor and delivery nurse, and I listen to your podcast while I drive into work every morning. I'm coming from the emergency department, so labor is completely new to me and I am learning so much. I desire to be the best advocate for my patients. I want to not only be the nurse, but I want to be their birth coach and help them through labor as well. Your podcast prepares my heart every morning to be the best nurse possible for my patients. Thank you, Dr. Rankins." Well, thank you. Thank you for that lovely review. I hope every pregnant mama out there has a labor nurse that has the heart that you clearly have for the work that you do. Thank you so much for taking the time to leave that lovely sweet and calm review. I definitely have a soft spot in my heart for great labor nurses. So thank you. Thank you. Thank you.

: Now I know that every labor nurse loves a patient who has a great birth plan, and I have the resource to help you have a birth plan that works. I have a free online class called how to make a birth plan that works. And in that on demand class, that's offered several times a day, you learn how to approach the process of making a birth plan- questions to ask, what to include in your birth plan, and how to get your doctors and nurses to pay attention. You can register for that free class at www.ncrcoaching.com/register. I would love to see you there. So do check that out. Great information. And as I said, totally free. All right. So let's get into the episode with Amber Manning.

Speaker 2: Nicole: Thank you so much, Amber, for coming back onto the podcast. I believe that the first time you came on, you were the first person who I had on who was pregnant at the time. And then now you are the first guest or the first birth story person who I've had come back.

Speaker 3: Amber: Well, I'm so, so, so happy to be here. I'm excited to share my experience because I was actually listening to my other podcast that I recorded with you to see how things have changed or stayed the same. So I'm excited to share some of the things that I thought were going to go a certain way and have slightly changed or, you know, just weren't what I expected they would be. So I'm excited to be here.

Speaker 1: Nicole: Well, let's get into it. Well, why don't we start off with a little bit, just tell us a little bit about yourself and your family.

Speaker 3: Amber: Yeah, so I am 27 years old. My husband and I recently got married in November. So at this point I was five months pregnant. My son is 10 weeks old currently, and I am actually a full time occupational therapist, but I have put that on hold obviously. And now I am a stay at home mom with return to work to be determined.

Speaker 1: Nicole: Well, that's nice that you have the option to stay at home for a bit.

: Amber: Yes, we're blessed.

: Nicole: Yeah. Yeah. So before you talked a bit about what your pregnancy and prenatal care was like, you guys had moved and you were finding a new person, so how did things end up going?

Speaker 3: Amber: Yeah, so my pregnancy was so busy. You know, as I mentioned in the last podcast, I was planning our wedding. I was working 70 hours a week. We relocated six hours across Texas, right after the wedding. So at that point I was 20 weeks pregnant. And two weeks before we got married, I was put on pelvic risk, because of my low lying placenta. So that affected kind of everything. My whole first trimester, I experienced antepartum depression. I feel like probably because of all the stress of everything that was going on. So we ended up switching providers four times before we finally landed somewhere that we were comfortable. So yeah, I remember when I last came on, we had switched and that was our third provider that I had mentioned because we moved obviously. So we had to find a new place in Dallas.

Speaker 3: Amber: So the first few providers were obviously back in where we were living before the wedding. And then as I had mentioned, last time, I ended up getting a new doctor because the first one their bedside manner was terrible. She was doing her lecture while she was performing my vaginal exam. So it was a whole mess. And so we got to Dallas, we ended up setting up with a third OB GYN. So this was our third provider. And at first I felt like we were on the same page, but then every appointment afterwards, we just moved further and further away from agreeing on anything. So she tried to argue with me about everything in my birth plan. She basically told me that I would have to choose between delayed cord clamping and immediate skin to skin contact.

: Nicole: That makes no sense.

: Amber: I know. And so she wouldn't budge on letting me be hep lock instead of being connected to an IV, which means she basically told me I would be stuck in the bed. I wouldn't be able to move around. She would make comments about me not wanting an epidural and then hinting that I would eventually cave in. So that was really disheartening. And even whenever I told her that I wanted to avoid an episiotomy at all costs, and for her to ask me before she performed one, she said she didn't see why that was necessary.

Speaker 1: Nicole: Oh yeah. Bye. She had to go. There's the door.

Speaker 3: Amber: Right? So at this point though, I was 32 weeks pregnant and I had this, I mean, you know that late in the game, you're nervous. You're scared. You think, Oh my goodness, I can't, I've got to stay where I'm at. And you just feel like, you know, overwhelmed with everything. So the way it ended up happening for us to switch to our fourth and final provider was I had started seeing a holistic chiropractor in the area. You know, I listened to your episode on it. And I also used to work for a chiropractor. So I truly believe in all the benefits of it, especially when you're pregnant and things keep baby in the right position and all of that. So I was talking to her about how displeased I was with our current provider. And she suggested switching to a birth center with midwives in the area. And I was like, wait a second. I'm 32 weeks. Isn't that risky? I mean, can you even do that? And so ironically, your podcast is actually what helped me make the decision to switch. So I prayed about it and I said, okay, God, if I'm supposed to switch, I need a very obvious sign. And so I went to sleep and the next morning I woke up and a new episode of your podcast was on. So I'm assuming it was a Tuesday morning. And the episode was about obstetric violence and birth trauma.

Speaker 1: Nicole: Oh God, girl. If that was not a sign, I don't know what it is.

Speaker 3: Amber: I was like, okay, God, I hear you. I mean, the first words out of the speaker's mouth were about how she switched providers at 42 weeks, I think, because she didn't feel comfortable. So I took that as my sign and I called the birth center and we got an appointment. And as soon as I walked in the door, I knew I was at the right place. I just felt at peace. It was just like this ah ha moment, you know, where you're like, okay, this is it. So yeah, so we switched to a birth center with midwives and I brought in my birth plan and they said, Oh, I mean, you know, you can have that with you, but all of the things that are on your birth plan are standard practice. So I actually threw my birth plan away.

