946| Vaginal birth, 32 Week Cesarean Birth, Redemptive VBAC + Miscarriage Discussion - Amanda Percival

I think my water just broke. I felt like things really intensified. She was right there and she was coming. It was an amazing feeling. I'm going to cry just thinking about it. I could feel her head. We heard her cry. We were squeezing hands and she was screaming.

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Today's guest is Amanda, and she has three birth stories to share, a hospital birth with an epidural, a cesarean birth at 32 weeks gestation, and then a redemptive feedback. She also talks about her experience with miscarriage. Let's hear from Amanda. Hi, Amanda. Welcome to the birth hour. Thank you for coming on the podcast. Hi, Brian. Thank you so much for having me. I'm really excited to be here.

Awesome. All right. Well, we have three stories to get to today. So let's go ahead and hear a little bit about you and your family before we get into those stories. Awesome. My name is Amanda Percival. I am a nurse and I live in Portland, Oregon with my husband, Ben and our three children, Oliver, who is going to be five next month, Declan, who is going to be three at the end of December, and then McKenna, who is seven months old.

All right. Well, let's go ahead and start with Oliver and finding out how your pregnancy went. All right. So we got pregnant for the first time in November of 2018. We found out around like five and a half weeks, but then about two weeks later, I had a miscarriage and that was my first one. So it was kind of as pretty sad. Yeah.

But the doctor did tell us we could start trying as soon as we were ready again. And so we did and we ended up getting pregnant the very next cycle. So with Oliver, and so that was really exciting. I did have a lot of anxiety all throughout my pregnancy because of that first miscarriage, but it got better around the second trimester. I didn't really go away, but it did get better.

I had a lot of nausea until 22 weeks, and then I had some really good weeks in there, and it was really nice couple weeks with that, you know, glow that they talk about in the second trimester. But then at 25 weeks, I was diagnosed with gestational diabetes, and that was really not fun. I always said that putting a pregnant woman on a diet is like the meanest thing you can do.

So yeah, I stuck to a diet pretty well and I was able to control it with the diet alone. So I didn't have to go on any insulin. So that was really good. And then I was going for this, you know, natural unmedicated birth, which is what I wanted to do. So I really didn't want any further complications, you know, with gestational diabetes. So I was really like militant about that diet. And then so I just carried on the rest of my pregnancy. I was checking my blood sugars, you know, several times a day.

stuff like that. And then I had my first cervical check around like 36 weeks and I was still closed high in posterior. And that's around when my doctor kind of approached the subject of induction because even with like controlled diabetes, she said that you can have like post until like degeneration after

40 weeks and then an increased risk of preeclampsia. And then I was already at risk for preeclampsia because my mom had it and I was on aspirin for that. So we came to the conclusion that I didn't want to be induced because I wanted this natural birth. So she took that into consideration and we made a plan and decided that we would have me be induced to 40 plus six. That was the best plan for both of us.

My next check was around 39 weeks and I was one centimeter dilated and about 80% of face and the baby was super low. Oliver was like super low in my pelvis just like I was really uncomfortable. My hips were hurting and stuff. When she was checking, she said she could feel him turning his head.

like in my, you know, service. Yeah, he was that low. So I continued to try to like walk that baby out of me. I, you know, did everything. I walked so much. I did so much curb walking. I went to this place here in Portland called Mount Tabor, which is affectionately called Mount labor by the people here because a lot of women go to try and walk their babies out there.

Then at my 40-week appointment, 40-week swirls around, I was one and a half centimeters dilated and 80% effaced. I'm sorry, I was two centimeters dilated and 80% effaced.

My doctor did a sweep and stretch and told me she was able to get me to like two and a half centimeters. And so we were hoping that I would go into labor then. So I just had a few days left, but unfortunately I didn't. And so at four game three, I messaged her and asked for another sweep. And so we had another sweep at 40 and three. And I lost like in between that time, I lost my mucus plug.

And then at four and four the next morning, I felt this big gush of fluid. And I was like, oh my gosh, I think that's my water. And I went to the bathroom and I was wet. So I was like, OK, well, maybe this is my water. So I went to the hospital and they tested the water. And they're like, no, I think you just peed your payers.

it happens. And I was like, oh no, this is so embarrassing. So they sent me on my merry little way. And I got in the car and I just cried because I was so not only was I just embarrassed, I was just so done being pregnant. And I didn't want to be induced, but I came to terms with the fact that I might have to be induced after all. And so the rest of the day, I just kind of chilled and took it easy. And then the next day, me and my husband, which is 45, me and I had been went to a really nice dinner.

And then we went home and just watched all the shows where people have babies like friends in the office, and that was really, really fun. And then we went to bed early with the plan to go in for my induction at 8 a.m. the next morning. Yeah, so that was my pregnancy. So the morning of my induction, I woke up with contractions at about two in the morning, and I woke up and I was like, no way. Am I really having contractions right now? Am I really going in the labor of like the morning of my induction?

So I like, I tried to sleep in between them, but they were coming every seven to eight minutes and they were continuing to get more intense as I lay there. And then about four times in the morning, I had a big, big contraction and I felt he had another gush of fluid and I was like, oh no, I pee myself again.

