by Informed Pregnancy and Parenting Project | Mar 28, 2023 | Labor and Delivery, Podcast Transcripts, Pregnancy
Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I’m your host pregnancy-focused chiropractor. Dr. Elliot Berlin. My guest today

Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I’m your host pregnancy-focused chiropractor. Dr. Elliot Berlin.
My guest today is a birth doula, an educator, nutrition consultant, skincare company founder, and now, brand new mom, Carson Meyer. Welcome back to the podcast. You’ve been here before.
Carson: Thank you so much. I have. But it’s been a while.
Elliot: Five years?
Carson: It’s been five years?
Elliot: Yes. Has anything changed?
Carson: So, much. Oh, my gosh. But I remember being like a newer doula when I came on your podcast. Yeah, so much has changed.
Elliot: And then, you rose to the top for a million reasons and you became like the most sought after doula. Let’s start at the beginning. Where are you from originally?
Carson: So, originally, I’m from Malibu, California. Now, I’m living in North Carolina, right outside of Ashville.
Elliot: How did they compare?
Carson: They’re very different. Both really special places with really special people and views. But I went from oceans to mountain. And, you know, Malibu is always very mellow. but I think it’s so close to LA and the life that I knew and grew up in. And so, this is just so new and so calm and relaxing.
Elliot: Do you miss the ocean?
Carson: I do. I mean, aside from my friends and family, that’s like I think the one thing that I don’t have here.
Elliot: Because you grew up in the ocean.
Carson: Yeah.
Elliot: Well, things change. Maybe Asheville will get a notion.
Carson: Maybe. At this rate, we might, you know.
Elliot: Sadly. So, you’re a birth doula, and you’re birth doula long before you’re a mom. How did that come to be?
Carson: Becoming a birth doula?
Elliot: Yeah. Like, was that an original, “Hey! I think I’ll be a birth doula.” Like when they say when you’re 15, what do you want to do when you grow up?
Carson: Definitely not. Well, I always say that I think it really started with my mom’s birth with me. Although I don’t remember it. I think that I was so drawn to the work when I found out what the work was because of my own story. So, it goes way back. But I went to NYU. I had no idea what I wanted to do with my life and I was lucky enough to go to a school called Gallatin, where you just create your own major.
So, I was taking Women’s Health classes, alternative medicine, mind-body, eastern medicine. I was just taking my interest and bringing them together. And looking back, I didn’t know what a doula was. But so much of the curriculum that I had created pertained to the work I do today. And in one of my classes, they signed “The Business of Being Born,” which was the first, you know, like so many of us birth workers, I think the first introduction really to this work. And the first time I saw a video of birth that wasn’t the scary Hollywood depiction, and was really just taken aback. I realized my reaction to it was not normal. I’m not everybody cries and talks about it for months on end like I did.
And then, I moved back home. Met my partner, Jonathan, who, you know, now, the father of my child. But he invited me to a birthday party. And we were like a month into dating and I met a midwife, who was a friend of his. And it was the first time I met a midwife, Haley, who you know was not my gynecologist, or a birth worker, or somebody who got to do this work that I could relate to. And was like, “Oh, wow!” Like, I just was captivated by her. I stalked her all night. And she told me she had started as a doula. And then, I took the training and really never looked back. It’s just was a calling.
Elliot: It makes sense you’re both like so special and unique. There are certain things that are in your hard wiring. For both of you, it seems to me like this type of work is in your hard wiring. Like, it’s just like you were meant to do this. I don’t know if I ever told you this, but I tell people that about both of you, you and Haley Oaks, that there’s no question in my mind that in a previous life, you were an extremely busy and high demand midwife.
And then, I also have like the honor of being out of birth with you more than once. You’re like a little mouse in there so quiet but so powerfully supportive. To see something so gentle be so powerful is rare. And again, for both of you, long before you had kids.
Carson: Haley and I really had that in common, which I think was why meeting her was so impactful is. We’re both didn’t have kids and we were both young for the job. That was something I was so insecure about in the beginning, but it’s always nice to meet people who do the work without having none of them do the work themselves.
Elliot: Sometimes, you hear people, “I don’t want to do that who hasn’t been through it.” And then, both of you rose literally to the top of the demand chain because it’s so much bigger than that.
Carson: Yeah. I always say, you know, it’s not my journey. That’s I think it’s actually going to be harder now having had kids, to separate from it. I think there’s something so wonderful about a doula or midwife without kids is it’s never a projection. Not that if you have kids it is, but you have to do the work to step away from your own experience.
Elliot: I am honored that you came and that we’re going to talk about your birth experience. But I always wondered about both of those. Going into your birth having had so much experience at other people’s births. How that may or may not have affected you. Now, that you have your own experience, how that may or may not change your supporting of other people down the road.
You mentioned “The Business of Being Born.” That was more than any other film. That is when I asked somebody, “What are your birth intentions? How did they come to be? What kind of research did you do?” It’s the number one thing that people mention. It’s what sparked me. We just launched our streaming service Informed Pregnancy Podcast. It’s what really sparked me to want to do that is to have a home. Because people were saying, “I don’t know where to find it.” To have a home for that film, and other birth documentaries, and web series, and just build on that a whole community of entertaining and informational video content. And, of course, it’s so far, we just launched that. It’s the number one thing that people are watching. So, 15 years later.
Carson: Yeah. It’s so true. I have chills thinking about it. I know that they know, but I don’t even think they know the extent of the impact that the film had on people and their lives, and generations because of birth.