Speaker 3: Amber: And it was perfect. I mean, it was just, it was so, so great. So the birth center that I delivered at it's a standalone center, it's two blocks from the nearest hospital and there's a children's hospital really close also. So my husband's main concern was safety as far as like, what happens if something goes wrong? And so they only accept low risk pregnancies. They perform emergency drills with the hospitals once a month to stay up to date on all the safety things. They, yeah, they do everything. You know, I just felt very safe and protected there. So that's when we ended up switching over.

Speaker 1: Nicole: Okay. So it was like, the way it should be where they had a close relationship with the hospital so that if transfer needed to happen, it could happen smoothly.

Speaker 3: Amber: Absolutely. And they actually, whenever a mom is in labor, they call the hospital and just have them on standby and say, hey, this is our mom. This is her blood type. This is what's going on just in case. And they actually have, I don't know if you've ever heard of this, it's called Teddy bear care. It's like a NICU on wheels. And so, yeah, so they offer that. So there's a children's hospital two blocks away. And whenever a mom's in labor, they have a Teddy bear care, which is basically like, I don't know all the details about what they can do in it, but I know that they said that they can actually do surgery inside of it if need be. So they call the Teddy bear care if the, you know, if infant is in distress and they just come right to the, basically to the front door and then you just hand them the baby and they do what they need to do. And they rush them to the hospital while they're doing what they need to do inside the NICU on wheels.

: Nicole: Interesting. That sounds really cool. I mean, that's how it should be. Their birth centers are integrated with hospitals, so that's amazing.

Speaker 3: Amber: Yes, exactly.

Speaker 1: Nicole: So let's talk about what you did to prepare for your birth.

Speaker 3: Amber: Yeah, of course. So my last, the last episode I recorded with you was all about this. So I'm not going to go into all the details, but briefly I read a couple of books. The main one was the Ina May's Birthing From Within. I really had my heart set on a natural birth non-medicated and so that was a good place to start. I obviously listened to all your podcasts and some other podcasts, Evidence Based Birth was a really great one, just so that I could know all of the options and then choose what I thought was best for me.

: Amber: And I started into the hypnobirthing, but I didn't take any formal classes. I just kind of did some YouTube video preparation kind of thing, as far as that goes. I took your birth preparation course, obviously. My husband and I went through that together. So that was really, really, I say, it's not, it's not really, it's just necessary. You have to take it. No question about it.

Speaker 1: Nicole: You're so sweet.

Speaker 3: Amber: Of course. You're going to be glad you did. So yeah, and I also, you know, in preparation, as far as like physically, I actually was seeing a prenatal chiropractor three times a week up until the day my water broke. And I was also doing hot yoga five times a week, which I know there's a ton of controversy on, you know, staying hot. And so I just want to, you know, kind of say that I was not in the hot yoga classes where it's like 108 or whatever, crazy degrees. I think they keep it around 90. So it is still hot, but I was very safe about it. I stayed really hydrated. I kept tracking my heart rate and oxygen throughout each class. I rested whenever I needed to. And, you know, there were other pregnant mamas in there with me. So actually the instructor had been pregnant with all three of her babies whenever she was teaching the hot yoga class.

Speaker 1: Nicole: They must have made you sign all kinds of waivers though.

Speaker 3: Amber: They didn't. No, they didn't. It was just such a really cool experience because everyone said, oh, you did yoga, like, you know, prenatal yoga. And I said, no, it was actually opposite. And so my mindset of doing hot yoga was that, okay, this is going to suck. Like, you know, having a baby with no medication is going to be tough. It's going to be a challenge. So each hour class that I was in, I took that mindset of, okay, I've got to control my breathing. I've got to, you know, make sure that my heart rate and oxygen are staying, you know, in safety limits. And then I'm going to be moving my body. I'm going to be challenging myself. I mean, so that's kind of my mindset going into the yoga and I was very skeptical about it. At first the class I went into, I just, I said, okay, Kingsley, talking to my baby in my belly. I said, okay, Kingsley, I want you to tell me if you're okay with this. Or if you're not. So I just listened to my body, listened to my baby. And he loved it. He flipped and kicked the whole time, every single class. And I actually went five days a week.

: Nicole: Wow. Okay. Yeah. Awesome. So what are some things that you wanted for your birth?

Speaker 3: Amber: Yeah, so I mainly wanted freedom and informed choice. I think that is, you know, that's pretty much, I feel like what every woman should get, but these things were guaranteed at the birth center, which is why I was so comfortable there, but I really wanted an unmedicated birth. I originally thought I would want to like eat and drink during labor and you know, all the things, but that never happened. I didn't want to be hooked up to any monitors. I wanted immediate bonding with my baby. I wanted delayed cord clamping. I actually wanted a water birth. I basically wanted to birth my baby the way it's meant to happen naturally and without any sort of medical intervention.

Speaker 1: Nicole: Okay. All right. So you really, it's not like you had crazy requests or anything like that?

Speaker 3: Amber: Yeah. I mean just let me have my baby.

Speaker 1: Nicole: Yeah. I mean, like all that fits in like half a page, like it wasn't like you needed a 12 page birth plan.

Speaker 3: Amber: No, no, no, no. It would fit on one page. And even then whenever I looked at it, I was like, actually I can take some of these things off, you know, but, and then at the end of it all, like I said, I just ended up throwing it away, so.

Speaker 1: Nicole: Right. Gotcha. So tell us all about what was your labor and birth like and all the things you were saying about what you thought might happen did happen or not happen? I'm super curious.

Speaker 3: Amber: Yeah. So I actually had some preterm labor symptoms. My mucus plug came out completely at 36 weeks and I was having some inconsistent contractions, but in order to deliver at the birth center, you have to be at least 37 weeks. So they said, we need to put you on bed rest, we need to check and see if everything is okay down there or whatever. So I ended up at 36 weeks going into the birth center. I was checked. They told me I was not dilated at all. Then my cervix was thinned out. It was a effaced, I think, 70% at this point, but I ended up having a yeast infection, which made my vaginal exam very, very painful. And so I ended up having to get on, you know, the antiviral medications and supplements and everything. And then I went home and was on bed rest for a week.