But I went to the bathroom and it was bloody show. And so I was like, oh my gosh, crazy. I was like, this is really happening. Awesome. And so I woke my husband up and I was like, guess what? I'm in labor. And he was like, that's amazing. You know, and contractions were coming about still seven, eight minutes. They were lasting about a minute long. We both tried to go back to sleep, but there's too many journalists.

we just couldn't and so we called the hospital at six because we were due to be there at eight and they had told us to call just to make sure there was no like delays in the induction and so I was like let me call and just see what they want me to do because I am and I feel like I'm in labor you know I guess maybe they'll just tell me to stay home you know and so my calls and they said well no you should probably still come in because you could just

be in very early labor and it could still be days. And so I was like, all right, cool. So I figured, okay, we'll go to the hospital. They'll see that I'm in labor. They don't need to induce me if I want to already in labor, right? And so we went to the hospital, we got there, they checked me in. When I got there, they immediately took me to the triage area and they checked me to see how dilated I was.

And I was a one and a half centimeters dilated is what they told me, which was odd because my OB had told me I was like two and a half, which did that last stretch and sweet. But so that was, I was like, oh, okay. And so they cooked me up to the monitors and my contractions had slowed down like just significantly. And they were coming like maybe one of every like 15 to 20 minutes. So we decided to go ahead and proceed with the induction. And so they started with a

cooks balloon and they inflated, you know, the balloon on top of your cervix and then the one on the bottom of your cervix. So in your uterus and in your vagina. And they were like, okay, well, this can be in for 12 hours. And then it'll get you dilated to four or five centimeters and it'll fall out on its own once it does that. Otherwise, we'll check it at 930, which is what time they put it in and we'll take it out and see where you're at.

And I was like, okay, so I labored all day. My contractions picked back up as soon as that balloon went back in. And they were coming pretty regularly about every four or five minutes throughout the day. I wasn't really timing them, but I'm thinking that's around where it was. The balloon never fell out on its own. About 9.30 p.m. They came in to check and see where we were at. So they tugged on the balloon and they checked and

sure enough it had dislodged from my cervix, but it just hadn't come all the way out. So they pulled it out and checked me and I was five and a half centimeters dilated, which was really cool. I was really encouraged by that. I had about 11. I was contracting, decided I wanted to get into the tub, which is in at the hospital. That's in a different room. So they had to go fill it up and stuff like that. They did that. And then I got in about 1130. They were regular. The contraction came right and I was felt like I was coping really well.

And then at about one o'clock, I just started to get really, really hot in the tub. I was just feeling really uncomfortable and hot. And so I knelt up and knelt over the tub. And as I got up, I felt a big old pop and a gash of fluid, another one. This time it was my water. So my water broke at one 10 in the morning. I remember looking right at the clock.

But nobody believed me. It's like the girl who quite will. It's just the water dripping off of you from the top. And I was like, no, it's not. I swear my water just broke. Anyway, so as soon as that happened, oh my gosh, those contractions went zero to 60. It was very intense as soon as my water broke.

And so at that point, I didn't want to get back out of the tub because I was just, I could not cool down and I felt like I needed to move around more. So I got out of the tub and we went back to my room. They were like, well, let's check. And I kept telling the moment. I was like, I swear, it's my water. I felt it, you know? And so they were like, well, let's check and see if it really was your water.

So they checked and sure enough it was, and they were like, oh, it was your water. And I was like, yeah, I know. And they were like, can we go ahead and check your cervix while we're down here? And I was like, sure. And I was six centimeters dilated. So progressing slowly, you know. So I want to say we went back to the room like at 130. And I labored for a little while longer. About three o'clock in the morning, I was really having trouble coping with the pain. And I just kind of started to lose my mind a little bit.

I was screaming and writhing in pain at this point and just completely forgot all of my coping mechanisms. And the pain was just so intense with the contractions. And that's when I started asking for an epidural. So my husband and I had talked about, you know, when I would get the epidural, so we had a safe word. And so once I said that safe word, I would get the epidural. So before then, he tried to encourage me to make it through and get the natural birth that I wanted, the pain medication free birth.

And so he was like, OK, well, let's try some less invasive methods first. So we tried nitrous. And I took a couple breaths of that, and all it did was annoy me. The mess just annoyed me. And I was like, I can't get this right. And I just kind of was like, no, that's not going to work. And so then they tried fentanyl.

And they gave me two doses of that and it worked for a couple of contractions, but then the pain came back and it was like almost like it was worse to have that relief and then have the pain come back so suddenly. And so I was done and I was like, I really want an epidural. I really want an epidural and they were like, okay, let's check you and see where you're at. And then you can decide. And I was like, okay, so they checked me about four in the morning for 15 or so. And I was six and a half centimeters.

And I was like, yeah, no, I'm done. Give me the epidural. And I said of our safe word. And so about 4.30 in the morning, I got the epidural. I had immediate relief, and it was great. I tried to sleep, but I just had too much adrenaline. I don't know how I didn't sleep. I had been up over 24 hours at this point, you know? And so about six in the morning, they came in at shift changed, and they checked me again. And I was still at six and a half centimeters. So that's when they started Potosin.

About 10 o'clock, I told my husband I was like, I feel a lot of pressure. Like, you know, I think I need to push. I think I'm complete. And even with, it was crazy because even with the epidural, I was able to feel that. So we went and got the nurse and the midwife came in and checked me and she was like, sure enough, you're complete. Let's start pushing. So at 10 30, I started pushing, took me a couple of tries to get the hang of it. And then I pushed for an hour and a half.

But that was just because my contractions were like two minutes long. And so I pushed twice for age contraction for about 10 seconds. And then we just have to wait for another contraction to start. And I was making movement. So anyway, so I pushed for about an hour and a half. And then at 12, 16 p.m. Oliver came into the world. And the midwife was like, I'm here to reach down and grab your baby. And I've reached down and grabbed him and pulled him up to me.