Elliot: Yes. So, many references even just on this podcast to people who said “The Business of Being Born” changed my life. Even though…
Carson: Your podcast, too! It’s so fun being in the age [unintelligible 07:09] and my friends are starting to go on their journey and their loving your podcast. Of course, my clients love it and I tell them to watch it. But it’s fun though like coming up in my social circles of friends being like, “I heard you on Dr. Berlin’s podcast,” or “I’m listening to this.” They’re coming to me, talking to me about birth for the first time because of you.
Elliot: Oh, thanks. I’m a tiny supporting role. But also, I work long hours. It’s like people have like, “How do you do 12 hours a day?” I’m just like, it’s the most crazy thing like I get to help people who are making humans, whatever it is that I’m putting in is the tiniest little ingredient in the mix. So, I feel honored to be a part of it and to be accepted into that world.
In addition to birth doula and education stuff, you also do some nutritional consulting. What’s your background there and what’s your approach?
Carson: Yeah. That’s a little bit newer for me. I started “Growing Together,” which maybe I’m skipping ahead. But that’s my virtual circle. My next one’s actually coming up in March. But it started early COVID, when I saw the isolation, lack of support and community and not having doulas in the hospital. So, I created this circle that is about 20 expecting moms. It’s so special. We go through everything from healthy pregnancy, nutrition, bodywork. Everything from in and out, the whole picture. Through preparing for birth, breastfeeding, postpartum.
And so, in that class, I started noticing I would talk about nutrition, which is a passion of mine and something that had played a huge role in my life. I was asking, “You know, how many of you are talking to your doctors about nutrition, or midwives? Or what do you know about gestational diabetes?” And every time, it was like one or two people would raise their hands. And they always had midwives. It was never as if they were with no [unintelligible 08:59].
I was like, yes, I’m passionate about this but I didn’t feel like I had formal training to be able to really support my clients in that area. But I know how important it is for life, but certainly for pregnancy. I was like, if this isn’t a conversation that’s going to be happening in the 10 minutes in your OB’s office, I want to be able to have those conversations.
So, I took a training online through the pandemic. And now, certified nutrition consultant for pregnancy and postpartum. And so, it’s something I just weave into the classes, and now, with my clients and then offer it separately as well. Because I now going through it myself, just know firsthand how big of a role it played in my journey.
Elliot: Yeah. I don’t know your specific approach, but it’s one of the things postpartum in particular that I see it’s one of the building blocks that gets lost sometimes where everything else is going on and so normally if you’re at least having great nutrition, your body can weather some of the other changes better. But that just falls apart, exercise falls apart, self-care in general falls apart, support’s not there.
I noticed something this week actually, just like a big epiphany. Because I’ve had several people want to do the 40 days postpartum, like home and not leave the house, which in some way seems quite beautiful and traditional, not just in one culture, but in many cultures. And so, it just seems like there’s a lot of logic there. But what I realized, the difference in Los Angeles anyway, is you’re self-isolating. It’s not like you’re not leaving your house a hundred years ago in a culture that did this where you lived with all your family and you were not leaving your space. But everybody else was there to support you, to cook you all these nutritional, rich foods, and to help with the baby and to support you if you were struggling in terms of lactation or anything else, make sure that you got plenty of rest.
I’ve now seen several people give up in the 40 days. I thought it was going to be amazing. I’m like, “Okay, day 26. I’m out.” And it’s just a different thing being alone without your family and without that kind of support is kind of more isolating and putting everything on yourself. So, I don’t know, maybe there’s a modern-day version of it.
But coming back to nutrition, that’s one of the things that gets lost. If you’re doing everything, that you put yourself last. My wife always says, you know, “On the airplane, you put your mask on before the baby’s mask in. In this sense too, you’re almost not helpful to the baby if you’re not taking care of yourself.”
Carson: Totally. And it’s easier said than done. That’s the tricky part of nutrition is you can know, you can talk about it, you can have an understanding for it, but you can’t just snap your fingers and it’s there. It needs to be, like you said, a foundation of support. Especially in those first 40 days when you have very little time to be, or nor should you be cooking for yourself.
Elliot: Yeah. Well, now, I want to take your nutrition class. Is there a separate nutrition — or is it one-on-one coaching?
Carson: I put the nutrition in “Growing Together,” but I don’t have a circle for nutrition yet. But it’s a great idea. Maybe I will. But right now, it’s just one-on-one.
Elliot: Amazing. Okay, last thing before we take a little break. You have skincare, “C & The Moon.”
Carson: Yeah.
Elliot: Now, tell me all about this. Because I love your products. And, I’m seeing that scrub everywhere now. When I go to homes, when I do a handful of home visits.
Carson: Oh, really? In your clients’ houses?
Elliot: Yeah. I see it like all, you know, step in to wash my hands on the restroom, it’s in their shower. It’s everywhere. I’m seeing it around.
Carson: That makes me so happy. Especially because it’s not a product specifically designed for pregnancy and postpartum, but you know where my heart is. It just makes me so happy that it’s adding a little bit if any like just nourishment and yumminess to that time. Especially, oh, my God, the dry skin postpartum is so real. And so, that scrub and the oil has been so helpful for me.
But, yeah, I created that around the same time actually I became a doula, is when I launched “C & The Moon.” And it’s a clean skincare line for minimalist like myself, who just want to feel good, and smell good, and have a yummy luxurious product without the whole 12-step ordeal. And was really born out of necessity. I was just making it at home in my kitchen and kind of grew a cult following. And here I am, and it’s been the journey I never expected to be a business owner. Because I’m like, we’re saying my heart and my calling is really in the birth work. But I like just learning so much and loving there’s a creativity in there that I really enjoy as well. And of course, just like you said, like knowing that people like it makes me so happy.