Speaker 3: Amber: Once I got to 37 weeks, I was safe. You know, I hit that safety zone and I went back to work. I went back to doing yoga, everything. So at that point we started trying to induce labor cause I was like, okay, we're here, let's do it. I was ready to not be pregnant anymore. So, we were trying to induce labor. We were bouncing on the ball, you know, doing stairs, hip openers, pineapple juice, sex, you name it. I mean, we were trying every single thing. So finally at, I was 38 weeks and six days. And it was a Tuesday morning at 6:00 AM, just a normal day. I was, you know, I had patients to see that day, since I'm an occupational therapist, I had patients to see, so I wake up at six and I go to the restroom and I stand up from the toilet and water comes out and I'm like, wait, was that my water breaking?

Speaker 3: Amber: I don't know, it was a trickle, but it's more than it's ever been. So I don't, you know, as a first time, mom, you literally don't know anything. And I thought at 36 weeks cause my plug came out that I was kind of getting close. So that was my first false alarm. And this ended up being my second false alarm. And I thought, I feel like the boy who cried Wolf. I thought I was, you know, thought my water broke. I texted all my people, told them to get prepared. I called the birth center. They said, you know, okay, well we're in no rush. You're not having a contraction. So just come in at 11, we'll check everything and see how you're doing, but just go on about your daily business. So I went to the chiropractor and I told them what happened. So they did a very, very good adjustment on me and said, if you are indeed in labor and you're not progressing, come back this afternoon and we can do acupuncture to kind of speed things along.

Speaker 3: Amber: So that was an option. You'll find out in a few minutes, we didn't end up doing that, but so we go to the birth center, 11, they checked me, I'm still at zero centimeters, water had indeed not broken. They said it could have been a high leak, but it also could have just been urine. Although I was a hundred percent sure that it was not. And they also said that I still had that yeast infection. So I was like, Oh my goodness, which is why I was in so much pain, you know, in that area down there. So I came home, I called my boss and said, okay, well I'm just gonna go ahead and stop taking patients, you know, get everything covered for me.

: Amber: And then I made it, we started cleaning the apartment, like deep clean, the windows, the baseboards, I mean stupid stuff that I've never cleaned before in my life. And so I was like, Oh, I think this is it. You know? And so I went about my daily business. I should have come home and take a nap. In retrospect, I wish I could have told myself that. But I came home, did my daily stuff. And then at six o'clock in the evening, so 12 hours later, my husband and I were going for our daily walk and I get out of the car and my water most definitely broke.

Speaker 1: Nicole: Then it was like, this is it.

Speaker 3: Amber: I hate it when people would say, Oh, when you know, you know. You know, they kept saying that about everything. And I'm like, but I don't feel like I'm gonna know, but I definitely did know. So for anyone listening, you will most definitely know when your water breaks. And so I called the midwife and I said, okay, what do you want me to do? So she said, let's go ahead and I want you to come into the birth center. And I want to put in the Foley balloon catheter because since I was not dilated at all that morning and my cervix was so ripened and ready, she said that, you know, at this point we're on that 24 hour time clock, we need to get this rolling. And once we put that foley in, you can most likely just get some sleep and then your body will start to dilate.

Speaker 3: Amber: So I said, okay, let's do it. So I was not for induction originally, but I was okay with the foley because I knew that it was reversible. If anything wasn't going smoothly or whatever, we could just take it out. So we did. So we go into the birth center at eight o'clock that night, my husband came with us. And so since the birth center, it's not a hospital, there's not any staff there. I mean, when it's closed, everyone goes home. So my husband actually helped her insert the balloon because she had no one there. So he actually like with the saline solution, the thing, he actually put that in there and inflated the balloon, and I was going, I was staring at him. I was going okay, babe, slow and steady wins the race.

: Nicole: That is hilarious.

: Amber: He was sanitizing everything. It was hilarious.

Speaker 1: Nicole: And you do, you do need a second person to start inflating the balloon.

Speaker 3: Amber: Right? And I can't help. So there was a picture of him with his gloves on and holding the little saline solution. Anyways. It's funny. So, as you know, the foley is supposed to help you get to about a three or four centimeters and then it falls out and then, you know, things start going. So I started having some pretty bad cramps. They felt like period cramps immediately, as soon as she put it in. And she said, yeah, that's normal because she said, I'm really sorry. Cause it kinda hurt when she put it in. But I assumed anything going on down there was not going to feel great. But she said that the reason it hurt was because she had to manually kind of dilate me to about a one so that she could get that fully in there. So she said, give it a couple of hours. The cramps will go away and you'll be able to get some sleep. So we went home, I know that at the hospital, you usually stay in there. You know, once you get the foley, it's like, okay, you're here. But at the birth center they send you home.

Speaker 1: Nicole: Some offices are getting more progressive. Now, usually if your water's broken and it's actually not all people will do the Foley once your water's broken. But, some opposites are getting more progressive and will do the Foley at home overnight.

: Amber: So yeah. So I mean, and I think it was, like I said, we'll get to that point. Let me just not get ahead of myself. So, it was very painful cramps and the birth center's about 20 minutes from home. So I had those cramps all the way home. And now looking back, I know for sure, because I've had contractions at this point that it most definitely felt like contractions, the painful cramps were indeed contractions. So I went home, and as you know, the Foley doesn't have a cap on the end. So if there's any fluid or anything, it just kinda like leaks out. I don't know if that's everyone's experience, but because she had to manually dilate me, I had blood and things coming out of mine. And so I was standing at one point over the bed, I think, and my husband looked down and said, there's blood everywhere.