He was seven pounds, nine ounces, and the first thing I noticed was that he had his dad's beautiful long eyelashes, and it was amazing, amazing, and he still has them, and they're just wonderful.

Yeah, well, I know you want to save the postpartum discussion for the end, so we will just go ahead and keep going and talk about baby number two. Yeah, so our second one was so very different. We decided to start trying for Declan when Oliver was a year old.

We got pregnant on the very first try, but unfortunately shortly after that, I had my second miscarriage, which was technically, and I really don't like this term because it minimizes the pregnancy, but it's technically a chemical pregnancy because it was before five weeks. But we started trying again. Again, the doctor said, go ahead, try when you're ready. And so we started trying again. And again, the very next cycle we got pregnant.

And so this time we made it to our first ultrasound which was about seven and a half weeks and our baby had a heartbeat then but it was low. She was measuring small and so we were not super hopeful that she would make it.

And so about two weeks later, we had another ultrasound. And that was about nine and a half weeks and she no longer had a heartbeat at that appointment. And so that was right before Christmas. So on December 23rd, I had to have a DNC for a Miss Miss carriage. And that was absolutely devastating. That was probably the hardest by far.

And then it took my body a really long time to recover from that, I think, and it took us another seven months to get Declan. And it was absolutely heart-wrenching. I got a little taste of what people who experience infertility have.

It was awful and so my heart goes out to anybody that experiences that because those negative tests broke my heart every single month, you know. But eventually we did finally get Declan and it was absolutely joyous. I cried and it was amazing. So I did have a small sub-choreonic hemorrhage.

at our first ultrasound, so I was put on pelvic rest with him and then it resolved around 14 weeks. And then at my 20-week ultrasound, I was really excited because I didn't have to do any more vaginal ultrasounds. And then they had to do a vaginal ultrasound because I had a complete posterior placenta previa. So my placenta was completely covering my cervix. Like, it was really bad.

But they told me they were like, well, most often previous resolve themselves. And you can likely proceed with your vaginal birth if it moves out of the way enough. And so we'll check you again at 32 weeks and see where you're at.

And I was like, OK, cool. So I carried on with my life. I did not have gestational diabetes this time, which was amazing. So I don't even know how that happened. But I didn't. So that was great. I did have nausea. It was not as bad as the first pregnancy, though. And then it was 30 weeks, five days when I was headed to an OB appointment. And I experienced this big gush in the car.

And I was like, oh, no, I'm way too early for this. And so I was like, oh, is that my water or am I bleeding? And so I checked. And sure enough, there was a lot of blood. And I had told that it can happen with previous, as your placenta moves, as your uterus grows, it can cause some bleeding. But this was a lot. And it scared me. And they told me that I need to go get checked and I'll empty.

And I panicked. My brain flew out of my head and I didn't know what to do. And I was driving. And so I called my mom and I was like, I told her what was happening. And I was like, I'm bleeding a lot. Like, I can feel it coming out. And she was like, she said, you need to go to the hospital. And I was like, yes, you're right. I do need to go to the hospital. And so I called my OB. And I told them that I was bleeding and I was going to go be seen analogy.

and headed towards the hospital. And then I called my husband on the way, told him to meet me there. And when I got there, the emergence, this is relevant because this nurse came to help me. So I had to park in the main garage instead of the emergency room parking lot because it was full. And so I had to walk clear across the lake hospital.

And this angel of a nurse saw how distressed I looked, I guess. And she came and asked me if I was OK, if I needed anything. And I told her that I was bleeding and that I was 30 weeks, five days pregnant. And I needed to be seen. And she was like, OK. And so she got me a wheelchair. She stayed with me. She checked me in the emergency room. My husband got there as we were checking into the emergency room. He flew. He must have flown because he got there so fast.

And they get me up to L&D. And that nurse stayed with me until I was, you know, she knew I was in good hands, the heads of the L&D people. She was amazing and it was not her job. She was not a labor and delivery nurse. I wish I remember her name if you hear this. Thank you. And so we get into the room. They immediately get me back to triage. They pull off my pants. And at this point, my pants are soaked.

all the way to my knees with blood. And I'm still actively bleeding. Someone throws the word out. They were like, oh, yeah, she's hemorrhaging. And I was like, oh, God, you know, and it's just absolutely terrifying. It was terrifying. The room just fills up with people very, very fast. Someone's got a doppler. They're trying to find the baby's heartbeat.

I got my arms pinned down by two nurses and they're putting IVs in my arms. People are talking at me and they're like, we're gonna get the NICU team. We're gonna preppy for a C-section. And I was like, oh my God, everything was just, it was so chaotic and so scary. I don't know how long it took for them to find his heartbeat because they were working with that Doppler and they couldn't find it. So they're like, we need to get an ultrasound. We can't find the baby's heartbeat. And I was like, oh my, I was like, have I lost my son? Have I lost my baby?

