Ep 84: Jennifer’s Birth Stories – One Hospital, Three C-Sections, and Birth Wishes as a Muslim Woman

We have another special birth story episode this week, but this time you're getting three birth stories in one!

Jennifer is an international board certified lactation consultant, wife and mom of three. She had all three of her babies at the same hospital and had a C-section with each of them - but as you'll hear, her birth experiences were different every single time. 

Jennifer and I talk about all three of her births so you can understand how her hospital experiences and self-advocacy developed over time. We discuss pre-eclampsia, why she really wanted a VBAC with her second and third babies, and how her prenatal care & birth wishes were shaped by her religion. Jennifer also highlights why her childbirth education was so important and why one great nurse played a key role in giving her the birth experience she really wanted. 

We also touch on how hospitals and providers can change their practices to become more baby-friendly and why it's never too late to change providers if yours isn't supporting your wishes.

In this Episode, You’ll Learn About:

  • How each of Jennifer's pregnancies and births went and why she got a C-section with all three babies
  • Why she really wanted to have a VBAC after a disconnected first birth experience
  • Why she delivered at the same hospital all three times and how their practices changed with each pregnancy and birth
  • Whether Jennifer felt like her birth wishes and overall care - which are shaped by her religion, Islam - were respected
  • How a nurse taking the time to ask Jennifer what was important to her totally changed her third birth experience 
  • What she learned about breastfeeding with her first baby that made her want to become a lactation consultant for other moms



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Transcript

Nicole: This is a birth story episode that you do not want to miss. Welcome to the all about pregnancy and birth podcast. I'm Dr. Nicole Callaway Rankings of practicing board certified OB GYN. Who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, competent, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only, and is not a substitute for medical advice. Check out the full disclaimer @ncrcoaching.com/disclaimer. Now let's get to it. Hello. Hello. Welcome to another episode of the podcast. This is episode number 84, and I am so glad that you're here with me today. So in today's episode of the podcast, I have Jennifer Abdul Ramond. Jennifer is a mother to three young boys, and she's also an IBC LC. That's an international board certified lactation consultant.

Nicole: Jennifer's birth story episode is a little different because she's actually going to share a bit about all three of her births. Normally on the podcast, guests focus on just one story for the birth story episode, but we really need to hear all three of Jennifer's births in order to get the full picture. Now for a little teaser about her births, the first was a C-section after an unsuccessful labor induction. The second was a bit of a forced repeats, the Cesarean birth after the practice where she went, refused to let her attempt a VBAC. And then the third was an attempted VBAC, also known as a TOLAC trial of labor after cesarean. And interestingly, all three of these births happened with the same practice. Now, there are so many great lessons in Jennifer story that all mama's can learn from. Also, Jennifer is Muslim, and in addition to her birth stories, she shares some of her cultural and faith traditions surrounding birth. You are definitely going to find this episode informative and interesting. I know I learned a lot and you will too. Now, before we get into the episode, I have a little bit of a secret to share within the next week. I am going to make an announcement about my signature online childbirth education class, the birth preparation course, the birth preparation course is exactly what you need in order to feel calm, confident, and empowered to have a beautiful birth. And if you have all been thinking about enrolling in the course, then you don't want to miss this announcement. Follow me on Instagram at Dr. Nicole Rankings that the place to go, If you want to hear it first. All right. So let's get into the episode with Jennifer's birth story.

Nicole: Thank you so much, Jennifer, for agreeing to come onto the podcast, you have a really interesting story and I am excited and grateful that you want to come on and share it.

Jennifer: Yeah, absolutely. Thank you for having me.

Nicole: So why don't we have you start off by telling us a little bit about yourself, your work and your family?

Jennifer: Sure. So I'm a registered nurse. Um, I've been a nurse for the last 10 years and I'm married. I have three boys. My oldest is eight. My middle child is six and my youngest just turned two in January. So we kind of live in Pennsylvania. It's been nice, I guess recently like a struggle and nice that we have more family time. The kids are home so the days a little unpredictable, but, um, today's a good day. So I'm just gonna go with that.

Nicole: Gotcha. Gotcha. I hear you. What kind of nurse are you or do you still practice nursing?

Jennifer: So I started out doing longterm care and then med surge. And I currently work as a lactation consultant. So I'm an IB CLC. Um, I work in a hospital and I also do private practice as well.

Nicole: Okay, awesome. And we'll talk about that at the end. You know, how people can find you in your lactation practice.

Jennifer: Absolutely. Thank you.

Nicole: Awesome. All right. So, so for your story, you know, a lot of times on the podcast, women go through one birth story, but in your case, we have to really go through all three in order to get the full scope of everything that happened.

Jennifer: Yeah, absolutely.

Nicole: Yeah. So how about we start off first with talking about your first birth. I know that was an induction for preeclampsia that ended in, Cesarean so how was that for you?