Speaker 3: Amber: And I looked down and the Foley had leaked blood everywhere. So my husband, who's an engineer, he stuck a water bottle, he stuck the end of the catheter into the water bottle and duct taped it so that all the fluid would go into the water bottle. So I'm walking around the house with a water bottle, dangling between my legs. But it worked. So I put a picture of it. It's not pretty. So we have this weird water bottle thing going on, and we get home. My midwife told me, go home. I want you to take a shower, make sure your bags are packed, eat a good dinner and have a glass of wine, go to sleep. I said, okay, I did that. So I get home, I take a shower, bags are packed, I'm eating my meal and drinking my wine. And then nothing.

Speaker 3: Amber: I mean, I can not go to sleep. These cramps are getting worse and worse and worse. They're not getting better. They're getting worse. So I'm like, okay, I don't think this is what's supposed to happen, but you know what? I'm just going to go get in bed. I'm gonna turn on my music, get in my zone and just try and get some rest. Even if it's not sleep, I need to get some rest. Cause I've got a marathon to run soon. So I get in bed, and for about an hour or so, I did lay there and try my best to kind of labor through it and things, but it just kept getting worse and worse. I eventually got up, got on my birthing ball and finally got into the shower. My husband was still asleep. I wanted him to rest. Then I got in the shower, I took a blanket and a pillow into the shower with me and just the shower on, got in there as if I was in bed and just try to relax.

Speaker 3: Amber: So my husband heard me do all of that. And so he wakes up and it's about two o'clock in the morning at this point. So I have not slept. And he's like, what's happening? And I said, I don't know. I don't think this is normal. I've been timing these because I feel like they're contractions. And so I want to say maybe they are, but the balloon hasn't fallen out. And so I don't know. And at this point they were coming every two minutes and lasting quite a while. And so I was like, this seems like it might be labor. So we went ahead, my midwife just said, here's my cell number. Just call me at home. You know? And we'll get everything taken care of if you have any issues. So my husband called her at 3:30 and said, Hey, you know, this is what's going on.

Speaker 3: Amber: We're just kind of nervous at that point. I kind of started to get in my head about this isn't normal. And then I kind of, you know, at that point you start thinking the worst case scenario. So she said, okay, go ahead and come into the birth center. We'll take out the Foley and then she can just get some sleep, but go ahead and bring your bags with you and we'll get you settled in the birth suite. So the birth suite, there's two of them at the birth center and you basically have a full kitchen. You have a King size bed, a couch, a full bathroom, and then the birthing tub. So it's like a hotel room. It's gorgeous. They have, you know, essential oils going, music playing. I mean, it's, they've got like the Bluetooth speakers it's best case scenario for having a baby.

Speaker 3: Amber: So we get to the birth center at 5:30. And at this point I had been up for 24 hours. So she goes to remove the Foley and she said, Oh, Amber, the Foley has been out of your cervix. It's just been sitting in your vagina and it wouldn't come out because you were clenching so tight because you were in pain. I said, Oh my gosh. So she just barely pulled it and it just fell out. And I was like, okay, I guess I could have done that myself. So she's like, okay, let's go ahead, and you know, she said, the cramps will stop and I want to go ahead and just get you in bed and get you some risks. So as I start to get off the table, I start to have back labor and she goes, let me check to see how your baby's positioned.

Speaker 3: Amber: Well, of course my little stubborn child had flipped and was sunny side up and had been face down my whole pregnancy. So, we had to turn the baby and she used a version of the Webster technique. And so try to explain this without, you know, showing you a picture of it, but you're basically, I'm laying on my back on the exam table. And my butt is scooted all the way to the edge as if I'm going to get like a pelvic exam. And my legs are dangling off the side of the table with no support underneath. So basically like an inverted triangle and think about being pregnant in that stretched position, it's already painful enough. And she wanted me to sit there through two contractions and she said that the baby would turn. And I said, okay, she goes, but it's going to be painful.

Speaker 3: Amber: So just bear with me. So I did, I sat there through two contractions screamed the whole time. And my husband said, you could literally see my son turning. You could see his shoulders, legs, everything flipping over. So he did, so he flipped over. We start to head upstairs. Now the birth suites are upstairs. I don't know why they did it that way. And I says, okay, on your way up the stairs, I want you to do lunges. And when you get to the top, I want you to do squats. You'll thank me later. So I'm doing my lunges, I'm doing my squats and I get up to the very top and then a contraction comes on and I'm like, wait a second. You told me I was going to get a rest, a break. And now I'm having these contractions. And at that point they were coming every two minutes.

Speaker 3: Amber: So I'm like, Oh my goodness, no. So I get in bed. I'm side lying. You know, we've got all the things going in the background to get me in the right mindset. I'm having contractions. My husband's doing his thing. He's read my birth affirmations to me. I've got Bible verses coming at me. One of my midwives is on my feet. You know, massaging my feet. The other, there's a student midwife who plays a huge role in my birth. She shows up like about 15 minutes into it. And like I said, she was a student, but I met her at one of my prenatal visits. And immediately we just had this instant connection. And so whenever we got to the birth center, I said, Lisa, can you call Ashlynn, please? Like, I don't know if she's allowed to come, but can she come? And she said, I already called her she's on her way.

Speaker 3: Amber: So that was really fun for me. Cause she got to kind of be there to learn. And also she played a really big role. So she was actually laying in bed with me applying counter pressure. So we were doing that for awhile and then about 30 minutes into it, I said, okay, I'm not getting any rest, let's do this. I'm standing up. Let's get this going. So I stand up and as soon as I stand up, I felt him drop and I had to push. And I was like, but it's only been like an hour. There's no way I'm where I'm supposed to be. And I know that if I start pushing too early, it can be a whole problem. So my midwife said, Amber, throw out any knowledge that you have and listen to your body, just do instinctively, literally what you think you need to do. Just follow your baby's cues. So I did and I started pushing and then I said, okay, I feel like I have to pee every time I push. So I went to the bathroom and then I'm having contractions on the toilet and I yelled and I said, I do not want to have this baby on the toilet.