Elliot: Yeah. It’s like something so easy you can do for yourself. And your one-word description is perfect: yumminess. I just have dewy dry skin, dry guy skin, and I love it.
Carson: The guys, I always say the men will never buy it, but will steal if from the women’s shower. And so, I’m secretly just starting now to market towards the men. Because I swear, they’re my biggest fan.
Elliot: Yeah. It’s amazing. I don’t know, it’s like a treat. You feel good. It smells great. It feels great on the skin. And “yumminess” is the best possible description for it.
Where do you buy it? Is it only online?
Carson: Yeah. So, it’s online. On my website, which is candthemoon.com, and then Violet Grey also sells it. And then, there’s some detox markets and other stores across the country.
Elliot: candthemoon.com is good for me. I don’t have to leave the house. I can stay at home scrubbing some yumminess while the next set is on the way.
Alright. Let’s take a little break. When we come back, we’re going to talk about your pregnancy and then your birth. We’ll be right back.
[break]
Elliot: Welcome back. We’re talking to new mommy, Carson Meyer.
Alright. Let’s talk about kids. Is this the time you plan to have kids?
Carson: Yes, we definitely planned this. Looking way back in my life. I don’t know when or if I ever had a plan. But this time was very intentional and planned.
Elliot: When you all your birth work leading up to — I don’t know if you keep count, but it must be a big number. All your birth work leading up to your own pregnancy, did you ever find yourself thinking, “Wow, that’ll be me one day.”
Carson: Well, yeah, I knew I always wanted to have kids. And I think around — well, that’s not true actually. I think growing up, I was really scared. I know I was really scared. I remember saying many times, being super young like, “I’m never going to do that. That’s crazy. There’s baby all around. How they come out is crazy. Raising them is crazy. Like, not for me.” I felt very disconnected to the process, very terrified of it.
I think, like most women just was taught that. That was part of cultural conditioning. What sex ed taught me was just, “Be scared of this.” But around the time I became a doula, and once I started really learning about the process, that’s definitely when I got the bug. That’s when I always saw myself in it.
Elliot: Yeah. But more specifically, different moments of birth. Like even once you were into it. Especially because you had overcome sort of a mental fear of it. Did you see things where you’re like, “Gosh, that could be me and I want to avoid that,” or…
Carson: Oh, like certain birth scenarios.
Elliot: Yeah? Or other things like, “That’s the birth I want for me.”
Carson: Yeah. I think we all know in this work that like every birth is so different. Just like someone’s life, you can’t look at it and be like, “I want that exact scenario.” It’s just there’s so much packed into it that will always be unique. And so, I always tried to kind of keep that and remove myself from it. But, of course, you know there was certain births that I attended that definitely informed and inspired what I wanted from a birth experience. I say this all the time, and it’s so true, every single client of mine has taught me so much and I feel them all. I feel every birth, and baby and mom, and that journey with me in such a beautiful way and like did through my whole birth process and pregnancy. I feel like they really helped me through. Even the hard ones, right? Even the ones where I’m like, “Oh, man! I’m on my way to hell and back.” You know, like those even still that strength that they tapped into, I think and that I admire so much is like just that’s such a big part of my journey.
But, yeah I mean, you know, there was one birth. It was actually the last birth that I attended before giving birth myself. I don’t want to put words in her mouth, but she seemed like it was completely pain-free. It was the closest thing to an ecstatic, or orgasmic, or whatever you want to call it, birth I’d ever seen. And so, it was hard not to be like, “Okay, cool. I’ll just do that.”
Elliot: Oh, I mean I could see how that would make it tough, too. Because that’s not the most common birth, especially for the first one.
Carson: But I do feel like — and I don’t need to jump ahead if you’re going to ask about it. But even though my birth was far from an ecstatic birth, it was not pain-free or easy. It was like, in retrospect, my dream birth. And everything that I would have wanted from it.
Elliot: Color me curious. But before we get to that, how was pregnancy?
Carson: Pregnancy was great. Like I said before, I think the nutrition part really was huge. I’m so lucky Jonathan’s a great cook, and he put a lot of time and effort into nourishing me through food. And through that, I feel like I was able to avoid a lot of the — especially, the first trimester crap that comes up. I was tired. I had a funny taste in my mouth the whole time, and just kind of laid low a lot. But once I got past that 12 weeks, I felt amazing.
Elliot: Were there things that helped you nutritionally that you think during that time?
Carson: Definitely. I mean I think it’s eating frequently.
Elliot: In that case, I’ll be fine.
Carson: Yeah. Eating a lot and, yeah, blood sugar balance is big. Broths, lots of bone broths. Healthy fats. Just kind of minimizing processed foods and eating a lot at home. It was so wild noticing the difference when I ate out and when I ate at home. I don’t know what that was. That was like seed oils or just the love that was cooked with, but it was hard for me to eat out at restaurants.
Those were kind of the main things. But I was just incorporating a lot of ginger, and spices, and things that I knew were going to be supportive of that trimester but also of feeling good.
Elliot: What do you do normally for exercise, and did that change during pregnancy?
Carson: I’m not like a big exercise or — I love moving. That’s really important to me, but I was never like the soul cycle maniac or high-intensity interval girl. So, that was easy for me to ease into a pregnancy movement routine that wasn’t too different. I did a lot of just yoga, stretching. You know, just kind of self-led strengthening weights.
I really liked doing the Sculpt Society workouts that are like 20 minutes. I kind of would customize them. She has pregnancy ones, but even I would just do the normal ones and really listen to my body and kind of follow what felt good for me. I like to dance. I live on top of a 4,000-foot — well, mountains — not 4,000 feet, that I live on. But I’m at 4,000-feet altitude and the mountain is so steep. So, I walked up and down there. That was a huge part of my preparation. And then, once it got too cold and I got too big to do that every day, I started just walking on the treadmill and that was medicine.
