954| Peaceful Hospital Birth with Unplanned Epidural After Weeks of Prodromal Labor - Saskia Bolger

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.

I'm Bryn Hunt Palmer and you're listening to The Birth Hour. This podcast is designed as a safe place to come together and share childbirth stories. Stick around and join us to hear informative and empowering birth journeys from all over the world.

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I hope everybody had a nice holiday break. We are so excited to be back. Of course, I have a little cold now, but had a wonderful break up until literally yesterday. So we celebrated my daughter turning 13, which is so wild because her birth was really the inspiration for this podcast. And I can't believe it's been 13 years. I'm excited to have a new episode for you today. We have Saskia and she's going to be sharing her hospital birth.

She talks about her experience with prodromal labor and how she had really been on the hunt for birth stories, sharing that experience when she was going through it. So hopefully this will help someone else out there. And then she talks about her hospital birth and how she was planning to go epidural free and things came up, things changed. She made the decision to have an epidural and she was grateful for that in the end and it was a really peaceful birth. All right, let's hear from Saskia. Hi Saskia, welcome to the birth hour. Thank you so much for coming on the podcast. Thanks for having me.

Of course, we're going to get to your birth story in just a minute, but will you tell listeners a little bit about you and your family first? Yeah, so my name is Saskia, and I live in Pennsylvania with my husband, Morgan, and our daughter, who is four months old now.

and we also have an elderly small dog. I'm a social worker currently working as a therapist and my husband is a medical student. Okay, so why don't we start with finding out how your pregnancy went, all of that? Yeah, so we always knew we wanted a family and in 2023 it felt like the right time to start trying. We'd been married for about two years.

So I went off birth control in May, and it took several months for my cycle to regulate, which was like a little bit frustrating at the time, and I remember getting impatient. But in hindsight, I think we were very lucky and fortunate to get pregnant as quickly as we did. So we ended up finding out that we were pregnant in October, so it was about like five months of trying.

And it was a few days after our wedding anniversary, which was kind of sweet. Had taken a test in the morning, thought it was negative, went down into our basement to do a bike workout before work for the day, came back up to shower, and literally pulled the test out of the trash because I just kind of had a feeling. And it was super, super faint. And I took another one and it was super, super faint, but it was there.

So I, you know, showed my husband kind of like, didn't really believe it until the next day when I took another one that was like a little bit darker. So, you know, we were just really excited to be pregnant. It was the first baby on my side of the family. My husband comes from a larger family. So there was already a few cousins, you know, waiting for the baby on that side. Yeah. That's so funny that you threw it away and you're like, maybe. Yeah, the hope was, the hope was there. Yeah.

All right, so then how'd your pregnancy go? Yeah, I mean, I had like, I think a mostly textbook pregnancy, you know, like pretty sick and exhausted first trimester. I only like actually threw up a few times, but I just like every day after work, I'd have to come home and be horizontal, had a lot of food diversions. And one thing that was hard was I did have to stop running and exercising just because I was so weak and would feel like much, much worse after exercising and

That was kind of hard for me just because that's like a very important part of who I am and what I enjoy to do. But thankfully after like that first trimester, after like 13 weeks, I was able to start exercising again and just started to feel better slowly. And yeah, I mean, after that point, we just kind of like had a lot of fun reading about pregnancy and birth and kind of getting ready and

I was planning on like a low intervention slash epidural free birth, I would say. And I kind of had a few reasons for that. I think I really wanted to avoid a C-section if I could, you know, just to avoid a surgery and recovery from a surgery. And I had read a lot about the cascade of interventions.

and how one thing can lead to another. And I think I also just sort of wanted to see if I could give birth without the epidural. But another big reason for me was just like without going into too many details, I experienced some sexual trauma earlier in my life. And I really wanted my birth to be as hands off as possible. I think I was fearful of feeling pain from interventions and like not knowing what was going on.

So I really just wanted to be informed and to feel like I was making empowered decisions and not just having things happen to my body without knowing what was going on. Yeah, that makes sense. I wanted to go without the epidural, but I also did a ton of reading and educating myself about

induction, c-sections, epidurals, and everything else just so that I knew what to expect if those things would come up and I could make choices. I knew that most things in birth are choices unless it's a true emergency, but I wanted to have the information available because I know that things can change.

So yeah, I mean, like with that said, my husband and I have always been really big planners. We had like the nursery done pretty much by around 20 weeks, you know, we were just were always like very excited. So we did, I think a lot to prepare for birth. We took a La Maas birth class together through our hospital, which was really hands on and really kind of focused on like skills and practical things, which I really appreciated. It was

you know, we would like get on the floor and do the exercises and go on the yoga ball and practice the breathing skills, which I think was really helpful. And then we read some books to prepare as well. I was going to mention these in the resources too, but just two in particular natural hospital birth by Cynthia Gabriel was one that was really helpful. And I remember it had this like scale for the epidural and it was like, you know,

A 10 was you were absolutely going to get an epidural, no matter what. And a one was, you know, that you would absolutely never get one. And then there was sort of all this space in the middle. And I found that really helpful because I think a lot of times people talk about or think about birth in like a black and white type of thinking where it's like one or the other.