And I started crying. I was, you know, besides myself. And so they get the ultrasound machine in there and he was just flipping all around. He was fine. Just hiding. And so they find his heartbeat and the whole room just like breathes this collective sigh of relief. You know, everything just calmed down a little bit. Yeah, it was just absolutely horrifying. It was so scary.

very traumatic so everything calmed down then and they're like okay you're still bleeding we're gonna admit you it was just so much blood it was scary to see you know and so I did meet with a NICU team they gave me steroids to mature his lungs and then they told me I would be in the hospital until I was bleed free for 48 hours and this again was right before Christmas of course

So I ended up being bleed free and then I was released on Christmas Eve. They let me go home and said that if I have any bleeds, I have to come back. And so I was able to be home for Christmas and then the day after Christmas, I bled again, but it was small. It wasn't very significant, but they told me I still needed to come in. So I went in, they kept me overnight and then they just charged me the next morning.

And then that same day, I went back to the hospital because I passed to very large golf ball sized cloths and had another very large bleed. And so at this point, they told me I had to be in the hospital until I gave birth. So which actually wasn't very long because the very next day, Declan's heartbeat started to climb upward. And it was just like trending upward. And he looked like he was starting to be in distress. And then my lab started to look a little funky because I was losing a lot of blood.

Then I started to go into preterm labor because my uterus was so agitated from all the bleeding. So at 32 and 1, they came in and said, we need to get the baby out now. It's time. And I was like, OK, let's do this.

So I'd already met with the NICU team. They had given me a second dose of steroids to mature his lungs and stuff. And they prepped me and my husband. And we went in and they gave me the spinal block, which was the least scary thing that had happened to me, you know, is interesting how different it was from the epidural. It worked a lot faster.

And so they opened me up and at 2.22 p.m. Declan was born screaming. I heard him screaming before they actually took him out. It was crazy. He was inside of me still when he started yelling. And so they took him out and we were able to do 60 seconds of delayed court clamping.

because he was over 32 weeks, I think that's what it was. And then we did something called baby in a bag where they take him out and then they place him in a plastic bag all except for his head to keep the warmth on his body. And I think that helps with his respiratory status. You know, if they're trying to maintain their body temperature, it can decrease their oxygenation.

So we were able to do that and he was 4 pounds, 5.7 ounces, which is actually kind of big for a 32-weeker. Then they gave him to the NICU nurse. I was able to see him through the

And that was really, you know, of course, I knew we had that plan that my husband would go with him. He's going to go with the baby. But gosh, I felt so alone in that moment. And it's just, it's scary. It's definitely really scary. So they close me up and yeah, then they sent me to recovery and Declan went to the NICU and we were in the NICU for five weeks. So that was the birth of Declan. Wow. Yeah.

unexpected and you want to share a little bit about the NICU stay? Sure. Yeah. So he really did really well. He was on CPAP at first and then they had to keep increasing his oxygen level because he was having more and more respiratory distress. So they did an X-ray and found that he had a pneumothorax, which is like air in the space between his lung and his chest wall.

So they put in a chest tube and they decided to intubate him and put him on a ventilator. And so he was on a vent for 24 hours while that pneumothorax resolved. And so they were able to take him off of the ventilator the very next days and once that

and he went back on CPAP and then he came off of CPAP after a week. And I had been pumping that whole time, so I went to recovery. And I don't remember much. It's very, very blurry because I was on a lot of pain medication. At first, I refused.

pain medication because I was like, I'm not having any pain yet. I'm like, yeah, but that's kind of what's going to wear off. You're going to need it. And I was like, I think I'm okay. That was the dumbest mistake I ever made. And so I was writhing in pain 15 minutes later. And they took, I don't know how many doses of pain medication to get my pain under control. And so I was on another plan.

But I do remember asking for a pump multiple times. I was like, I need a pump because I have to start pumping. Like, I have to do this. This is what I know I need to do. This is the only thing I can do for him. Otherwise, it's completely out of my control, you know? And so I asked for a pump. Even after they'd brought me a pump, I was so out of it that I kept asking for the pump. And they were like, your pump is here. Like you've got it. And I was like, oh my gosh. And so then I started pumping every two hours. It was just such a blur. I don't even remember going

see him for the first time in the NICU. The first like 12 hours are really blurry. But I was able to pump every two hours overnight and throughout the day. And then after he was taken off CPAP, which was only like seven days later, which is awesome, he started being able to latch. And so we would latch to a dry breast at first.

He did really great. He had a great latch from the very first time, even being so tiny and was transferring milk just wonderfully. And he was just a feeder grower for the next four weeks. And so we did koala blocking, which is like six hours where they don't give him a tube feeding. And then we just do our demand breastfeeding, which was really cool. And I had so much support from

the IVCLCs, they were wonderful, just so wonderful. And once we went home, he was still getting fortified bottles because he needed to grow a little bit more, but he was exclusively breastfeeding. And we transitioned out of that by three months old. He was exclusively breastfed, and we breastfed for 19 months. And it was really awesome.

It was really cool, you know, thanks to the support of so many people. And the only thing really, I was really hyper focused on him when we were in the NICU. I didn't have a lot of recovery for myself. So it was really tough. It was a really tough recovery. I was in a lot of pain. And then I neglected my mental health completely.

And so it all came crashing down on me when we came home for sure. And I experienced some really severe postpartum depression when we got home and anxiety. I saw my doctor, you know, and I was medicated and stuff like that. And I got better, but it definitely that delayed, you know, thing happens. And I was told that that could happen. And it definitely did because I was just hyper focused on making sure that he stayed alive. Yeah.

and got what he needed. But he is now the same size as his brother, as his older brother, and he's a rambunctious, almost three-year-old, and he's huge and beautiful, and he also has to save long eyelashes of his brother.