Elliot: Yeah. I mean you can’t go surfing.
Carson: No surfing. I mean, I have friends who surf their whole pregnancy. I’m just not a good enough surfer for that.
Elliot: And you’re not that close to the ocean.
Carson: I’m not that close to the ocean.
Elliot: But I mean it just sounds like you just naturally like to move, be outdoors, and move.
Carson: Yeah. I know it’s good for me, but I do love it.
Elliot: In the second and third trimesters, with your body changes and the baby development, were there any highlights for you?
Carson: Feeling those kicks, of course, it’s just the best feeling ever. They actually didn’t feel like kicks, I felt more like hands, wiggles [unintelligible 21:29] because she is, totally, she’s so expressive with her hands. I felt those the whole time. I felt her communicating with me a lot. It was really cool. I wasn’t expecting that, but I feel like I’ve known her for so much longer than the eight weeks she’s been here. I do feel like she had a very strong presence.
Elliot: You are probably very strongly present as well, I imagine. What was your plan for further intentions? What was the vision?
Carson: I knew I wanted to have a home birth, which was really important to me.
Elliot: Why?
Carson: For so many reasons. I mean, I’ve attended so many of both. I think even though birth is so beautiful in all the spaces, I just really admired the way the midwifery model. The model of care and even just the freedom, the comfort of being in one’s own home. Not just for the birth, the prenatals too, right? Having those be in-home, talking about nutrition, talking about life, about your relationship, and so much more than just checking the heartbeat and running out the door.
Elliot: Wait. They also measure the bump and have you pee in a cup.
Carson: That’s true. Don’t forget to pee in the cup.
Yeah. I wanted more than that. And so, you know — and then, for the birth. I loved not having to get in the car. I love the idea of having full freedom and mobility to move and birth as I wanted, to not to be home already. I’ve really seen birth as a really sacred ceremonial event. Again, not that that can’t be the case in the hospital, but for me, I knew that it would cause stress to try and control that environment or create the experience that I wanted with a bunch of strangers, not being under my own roof. And so, giving birth at home I really felt like I could create the environment that I wanted her to be born into with more ease.
Elliot: I also find that at-home birth, there are much better snacks.
Carson: Definitely, that too. Much more of that.
Elliot: If you’re even allowed to eat at the hospital. And yeah, everything you described sounds amazing.
Did you have any — because you’re human also, did you have any anxieties or fears? Anything that was like, “I got to overcome that.”
Carson: Yeah. My fears were never home-birth-specific. I think that’s the beauty of getting to witness birth in both places is really like debunking these myths that there’s a danger around home birth that isn’t present at the hospital, right? There’s risk and birth wherever you give birth. The hardest and scariest births I’ve been a part of have been in the hospital. So, I knew that, obviously, just like life, right? We may have to face really dark and hard times regardless of where we are, and that we can’t always control for that. And so, of course, like you said, I’m human. So, those fears have always come up, but I never felt like being at the hospital would take away those fears, if that makes sense. I knew that they were more — existentials not the right word. But, you know, they’re just bigger than that. They had to do with being a human in this world like they’re more spiritual concerns, or just life concerns than they were location concerns. I think that is an important part of preparing for birth. It is coming to terms with the reality of what it means to be engaging in this world. Not just that we can control factors based off of isolating a certain event, or provider, or whatever it may be.
And so, those are things I’ve worked through with clients but also had to work through myself. And then, yeah, of course, like will the baby come out breathing well? Shoulder dystocia, like things like that that you hear a lot of and see, and you pick up on the fears of providers, or even the things like bleeding too much. Those are things that have also been a part of in birth myself and seen happen. And so, it was work for me to have to detach from those experiences of others. And then, also to continue what I, fortunately, had such a foundation on already. But to explore the, how can I prepare for those fears? How can I learn how to face them if they come up? What would I do in those situations? And so, that was definitely a big part of my preparation for my partner who hasn’t been in those environments. It was helpful for me to also prepare him for it, for the what ifs or for those fears.
Elliot: Well, what does that preparation look like?
Carson: We watched a lot of videos, you know. I think for me, I’m one of those people that like information is power. We would talk to our midwives about the what-ifs of those. That helped kind of walking through the measures in place that would support us in those situations. I love Indie Birth as a resource, and those videos were really helpful for both of us. He was always planning and he did catch her. And so, I helped prepare him with those videos. So, he knew, “You know, it’s okay. If we’re on the bed, and she’s slippery and falls through your hands, like, ‘Look, maybe just fell right onto the bed and it was okay.’” Or, you know, this is something we can do if the midwife doesn’t make it, and baby has a hard time breathing, these are the ways that we can support her ourselves, and things like that.
Elliot: I like watching birth videos of animals in nature. And just trying to see how they do it without the neocortex, without thinking about it, wondering, worrying. It’s always mind-blowing to me that they don’t really look fearful. They don’t make a lot of noise. They don’t have a lot of support. And then, as soon as they give birth, they turn around and start doing neonatal care. I’m like, “How do they know how to do that?” You know, it’s insane. But also I’ll think of birth to a 240-pound baby that just like drops on the ground, and they’re fine and they turn around.
Carson: They give them a little kick. Like, “You’re good!”
Elliot: Yeah, exactly.