Jennifer: Yeah, so I was actually working at a nursing home at the time and I was not feeling well one night and I took my blood pressure and it was very, very high. And I had an appointment the next day. So I went home, I slept, I went to my appointment and it was still high. So I was about 32 weeks at that point. And they immediately put me on bedrest. So I was out of work. I was doing bed rest, but even though I was a nurse, I hadn't been a nurse for very long. I didn't work OB. So I don't think I fully understood how severe preeclampsia can be. So I was on modified bedrest rather than strict bed rest. So I probably didn't do as much bed rest as I should have,

Nicole: No don't beat yourself up about that. How, you know, bed rest, we don't even know that it really does anything. So you were doing the best that you could at the time?

Jennifer: Yeah, absolutely. And I'm around 37 weeks. I went in and it was like, nothing was working to keep my blood pressure out. So finally at that point they were like, we need to induce, like we need to deliver the baby and going through all of my experiences, I found that I was one of those people who, as soon as the baby was delivered, my blood pressures came back down immediately, like yearly, like pregnancy related. And, um, that was what cure or the preeclampsia for me. So with my first I was induced, it was an exceptionally long labor. I felt like I had every intervention. They could throw at me to help to help my labor progress.

Nicole: And how, how long was the induction?

Jennifer: Um, it was probably almost 40 hours.

Nicole: Okay.

Jennifer: They started with some Pitocin, but because my blood pressures were high, they also put me on magnesium. So it was kind of like this game of like keeping the magnesium, you know, at a level that it's actually going to benefit me and help my blood pressures, but then also trying to increase the Pitocin to help the contractions and help the labor progress. They tried helping to dilate my cervix and I eventually stalled at five centimeters. And I was there for quite a while. Finally, when, uh, one of the doctors kind of had a conversation with me about doing a C-section cause at that point I was kind of going on almost two days of being in labor.

Nicole: Gotcha. And how, how did you feel about when you got to that point?

Jennifer: I had a mix of emotions. I was definitely exhausted. Um, I, I could barely say awake. I was so tired. I remember when I was in the, OR I just, I kept telling that the anesthesiologist, I was like, I think I just need to sleep. I need to sleep. And he's like, it's okay. He's like, it's okay. He's like, just go to sleep. It's okay. And I was like, I was like trying to fight it so hard, but I, you know, it was a mix of emotions of being tired and also disappointment that things didn't go as I had planned.

Nicole: Gotcha. And what had you planned? What had you wanted for your birth?

Jennifer: Yeah, I mean, I definitely had wanted a natural delivery. Um, I wanted to be able to deliver naturally and I guess kind of just have my baby, how we're supposed to have babies and, um, not quite the, it didn't quite go as planned.

Nicole: Gotcha. Gotcha. Do you feel like during the process, people listen to you, you were treated well, what about that aspect?

Jennifer: I felt like with my first, they were, you know, very, um, supportive and understanding of the fact that things were not going as planned. And I do, like before, remember, before I went back to the OR that things were very kind of calm. And then once I said yes to the C-section, it was like a rush, like, I don't even remember going from the delivery room to the OR it was just, everything went so fast at that point. And it was like before I knew it, the baby was out and it was like all done. And, um, I think it was just, it was the whole experience seemed to kind of be cut short in a way, especially cause my baby was then taken to the nursery. It wasn't a baby friendly hospital at the time, so they didn't allow the babies to stay in the OR so I was separated from him for almost two hours.

Nicole: Okay. Got it. Yeah, that's sucks. Yeah, for sure. For sure. So then you Got pregnant the second time and then there's this discussion of wanting to try for a VBAC versus having a repeat C-section. So what did you decide in that situation?

Jennifer: So I had wanted a VBAC and I did all of my research. I studied all the evidence. I talked to people, um, I did everything. I felt like I could on my end to educate myself and I knew what the risks were, but I also knew what the benefits were and the practice that I was at. I don't think it was a policy yet to do a VBAC after Cesarean. So every doctor I talked to refuse to do a VBAC, they pretty much said I had to go into labor on my own, or it was a C section. So I felt like, I guess, powerless, it was all out of my control. You know, I pleaded for just low-dose Pitocin or just the Foley balloon to help dilate my cervix. Something like just something to, to start things because I was 41 weeks with my second and still only fingertip dilated and nothing was happening as far as contractions. And even at that point, nothing, they just said, no, if I didn't go into labor naturally I would have to have a C-section.

Nicole: Right. Right. And what area were you? Were you still in Pennsylvania at that time?

Jennifer: Yeah. And that was in 2013. My first was born in 2012 and then my second was they're 18 months apart. So my second was then 2013.

Nicole: Okay. Okay. Did you consider trying to find another practice or were you hoping things would just sort of that you wouldn't get to that point?

Jennifer: Yeah, I had considered it, unfortunately the insurance I had, I could only go to that hospital.