This book kind of talked about all the space in the middle of the gray area and sort of like how decisions can change and where you might feel differently about things. That's great. That's always a good approach. And then the other book was pelvic prep school, which is written by a pelvic floor physical therapist. And that had a circuit of like pelvic floor exercises that I tried to do every day just to kind of like get my body ready. Awesome. I haven't heard of that one.

And of course, I also listened to a ton of birth hour birth stories in preparation. Oh, good. Love to hear that. And then we were super fortunate to have a doula program through our hospital where we were actually able to get a doula for free.

Oh, nice. Yeah, it's a really cool program. It's a little bit different from the traditional doula model. So you got one doula that you worked with throughout your pregnancy, who you met with via telehealth. And they would time the appointment so that they were right around your prenatal appointments. And so you could just kind of discuss the appointment, discuss your birth plan.

And then for your actual birth, it was an on-call system. So just whichever doula was on call would come to the hospital for you for your birth. So like a little bit different, but for me, and that being free, that was really amazing because we wouldn't have been able to afford a doula otherwise.

And then my practice worked in a similar way in terms of whichever provider was on call at the hospital would be the one to attend your birth. And I went to a practice that had both OBs and midwives. And I felt that everyone there that I had met with had been really respectful of my decisions and my birth plan. And I had been going to that practice before getting pregnant just from my regular

You know, gynecological care. So I always knew that I wanted to give birth in a hospital. That's just where I felt safest and, you know, wanted to have a NICU available and things like that. So I think all that preparation made me feel really good sort of going into the birth.

And the only slight complication I had during pregnancy was that I do have a bleeding disorder that's pretty minor. It's called von Willebrand's disease. And it's really only an issue for things like childbirth or surgery where there's potential to lose large volumes of blood. So I just worked with a hematologist who prescribed some medications and had a plan in place

for the actual birth and then postpartum as well. They kind of had like a plan. If there was more bleeding, you know, they would give these medications. But it didn't really impact my pregnancy in any way. I did have low iron at one point that was not related to my bleeding disorder just kind of separately. And I did have to get iron infusions for that.

Other than that, the pregnancy itself was very smooth and I really enjoyed being pregnant. So good. Yeah, it sounds like you kind of had all your bases covered going into the birth, super prepared. So I'm excited to hear how things went for you.

Yeah, so starting around 38 weeks, I began having Prajama labor and I had heard of Prajama labor in like my reading and I remember searching the birth hour and I like listened to a couple of birth stories where people had experienced it but

nobody in my personal life had, and I just didn't really know about it, or I didn't really expect it to happen to me. But basically, almost every night, or more nights than not, I would say, I would wake up to contractions, usually in the middle of the night, or they would start in the evening. And they would usually be about 10 minutes apart, not quite a minute long.

They weren't painful but they were like slightly more crampy and like felt different from Braxton Hicks. Just sort of like a little bit more intense and the biggest difference is that they were regular so they would just keep coming for like every 10 minutes.

But they would never, you know, progress or get closer together or get more intense. And so like the first time that happened, I definitely, you know, full on thought I was going into labor and lost a full night of sleep only to have the morning come around and they just like completely went away. And so that pattern just kind of like persisted. So after the first few times that it happened,

I stopped timing them and I would just kind of try to ignore them and just kind of would assume that they were the same progoma labor. But this was, I would say like for sure, the hardest part of my pregnancy. I think, you know, it was harder than the first trimester, the morning sickness or like anything else because there was just so much anticipation. Yeah.

It's just so hard not to get your hopes up every time. Right. And even if you aren't having that, you're getting your hopes up every night when you go to bed at the end of pregnancy. Yeah. Yeah, that's a lot. Did you call your care provider the first time it happened or you just kind of watched it?

No, I just watched it because I was always sort of planning to labor at home as long as I could. So I was just kind of waiting it out. So if anyone's going through that right now, I'm so sorry, but I promise you will eventually have your baby. It is agonizing.

So yeah, so that was kind of like going around in the background. And then at my 39 week OB appointment, I was actually like 39 and four days. So it was like a little bit late. And I had avoided cervical checks up until that point, just because, you know, I knew they didn't tell you much. I knew they could be painful.

But I decided to get checked at this appointment because I was starting to get a little nervous about needing an induction. My mom went past her due date with her first and I just was kind of assuming that I would. And I really didn't want to be induced just because of all the interventions that come with that. I knew it would probably make it longer. It would probably make it more difficult to go epidural free. After all of my research, I was really only comfortable going until 41 weeks. So I knew the clock was ticking a little bit.

And I had decided that I would be open to a membrane sweep as a more natural way to get labor moving. So I decided to get checked. And I was not dilated at all. You have to be at least a centimeter for them to do the sweep. So I was, of course, very crushed and sad. But I did have a meeting with my doula right after that appointment. And I remember her saying, like,

We're not even going to think about the induction until your 40-week appointment. I was already kind of going into planning mode, and I was like, what are we going to do? And she was like, just don't even. We're not even going to talk about it. We're not even going to think about it. Just focus on right now, just do all the things that you can do to try to get labor to come on its own. And I was doing all of the things. I was walking lots. I was spending lots of time on the yoga ball, doing the mile circuit, eating the dates, literally all the things.