Carson: Yeah. And I think that’s something part of the Indie Birth videos that really helped. Me, it was watching the moms resuscitate, or the moms be involved in that process of, or even the mom’s move in a shoulder dystocia to help the baby come out. Whereas, in not traditional, but our current tradition in 2023 in the United States, is we see and we’re told kind of that we don’t have the knowledge or strength to manage anything, right? You know, that has to be in the hands of somebody who’s an expert. Obviously, many cases there are.
But I think tapping back into the fact that a mom can stimulate her own baby, a mom can suction her own baby with her mouth, the mom can move to open her pelvis, and those things felt really empowering to me and how helped alleviate fears, right? It wasn’t just somebody in a lab coat that knew how to help me or my baby.
Elliot: Right. I think 20, maybe almost 20 years ago, I had a conversation with the midwife, Aleksandra Evanguelidi. We were talking about roadside delivery. A patient of mine who I’d give birth at one side of the road. I was just like, “Okay, if people are not planning, that’s when it happens.” So, you’re in an elevator, and the elevator gets stuck and you have to give birth. I remember asking like, “Oh, but what do you do if the cord’s around the neck?” She’s like, “You take it off.”
Carson: You unwrap it.
Elliot: Right. I think that’s a normal concern people would have. Like, “I don’t know what to do!” I’m like, “I think you will know what to do.” I would be a great nutritionist for myself if I could hear my inner nutritional voice, but I don’t. I just drive by like giant billboards of fluffy stacks of pancakes with butter and syrup, and I forget what I was supposed to be eating.
So, I mean there’s a lot, there’s so much hard wiring, and particularly, into the female DNA, the energy of building babies. You don’t think about, “Where do I put the eyes in? Where do I put the nose? And how am I going to this nervous system quite right?” It’s just all there.
Carson: It’s so true. I love that I always tell it to my clients it’s like, “What is it that we assume and expect that the pregnancy?” Our bodies know what to do, we know how to do it. It happens without our thinking and worrying about it. I mean we, of course, we worry and think and all the stuff, but it’s going to happen innately. And then, with birth, from one day to the next, it’s something that all of a sudden the mom has no idea what to do and could, God forbid, could ever do it without [unintelligible 29:46].
Elliot: You could never do this without us.
Alright. So, before we go to break, who was the birth team? Who are you planning to have with you and around you?
Carson: Yes. So, Aleks, that you mentioned, was our virtual prenatal midwife who supported us throughout our pregnancy. And we worked with and Zoom with, often for nutrition, and just support all along, and we weren’t sure if she was going to make it or not because she’s in LA and we’re in North Carolina. She ultimately didn’t, but she was an amazing part of our birth team. And then, we worked with the local midwife out here. It was just her, and Jonathan and I, and my postpartum doula is her assistant midwife, and she came the last hour and photographed and held beautiful space for us. And then, supported us postpartum. So, that was our team.
Elliot: I mean we didn’t talk about it, but you’re also a photographer, quite the photographer. You’ve done a whole bunch of birth photography.
Carson: I have, and it’s funny, I didn’t have a birth photographer. Our postpartum doula is not a birth photographer. She just took my iPhone and took pictures. She took great photos. But it’s something I do. I knew I didn’t want a birth photographer, but I wish I had had those photos and videos that I’ve done for so many other people.
Elliot: I don’t know if this is a good tip to infuse here at this point. But what I’ve seen a few people do now is set up like a camera or phone, just with a wide angle, just on all the time. Just catch the whole thing. And then, take out whatever you want from it and throw it away the rest.
Carson: Yeah. And I thought about that. Before, I was like, maybe I’ll do that. And then, in the moment, I think there was just no way I was going to facilitate that for myself. Being that we had such a small birth team.
Elliot: Yeah. It was not extra hands-on on deck.
Carson: We’ll talk about my first story, but I’m glad that the things that came out of my mouth are not recorded.
Elliot: They’re not documented. I’ve seen it both ways. Really small birth at home, and really big birth at-home teams. I remember one, it must have been not too long before you left here that we were out together. I don’t know that she was always planning home birth, but she definitely wanted a big cast of characters around her. She has I think the biggest welcome mat I’ve ever seen in my life inside the house. I was one of the later people to come to that birth. When I came in, there was still no room for my shoes on the welcome mat because there’s so many people there. I can almost even tell, I’m like, “Okay. Those must be Carson’s shoes.” You just go around and tell us who’s already there.
Alright. Let’s take a break, and then find out the big story of your birth. We’ll be right back.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We’re talking to Carson Meyer.
Okay, it’s time. You have your pregnancy. You’ve done your preparations. It’s time for birth. When, in relation to your estimated due date, did birth start and how?
Carson: I was due on my birthday.
Elliot: Oh, wow!
Carson: Yeah. I had no idea. I just feel really stupid admitting this as a doula that I didn’t know how to calculate a due date. Like I just was like, okay. But I didn’t realize there’s like this two weeks that are not really pregnancy, but you count it. So, I didn’t know! And then, I literally just like put into Google like, “conceived on this day, what is due date?” And, it was my birthday. I was like, “Oh, my God!” I was freaking out. In my head, I like thought it was a month late. I just didn’t, no idea.
And then, I always say like never tell anyone your due date, it’s a secret. It’s going to get in your head. It’s going to get in everyone else’s head. Just leave it alone. It doesn’t matter. Your baby doesn’t have a calendar. But, yeah, around 39 weeks, I was like, “Why am I still pregnant?!” Even though I talked to so many women off this cliff just feeling defeated at that point.
So, I went only two days past my due date before my water broke. But it felt like two years, especially because of that birthday. That was such a big marker. And I didn’t care if we shared a birthday or not, it wasn’t that. It’s just I knew the date, and I was holding on to it. But, yeah, two days after my due date, my water broke at 8 pm sharp on the couch. That’s how it started.