Speaker 4: Amber: So the tub, it takes 30 minutes to fill up. Cause it's pretty big. And so they said, well, we're going to try to get it. You know, we'll get it going. But I don't know if you're going to make it. And I said, Oh, we're going to make it. I'm not having this baby. I want to have a water birth. And so I get back into the room and Ashlyn the midwife, a student midwife says, I'm going to go ahead and check you to make sure that you're at a 10 so that you can continue pushing. And that will give you peace of mind. And I said, okay, so she did, she checked and she goes, Oh Amber, I can feel his head. And I said, okay. So I had dilated from a four to a 10 within an hour and a half.

Speaker 4: Nicole: It's, you just never know.

Speaker 3: Amber: I know! So I called my Mom, you know, to tell her, to go ahead and come and the photographer and they live two hours away. So, so at this point, they're on their way and we've got about 20 minutes into the tub being ready. Finally, the tub's ready, so we move into the tub. I sprinted, I mean, sprinted to that bathtub, hopped in, get comfortable. And this is about 7:30 AM. So we got there at 5:30, now it's 7:30. And so I'm pushing or whatever, but I'm laying like as if you lay in a bathtub, but since I'm so short, my feet didn't touch the other side of the tub. And every time I would push my butt would just float to the top of the water.

Speaker 4: Amber: I was like, wait a second. I'm not getting any, I can't ground myself. You know? And so I don't have any like leverage. So I said, I need to flip over and flip around. And I got on all fours while I was so exhausted from pushing that I fell asleep in the water and I was on all fours. So that wasn't safe. So I flipped back around, sitting again, and I pushed a couple of times that way. But the problem with that was my midwife and her student midwife were in front of me so they could see what was going on down there. And I could tell from the reactions on their face, what was happening. And so I would push, push, push, push, push, and they would say that, you know, their face would get all bright, like there's his head and then stop pushing. And then his head would suck back in and then they would look disappointed. And I couldn't keep looking at that because I was like, this is discouraging me. I'm going to turn around. So I turned around again, got in the tub and I was falling asleep. So they gave me a honey stick. I don't know if you've ever heard of those for birth, but it's just like a stick of honey and you stick it in your teeth.

Speaker 3: Amber: And I just, I mean, my husband just like poured it into my mouth and was like swallow. And so I did that and I immediately got a burst of energy. So I flipped around and got on my knees and I was like kneeling. So my arms were in my husband's lap. He was out of the tub. And originally he was supposed to be in the tub with me to catch the baby. But nothing went how I thought it was going to, I was in the tub by myself and I'm pushing that way on my knees. And the midwife goes, okay, Amber, you know, let's, you know, you've got this and she's encouraging me. And the student midwife was behind me ready to catch the baby. And I felt, okay, this is it. So I push and I felt his head come out. And then I felt the ring of fire and my midwife got in my face. I mean, we were like sharing oxygen at that point.

Speaker 5: Amber: And she said okay Amber, do you want your vagina to tear? And I said, no ma'am. And she said, okay, I need you to sit right here with his head right there until the next contraction, do not push. And I want you to give it all you've got at the next contraction. And I said, okay. So I waited and I waited and what felt like an hour, but it was like 30 seconds probably, you know, and I was begging for the next contraction to hurry up and get there. And next contraction comes and I pushed, she told me it would take about three more contractions. I was like, no, I'm done with this. I pushed. And he shot across the bathtub.

Speaker 5: Amber: My midwife was a student, and was like, oh my gosh, like trying to catch him because she had her hands like right under me, but I've like shot him across the tub. And he actually had bruises all over his face and his head, poor baby, cause he came out so fast. And so, um, so yeah, she's holding him. Then she sends him back under the water, through my legs. And then I sit back and he was actually blue. When he came out, he wasn't breathing, he was blue. And so they're doing their thing, you know, trying to get him all pinked up and everything. And I'm so exhausted. I'm like, I don't know what's going on. I mean, I could tell that something was kind of off, but they did such a good job of keeping their composure. I mean, they weren't saying things like, come on, baby.

Speaker 3: Amber: We need you to breathe. They were just like, come on baby, we want to see that smile. You know? So it wasn't like, I didn't feel, I mean, looking back, obviously I knew that something was going on, but I was just so like, did that just happen? Oh my baby's right here. Oh my gosh. What's going on? And actually, so my midwife that ended up delivering my baby, she was on call until 8:00 . Well I ended up having him at 8:12 AM. So they had the second set of midwives and nurses and stuff on standby. And they were actually in the room with me. So originally it was just my husband, the midwife and the student. But after it's all said and done, it was my husband, my midwife, the student, and then another set of like three or four women at that point.

Speaker 3: Nicole: Gotcha.

: Amber: So they were like cheering me on while I was pushing, they were like, come on superwoman, you've got this. And they were just like, I felt like I had a whole team of like, you know, coaches just sitting there coaching me through it. And so at that point, all like six or so of the women rushed over to my baby and were, I could tell at that point that something was kind of wrong because it doesn't take six for one baby. I knew that. So they did, it took, it took less than 60 seconds because his apgars, you know, at the like one minute mark were completely normal. So I was, you know, after it's all said and done, I was, it was fine. But my husband said he was very nervous because I heard them say, get the resuscitation equipment, like in the background. I heard that. And so that's whenever I was like, Oh no, something's not right.

Speaker 6: Nicole: That was the longest 60 seconds in your life.

Speaker 3: Amber: I'm telling you it was so scary, but I was so exhausted that it really almost didn't even, you know, like it was hard for me to really know what was going on, but they, but he did, he pinked up, he was fine. And then they put him on my chest and then everything was fine. And my mom walked in at that moment. So she missed it by like three minutes, and my photographer wasn't there either. So she did take like the fresh, you know, 24 hour photos or whatever, but I wanted the photos of like laboring and the actual birth, but we didn't get that because it happened so fast. But I was thankful that it happened so fast. So, you know, it's okay. I'll have the memories in my brain forever. And, actually I didn't tear. So my, that whole wait for his head to come out kind of thing, that really paid off. I didn't tear at all, no stitches.