My due date was July 1st and that day came and went with nothing but pyjoma labor. So on July 2nd, I had my 40 week appointment and I was dilated to like a fingertip, but it wasn't enough for them to do the membrane sweep still.

I did have a conversation with my doctor at that point about what the induction would look like. And she was actually open for me to do an outpatient fully balloon, which I was really excited about because that meant that I could still labor at home, which was something that was really important to me. So I left that appointment feeling, I think, more hopeful. And we scheduled my induction for July 8, which is I would have been exactly 41 weeks at that point.

So that was July 2nd. And on that same night of July 2nd, which was a Tuesday, we went out to dinner with a friend and I started to get the contractions while we were there. And this was like a pretty typical pattern of like right around dinner time or like before bed, I would sort of start to get these contractions.

I assumed they were the same, you know, progeroma labor that I've been having for literally ever. But I came home just like did the mile circuit. I pumped a little bit, which my OB had, you know, given me the OK to start doing.

and we went to sleep and I woke up a few times overnight and the contractions were continuing and they were feeling like a little bit more period cramp-ish. But I was able to like go back to sleep so I wasn't getting my hopes to up at that point and you know kind of like getting up to pee in the middle of the night. I thought maybe I was losing parts of my mucus plug but I like wasn't sure you know.

And then I woke up for the day around 5.30 in the morning and I was still having the contractions. And so that's like the first time that I let myself get a little excited because I had never woken up in the morning to like still having the contractions. So it was now July 3rd, which was a Wednesday.

And that was my last day of work before maternity leave because we had July 4th off. And then I had just taken that Friday off since my induction was scheduled for Monday. And I told myself, if I'm still pregnant by July 4th, I'm not going to work after that point. And then my husband had also taken a remote elective rotation. So he was working from home as well.

So we decided to just go for a morning walk, which we had been, you know, trying to do a lot before work. And we walked about two miles with our dog and I was still getting the contractions. And so I was kind of like, you know, feeling a little bit more excited. I wasn't timing them yet. I was just, you know, kind of like letting them come and they were feeling a little bit more crampy, but nothing kind of crazy yet. So we got home. We both worked from home.

I was just sort of sitting on the birth ball at my computer most of the day, just taking breaks to walk around and things like that. And by about 1.30 in the afternoon, the contractions were a little bit more than five minutes apart and they were starting to feel more intense as they were coming on. So I kind of remember like sort of feeling like, okay, like we're making progress.

at that point, but I decided to just kind of keep going. So I kept working for the rest of the day. And when I finished work for the day, we went for a few short walks just kind of up and down our street. And then we're just sort of resting at home. And I remember the contractions would get

more intense with walking and then they would slow down and like space out if i like lay down on the couch and i was kind of stressed out by that because i was like maybe this is still pyjoma labor you know like i don't feel like they should be spacing out when i'm at rest but i was also trying to rest because i knew that was very important in early labor.

So I was just kind of going back and forth and kind of gaslighting myself a little bit like, maybe this isn't real. I didn't even text my mom who was, you know, like on call to watch our dog until later in the afternoon because I just, I didn't want to sound the alarm too soon. Even though I think I kind of knew this is it, I just didn't quite want to let myself believe it. So.

Around 7 p.m. I started to get frustrated because I was like they've been the same for a long time like it had been about five hours at this point and they were still like about five minutes apart. They weren't quite a minute long yet and they just really like weren't getting closer together more intense.

So I called my doula, the same one that I'd been working with throughout my pregnancy and she said, you know, why don't you try getting in the shower and just like relaxing a little bit and see if you're still getting the contractions at that point and then, you know, maybe try pumping and see if that like will speed things up at all.

I did. I got in the shower. The contractions were still coming. They did slow down a little bit in the shower, but they were still coming. So then I got out and pumped. And all of a sudden, the contractions were three minutes apart and a minute long. And I was like, okay, I guess we should go. It was just like, yeah, it's a big shift.

Yeah, and it was like very sudden. So we decided to leave for the hospital around 830, and my husband did frantically lose his phone while we were packing up the car. So that was, you know, just like a fun wrinkle, but it was fine. And the drive to the hospital, we live about 20 minutes away. It wasn't too bad. It was definitely like painful when a contraction came, but I was like coping okay. And I remember wondering if we were going in too early because I was like, I feel like I'm still like, okay.