Elliot: What were you doing?
Carson: It’s very funny actually. We were cuddling with Paulie, our dog, who is adorable and was our only child until Lou came along. He was smiling ear to ear. He is such a goofball. I don’t know if he could feel it before or sense something, but he was acting really funny and making this big goofy smile. And so, we kept taking pictures of him. And then, oohing and awing over pictures of our dog, and then my water broke. And so, we laughed because like a few days after she was born, we were thinking like, “What were we doing?” I went to my phone and it’s the picture I took of him, I took on the exact minute my water broke. So, literally, we have this time stamp of what we were doing. It’s a really funny photo of him grinning ear to ear.
Elliot: Okay. So, you’re cuddling on the couch, water breaks, and it’s not a question. It’s like, “Well, oh, yeah, that’s water.”
Carson: Oh, yeah. And again, I always tell people like, “Usually, it’ll break in a trickle. That Hollywood gush is more for the movies.” I was like, “What is going on? This is so much fluid.”
Elliot: Ah! You can take the girl out of Hollywood, but…
Carson: Exactly. I’ve had a full-on Hollywood good.
Elliot: Okay. And then, is that exciting? I mean you seem very ready.
Carson: So, exciting. Heart was pounding. But it’s also nerve-wracking, as you know, labor doesn’t really start for long time after that.
Elliot: Yeah. Did yours?
Carson: It did. So, I took that moment to like I called Aleks, who was in LA, and I called my midwife here, who just got all excited. And then, I really wanted to like get our ducks in a row. So, I was like, “Jonathan, make some… so we have food.” And, you know, “Can you wash my pants?” because these are my favorite pants. I started bossing him around as per usual. He was a great sport about it.
And then, I just got everything like I felt like I needed to in order quickly. And then, I really wanted to go to bed. I knew that we should sleep because I knew that things could start up and we could be in it for the long haul. It ended up contractions started around midnight. So, around four hours later.
Elliot: A few hours later, okay.
Carson: Yeah.
Elliot: Yeah. And had you been able to fall asleep?
Carson: No. I got settled in bed. And then, they kind of started exactly when I finally was dozing off, naturally. But it’s funny, I don’t remember it didn’t feel sleepless. Like, it didn’t feel like a sleepless night. The time just went “swoop,” so quick.
Elliot: How are the early contractions?
Carson: They were so mild and lovely. I was having them for a few days. I had a lot of Braxton Hicks. I took a car ride a day, two days before, where I just felt like the whole car ride. And it was like, “Oh, my gosh!” But I didn’t think I was in labor and in retrospect, I might have been dilated early. I will never know, but there might have been a lot of work happening before because of the contractions that came at midnight felt really familiar. And they were very similar to my Braxton Hicks.
Elliot: Okay. So, you said lovely, which is a rare…
Carson: Well, it was not lovely the whole time. But…
Elliot: The early ones.
Carson: In comparison, yes.
Elliot: So, like wave-like?
Carson: Yeah. I guess wave-like, and I was able to just move through them, and move with them and I was just really excited that they were there and happening. And so, they weren’t too bad. They were kind of quick. There was definitely not a lot of space in between and they were long, but I liked them.
It’s funny because my mom used to always say she liked labor, and that the contractions felt good. And so, now that it’s happening, I was like, “Oh, I’m going to be like my mom.” It feels good for us. Again, it did not — that not remain the whole time.
Elliot: Okay.
Carson: I knew what she was talking about in that moment.
Elliot: And then, from that point, were you able to get any rest?
Carson: Not really. I think I lied down like on my side throughout. I’d say like around 3:00 in the morning, 2:00 in the morning, I wanted Jonathan to be like up with me more, and kind of got him up. And then, by 6:30, I was starting to get a little more flustered. I didn’t have a doula, which is funny because everyone asked, you know, “Did you have a doula at your birth?’ And I’m like, “No.”
But in that moment, I was like — and Jonathan was so amazing the whole birth. But in that moment, I told him to get rest. He was getting rest. But things shifted, and I don’t think he realized that I was doing great on my own. I was like, “You do you.” And then, all of a sudden, I was like, “You’re not helping me.” So, I kind of was like what, “I need help.” He’s like, “Whoa, whoa! “What’s going on? You were doing great.” And then, I started getting like a little bit — I think that was the act of labor taking over, where it started to feel like, “Okay. I need help.”
Elliot: What are you doing for all those hours?
Carson: Before?
Elliot: Yeah. From like basically 12:00 to 6:00.
Carson: That’s what I don’t remember. I must have been dozing in and off. I just kept the lights off. It’s so interesting. I really have a very strange — I think I like blacked out a lot of it because I don’t have a lot of recollection. But I remember just kind of like moving around the room, and cuddling, and just moving through. I was like in a state of wasn’t very conscious. But at 6:30, I remember being like aggravated and kind of coming to and being like, “I need help.” He was tired and he was helping me. But also I was like, “Okay. Call our midwife.” I knew it was too early for her to come, but I also wanted him to feel supported. I wanted female energy in the space. The reason I didn’t have a doula is because she was going to be both for me and that’s how she practices. So, I knew that she would provide some physical support, too. And help Jonathan guide me through some of those double-up squeeze and things like that. So, she came around 7:30.
Elliot: Do you remember what your dog was doing during that whole time?
Carson: He was under the bed while I was pushing. I’ll tell you about what he did at the end. But he was cuddling with me most of the time when I was downstairs. He’s not allowed on our bed, but he would have been right by my side. But when I moved to the couch, he sat next to me and kind of like watched on guard. He knew something was different. He had a hard time relaxing, but he didn’t leave my side.