All right. One more story. I know this one was quite different. Yeah. So with my last pregnancy, we started trying to get pregnant with McKenna when Declan was about 14 months old. We wanted to make sure that his adjusted age was a year. So we got pregnant again on the very first try. We're really good at that. But unfortunately, again, I had my fourth miscarriage.

So, and that was my final miscarriage. We started trying again, and I think it was two cycles this time. We got pregnant with McKenna. So, that was great. This pregnancy was the hardest by far. I didn't have any major complications, but I did have hyperomesis. It was awful.

I had to go get IV fluids at the hospital because I couldn't hold anything down, not even water. And I was sick until my third trimester. And then it kind of tapered off around like 26 weeks. But I didn't have gestational diabetes. My placenta was completely out of the way. I was monitored very, very closely. I saw a perinatologist and I had several ultrasounds.

I saw my parent etologist for the last time around 30 weeks, I want to say. And she had told me because of my age, I was 36. She didn't want me to go into post states.

I was like, okay, you know, I don't really want to be induced. I'm going to try again for this natural unmedicated birth. I was like, but, you know, I want to stay safe, of course, you know. And I was also going for a v-back. So I really didn't want an induction. So she was very supportive. And that was great. And I had the same doctor.

third time that I did the first time, same OB, and she was also very supportive. We decided, again, that I would wait until 40 and six to be induced. I had a pretty good pregnancy. I wasn't working anymore, so that was nice. I was really tired and really uncomfortable with two other kids. So that was hard, and then I just had that hyperamisis, and that was horrific. So we decided on 40 and six, at around 38 weeks, I had my first cervical checked, and I was completely closed.

and posterior infirm. But I was 25% of faced. And so I did all the labor things. I was walking. And I started EPO because I posted in our group and asked how I could help things along. And EPO was one of the things I was suggested I love our group. The Patreon group. Yeah, the Patreon group. Oh, good. I always love the support in that private Facebook group for our Patreon members. Can you explain what EPO is for people who don't know?

Yeah, absolutely. EPO is eating primrose oil, and so I inserted two capsules into up close to my cervix, and that's supposed to help soften and get you ready. And so then at my 39 week appointment, I was one centimeter dilated and 60% of face of that EPO worked.

It works, guys. And she did a cervical sweep at that appointment. And so I had been having projima labor every single day, every, well, every night, starting about 10 o'clock until about three in the morning. And it was awful. And so I was so done. I was like, no, I'm done. I can't do this. I had gotten sick again. So my hypermosis went away for a little while and then came back towards end of my pregnancy.

And so at my 39-week appointment, I told her I didn't want to go post-dates. So we changed my induction to 40 in one because there was an induction appointment at 40 weeks. And so at my 40-week appointment, I was still one centimeter, but I was 70% effaced. She did another membrane sweep, and I was also more midline this time, and Dr. said she was able to give you two baths, centimeter and a half.

and my induction was scheduled for the evening the next day. And so I was hoping I would go into labor, but I didn't. And that's okay. So we went in the next evening to be induced at 8 p.m. There was like this huge ice storm right around that time too. So we were all really nervous that I would go into labor and wouldn't be able to get to the hospital, you know.

anyway so we got checked in and they got me back into triage and checked me and they said I was one to two centimeters dilated because I had had a previous desection I couldn't have any cervical ripening I was still firm they said but I was dilated so they were able to insert the

balloon, yay, lovely balloon. But this time they only inflated the top balloon, not the bottom balloon, and they told me it could be in for 24 hours. So things changed, ma'am. And so I had that in. I started about 8.30, I want to say. And I had immediately started having painful contractions. And they were very crampy, very weird. And it lasted all night. I couldn't sleep. And they were about every five to six minutes. And so at 7.30 in the morning, that was around shift change the middle.

in and checked me. She said that balloon had dislodged and that it was just kind of stuck in my vagina again. She was like, I'm just going to pull it out. And I was like, OK, I've done this before. It didn't hurt last time. It was fine. But this lady, she pulled that balloon so hard. It came out with this sickening pop and just the stream of blood. And it was the most painful thing. It was more painful than the worst contraction I experienced. And it was awful. I was like, oh my gosh.

Anyway, so she was like, OK, so that should have you dilated to four or five centimeters. But she didn't check me, which will come into play later. The contract just slowed down. And about an hour later, they started to put toast in. And I was

30 minutes. Like it was on and off and they were just kind of, they were really sporadic. They weren't very regular. And throughout the day, McKenna started having variable D cells, which meant, so it's like a D cell like right before the contraction. I think that's what it was. They told me that it's because her cord was likely getting compressed somewhere. So we were doing a lot of position changes and stuff like that to get her feeling better. But she was doing okay. They would pop back up. She only had one really, really scary one where

like 20 people ran into the room and it was like really low, but then she popped back up fast and didn't have another one of those. And so it was like around 5 p.m. when my contractions started to become really regular. Like every two to three minutes apart and they were painful, but manageable. And I felt like I was like really hitting a stride like after that, like 20 hours. So about 6 p.m. again shift change. The midwife came in to check me and she did and then she kind of had this weird confused look on her face and she asked me. She was like,

Can I redo that check? I'm a little confused. And I was like, okay, yeah, sure. So she checked me again. And then she said, okay, yeah, she's like, you're only one to two centimeters dilated. And I was like, what? Like how? And she was like, well, I think maybe what may have happened is that the balloon didn't get placed correctly and didn't dilate you at all. So I didn't even know what to think. I was completely crushed because I thought this whole time we'd been making progress, you know, and I was tired. And so

I lost it and I just started crying. I was really, really upset. And so they gave me a couple of options. They said we can replace the balloon or we can start Potosin and just continue on the Potosin and see what happens or we can do both. I was like, I have no idea what to do. So I called my sister who is a labor and delivery nurse and we kind of talked it out. I call him down, took a minute. You know, I was like, there's no way I can have that balloon placed again. I just can't do it without an epidural. Like I'm in too much pain. I just, I can't.