You know, so we got to the hospital around nine and had to go through triage and, you know, got hooked up to the monitors and everything, but I was still able to stand and walk around. They had like the mobile monitors. So that was nice. So they finally came in to check me around 10 p.m. And I was three centimeters dilated, 90% of face and minus two station. And I was like pretty jazzed by that because

like if you remember just the day before was when I was like barely a fingertip and talking about an induction. So I was like, okay, you know, things are happening. And the resident who checked me, I remember she said she was like, cervical checks are an art, not a science. And you know, you feel very labory to me. And I was like, okay, great. So they gave us the option to stay or to go home. And I decided to stay just because I was like,

20-minute drive home, 20-minute drive back, plus going through triage. I kind of just want to be in my space. We had brought all of our tools, all of our things, and I was like, I just want to go and start this thing.

So we decided to stay and around 11.30 p.m. our doula, the doula on call arrived and we got moved up to our labor and delivery room. And our hospital has a few rooms that have tubs that unfortunately all of those were being used. So we got a room that has a shower instead. So we spent the first hour or so just kind of trying out different positions, trying different coping skills that we had learned in our class.

And I learned pretty quickly that I had to be standing or be upright. Anything on the bed or horizontal was just much more painful. So I was doing a lot of standing, being on the yoga ball, things like that. My husband was using a lot of counter pressure. He was using a tennis ball on my back. So all that was really helpful.

And then around 1 AM on July 4th, who are now on July 4th, I got in the shower, which brought a ton of relief. That was really great for about an hour I was in there. But unfortunately, the monitors that they had kept sliding off, and they would pick up my heart rate, and it was just a whole thing. The nurse kept coming in.

And I had indicated on my birth plan that I was okay with either mobile or intermittent monitoring. And they had just put me on the mobile monitors because that's kind of like the standard. But the nurse came in and she was like, hey, we got the okay to put you on intermittent monitoring just because these things keep sliding off. But we do have to get a good strip on the baby first. So she was like, can you get out of the shower for 20 minutes? We can get a good read on the baby and then you can do whatever you want. We'll take the monitors off.

I got out I was still able to stand and everything which is good so about 20 minutes they got the read on the baby and then I was able to be off the monitors for I think an hour and then you know had to get back on every 20 minutes.

And I will say, you know, I felt very, very supported by my birth team. You know, the nurses, the duals, the doctors, like everyone was very, very respectful. And the nurses were actually very hands off, which is what I wanted. Like I kind of just wanted to be in my own little world with my husband and my doula. But you know, anytime that I asked for something, they like did it super quickly and responded and just were so, so kind and like non judgmental. So I'm just, I feel really fortunate to have had such a great team.

Yeah, that's wonderful. So I ended up staying out of the shower for a bit, spending a lot of time on the yoga ball, and things were definitely getting a lot more intense. And I was having a harder time, like coping as the contractions came around 3.15 in the morning. I got super nauseous and threw up, so I requested Zofran. I didn't have an IV, but I did have the, like, hep block, so they were able to

just administer it right away through that, which was really helpful. That brought great relief. And so the OB on call who we had talked to when we had gotten into labor and delivery said that their policy was to check you every four to six hours or upon request. So they were like, we can do it sooner or later. But if you don't have any other preference, we'll do it every four to six hours.

So we were sort of approaching like the five hour mark. And I remember talking to my doula and my husband. And I said, when they checked me, I was like, if I'm more than five centimeters, I'm OK with just kind of continuing on as we have been. But if I'm less, I think I want some sort of pain relief or something because we're approaching 24 hours without sleep here. And things weren't unmanageable. But I was definitely just getting tired. And I was like, I kind of just need a little break.

And I knew about the IV pain meds as an option. And I was like, I think maybe I want to try that because I know you can only have that when you're early on in labor and that it's short acting. So it's something that they could just give me and then it would wear off. So the OB came in around 3.30 AM. And so that had been like about five hours since my last check. And she felt around for a long time. And then she was like, how much did you say you were dilated before?

And I was like a three, and she was like, yeah, you're maybe a four. And I was like, I was like, OK, perfect. So that was very disheartening. But I had my plan. And I was like, OK, well, let's try the IV pain meds. And so she was great. She went over the benefits and the risks explained everything to me.

If you told me I should get about 30 minutes of solid relief and then it wears off completely after about two hours. So I went ahead and got the IV pain meds and it honestly didn't really help the way that I was hoping. I think I was hoping that I could take a nap and then come back and be all energized and ready to go.

It doesn't fully take away the pain. It just sort of dulls it a little bit. And then on top of that, trying to take a nap, I was horizontal in the bed, which was the worst position for me to be in. So I maybe took a little bit of a rest, but I didn't really get to nap or anything like that. And I was still feeling the contractions coming on. So after about 20 or 30 minutes when it was wearing off, I started to sit up in the bed. And as I was sitting up, my water broke.

which kind of like freaked me out a little bit. It definitely felt like a water balloon popping, which I had heard people say before, but it was just like so sudden. I was like, whoa, you know? And I think the combination of like my water breaking and then the pain meds wearing off at the same time just caused things to like really intensify all of a sudden. So that was the point where I started to have a very hard time coping. And I think what I didn't

Expect was like the emotional impact that that would have on me and I was kind of starting to like panic as each contraction was coming I was feeling you know scared feeling out of control and I think this is like the point where I was starting to like reconsider my birth plan and

I was definitely in that fear tension pain cycle that they talk about. I remember hearing about that in my classes and in my reading of just how your emotions can contribute to feeling tense in your body and then that can actually make the pain worse. So I knew that was happening, but I just couldn't really relax too.

stop it from happening. So I decided to ask for the nitrous oxide, which I had always had that on my birth plan as something that I was very open to. I'd heard people having success with it. And I thought that maybe it would help me to be able to relax a little bit more, because I knew I needed to do that.