Elliot: Okay, cool. You probably said birth, also home birth, they’re just so different how they react.
Carson: And, the funniest part, we keep laughing about it — Well, hey, we go back to your first question is like, “why is a home birth important to you?” Honestly, a big part of it was being able to have my dog with me.
Elliot: I heard that a lot. I just became a dog owner for the first time a year ago. I sort of get it now.
Carson: Yeah, they are. They’re just like such love bugs. But what’s so funny, and we laugh about it is I would be like, “Ah!” during labor. Yelling at Jonathan. Poor Jonathan, my midwife. Like, “Get away!” And then, I remember just seeing Paulie, and I would just be like, “Oh, I love you, Paulie.” I would just smile and I would be so sweet. And then, I’d like snap at poor Jonathan again. But he could do no wrong. And so, he was like this little like heart melt there for me.
Elliot: Oh, you did have a doula.
Carson: He was my doula, exactly.
Elliot: A male doula. Who would have thought? Okay. So, 7:30, midwife comes. And?
Carson: She came. But it was funny because the contractions were intense. And that’s why I wanted that physical and support, and they were close together. But in between, no pain. No sensation. Totally back to my normal self. And that’s kind of always how I thought of early labor. So, I was like, “Gosh. This is super early.” Because, yes, the contractions are intense. And yes, they’re close together. But I was talking to her about like music, and we were eating, and I was totally myself in between. And then, I would have a surge. I would be like, “Aah!” You know, and she would help me, and then we would go back to doing our thing. So, that lasted probably until noon.
Elliot: Did you have a sense where you were on the spectrum from beginning to end?
Carson: In terms of progress?
Elliot: Yeah.
Carson: No. So, I knew that I did not want any cervical checks. I never had one in my pregnancy or in labor. That was important to me because I know myself, and I didn’t want to get in my head. I didn’t want to compare myself to other births. “Oh, in this birth, when it was 4 centimeters, at this time, this happens,” you know. Because it’s not a crystal ball.
Elliot: Yeah. So, I’m not even talking about how many centimeters.
Carson: Yeah. Progress.
Elliot: In terms of your pattern whether you’re —
Carson: That can be as useless as the cervical exam. I don’t know if you’ve experienced this in your practice as well. But sometimes, you see these patterns and you’re like, “Oh, baby’s coming. Like, look at the time, right?” It looks like what the app tells you is active labor. And then, 40 hours later, you’re still sitting there.
Elliot: You’re still there, yeah. So, I mean not as an observer, but as…
Carson: Inside.
Elliot: For you. Yeah.
Carson: Yeah. I try to stay away from all those things that [unintelligible 42:48].
Elliot: In a kind of spectrum timeline.
Carson: Exactly. So, we didn’t time. We’d do anything. I had no idea, I think how close I was, but I really wasn’t thinking about time. At this point, my worry was that I’d have a really, really long labor. So, I guess in my head, I was like we’re so far away. I kind of felt bad. My midwife was pregnant. And so, I’ve definitely felt guilty. I was like, “Oh, she’s going to be here forever.” I definitely called her too early, but I really love having her here. So, I had no idea.
Elliot: Okay. No idea where you were. Do you have any recollection of what that pattern looked like, contraction pattern? Or you just didn’t even pay attention to it?
Carson: I was say, every 3 minutes, for a full minute.
Elliot: And then, where did you feel it?
Carson: At this point, they were intense. But this was when it started to I’d feel it in my hips. The contractions that happened in my uterus were the ones that I liked, and they didn’t bother me. They were not as bad as any period cramps or anything like that. What really took my breath away and really brought me to my knees were the feeling of my pelvis and my bones opening, which I know you could probably explain to me better than I can of what was going on. But my legs, my thighs, something was going on there where I just felt everything in my legs. I felt it my pelvis opening, my hips opening, and then I felt my tailbone, which again is funny. Because every birth worker knows, “Okay, if you feel it in your tailbone, we know what that means.” But I wasn’t even thinking of that. I didn’t know that meant the baby was low. I just was like, “My tailbone is stuck. Somebody needs to pull it off.”
Elliot: That’s me!
Carson: Yeah. I was like, “Can someone tell me where is Dr. Berlin? Pull my tailbone up and away from me!” Because I just felt like her head was pushing it back. And so, honestly, the contractions I don’t remember being hard. It was the physical sensation of — and I’m petite. So, I think, I just…
Elliot: You have to open up.
Carson: Making room. And that was really hard for me.
Elliot: Yeah. You had to open up. Okay. So, how did you cope with that?
Carson: The manual, you know.
Elliot: Covering pressure.
Carson: Covering pressure, and all that, was helpful. But I got into the shower, which was nice. And then, I wanted to get into the tub. That helped but I still was overcome at this point. And now, looking back, I was in like a very active kind of transition point in the tub. I was probably in there for two hours. But what really helped was howling. I was so loud. Louder than any client I’d anybody I’ve ever seen give birth. I was louder by a million. I was like, “Wow! Okay. I was not expecting this.” But I roared.
Elliot: Wow!
Carson: I could not have not done that. Like, it was such an important part of my process. I was so glad that my birth team really like invited it, and encouraged it, and let it happen because I do feel like I was what I needed to do.
Elliot: I mean this one’s like primal instinct.
Carson: Yeah. Oh, I was so loud. I don’t know if I cried tears but I cried out in agony and was just like, “Help!” You know, that was such a big part of it for me that I think I needed to do.
Elliot: Is this like a birth tub that you set up?