Nicole: Gotcha. You know, you you're faced with what you're faced with and you're trying to make the best out of the situation that, that you had. Yeah. I mean, how did you feel during your pregnancy? And like every single time somebody saying like either it's this or, you know, or a C-section

Jennifer: I really felt like it was my body and I had no control over what was being done to it. And you know, it wasn't, it wasn't like I was, I didn't feel that I was taken a risk because I had done all the research and I knew what the risks and benefits were. And I had seen what was being done in other places in our country and that this was an option for a lot of women. So I think that was the part to where this was being done. And even though I'm asking for it, I was just repeatedly denied. And even when it came time for the delivery, I asked for delayed cord clamping, and I asked for the note going in knowing I was going to have a Csection this time I asked for the drape to be dropped. So I could see my baby come out and, you know, have the baby stay in the OR, be skin to skin. And all of those things were denied. So that was the hard too, because I knew once again that my baby was going to be taken away for two hours, I wouldn't see him. And I think that was the hardest part about my first delivery, because I felt so disconnected. And that's why I wanted a VBAC so bad with my second, because I felt so disconnected from the whole experience. Like I never felt them come out. I never saw them come out and that's hard to like cope with that afterwards when you something's happening to your body, but you can't even feel or know that it's happening.

Nicole: Wow. I just hearing it. It's just really hard to hear. Cause I could imagine how difficult it was for you. Do you feel like it made it hard for you to establish that bond and that connection with your baby, that you had this delay?

Jennifer: Um, with my first definitely, you know, I hear a lot of people say they're like immediately in love with their baby. And with my first I felt like it was a couple of weeks until I really had like a connection with him or like had like emotional feelings towards him. My second, I felt like it happened a little bit more quickly, but it was still difficult after to kind of get my mind past that, that disconnection. Right.

Nicole: Right. And then I guess what was their response with at the second time when you come to this conclusion that, okay, I'm going to have this, Cesarean, you come to this conclusion and then you ask for things like delayed cord, clamping and skin to skin, what they say when you ask for these things.

Jennifer: Things literally just no it was the doctor that I spoke to that was there to do my C-section that day. He was just like, no, we don't do that. And I, I, I was kind of like taken aback because I was like, wait, what? Like, I like, I've researched this and there's evidence based research on this. And I just couldn't understand. And I think a lot of it had to do with policies and procedures, which I also feel is unfortunate that we can't make room for accommodations in that way, especially when it makes such a huge impact. But I also feel like the impact that those experiences had on me that was never discussed. I don't think anyone maybe even realized it or even discussed those things with me. So I also feel like they didn't really have the knowledge to know the impact that that was going to have.

Nicole: Yeah, for sure, man. That is just so tough now at this. And was this the same hospital where you had your first?

Jennifer: It was, yeah.

Nicole: Okay. Did you know anything about the hospital ahead of time in terms of how they, like, what kind of, I'm just curious that they had a reputation in the community for birth.

Jennifer: I mean, the hospital has a good reputation and I think that baby friendly designation made a huge difference. Cause at that time they were not baby friendly, but once they were, then all of these practices were implemented. So that made a huge difference.

Nicole: Gotcha. So all three of you, your babies were born at the same hospital?

Jennifer: Yeah, my second one or my third baby. I had at a different site though.

Nicole: Okay.

Jennifer: So it was not in the same environment.

Nicole: Gotcha. Gotcha. Okay. So you have the second C-section so they won't do delay core clamping skin to skin. And again, they took the baby away to the nursery.

Jennifer: Yeah. So it was another instance where I asked, you know, can the baby stay in the OR at least for a little while? And they said no. And I think it was something that they didn't have the staff to support having the baby stay in the nursery. So my husband went with our son to, to um, or stay in the, or, I mean, so my husband went with our son to the nursery and then I stayed in the, or, and then they brought him back to me when I was in the recovery room. And my second C-section actually, because I had a lot of scar tissue from my first, I was in the, or for probably a good hour and 45 minutes. Cause I could start to feel like the EPO, the epidural starting to wear off and the morphine doesn't do anything. They gave me some extra morphine and I was like, yeah, maybe a little sleepy, but I still feel the pain.

Nicole: Right, right.

Jennifer: So it was, it was probably a good two hours, maybe even longer until I saw him in the recovery room. Then

Nicole: Nobody said that your husband could just sit there and hold the baby, like while in the OR like nobody. Oh,

Jennifer: Okay. And I, and at that time, you know, I, I, I felt like I did a lot of education and, you know, educated myself and I still wasn't even aware of like even asking him to, you know, like, can he do this, you know, that part of it was not even considered either.

Nicole: Sure, Sure, sure. Oh, that's really heartbreaking to hear. So then you get pregnant a third time and you decided again that you wanted to try for a vaginal birth. How did you, how did you come to that decision?

Jennifer: So I think because both of my first experiences, my first and second pregnancy, I just had that major disconnect and I just mentally could not get past that, that experience. And I also felt like I didn't do everything I could to try for a vaginal delivery. You know, like I was just always in the back of my mind, like if I had had this option, could I have delivered vaginally? And I just couldn't let go of that question. So the third time when I,

Nicole: You did everything, you could like one more thing I have done?

Jennifer: I guess I did in the, in the, you know, in the constraints of like where, you know, what options and resources I had, you know, I did everything I could and I, I advocated for myself as best that I could. And I guess I just, I really wanted to deliver naturally and just like have that, have that moment. And when I went to the OB for my third, uh, pregnancy, they were actually like, Oh yeah, like we can do all of these interventions now. And I'm like, really? I'm like, not even like four years ago, this, like I was told nothing. And now, you know, we were able to do all of this other, like everything I had asked for that second time now it was an available option.