: Nicole: And then how much did he weigh?

: Amber: He weighed 6 pounds 12 ounces.

: Nicole: Okay.

: Amber: Yeah, he was a little bitty thing, but I'm not, you know, a big person. So it was like, okay, well, I don't know how I would have done with an eight pound or nine pound baby. So anyways, so yeah, so he was healthy. And then we had him on my chest. I got immediate skin to skin. We were in the bathtub or in the birthing tub. And then my placenta, so she said, my student midwife said, do you want to feel the cord pulsing? And I said, yeah. So I grabbed it and I could feel the blood pulsing from me to him and vice versa. It was just like, Oh my gosh, like, this is literally our connection. And so we waited. So they delayed cord clamping, they waited until completely the cord was done pulsing. And so it took about five minutes or so honestly time is like, not even, you know, in my head, I'm thinking, I don't even know if this is accurate. I think it was about five minutes. And then my husband cut the cord and then I handed the baby off to him and then they got me cleaned up.

Speaker 6: Nicole: Let me ask you, how did you feel being in the water with all the stuff?

Speaker 3: Amber: You know, I never even looked around in the water. Like I don't even know what was in there. There could have been snakes in there with me and I wouldn't have been, I mean, everyone says that like, ooh, you know, you have all your stuff, but I'm like, at that point, you're not even focused on that at all. And I will say from the moment that I was laboring just on land, and then when I got into the water, I immediately felt like, okay, I can do this. It's like the pressure was taken off of my body and the pain kind of decreased. It didn't go away, but it decreased for sure. And I don't know if I've ever heard this, but they actually call the birthing tub, the midwives epidural. So, I mean, it's pretty, pretty accurate. It works.

: Nicole: It is. Water is very effective.

Speaker 3: Amber: It is. And, oh, I forgot to mention earlier. So, you know, we're in the coronavirus pandemic right now. And one of the only method of pain relief that they offer is the nitrous gas oxide. And I really wanted to try the nitrous. I was so excited about it. And so whenever I got up to the top of the stairs, at the very beginning of all of this, I said, when can I get the nitrous? And she goes, oh honey, I'm so sorry. But because of the coronavirus, we're not allowing the, we're not allowing the nitrous. And so it was like, what? I wanted to try it. You know, I know some people love it. Some people hate it, but I wanted to try the nitrous. So that was really the only thing that the coronavirus took away from me was that. Because they were allowing as many visitors as I wanted, they were allowing a doula if I wanted it, I didn't end up having a doula because I felt like my husband and I were were okay without it.

: Amber: And so I think it would be beneficial for sure to have a doula, but with me, I just wanted to see if I could do it by myself. So, but yeah, so they didn't have any restrictions or anything. And we actually went home four hours after he was born.

: Nicole: Oh, wow.

: Amber: So, yeah. So the difference, so we, you know, obviously we finished with the delivery or the birth, and then my husband took him and then I stood up and gave birth to the placenta and which is beautiful by the way. And I know people think that it's gross and all of that. And I did before, whenever I was just pregnant, but then you're like, Oh my gosh, I made this. And so...

Speaker 1: Nicole: It's a miraculous organ, actually.

Speaker 3: Amber: It really is. I had my photographer actually take photos of it because I wanted to, you know, to remember it. And then they actually drain the tub and clean it and then refill it back up. And they put in an herb, it's like an herbal bath. And then mom and baby get back into the bath. And then you have your first bath together experience. And it also helps mama's tissues down there.

Speaker 1: Nicole: Does your husband get in too, or just you and the baby?

Speaker 3: Amber: Just us. I told him he had like, you know, a change of clothes because I thought he was going to kind of be in there with us, but he wasn't. And that was okay. I mean, you know, he was definitely right next to the tub and he was there, we did pictures and stuff there also. And then we got out and we did like our photo shoot in the birth suite and they gave him a birthday cake and we sang happy birthday. And the photographer was there and it was just, my midwife was literally spoon-feeding me a yogurt parfait afterwards. I mean, I was treated like a queen. I was laying in this king size bed. They were like, fixing my hair for me. They were feeding me food. I mean, it was just the most magical experience ever.

Speaker 1: Nicole: Oh, that's really nice. Really, really nice. And then you went home four hours later. Did they come check on you? Or when did you, like, when was the next like check in point?

Speaker 3: Amber: So actually, they have you, it's a mandatory class that they have. It's a, like an at-home class. And so it teaches you all the things to do and to know, and to be aware of for the first 48 hours as if you were at the hospital. So you have to have a thermometer, you keep track, they give you like a little wet and poopy diaper tracker. So you are keeping track of that. And then, so we went home, so he was born at 8:00 AM. We went home at noon and then I was like walking around and stuff. They were like, Amber, sit down and rest. I was like, I just had this baby. I feel 15 pounds lighter.

Speaker 1: Amber: And then we got our Chick-fil-A, took a shower and we've been here ever since. And then they come in, the midwife comes in at 24 hours for a checkup and they come out to your house. And so you don't have to leave. You can just stay in the comfort of your own home. So she came out the next day and she checks his weight. She checks his bilirubin levels. She checks, she does the metabolic panel. I think that was it at the 24 hour visit. And then there's a two week checkup. They come out and they do all of that over again. And also like the cardio, like the stress test on the heart or whatever it is, they do that as well.

Speaker 1: Nicole: Okay. Okay. And then how was the postpartum period for you?