Around 5 a.m. they came with the nitrous and they actually consented me for the epidural at the same time and at first I was like kind of put off by that but the anesthesiologist was very kind about it and he said you know he's like if you're even considering it you might want to consent to it now because you actually can't consent to it while you're on the nitrous oxide because you're considered to be like under the influence huh

Um, which I did not know. So they said, you know, there are policies that I would have to wait at least 15 minutes being off of the nitrous in order to sign the consent for the epidural. And, you know, if you really want the epidural 15 minutes, I think it was like an eternity. So I decided to just sign the consent for the epidural at that time. I was like, you know, I have nothing to lose.

So got the nitrous around 5 a.m. And I know that works great for so many people. I've heard so many good things. But for me, it just really did not. It made me feel dizzy and out of it for each contraction while it doesn't provide any relief from the pain. That's not its intention. But it didn't really help me to relax. It didn't help me to be able to cope with the pain any better.

And again, on top of that, I had to stay in the bed with it. And that was just like made things feel so much worse. And I think like in hindsight, looking back, my one regret, like I really don't have very many regrets for my birth, but my one regret is not trying to just like get back upright and like get back in the shower before trying the nitrous because that was like the one thing that had actually brought me relief. And I think I just sort of jumped to the nitrous and thought that that would be sort of like the next step.

So I was on the nitrous for about an hour. And then finally around 6am, I decided to ask for the epidural. And both my, my doula and my husband were like, you know, are you sure? And I was like, yes, you know, I'm sure I was just like really struggling through the contractions and just those feelings of like being scared, feeling out of control. And just like, I was not feeling empowered. You know, that's like the opposite of how I wanted to feel in my birth.

And I think on top of that, I had no idea how much longer I had to go since in my head, I was like, I hardly made any progress in five hours, like, you know, who knows how much longer I have. So I was definitely like disappointed at first, but I remember my doula at one point, my husband stepped out to go to the bathroom. And I remember her saying just like very simply, she said, you deserve to enjoy your birth. And that like really helped me like that one sentence because I was like, yeah, you know, I'm like not,

I'm not enjoying myself right now. I'm not having a good time. I'm actually feeling really scared and really anxious. And I would like to enjoy this experience. I wanted to enjoy this experience. So at this point, I had been in labor for like over 36 hours. So they came in around 6.30 to place the epidural. And I barely remember it. I know a lot of people

talk about like the needle and like I don't remember any of that because I was just like really kind of going through it with the contractions. And so they told me that it should fully kick in after about 30 minutes. So 7am came around and I was still feeling a lot of pain like still really feeling the contractions coming and not feeling a lot of relief. So they sent the anesthesiologist back in and this was not funny at the time but I think it's hilarious now. They used an ice cube to determine if it was working.

So they took the ice cube and were putting it on different parts of my leg. And they're like, can you feel this? Can you feel this? Oh, I have not heard that before. Yeah. I mean, I guess it makes sense, but I just think it's funny. So the anesthesiologist was like, it is working. It's just not strong enough. So they just gave me a bolus of more medication and that worked. So by about 730 in the morning, it had kicked in fully and it was really

really a game changer. I could like literally feel my body relax and I was just able to like talk and laugh and be present. And I remember being like, you know, I admit I was wrong. The epidural is amazing. But you know, like, of course, the physical pain was gone, but I think the emotional difference for me made it so worth it. And I don't hear many people talk about

about that part but like I went from feeling so just like scared and out of control in my body to just feeling like really relaxed and that I was able to be present. You know I mentioned I'm a therapist and like I talk with clients a lot about like trauma.

responses and I think my brain was just in like fight or flight mode and hyper arousal and just like the amount of tension that was going through my body and I you know I knew that I needed to relax but I just wasn't able to access that and the epidural was able to help me do that.

And I just really kind of felt like I was able to be in the room again. So that was great. They came to check me right after it had fully kicked in. They actually had tried to check me earlier around seven when I was still in a lot of pain. And my doula actually advocated for them to come back. She was like, yeah, no, not right now.

And so when they checked me, I was 7 centimeters dilated, 100% effaced, and minus one station. So I was thrilled with that progress. And even though I was a little sad about getting the epidural, I was really happy to have progressed that far without an epidural. And just in general, to have gone into labor on my own and avoided the induction, my water broke on its own. I didn't need any augmentation. I was just really happy that all of that had happened.

because those were all things that were really important to me. So I was definitely feeling like really proud of my body and my preparation at that point. So right around this time, like the 730-ish mark, the doctors and the duals actually change shifts. The duals are only on call for about 10 hours at a time.