Nicole: And this is the same group of doctors.

Jennifer: Yeah. Yeah.

Nicole: It definitely must have annoyed the blank out of you.

Jennifer: It did! This is everything I advocated for with my second pregnancy, not even four years ago. And it took that long for them to kind of catch up, I guess, and get on board with this stuff. So that part of it, it was definitely frustrated. It was definitely frustrated, but I also had a little bit of hope cause I felt like, okay, like even though this is late, I guess, better, late than never. And we did do as much as they could. And I actually, uh, with my third at about, I think it was about 32 weeks, I got the stomach bug. I do not recommend the stomach bug while pregnant. Um, it was the absolute worst. It lasted an entire week. I was constantly like nauseous, vomiting, getting dizzy all the time. And because some of the symptoms overlapped with preeclampsia and because of my history, I was kind of in and out of the hospital a little bit. And they had done a 24 hour urine, which showed some trace protein. And that was kinda like my worst fear like that preeclampsia would develop and would limit my options. I was kind of labeled as like mild pre. So it was kind of just a game of, you know, how long can I go until those symptoms could possibly get worse, but also given my body enough time to be able to go into labor naturally or hope that it does. So I kind of, I hit 38 weeks. And at that point I was, I decided to do an induction because I was like, I'm far enough along at this point that hopefully my body will kind of start to kick in with the induction methods, but also the pre like for me, I felt fine. I know what pre he feels like because I had it with my first and I did have severe symptoms. Um, like all of the symptoms that they say you get, I had the floaters, the flash edema, um, the headaches, everything, everything. So I knew what that felt like. And I did not feel like that at all. With my third, I actually felt really healthy. I gained way less weight with my third than I did with my other two. So I just, it felt like a much better healthier pregnancy. And then when I came for the induction, so we did some low-dose Pitocin, they dilated my cervix with the fully balloon. I got to about five centimeters and I was having contractions like every two minutes, um, because of the Pitocin. And then at that point they broken my water and I was kind of, you know, in that for a while. Um, and my body just wasn't progressing again. So it kind of stalled at five centimeters.

Nicole: Okay. But you, but you felt like this time you actually had the opportunity.

Jennifer: Yeah. I felt like I had the opportunity and I think the thing for me is that when we did decide to do a Csection again, they shut the Pitocin off and my contractions immediately went from like super strong, every two minutes to like mild every 10 minutes. That was like a huge clue to me that I was like, okay, like, no matter what I do, my body just does not go into labor. Like, it just doesn't happen. So that was kind of like validated for me that it wasn't something I did or didn't do. Like my body was just not meant to go into labor.

Nicole: So this time you, do you feel like you felt better about that? The C-section

Jennifer: I do. I felt more confident about the decision and I felt like the decision was mine. I felt like I was the one who made that decision and have control over that decision. And I'll always remember the one nurse I had. She was probably the only person ever throughout all three of my pregnancies who really had this conversation with me. But when I was in labor with my third and I, and we were kind of like, you know, on the fence of, you know, they're trying to talk to me about a C-section and I was like not having it. And she was like, why is this so important to you? She's like, can you tell me, like, just tell me why this is so important. And I just like burst out into tears. And I started telling her about my horrible experience with my first two. And she was probably the only person that ever even asked me that question. And then I just remember her going above and beyond to do everything she possibly could, like I was in the OR and she was yelling. She was like, where's the clear drape, let's get the clear drape. Where is it? And they found it and no one had used it before. So it was kind of a little awkward, but we figured it out. And I was actually, I was actually able to like pull the drape down. I could see him come out. I could see him, you know, they were holding him up and I could see the cord. And then they did the delayed cord clamping. So it was just a totally different, totally different experience. And she really was instrumental in that in helping to make that the birth that I had wanted for my last two even.

Nicole: Right. Right. I that just must have made a huge difference in how you felt when about the whole experience.

Jennifer: Yeah. And I definitely felt more connected. They took him to the warmer for the one minute and five minute Apgars, and then they brought him right back to me and put him on my chest and he was on my chest in the OR he breastfed in the OR and he was there for like a good 45 minutes. The one nurse was like, okay, we have to take them in a little bit. Cause we're, you know, we're going to put you over onto the stretcher. And she probably had to say it like four times and I was like, you're going to have to take him, I'm not. So it was just, it was a totally different spirits. And I remember like he breastfed in the, or at least twice. And then when we got back to the recovery room, he breastfed it. He was just on and off the whole time, like the whole time he was breastfeeding. And I remember with my first two, because they miss that initial breastfeed in the first like hour or two, it was like they fed, but it was like 10 minutes. And then I don't even think they had again for like three or four hours. Like it was just not the same experience at all. It was totally different in that respect as well.

Nicole: So do you feel like even obviously the nurses were like saving the day for your third section. Do you feel how were the physicians?

Jennifer: So when I went into the hospital, I was there for two different shifts and I felt like the first doctor was definitely respectful, especially for, you know, for me as a Muslim. I think there's certain things that I prefer.

Nicole: Yeah. We'll, we'll talk about that in a sec.