Speaker 3: Amber: Oh, well it was the first three weeks were great because my husband had paternity leave. So he was home with me 24/7 for the first three weeks. And my mom actually stayed with us for three days also. So while I was able to kind of rest up, cause I had been up for 24 hours. So I took a really long nap. And then I had the support of my mom, which she's had kids. So I knew that she was not gonna let anything happen to this baby on her watch. And so then my husband was there for three weeks and it was great. It was blissful. It was obviously we were exhausted and breastfeeding was a whole other, we could have a whole other podcast. So breastfeeding was tough, but we've been 10 weeks exclusively breastfeeding. And so you can do it mama's.

: Amber: If you're listening and you're at day seven, I wanted to give up, I wanted to throw in the towel. But I did it and we are still here and it's 10 weeks. And so really proud of myself for that. But then at the three week mark, my husband went back to work and I immediately experienced postpartum depression. It hit me like a train, which I was really, really on watch because I knew that since I had antepartum depression, that I would probably have some sort of, you know, depression or anxiety postpartum. But since I got through those first three weeks, I thought I was in the clear, but that wasn't the case. And so I went from having 24 hour support to doing it all by myself. And since my husband was working, I really wanted him to sleep at night. And so I was getting up the baby all the time.

Speaker 3: Amber: So I was exhausted. So yeah, my husband, I talked to my husband before, when we were still pregnant. I said, I want you to know the signs and symptoms of postpartum depression. And I want you to call me out on it. If you start to see these things, because I can't always, you know, if you're the one experiencing it and you don't always know. So he's the one that actually called me out on it and said, I think something, I think we need to do something. So we had an appointment with the midwife and I failed my depression screening almost, I guess I was on the borderline. And she said, okay, I want you to do these few things and make, you know, make some changes. And then let's recoup in two weeks. And if you're still feeling this way, then we'll start to look into some medicinal, you know, solutions, which I was, I really didn't want to have to do that.

Speaker 3: Amber: So there's nothing wrong with that at all. But I just personally just didn't want to go down that road. So, you know, we started doing all of the things, you know, getting some air, making sure I was going for exercise every day. Just, you know, visiting family and friends, it was really hard for us because as other moms that are having babies in this pandemic, you know, you're just so scared about taking your baby out into the daylight, which is not healthy for you or the baby. And so I think I'm curious to see if they do statistics on this. Is there an increase in postpartum depression during the pandemic versus other times?

Speaker 1: Nicole: Yeah, I don't know if anybody's studying it, but I'm sure it has to be higher. That isolation is just, I can't imagine that it's not.

Speaker 3: Amber: Yeah, it, I mean, it was so hard because you just want to show off your new baby and stuff, you know, you're like, okay, well we'll come over, but have y'all been quarantined, you know, and all this stuff. So, since then we've kind of loosened up on everything. And so we have kind of, because for my sanity, I had to go to my mom's for a weekend and just get away. And that was really, you know, it was like, okay, well you're risking this, but is the benefit, you know, does the benefit outweigh the risk and things like that? So I had to make some real changes and it took a lot of work. And I would say it took me, you know, from week three until about three weeks ago. So I don't know the math, but however long that is, it took quite awhile, and I would go a couple of days and feel great and think, okay, I'm past this.

Speaker 3: Amber: And then I would have another day where it was just like, nope, I'm back to square one again. So it's really frustrating. And you know, just that it's a roller coaster ride. And as you've probably preached this so many times, the postpartum period in our society today is just not what it needs to be. And I mean, go back to ancient times whenever people were helping breastfeed, other moms, babies and things, and helping and coming over and stay in for weeks at a time until the mom feels better. And you know, all those things that we just don't have today and we're just setting ourselves up for failure. So I think that we need to do better. As far as postpartum care goes.

Speaker 1: Nicole: You're 100 percent right. It's just, that was one of the things I realized with the pandemic is like, I was focusing a lot on people's thoughts about pregnancy, but not really like that postpartum period is going to be a little crazy as well.

Speaker 3: Amber: Yeah. Never expected it. I mean, it kind of, you know, the pandemic came out of nowhere, so it's not like you prepared. You prepare yourself for birth, if you want an unmedicated birth or whatever. And then you didn't prepare yourself for the postpartum period, but you can not prepare yourself for postpartum period during a pandemic. You just can't, there's not a book on that. I mean, maybe I'll write one.

Speaker 1: Nicole: Yeah. There's not, there's not. Well, I am glad to hear that you are doing well and that things are going well. I know breastfeeding can be tough. I always called it a labor of love because it can be challenging, but I'm glad to hear that 10 weeks in things are looking good.

: Amber: Yes. For sure.

: Nicole: Yeah. Yeah. So just to end, what would be your favorite piece of advice to give to women as they go through their pregnancy and get ready for their birth?

Speaker 3: Amber: Yeah. So this piece of advice has changed so many times as I think about this, you know, there's so many things that you can tell women, but really looking back on it all, I just want to really, really emphasize that you should never settle at all with anything within your pregnancy. If you feel like you're not in the right place, look into other options and do not be scared to ask questions or even change providers even at week 40. I mean, you know, you, the mom, are the one that will live with these memories from this experience forever, not the doctors, not the nurses, not your husband, you. Only you. And I know from experience that, you know, if you have a bad birth experience, you have a good birth experience, all of these things can affect the postpartum period. And that's when motherhood begins, that's when your baby needs you. And so it's just really important that you know, that you deserve the world and you should just not settle with anything less than that. Absolutely.

Speaker 1: Nicole: I love that. I love that. Thank you so much. So again, thank you for coming back on. I am super excited to have like, that closure. It was so fun to talk to you while you were still pregnant. And then now to see how things are now that you've had the baby, not everything has been perfect, but you've managed to go through everything super strong. I mean, you rocked that unmedicated birth and managing the challenges, the ups and downs. I hope you're really like, proud of you.

Speaker 3: Amber: Yeah. And that's what I tell everyone. I said, okay, if I can do that, I can do anything. I mean, just being pregnant and being a mom and giving birth, and then, you know, going through all the trials and tribulations, you just feel like super woman. Like you can, you can do anything. I mean, you'll find strength in yourself that you didn't even know that you had.