Our new duel came on and she was amazing. Our first one was amazing as well. She was a little bit more hands off and just kind of available if we needed her. But our second one, her name was Kiara. She was so great and she was a lot more hands on and she gave

like tons of suggestions. She was constantly moving me in the bed with the peanut ball to try to keep the progress going. She talked to me about the pushing stage, which I was feeling really nervous for, because I had planned to push intuitively without an epidural, and she just gave me so much guidance and reassurance about what would happen.

who would be in the room, you know, how my husband could help me, how I could breathe through, you know, the pushing and things like that. So she was amazing. And the next few hours, we kind of just spent our time talking to her. I talked with my husband. We had curated a bunch of like funny TikToks to watch the just like past the time during labor. And so we watched those. I was able to take a nap. So we just had a couple of good hours of just being able to relax.

And then around 11 AM, they came to check me because I was starting to feel some pressure and I was complete at 10 centimeters, 100% of face and plus two stations. So I was ready to push. And I had let the nurse know that I wanted to push on my side, given that I had the epidural. That was one of the positions that I knew I could still do while having the epidural.

And she said, she was like, well, would you mind starting on your back so that I can see how you're pushing and I can give you feedback? And then after a few pushes, you can switch to your side. And I was like, sure. But the first contraction I pushed on my back and the baby's heart rate went down. And it was kind of slow to recover.

And I remember kind of like being really nervous at that point because I was like, oh man, like after all of this, all this time, all this prep, I'm going to end up with the C section. But the nurse was super kind and she was like, you know what, scratch my plan, let's go with your plan, get on your side and let's try that. And I did. And from that point on, the baby's heart rate was totally fine. So much preferred pushing on my side.

And I pushed for about an hour and it was honestly so peaceful. I had an amazing epidural, like I was really feeling no pain, but I was still able to move my legs. I was able to change positions and kind of get on both sides relatively easily. We had music going, my husband and I were talking, like it was just so peaceful and so nice.

And so at 12.08, she was born. And we didn't know the sex. And I was honestly so just immediately overwhelmed with emotion and love that I forgot about that. And they went to put the baby on my chest. And the OB was like, oh, wait. And she lifted the baby up to my husband. And he was like, it's a girl. And I was like, yeah, I was just so happy and just immediately so just flooded with emotions.

You know, it was, it was amazing. Oh, I love that. Did you have notes from your team? I feel like you have the timeline and everything so well remembered. I did, yeah. Okay. I love it. It's like it creates a great image, but yeah, not everybody has like specific times and everything.

Yeah. We had been like sort of taking our own notes and then like I went back and looked at my chart too. Smart. Yeah. Awesome. Okay. So then how was your immediate recovery and longer term postpartum? Yeah. The only like very minor complication I had was that the cord of Volst or like it came off basically when they went to put her on my chest because she had a short cord. So basically like they went to pull or put her on my chest and the cord came off.

So the OB was very calm about it, but she said, you're going to feel my hand inside you because I have to manually remove your placenta because it starts to basically hemorrhage at that point when the cord comes off. So that wasn't fun, but also I was very grateful again that I had the epidural for that and that I didn't have to feel that.

But once they manually removed my placenta, it was fine, and they were able to control the bleeding, and they used the protocol from the hematologist. So everything was fine there in postpartum as well. My bleeding was fine, so that was good.

Postpartum generally for me was for the most part really positive. We were really fortunate to have like a full term healthy baby who has a wonderful temperament. She's great. She's been a pretty good sleeper from the beginning and we also have family in the area. So I think

All of that helped to just make the transition a lot easier. My husband was able to work remotely for her first three weeks of life. So we just had a lot of time together. The only like slight snafu actually came when she was about two months old. She went through like a bit of a nursing strike. And this actually happened while my husband had COVID. So he was quarantining in our guest room, which was just like very unfortunate timing.

Yeah. But sort of like out of nowhere she just didn't want to latch and she had done it, you know, a couple times before when she was really overstimulated like at the end of a long day or like after seeing a lot of family or going out a lot. But then, you know, during this one week she just was doing it almost every time we were trying to nurse and it just kind of would like escalate where

you know, she wouldn't latch and she would cry and then she would get really worked up. I would take a break and then she would end up being, you know, super hungry and crying because she was hungry, but then like still was worked up and not able to latch. So that was just really stressful. Yeah. Especially because we hadn't had any nursing problems leading up to that. Like she had latched right away. You know, we've just super easy breastfeeding journey up until that point, but

We did have access to a lactation consultant through her pediatrician's office, which was really great. They weighed her and she'd actually lost an ounce since her two-month visit, which had been like not quite a week ago. So that really stressed me out.

that came with like more weight check appointments because like everyone kind of freaks out anytime a baby loses weight but the lactation consultant was helpful in trying to like help us troubleshoot what was going on and we still like don't really know exactly what causes it like our best guess is either that she was just sort of in that phase of beginning to be a

aware of the world and was just overstimulated or possibly she had COVID since my husband had it. She didn't have any other symptoms, but they were like, you know, maybe this is, you know, sometimes like not wanting to eat can be a symptom in babies. So we tried like a million different things, you know, different positions, nursing in a dark room. We were, you know, trying the bottle and switching to nursing, all these things. But