Jennifer: Yeah. So there's certain things that I prefer and I felt like he was definitely respectful of that. And so I actually refused magnesium with my third. Um, they wanted to put me on it and I said, no, because I knew my body. And I knew that I was not experiencing preeclampsia. I knew that my blood pressures were fine, even though my average blood pressures when I'm pregnant are like, kind of like considered like mildly high for, for pre that's, like normal for me. And if I take sure meds, I'm actually highly sensitive and I dropped too low. So I know what my good ranges and what my bad range is. And I knew how it felt. So I actually refused the magnesium. He didn't really agree with that.

Nicole: What are your numbers? I'm curious. Do you know what your blood pressure was in the hospital?

Jennifer: Yeah, so I was averaging like one 30, over 80 to one 40, over 90 with my third in the hospital. And they would go up a little bit when I was having contractions, but then they would come right back down. So I think just because I had that diagnosis of pre, they had wanted to do the magnesium, which I knew would stall my labor for sure. So I, I was not okay with that.

Nicole: Yeah. We don't actually, we don't so much, um, you were right. We don't, we don't, we don't do magnesium unless the blood pressures are severe or you're having symptoms. So they have to be like 160 over 110 consistently, or you're having the bad headaches or things like that. And what did you do magnesium. So..

Jennifer: and I think they may have been worried that I wouldn't disclose if I had symptoms, but I was like, I'm not going to put me and my baby, like in harm's way. Like if I have symptoms, I'll, I'll tell you. But I was like, as of right now, I don't have symptoms. So I just, and it's hard to where, you know, the practice that I go to and then where I deliver, it might not always be the same doctors that I have that I see in my, in the office.

Nicole: Sure.

Jennifer: So, you know, I feel like there's oftentimes, you know, not a trust there, you know, they don't know me, they don't know what I know, but I also know my body and I know myself, so I think it's hard in that situation too.

Nicole: Gotcha. Okay. So you said that first doctor was respectful, but the second was how?

Jennifer: So the nurses really kind of stood up for me. And, um, I, he wanted to, I guess, come in and do a cervical check and the nurse had told him like, Oh, she's Muslim. She would prefer that the OB resident do it. And it was all third year residents that were there. And he was kind of very forceful about being in the room. So the resident female resident did do my check, but he was kind of like there. And I just felt like his demeanor was kind of aggressive in a way. And I felt like, because maybe I had like refused some things along the way wanted things a certain way. I was almost like kind of being punished for that by him needing to like take control somehow. So that part of it was a little frustrated, but the nurses really, like, I remember she did the check in to the nurses, kind of stood on my left side, which was in front of where he was standing. So they kind of put like a wall there, um, and made sure that I was completely covered with the blankets and stuff so that nothing was visible to him. And it's not that like, I would not accept a male provider if it's like an emergency or if, you know, they're the ones that do the C-section cause he did end up being the one that did the C section, but you know, if it's necessary. Absolutely. But like, if there's another option, like that would be preferred. So I just, I felt like there was maybe a little bit of hostility from that, that, and that kind of, you know, reflected on how things were handled.

Nicole: Right. And how did that make you feel then turning around? And this was the person who was doing your surgery?

Jennifer: It was a little difficult and I guess I kind of felt like, I guess I didn't really have a choice. There was two other OB residents that were females that were there. So they were also assistant as well. And then there was a lot of nurses in the room that had been with me throughout the entire experience too. So I kind of just, you know, focused on them pretty much.

Nicole: Gotcha. Gotcha. And was your husband with you this whole time?

Jennifer: He was, yeah.

Nicole: Okay. Okay. Did you feel like he was able to help advocate for you at all or not?

Jennifer: A little bit? Yes. He also doesn't have a medical background at all. Um, he's an accountant, so we always joke about that because he definitely is good at standing up for, you know, me and supporting me through all of that. I think it's a little bit harder for him to kind of stand up to medical professionals.

Nicole: Sure.

Jennifer: Which I wasn't so much because I am one, so I kind of knew what was appropriate, what wasn't and I felt comfortable voicing that.

Nicole: Gotcha. Gotcha. That makes sense. That makes sense. So let's talk about, for a bit, you said you're Muslim. So what does that mean for you in terms of what you desire for your care, both like during your prenatal care and then during your birth as well?

Jennifer: Yeah. So prenatally, we try to choose female providers just for, out of respect for modesty. And it's also usually easier to converse about female body with them. You kind of understand that as well. So we try to, for modesty reasons, so with female providers, obviously, if there's ever like an emergency and there's not a female provider available, we're not going to refuse care. That's often like a misconception. Like we would never refuse care, but obviously, you know, you always have like the ideal and then you have the backup. So if the ideal is there and available, that's what we would prefer pregnancy, you know, is, is something, is Islam that's like highly respected. So I do kind of expect that providers, you know, incorporate my religious beliefs into my prenatal care because everything we do in Islam has a purpose and there everything is meaningful and it's, you know, all of those things intertwined with each other, typically prenatally. I am cautious about what I eat to make sure that I'm only eating like halal meat or halal food products. Vitamins were always a struggle with my third. I think I was finally able to find halal DHA vitamins.