Speaker 1: Nicole: 100%. So where can women connect with you if they want to connect with you after the show?

Speaker 3: Amber: Yeah, of course. And actually I wanted to say, that because of my last podcast interview with you, I have connected with, I want to say like probably 10 to 12 women that, you know, listen to your podcast, reached out to me on Instagram and we talk every single day. And some of them are from like different countries. There's a girl that I talked to from the Philippines. She just had her baby. And so she sent me photos. And so it's just crazy how this one, you know, just one interview here has led me to all these connections that I've made with other women. So I totally love that. So I just wanted to let you know, you are definitely the bridge between that gap there, but, uh, yeah. So my Instagram is Amber_Manning_ and that's where I kind of hang out all the time.

Speaker 1: Nicole: Yeah. Yeah. She has a beautiful Instagram feed, lots of lovely photos of her and her son and her husband and her family. Beautiful.

Speaker 3: Amber: Well, thank you. Yeah. And I try to do, you know, informational stuff as well. So, you know, to kind of keep everyone informed and empowered and things like that. So I would definitely love to connect with anyone, just head over there and send me a message and we can, you know, get that started.

Speaker 1: Nicole: All right. Well, thank you again, Amber. It is so lovely to talk to you again and I'm going to still be around. So, you know, next time you're thinking about having a baby, maybe I guess I'll have to have you back.

Speaker 3: Amber: Yes, I would absolutely love to. Thank you so much.

Speaker 2: Nicole: You take care.

Speaker 1: Oh my goodness. Wasn't that a great episode? I love her story and her energy and I am so touched that her last episode, her last appearance on the podcast sparked a little community. That really, really warmed my heart. Now, you know, after every episode where I have a guest on, I do something called Nicole's notes where I do my top three or four takeaways from the episode. So here are Nicole's notes after my conversation with Amber.

: Number one, and I've said this before, and I'm gonna keep saying it because it's so important to say, find another provider if the one you have isn't working for you. Yes, it gets harder the further along you get in your pregnancy, but it is really never too late to change providers. If the one that you have is not serving your needs, please do not stay with someone who you don't feel comfortable with, who's not working for you. If you need another provider, then find one. There are definitely some great ones out there.

: All right. Number two, I love the collaboration she described between the birth center and the hospital. That is exactly how those types of collaborations and agreements should work. And I know most folks deliver in a hospital in the US because that's what's available. But if you are looking at a birth center or are going to deliver at a birth center, then this is the type of collaboration that you should be looking for, where the birth center is in contact with the hospital. They do drills. They communicate well. That type of integrated system is how we keep moms and babies safe. So if you're looking to deliver at a birth center, make sure that they have that good backup and close collaborative relationship with the hospital in case there needs to be any issues. And also that the birth center is careful about who they know that they should take care. The birth center where she was only took care of low risk women. That is what is appropriate for a birth center.

: Okay. Tip number three, I love how she talked about the position changes that happened during labor. Position changes are really important and can be really crucial to help facilitate getting a baby in their best and most optimal position to facilitate birth. So when you don't have an epidural and you're moving around, that may mean getting up, may mean squatting. That may mean lunges, it may mean being on your hands and knees, really moving things around. There's something called spinning babies that a lot of nurses and healthcare providers are trained in, nurses mostly, that I'm starting to learn more about. I'm actually going to try and reach out and maybe see if someone from that organization can be on the podcast, just doing different things in order to help facilitate getting a baby in a better position to facilitate birth is really important.

Speaker 1: Some of the things we also do are like use the peanut ball to help open up the pelvis. If you have an epidural and you're not moving as much, you have to move around in the bed when you have an epidural. So just really paying attention to position changes to help move labor.

: And then the final thing I'll talk about is actually loved when Amber said she was able to throw away her birth plan. That is actually my wish, my big goal in all of this work that I do, that it gets to a point where so much of this work is not needed anymore because we are by default doing the things that women want and need in order to have that beautiful birth that they want, that beautiful birth that you deserve. So I really, really liked how she was able to know and trust and believe that her providers were there to support you. That's what I hope for every single pregnant mama.

: Unfortunately, that is not the case right now for everyone. And until then, then you definitely want to be sure to continue educating yourself and get ready, do check out my free class on how to make a birth plan that works. That's www.ncrcoaching.com/register, where you learn what to include, how to get your doctors and nurses to pay attention, questions to ask, how to approach the process of making a birth plan. And it's a free class offered on demand. It's about an hour. So do check that out. Women find that incredibly helpful to get ready for their labor and birth.

: All right, so that is it for this episode of the podcast, be sure to subscribe to the podcast ain Apple podcast or wherever you listen to podcast Spotify, Google play. And I would really love it if you leave an honest review on Apple podcast, it helps other women to find the show helps the show to grow. And I give shout outs on episodes.

: And, you know, just like I loved having Amber in The Birth Preparation Course, I would love to have you in The Birth Preparation Course. The Birth Preparation Course is my online childbirth education course that ensures you are knowledgeable, prepared, confident, and empowered to have a beautiful birth. You can learn all the details of the course at www.ncrcoaching.com/enroll. Covers everything from mindset, having the right support, all the details of labor and birth possible things that could happen, how to get off to a good start in the postpartum period. Even more details about making your birth plan. So do check the class out at www.ncrcoaching.com/enroll. It is currently very heavily discounted right now because the COVID and will stay that way as long as COVID is around, but do check it out at www.ncrcoaching.com/enroll.

: Now, next week on the podcast, I am going to talk about episiotomy. So do come on back next week. And until then, I wish you a beautiful pregnancy and birth.

Speaker 1: Thanks so much for listening to this episode of the All About Pregnancy and Birth podcast. Head to my website at www.ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class, on how to make a birth plan, as well as everything you need to know about The Birth Preparation Course. Again, that's www.ncrcoaching.com and I will see you next week.

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