Ultimately, I think the thing that actually worked was sort of like taking the pressure off and just trying to feed her more frequently and just kind of going off of her cues. And if she refused, I would just like immediately stop instead of like letting her get worked up. I would just like, okay, like you're not hungry right now. Try again in like 10 minutes. So that, you know, we kind of eventually got more into a groove. And now at four months, she's doing a lot better. Sometimes she will still refuse, but I just, you know, take the pressure off.

like okay you're not hungry and yeah just kind of let her decide when she is. That's good yeah that's so stressful when you know they're hungry and they're just it feels like they're just like screaming at your boob and you're like I don't know what to do it's yeah so emotional yeah it definitely is but yeah otherwise things have been great. All right you mentioned a couple good books and other things anything else you want to mention here at the end.

Yeah, I mean, those two books that I mentioned were really helpful for me. I think the natural hospital birth book just has a lot of really insightful ways to think about your birth plan and just sort of your view of birth and what's important to you. And the pelvic prep school book, like I said, has that circuit of exercises and also talks about

uh, pushing positions and things like that. So both of those were super helpful. And then the other thing I just wanted to mention was the dual program at my hospital. So it's McGee women's hospital in Pittsburgh. It's the birth circle doulas. So they are free for anybody that wants them and my experience with them, you know, was really, really positive. Awesome. All right. And then what's the best way for people to connect with you? I think just through the, leaving a comment through the show notes would be great.

Okay, perfect. All right. Well, thank you again so much for sharing your story. Yeah, thank you.

Now I'm going to talk with Ryan from Needed. And don't forget, you can use the coupon code BIRTHOUR at thisisneeded.com to save on subscriptions and single products as well. All right, let's hear from Ryan. Hi, Ryan. Welcome to the BIRTHOUR. Thank you so much for coming on the podcast today to chat with me about Needed. I am so excited to be here. Thank you for having me. Of course. Before we get into the discussion, will you tell people just a little bit about you and your role at Needed?

Absolutely. So I'm Ryan Woodbury. I'm a co-founder and co-CEO of Needed, along with my business partner, Julie. I'm based in Los Angeles, California. I'm a mom of two, or we joke and say four, because I have a two pretty wild rescue mutts that make it feel like we have four kids in there just two sometimes. And let's see. I am a trained holistic nutritionist.

lifelong sort of passion for the intersection between human health and environmental health and never expected to end up in the supplement space but kind of did and you know a fundamental belief that sadly now kind of supplementation is widely needed due to mostly environmental factors with

you know, extra pollution, soil depletion and just stress that we're all kind of facing from our environment, sneaking more supportive supplementation, being a critical focus, especially at the perinatal life stage. So before, during and after pregnancy, where we spent a lot of our time at needed. Yeah. Okay. So will you tell us a little bit about what makes needed unique and what this, you guys use the term needed standard? I would love to hear more about that.

Yeah, absolutely. I think it really comes back to we know unequivocally that nutrition has the power to change health outcomes both for mothers and for babies and we're not just talking about birth outcomes but this is really fertility pregnancy postpartum and lifelong health thereafter.

We found that despite 97% of women taking a prenatal, 95% of them were nutrient depleted. And so, and if Julie and I were pregnant at the time, we would have been one of them despite, you know, as an environmental science major in school, focused on food systems. And ultimately, we realized that current prenatals were not cutting it. And we really wanted to set women up to thrive, which means ultimately avoiding

So what we're advocating for is that a new sort of needed standard, which takes into account more replete of dosing to really support women to thrive and pushing for this new and better standard can be standard of care at some point for all.

Okay, so there's so many prenatal vitamins out there, so many choices. It can be overwhelming. What are, let's say, the top three plus things to look for when you're choosing a prenatal? I think three big things to pay attention to is one, sort of nutrient form. The second is dose, and the third is confirmation that what is in the prenatal

that you want is there is actually there so that really comes back to sort of are you getting the full nutrients that you need in the right forms that your body can absorb and you know is dose appropriate to actually support your health and then lastly the company doing the right sort of validation that

Hey, the ingredient that we say is there on the label is actually showing up. And things that you don't want in there, whether it's heavy metals or gross fillers or certain nutrients that interact with each other, are removed from the product as well.

That makes sense. And I know you guys have a really helpful kind of breakdown of all these things on your website that I will link to, because it's overwhelming, as I mentioned, when you're looking into it. Can you talk a little bit more about why bare minimums aren't going to cut it, especially for my listeners who are mostly those that are trying to conceive, pregnant, postpartum, dosage is a really big thing for you guys with your prenatal powder.

getting in as much as you can and everything, but just kind of how you guys figured out that so many of the vitamins out there were just giving people the bare minimum. Yeah, I think it fundamentally comes back to at this life stage, we really want to support women to thrive. And before during and after pregnancy is really some of the most nutritionally intensive time periods of a woman's life.