And so I decided to get an epidural and then replace the balloon and run Potosin concurrently. We did that. I want to say it was like an hour and a half later after I got the epidural that the midwife came into replace the balloon. Yeah, so it was about an hour and a half. And when she came back, I was three and a half centimeters dilated and super duper soft. So just in that amount of time, I dilated quickly, you know.

So I labored the rest of the night. McKenna still was having variable D cells. Not as bad as that, really big scary one, but she still had the variable D cells. And then about 10, 20, I felt like it was not that long after that balloon was replaced. I felt a lot of pressure and I was like, oh, I think the balloon came out. So they came in to check and that thing just slid right out of me. It was like butter. It just came right. I'm serious.

It was crazy. And she checked me and I was six centimeters dilated at that point, so it was moving pretty quickly. So the variable de-cells continued with McKenna, and then she started to have minimal variability in her heart rate, which meant that she wasn't having those peaks and valleys, that they like to see the ups and down. She was just more kind of stagnant in the same area, which also can mean cord compression. And so somewhere in there, her cord was getting compressed.

So they wanted to put an internal monitor next to her head to measure the true strength of my contractions and maximize the use of Potosin. And so they did that, and they were able to see these true things by contractions and stuff. And then they decided a little later that they wanted to give me a new infusion to try and give her cord a little bit more room to breathe.

And they did that and her heart rate got better after the M new infusion around like it was just before I was complete. I started to have a lot of anxiety and almost had a panic attack. And I had this weird sense of foreboding. And I was like, I need to get her out right now. And in that moment, I almost asked for a C section because I had this really strange sense that something was wrong and I just needed to get her out. And shortly after that, it was like three o'clock in the morning and I said, Oh, I have a ton of pressure. Can you go get the nurse? I think it's time to push.

sure enough, I was complete and I started pushing at 3.05 AM and I was, I just had this intense motivation to get her out. And I pushed that kid out in six pushes, three contractions. I started pushing at 3.05 and she was out and born at 3.18 AM. Wow. Yeah. I was like, get her out right now. And so as she's coming out, I had a mirror and I could see as her head came out, she had a nickel cord that was wrapped around her neck.

and then around her torso again, so twice as she was coming out. And then as they pulled the cord more, she had a true knot in the cord, which is super duper rare. Everybody was like, oh my gosh, she has a knot in the cord. And I was like, oh, and so that's where the cord compression was coming from. And so I was like, I knew it. When I saw the nucal cord, I was like, I knew there was something wrong. Like I just felt it, you know? But she came up to my chest and she did great. She was fine. And she also had the eyelashes.

All three of them. And she was six pounds, 12 ounces of absolute perfection. She was perfect. Oh my God. And she still is. She's wonderful. So yeah. So that's McKenna's birth. Okay. So you want to tell us about your postpartums?

Yeah, sure. So to immediately postpartum with Oliver, I had a second degree perineal laceration, and a few minutes after he was born, I spiked a fever of 102. I ended up with an infection called chorium amionitis. So it's like an infection of the amionic fluid and then the chorion around the baby.

So they gave me Tylenol and I threw it up. And so they gave it again. I felt awful. The nurse was talking to me and I was literally falling asleep, right? So I felt so bad. Oh my gosh. I was like, I'm so sorry, I'm falling asleep. And she was like, it's okay, you don't worry about it. And so all of her started nursing, but they slapped a nipple shield on me before I even had a chance to try and latch in. And I was so out of it with that fever that I didn't even protest. I just let them do it.

And in retrospect, I really shouldn't have let her do that. But it happened. So because of my infection, I had uterine at knee, which wouldn't let my uterus contract fully. And so I ended up having a postpartum hemorrhage because of that. It wasn't super bad. I had to have an iron infusion, but not a blood infusion. But it was enough to make me feel funky.

I'll ever had some blood sugar issues. So they told me I needed to supplement immediately. I was able to supplement at the breast with donor milk, but they also had me start pumping immediately, which created like this massive oversupply and I was triple feeding for about four weeks after that because of that. He wouldn't latch without the nipple shield and we just really struggled with breastfeeding after that. And I feel like if we'd done things a little differently, maybe we wouldn't have, you know,

So around four weeks postpartum, I got a severe, severe case of mastitis and it was antibiotic resistant. So I was rehospitalized for five days and I had to be given IV vincomycin to get rid of it, which is also pretty rare. That doesn't really happen. And I had really bad postpartum depression and anxiety after that.

because of it, those four and a half weeks were really, really rough. And so after the hospitalization, I decided that it would be best for my mental health and for Oliver, because he was also having issues gaining weight that I exclusively pumped. So I ended up exclusively pumping for 12 months. I saw my doctor and got on some medication for post-farm depression and anxiety.

started getting better and felt a lot better after that. Yeah, so, and then I kind of told you guys about decklands. But McKenna was the easiest recovery by far and it was so wonderful to have my V-back. I did have a small first degree perineal laceration, but it was really, really small. I had like two stitches. It was

you know, really, really an easy recovery. I barely bled at all. I felt really good. Emotionally breastfeeding has been going great and it still is going great. She had a really strong sex and my nipples were a little, a little bit raw and torn up the first like week or so.