Nicole: Oh, what does halal mean? Is that the way it's prepared?

Jennifer: Yeah. So it's the way that the animal is slaughtered and really the way the animal is raised. And, um, it means that the animal is essentially like free range, grass fed organic. It's treated fairly throughout its life. It's killed in a way that is humane and they're treated humanely throughout their entire lifespan. And then when they are slaughtered, there's a prayer that said over the meat and it's slaughtered in a specific way. That's actually healthier versus ways that kind of stagnate the blood into the animal. So the way it's killed also has to be humane and done in an ethical way. So when we look at like vitamins, a lot of vitamins have gelatin in it, which come from pork and pork in Islam is, is forbidden, like we don't eat pork at all. So a lot of the vitamins have gelatin, uh, and there are a lot more like halal brands now, but I really couldn't even find that DHA with that was halal and had halal gelatin in it, um, until my third pregnancy. So I think for some of them, I didn't take the DHA because I couldn't find one that, that had, that was halal that I could actually consume.

Nicole: Right.

Jennifer: So the midwife that I had seen through parts of my pregnancy actually was really understanding about it and tried to help me find some alternatives. And then I don't even think I really mentioned it to anyone else.

Nicole: Gotcha. Gotcha. Were you worried if you mentioned it that you would get some sort of pushback or that they wouldn't be open to helping you?

Jennifer: A little bit? I guess I probably kind of felt like maybe they wouldn't understand or I would, you know, like get, you know, like in trouble kind of yeah. Taking it or kind of, you know, like almost be talked down to. Um, so sometimes I just wouldn't even mention it.

Nicole: Gotcha. Gotcha. Anything else that was different about your, your care because of your religion?

Jennifer: Um, so typically, uh, throughout the delivery process and the labor process, we listen to Quran a lot. So we usually have it playing in the delivery room when the baby's born. And then right after they're born, usually my husband will do it. Um, in one year we whisper the Adon, which is the call to prayer. So we pray five times a day. And the Adon like, if you were in a Muslim country, you'd hear it just from the mosques. Um, they play it really loud. So it's the call to prayer. And that we say that in the right ear. And then in the left ear, we say like a shortened version of that. And that's essentially us welcoming the baby into the world as a Muslim. And it's kind of similar to, I guess, like baptism in other religions, like this is our way to kind of bring them into the Muslim world and, you know, tell them that they're Muslim. So that's something that we do after delivery. And then we constantly have the Koran plan, um, as well. And, uh, I think through some of my C-sections, I think one of them, we, they did put the Koran on in the OR and then the other one, I don't remember why we didn't, but I think one of the other things is that it's kind of like a religious, you know, it has some religious significance, like as the babies being born and for them to hear like the words of God as they're being born and all of them. And there was times like in the, or where there is kind of like some side conversations or like, you know, just, it was almost like we weren't there and there was other conversations happening, you know, and then they would stop at, you know, if we ask them to stop. But I think that was something that it was, it was kind of, uh, difficult to, to, to deal with. Cause it's not always the ideal experience, how you would want it, especially when other people maybe don't understand like the importance and the significance of what's happening.

Nicole: Gotcha. Gotcha. Um, I'm no, I'm learning something myself right now. So, um, anything else that's different, which, and you're not actually asking for a lot. It's not like it's like a ton that's, that's, you know, super different.

Jennifer: Yeah. Yeah. The other thing that, uh, we do after the baby's born, it's called tenique and it's where we take a little bit. So I don't know if you've ever had like a miduel date, but those really big juicy ones where you open them up and it's like really kind of like the day you can kind of pick it out. It's very sticky. So we take a little bit of that and it's almost like a puree and we rub it on the lower gumline of the baby and their mouth. And it's actually like a 1500 year old tradition and it comes, it's rooted in when, um, we believe Mary gave birth to Jesus and she gave birth alone under a date tree. And she used the dates to sustain herself and her energy. And then also, um, rubbed it on the inside of Jesus's mouth after he was born. So it's something that we do traditionally and we rub it on the inside of the baby's mouth and it's supposed to be the first thing they taste before their mother's milk. So that's something that I didn't really know about that actually, when I had my first child and things were so chaotic, I don't even think it ever would have happened. But with my second and my third, I was very firm and like demanding that those things be done. So, uh, we were able to do that with our second and then also with our third.

Nicole: Okay. Now I did not know that either again, learning something new.

Jennifer: Um, I've actually talked to a lot of friends who have had babies and I've told them that I've done that. And they were actually shocked that I did it. And I was like, why? And they were like, well, they're like, we just never asked because we assumed we wouldn't be allowed to.

Nicole: Hmm, gotcha. Gotcha.

Jennifer: Yeah. Cause I've had a lot of other providers say that they never knew about it. And I said, I honestly think people probably just aren't asking because they assume they won't be able to.

Nicole: Okay. Okay. Interesting. Yeah. And I don't think there's no reason why you can't Do it, so yeah. Wow. Okay. Anything else? I'm like, what else do we need to learn?