And basically what most prenatals are designed around the RDAs as a kind of like original governmental standard is designed around how do you avoid a disease condition, not how you set someone's body up to

thrive. And it's there in the data. We wrote a 50-page white paper with over 600-sided studies around why more supportive dosing like our assortment is important to changing outcomes. And it really is around how do you set your body up for success such that it has what it needs to support more optimal outcomes for both you and your baby.

Okay, so what supplements do you think that people should be considering, especially during this phase of trying to conceive pregnant postpartum?

Yeah, so certainly the two that are most important is a supportive multivitamin, but you want to look at sort of, you know, more supportive dosing. So an example of this would be 4000 IU is the clinically studied amount of vitamin D that is safe and effective during pregnancy. Most pre needles have sort of far less than that.

or 400 milligrams of choline is the minimum recommended amount for pregnancy and most prenehiddles have far less than that. So paying attention to this more supportive vitamin and mineral blend and then really getting by with a omega-3 DHA EPA.

as well as the two sort of core products and those are, you know, two of our we make three multivitamins and we have two omega-3s that we make. They are among our top selling products and that's really your foundation for this life stage. Though we also believe that too many companies have really made a single kind of prenatal or mega skew and quickly moved

past this customer, and we think that this is a woman that has many, many needs beyond those just basic nutritional needs that you need from a multivitamin and omega-3, whether it's helpless sleep or help with blood sugar balance or stress management, and we've really created skew assortments around those needs that all work together in a system to really set women up for success.

Yeah, I love that there's like the core products and then there's more that goes beyond that. And I know you guys are always coming out with new things. And one of the newer ones is the cognitive support. Can you talk about that? I know you personally have been using it. Yeah, absolutely. Cognitive support is one of my favorites. And it really came out of my first postpartum experience.

where I struggled in my transition back to work. I think the balance between breastfeeding, trying to show up for my new child and feeling like myself again at the job was something that I think I underestimated how big that transition was. And turn to nutrition.

And that has continued to be a game changer for me in really creating a breastfeeding safe option that helped me feel like myself again through supporting and really focus attention, memory and some of the other kind of mental faculties that are important for kind of assuming that the career side of things while also balancing even the stressors at home of just like moms at home have a huge amount on their plate as well and keeping track of how am I going to make dinner tonight.

What are some of the things in the cognitive support that are helpful for concentration and focus and things like that?

So basically our cognitive support combines nine targeted sort of new trophic and botanical ingredients that support focus, attention, brain health, memory, and they alleviate some brain fog and eye fatigue. And they are things like some of your medicinal mushrooms. We have some coldening derivatives like alpha-GPC and phosphatidylserine, and then some herbs like ashwagandha, focopa,

And, you know, Lutinansi is Anthem that really support the I fatigue that I think drives a lot of cognitive impairment with how much time we're spending on our phones and computers. Okay, so I feel like a lot of people are going to be interested in this one because we all deal with the brain fog. And this is one that is intended for after babies born, right, not during pregnancy.

This one is intended for after babies born exactly. It really, I think, was that, you know, the transition to motherhood, your brain goes through a transformation, and that transformation is exacerbated for breastfeeding moms due to hormone interactions between prolactin and dopamine, which are antagonists to each other.

So we really designed this as that like mom coming back into feeling like herself in this postpartum period, but it really then sets her up as something that she could take for life thereafter and supporting through, you know, kind of the mental toll that motherhood takes and some of the, you know, the next cycles of womanhood and perimenopause.

I'm just nodding along, like I remember, especially in that newborn phase, like that feeling when you have the word, like just on the tip of your tongue, but you can't think of the word and the brain is so real postpartum. It's very real. Yeah, there's a reason that people call it, you know, bomb brain and some of it is literally your brain is restructured and then some of it is certainly hormonal and people will make the argument that like a lot of that brain restructuring is

natural that we want to prioritize being with our child and not worrying about work and I certainly like very much resonate with that and the reality of life is that you know we live in a much more kind of fast paced world and we often have to be in between you know our like you know snuggles with our babies and whatever the rest of life reality is and really wanted a safe and effective product to

help women feel fully like themselves. Yeah, I love that. I love that you guys are like developing products for all stages and phases. And we will be sure to link to everything on the show notes, including discount codes. And you guys have some great bundle options and things like that. So I hope everybody will check it out. And I really appreciate your time today chatting with me. Thank you so much, Bren. I appreciate it.

Thank you so much again to Saskia for sharing her story with us and, of course, to needed for sponsoring this episode. Hope you guys will check out there, especially their subscriptions where you can get kind of everything you need in one place. I've been sharing about it more on Instagram. I have a highlight reel there of some of the things I've tried from needed.

And then, of course, use that coupon code, birthhour, at thisisneeded.com. Everything is always linked on the show notes, which you can find by going to thebirthhour.com and just searching for the guest's name and the search bar. Or you can just look in the podcast app where you're listening to this episode, and I try to include all the links in there as well.

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.