But other than that, it was fine. We were discharged the very next day, like she was the shortest hospital stay. And she did have a little bit of trouble with weight gain at first. It was fine. And then she just kind of plateaued a little bit. And so they were a little bit worried, but then she popped

right back up and it was fine. We didn't have to do any supplementation. This was the only time that I did not pump at all. At the beginning, I just let her create my milk, and that was amazing to not have to do. So it was incredibly redemptive, even with the scary, like, desales and stuff like that, and the, you know, the mistake of the balloon. It really was such a wonderful experience comparatively to even my first birth.

I really was happy with the way it went. And now she's seven months old and she's crawling all over the place and she's starting to pull up on stuff, which is insane. I just can't even comprehend how that is. But yeah, I'm still on medication for post-partum depression. So I haven't experienced anything. I have some, a little bit of anxiety, but nothing horrible.

So of all three. It's a really nice way to close our entire family. Yeah. Awesome. Yeah. All right. Well, any resources you want to share?

Yeah, so actually, I said I love our group. My Patreon group is really great. And then I also love, done naturally, I don't know, Summer is amazing. She runs a group on Facebook, so if you want into that group, you can message me. It's for breastfeeding. And she's just, it's full of doctors and nurses, and she's an amazing IITLC.

And she also has a YouTube channel called Done Naturally. And it's just so fantastic. She is one of the reasons I had such an easy time with Declan. And she was able to help me transition from bottle feeding and pumping with Declan safely. And she's just a great, great resource. So I can post that link. So I think that's it. All right. And where's the best place for people to connect with you?

Instagram is great. I can also do Facebook or I'm on TikTok. Yeah. All right. Well, yeah, we'll put anything you want to share on the show notes and then any other birth hour page you're on members will stink and find you there as well. Awesome. Thank you so much. All right. Thank you, Amanda. Now I'm going to chat with the co-founders of Nurture by Naps, Emily and Jamie.

Hi, Emily and Jamie, thank you so much for coming on the podcast to chat with me about naps. We're so happy to be here, Brian. Thanks for having us. Thank you. Awesome. Well, can you just tell me a little bit about yourselves and how you got involved and started naps?

Yeah, so we'll try and keep this short and sweet. We have a whole podcast episode on just how we start. I know, yeah. I'm Jamie O'Day. I'm a registered nurse. I'm an international board certified lactation consultant, also known as an IVCLC. I have three daughters. They are nine, seven and five. And I am the co-founder of NAPPs, which stands for newborn and parenting support. We'll talk a little bit more about what we do in just a second here, but I founded NAPPs with my business partner Emily.

Yeah, also turns out I'm your best friend as well. I am Emily Silver. It's so nice to be here. I am a family nurse practitioner, although my wheelhouse really is just moms and babies. And I'm also an IBCLC, a lactation consultant. And I have three girls as well. They are nine, seven and three. All right. So what inspired you guys to start NAPs and what makes you different from other resources out there for prenatal and postpartum?

Yeah, so Emily and I worked on labor and delivery here in Boston. We worked at a major medical center teaching hospital here. While we were working on labor and delivery, anybody who has had a baby, which I know is a large population of your listener's brain, knows that there is a massive gap in care for women and families. I mean, really starting prenatally, but especially postpartum. And we realized this gap in 2009, even before we had our own kids, we had

just met and really wanted to do something about that, that gap in care. So brain stormed a lot of different ideas on the night shift and ultimately decided to start NAPs in 2011 because Emily and I didn't have any kids yet. We were two of the nurses who worked the shifts. We hired a handful of nurses and at the time, the very first service that we ever provided to clients here in Massachusetts was daytime and overnight nursing care. So that's, that's how we got started.

Yeah. I mean, it grew. It snowballed as we went on to, I became an NP. We started teaching our careers evolved, but we, our families evolved also. We started having kids ourselves. Yeah. So that is sort of our business grew from clients telling us what they needed or us experiencing it, truly ourselves.

I think, Jamie, you mentioned that we hired a bunch of nurses, and I think that answers the other piece of your question, Brian, is what makes this different? At NAPs, whenever you engage with someone here on our team, you will always interact with a registered nurse or a nurse practitioner. We have other experts in our membership platform, from mental health to OT to PT. But, you know, we found that parents are just piece-smealing information together, going here and going there for this and for that. And we wanted to create a safe space where

you can come to get an answer always from a medical expert. But we're also moms as we already mentioned too. So we're always willing to.

bring in that real life parenting advice to help parents navigate their options and just like bring it all together into one safe space. Yeah, I think the one third that you'll see across all the services that we offer is that we saw a lack of the integration of the medical world and the real life parenting world. So that's really what we wanted to bring to the table was that aspect of it, that integration of those two worlds while also providing high quality care from medical professionals, right?

So that's one piece of it. And as Emily mentioned, the other piece of it is this idea of there's no reason why there can't be one place for people to go for all these different stages from pregnancy through potty training and the transition to preschool. So that's what we've really been trying to accomplish is having one place with the same providers who have the medical background, but the real life, you know, real life experiences to be able to meet parents exactly where they're at and help them feel empowered and confident. Right.