Jennifer: Um, so it was, I actually have an interest in story and actually when my second child was born because I was pregnant for 41 weeks, he was very large. Um, and he was on the hypoglycemic protocol. It was really hard to get him to wake for feeds. So I used to rub a little bit of the date on the inside of his mouth, like right before every feed and he would perk up, he would feed. Great. And then he just, I did that each time and he got off of the blood sugar protocol. His blood sugars were great. One of the nurses even commented. They're like, wow, his sugars are like in the seventies every time they're like, we usually don't see this. This is really good. He must be feeding really well. And I was like, Oh yeah, I never mentioned it was the only way, and it was just, my logic was like, Oh, you know, like I know they used to give like sugar water sometimes to like get the babies to wake up and feed. And I was like, maybe this'll do the same thing. And it absolutely worked. And then I told a friend about it and a few months later she sent me like a research article. I don't think it was done in the U S but it was on, you know, probably in a Muslim country. But, um, it had said that they used like dates to help babies on the hypoglycemic protocol to prevent hypoglycemia. And I was like, wow. So like something I did as like a 1500 year old tradition then shown in like evidence based research too.

Nicole: That is really cool. And, you know, I don't think we've appreciated enough of what happens, like taking some of ancient traditions and carrying them forward. So, um, and kind of marrying the best of both worlds. So we definitely need to do that more.

Jennifer: Yeah, absolutely.

Nicole: Now I know you also, just from the picture that you sent, you wear a hijab. Do you ever, did you ever experience any difficulties or backlash because of that?

Jennifer: Throughout my birth and experiences, I felt like people were generally respectful. There was a few times, especially with like male doctors where they were kind of just like knocking barge into the room and I'd be like scrambling to put my scarf on. So there was like multiple times where I know I asked the nurses to like put a sign on the door to please like knock and wait for people to come into their room, just so that I could put my scarf on. And, um, I think that sometimes there's this misconception that because they see one part of me that they have access to all of me and that's not necessarily okay.

Nicole: Yeah. It's not. Okay.

Jennifer: Yeah. So just because, you know, you're able to see one private part of me doesn't mean that the rest of me is free game either. So I would always, you know, still prefer to like wear the hijab if I was talking to another male or to somebody who's outside of my family. And most, I feel like most people were respectful and a lot of people didn't need that reminder on the door, which is fine because it is probably, it's not the norm for that to happen. So I think it's probably something that, you know, just gets lost, but have, you know, having the staff, but like a sign on the door was really helpful, um, to just alert staff, you know? And then especially when I was up on like the mom baby unit, I just kind of said like, no, like no males, unless, you know, like they announced before they're coming in because you know, sometimes you have like the food delivery, people bring in stuff in and you know, it's just, it's so many people in and out. So we always just had like check with the nurse and then, you know, if somebody needed to come in, at least I could like get myself dressed in appropriate before somebody from the opposite sex would walk in.

Nicole: Gotcha. Gotcha. Gotcha. Okay. Anything else you want to share about your birth experiences and your religion or anything in general?

Jennifer: I think, um, one thing that I always try to tell women is, you know, when you're going through this, like educate yourself as much as you can and not even just reading online or reading evidence online, but talk to other people. And I think for me, I was the first person out of all of my friends to have kids. So now I, I feel like I got to become an advocate to all of them because they're all having kids now. And I'm like, well, you need to know this is what you need to do. So it's like, okay, like, you know, even though parts of my experience were like very traumatic for me, I was like, now I feel like I can help other people, you know, but definitely like talk to other people and, you know, find out what their experiences have been. So that way, when you're going into it, you have more knowledge and you have the ability to really advocate for yourself in those situations. Cause I think sometimes, you know, we are like the only advocates we have and um, if we're not the one saying something or standing up for ourselves, there's no guarantee that anyone else will be there to do it either.

Nicole: That is very, very true and an excellent way for us to end. And I'm curious, do you feel like your experiences have, as you know, as I ask, where can people find you with your work? Do you feel like your experiences have influenced your decision to become a lactation consult?

Jennifer: They absolutely did. I mean, with my first child, I didn't even know what a lactation consultant was and looking back, I definitely needed one my first, uh, first breastfeeding was painful for like the first three months. And I came to find when he was seven years old that he had a tongue tie that was never diagnosed.

Nicole: Oh my gosh.

Jennifer: Yeah. So I mean, we breastfed for a year, but it wasn't like it wasn't easy. And had I known about those services, had I known that there was people that could help me, it could have been totally different or a better experience. So that was, you know, that was for me something that I definitely felt like I could relate to more. And I always tell people now, like when they, as soon as they get pregnant, I'm like prepare yourself for breastfeeding because you, a lot of people, I think, think it's just going to happen or it just works. And sometimes that happens, but the majority of the time, it usually does not. And there's going to be obstacles. There's going to be questions. And especially in the U S we don't breastfeed and isn't normalized. There's so many people having babies now that don't know anyone that has ever breastfed. And in a lot of cultures that used to be generational knowledge. That used to be something that, that was passed down from grandparents to mothers, granddaughters, and it's not anymore, people are breastfeeding and they have no concept of what that's supposed to look like or what it's supposed to feel like or how it's supposed to work. Um, and we've kind of lost all of those generations of knowledge. And now we're trying to rebuild that, but it's not, it's, you know, it's not really at the point yet where it's, it's generational or, you know, that knowledge is passed down.