Right? And all of these services are available online to anyone. So you mentioned a membership. I would love to talk about that and what is offered with that. Yeah. So membership is definitely, you know, one of our signature offerings. That is where parents can come really at any stage of parenting to be able to get on demand advice and support again from medical professionals, right? So within that membership at a minimum, what's included in that is a video library with over

I think we're up to like 150 different release that every month more more video content Yeah, so you know short form videos to be able to answer those like everyday common parenting questions like you're about to go to Google and put something in about spit up or weight gain or peeing at night and When you're trying to potty train like something from babies the toddlers you'll find a quick answer. Yeah

So that's meant to like, yes, replace the 3 AM Google rabbit hole. We've all been done that one. But in addition to that, we want to touch points with our clients, right? So anybody who's a member can also come to one of our three weekly Q&As. During those Q&As, there is a registered nurse or a nurse practitioner online for an hour there to answer any of your pregnancy or parenting questions.

And then we also have our which is our most popular feature it's an ask nurse message board. So you can ask a question on that message board 24 seven you'll receive a response within 24 hours from an actual human being this is not a bot. That's just at a minimum what you get on the nurture membership.

For people who do an annual membership, what's included in the annual membership are all things that we know through research that positively impact maternal child health outcomes. So all of your prenatal education, feeding support, sleep consultations, and then the peer support groups. So those are all individual services that you can book with us. But those are all also services that are included in the membership because we know through evidence through research that those things positively impact maternal child health outcomes too.

And so just wanted them to be part of your experience with us? No, it's not like cookie cutter, right? When you have a question about feeding, we're going to need to ask you about your routine and sleep and your home life. So I think too, about the piece that we're nurses is we just love talking and asking questions. So we ask a lot of questions to help you get to your right answer. But you don't have to be a member to work with us either. You can try us out. You can try us on, right? You can jump on our website and even just book a service or a call.

just to see how it feels for you too. Yeah, absolutely. All right. And I love that you have that lactation support that can be offered virtually. And I know that.

even a lot of insurance policies will cover that as well. Yeah, so one of the biggest updates that we've had as of late is we do now accept certain health insurance plans. So that is for people who want an in-person lactation visit. If you're here in Massachusetts, we're seeing a lot of our clients not even having to submit it themselves to get reimbursed. Like it's actually being covered by their insurance fully for them to just engage with us in person or online.

So many of these insurance companies also offer unlimited telehealth appointments. So this is where we're really starting to, we already were reaching patients outside of Massachusetts with our virtual offerings, the membership, our online classes support groups. But now with the insurance coverage, we're

seeing more and more people virtually for that either through a remote lactation visit or because this is something that's covered until us or the patient deems they no longer need help. We're sort of following these people for many weeks and answering those everyday feeding and sleep and newborn questions. So just really trying to make our services and our care more accessible to more people.

You can jump in at any time if you're expecting a baby, if you have a newborn, a baby, or a toddler, maybe you're having your second or your third baby. It's never too late to get involved in the journey. I love that. And the way that I found out about you guys was through a guest who had been a member of one of your postpartum support groups. And that sounded amazing as well.

Yeah, yeah, so yeah, the peer support groups are are an amazing offering again, either as part of the membership or a one off service that you can book. Those peer support groups are for all these stages too. So pregnant support group, we do a new mom support group, we do a veteran mom support group for for seasoned moms, we do a working mom support group, we have a dad support group.

So that is just peer support is such an integral part of your pregnancy and postpartum journey and just life is apparent. So again, really just trying to make that service more accessible and we're so thankful to Robin for mentioning. I felt so proud listening to that episode and you asked her what her best resource was and she said naps and it just felt really nice to hear. Yeah.

Amazing. Why I love you guys are just this hub for so many different things that come up during this stage of parenting. And I love that, you know, it's available to everyone now. I think it's one of the things that kind of came out of COVID is we learn there's a lot more we can do virtually than what people were even trying to do before. So it's really cool.

Yeah, totally. It gives more people the option to have access to this level of care regardless of where you live. So it feels really, really exciting and it's just awesome to be able to support more people.

Yeah, and where is the best place for people to connect with you guys and find out about all these things? Yeah, I mean, to just check us out, check out our services, try us on. If you want to book a call or join a class, you can go to our website, nurturebynaps.com. There's also information about our membership on there as well. Or if you use social media, we are very active on our Instagram account, which is nurturebynaps.

That is where we are constantly serving up education, put a question box out once a week, and we'll answer as many of your questions as we can to give you a taste of what it's like in the membership. And we just are very real. We don't make it look pretty. We show our real lives and our real selves with our own families to help you feel connected. We're in it just like you.

Yeah. Yeah. Yeah. I love that. I love that you guys have the, you know, personal experience, but also the medical background. It feels like just, you know, like the nurse line, you might have your pediatrician, but like 10 times better and more personal. So it's such a cool offering that you have. Yeah. I mean, it's also those weird questions that you want to ask your pediatrician, but you're like, I don't think I can call them. Like I don't know that I would call them and weird stuff that you're googling that they're going to get crazy answers on Google. So yeah.

All right, perfect. Well, we will link to all of those things. And I will share on Instagram for sure because your Instagram account has so many great infographics and information and everything. So I hope more people will follow you over there from our account. And I just really appreciate your time today. Thanks so much, Brandon. We appreciate you having us. Thanks for having us.

Thanks so much for listening. If you enjoyed today's show, head to thebirthhour.com and click Become a Member to pledge your support. And as a thank you, you'll get an invitation to join our private Facebook group and access to exclusive episodes. Your vote of confidence and support means the world to me.