Nicole: For sure. For sure. So where can people find you to find out more about your lactation consultant work?

Jennifer: Yeah, so my private practice is called latched eternal lactation consultant. So on Instagram at, um, at latched underscore eternal. Um, and I also have a page on Facebook as well. One of my biggest things that I really advocate for is informed consent through my own experiences and also talking to other families. It is never harder when I hear, you know, that parents would have made different decisions. Had they had that information, you know, they're like if I had known this two years ago, I would have done things differently and that's heartbreaking to me because the information is there it's always been there, you know, and it's just that it's hard to access sometimes for a lot of families or they don't know who to reach out to, or they don't have the support to be able to implement those things. But that's one of the things that I really advocate for is that parents and families have the information, they need to make an informed decision on how to care for themselves and their babies.

Nicole: Exactly.

Jennifer: And that's the really important part.

Nicole: Yeah, for sure. For sure. Well, Jennifer, thank you so much for agreeing to come onto the podcast. This has been a really helpful and informative interview, and I really appreciate you coming on to share your story.

Jennifer: Absolutely. Thank you so much for having me.

Nicole: Don't you agree that that was such a great information and really informative. I really enjoy talking to Jennifer and I really appreciate her sharing her story now, you know, after every episode, when I have a guest on, I do something called Nicole's notes where I do my top three or four takeaways from my discussion with the guest, and here are Nicole's notes for my discussion with Jennifer. And actually it was hard for me to narrow it down to just four.

Nicole: Okay. Number one, practice patterns can differ so drastically from place to place or even between doctor to doctor within the same practice. Jennifer mentioned that for her second birth in 2013, she knew that labor induction in the setting of a trial of labor after Cesarean was possible because she's seen it done in other places. And she is exactly right. You can definitely be induced for a trial of labor After cesarean. In her case. She unfortunately cannot find other options because she was constrained by insurance. But many times you can. So I say that to say that, if you have a provider who's telling you things that aren't possible and you either suspect they are possible, or, you know, for sure that it's not true. If you can then find other options, look for another provider. It is never too late to change to find someone who is more supportive of your wishes.

Nicole: Okay. Point number two, nurses can save the day. Let me tell you a good L and D nurse is so, so, so important. They're the ones who are with you at the bedside for the vast majority of your labor. And they can make such a big difference in your care. It was a nurse for Jennifer who asked, why are the things that you want important to you? And she listened to her and she went that extra mile in order to help Jennifer have the experience she wanted. And in the case of Jennifer, she actually helped buffer against some of the negative care that she was receiving from the male care provider who was more kind of aggressive about wanting to be in the room when she was being checked and not being respective of her preferences or wishes. It was nurses who helped advocate for her. So a great nurse for your labor and birth can make all the difference. This is another area where if you are not happy with the nurse that you have, then ask for another nurse, you can ask to be assigned a different nurse, just ask to speak to the charge nurse. The charge nurse is the nurse who is in charge for the shift, and she does not have any patient care responsibilities typically, or they're very small patient care responsibilities. And she is the one who can give you another nurse. If you're not happy with the one that you have, so nurses can save the day. If you're not happy with the one you have, then ask for a different one.

Nicole: The third point I want to make is that doctors can change. Our system can change Jennifer delivered with this same practice for all three births. And by the third one, they'd finally come around. However, as you can see, change can be slow. It can take on average many, many, many, many years for change to occur in medicine. Actually Jennifer knew about delayed cord clamping and skin to skin before the doctors in her practice did. But I do want to mention that there is hope that our system can change. So all is not lost in terms of having that birth experience that you deserve. It really, really, really is possible.

Nicole: And then my final point in something that Jennifer said that I want to echo is to educate yourself. Of course, information alone doesn't necessarily fix everything in Jennifer's case. She had information, but she still faced some challenges. However, without information, without that education, without that knowledge, you're really leaving yourself completely at the mercy of those around you. And you may not have what you need in order to advocate for yourself. This is where great childbirth education is so, so, so important. Really everyone should invest in great childbirth education. It's key. And speaking of childbirth education do not burk yet to go follow me on Instagram at Dr. Nicole Rankin. So you don't miss the special announcement that I have about my online childbirth education class, the birth preparation course.

Nicole: All right. So that is it for this episode of the podcast, be sure to subscribe to the podcast at Apple podcasts, Spotify, Google play, wherever you are listening to me today. And I would really love it. If you leave a review at Apple podcast. First of all, I love hearing what you think about the show. All of those comments helps keep me going, helps keep me motivated. It gives me ideas for things to talk about on the show. It also helps the show to grow and helps other women find the show. So if you can leave me that review honest review in Apple podcasts, I was so appreciated. Now next week on the podcast, I have a guest on who will be sharing her very interesting fertility journey and how she took a bit of a different approach to it. So do come on back next week. And until then, I wish you a beautiful pregnancy and birth.

Nicole: Thanks so much for listening to this episode of the all about pregnancy and birth podcast, head to my website ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and a 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 NCRcoaching.com and I will see you next week.

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