Carson: Yeah.
Elliot: Okay.
Carson: We rolled out a birth tub. But, unfortunately, it had holes in it, which we didn’t know about. It kept deflating while I was in it. And luckily, my midwife was like repairing it in real-time. That was a little bit stressful. It all worked out fine, but yeah. That was fun.
Elliot: I could see how that would be a little deflating, in general. Okay. So, then, if you’re in transition. What happens next?
Carson: At this point, was when I was like, “I’m going to die. I can’t do this.” I remember just like fantasizing about the hospital, which I never thought I would do. You know, that was my worst nightmare, to have to go to the hospital. And all of a sudden, I was like, “Oh, please. Just take me there. Give me the epidural. This is too much!” I remember also like really wanting external things. At this time, I wanted other people to come in and take the pain away. I was calling for my neighbor. I was like, “Maybe call the neighbor!” Like, she was going to help or something, you know. Like, I just wanted…
Elliot: Somebody must have something.
Carson: I just wanted somebody to hum, and just do something. So, that was really my experience transition. I felt so much pressure in the tailbone and back there, which again is comical. Because if somebody was yelling, “My butt! My butt!” I’d be like, “Okay, you’re pushing,” at the time. I was screaming that, but had no idea that meant I was close, right? I just forgotten everything I knew about birth. I just felt her so low down there. I’m like grunting and howling. And then, I just remember saying I had so much doubt, which is that’s when I knew it was transition because that doubt was so big in me.
I said to my midwife like, “I just don’t think it’s going to work. This is not going to happen.” And she was like, “Well, why don’t you just like feel?” I could feel her head like right there. But still, in my head, was like, “I’m days away.” Like, “I’m going to have to go have a cesarean.” It’s just nothing in me. Even feeling her head, made me realize it was real.
And then, I wanted out of the tub right away. I got on the bed. I knew in that moment I looked at her, I said, “I’m in transition,” because I just knew that I couldn’t go lower. Like I would think that’s some hell. So, I was like, “This is a transition.” She shrugged. She never said, “Yeah,” or she’s like “Maybe.”
Elliot: Wow! And so, when does her assistant come?
Carson: She wasn’t going to come because she actually had a little cold, and they told me that. They were like, “She has a cold. She wanted to come.” I said, “No. Do not want a cold right now.” So, I was just going to be my midwife, which we felt really good about and we were totally fine. But in that moment, remember when I told you I wanted external? I just wanted everyone else to come save me. I screamed out, “I want her here!” Again, not that she was going to come do it for me, but I just felt like I needed something to change the environment.
So, they called her, and I’m so glad that we did. She was getting over her cold. She was like totally fine. I think she knew that I would be on edge if I heard her clear her throat. And so, she came and she really just took the photographs, which is I’m so grateful I had because I wouldn’t have had that if she not come. She showed up probably an hour before Lou was born, while I was on the bed.
Elliot: Alright. So, you got out of the tub onto the bed?
Carson: Yeah.
Elliot: Were you like, in some ways, more comfortable on the bed?
Carson: Well, I love the tub, but it was so wild. It was like from one second, it was great. The next second, it was like, “Nope! Done. Get me out now.” I don’t know if the temperature went down, or what happened. But my body just told me, “It’s time to get out.”
Elliot: Okay. I was like how long are you on the bed for?
Carson: Probably, two hours. At first, I instructed Jonathan to sit with his back against the headboard. And then, I leaned over him on all fours.
Elliot: Okay.
Carson: Which was really nice. We kind of like snuggled like that for a while. It allowed me to be on all fours to be in his arms and supported. He was a little nervous because he knew he was supposed to catch, and that was something he was excited about.
Elliot: It was like, “Hut!”
Carson: He’s like, “How do I catch from here?” I remember that being like a moment where he’s like, “You seem to like this. What should we do?” But we did that for a while. And then, I got on the peanut ball. I laid with my leg up on my hips. I don’t even remember, but I just like tossed and turned around. I wasn’t on my back at any point. I remember my midwife saying — so at this point, I was clearly pushing. Again, I still don’t even — no one said, “You’re pushing.” No one said, “Push.” I just was pushing. But honestly, I don’t even think I knew. I was so out of my body and so out of my head and into my body, I just was doing it.
And then, I remember my midwife saying, “It might help. Just because of the position like that. If you wanted to get on your back, you can try that.” I just was like, “I’ll kill you.” There is no way — and in that moment, my admiration for the strength of the women who have birthed on their backs in the hospital, unwillingly, which is many. There’s no way I could not have done it in the hospital. I just couldn’t have because there was no way I would have been told what position to go in. I could not have tolerated that. I think the only way I was able to get through was being able to fully move in the patterns I wanted to.
Elliot: Yeah. It seems like your mind kind of shuts down…
Carson: Yeah.
Elliot: …at that point because you’ve seen so much.
Carson: I was clueless.
Elliot: Yeah, in the moment, maybe you were clueless but just in that neocortex.
Carson: Yeah. Such a gift. Such a gift for me because I’m a thinker. I was so happy. I kept asking I was like, “Is the baby under the pubic bone?” while she’s crowning!” I was like in such a daze about what was going on. And I’m in disbelief! I think there was a part of me, given I was born cesarean. I was told because of my size from doctors, before becoming a doula. “Oh, you’re so small. It’ll be hard to give birth. You won’t be able to give birth vaginally.” All the BS that I think I heard those in me while I was birthing.
Elliot: But then at the same time, while you’re closing that out as much as you can, you’re like very aware of what’s happening and what you need on the deeper older limbic part of your brain that does birth.
Carson: Yeah.
Elliot: It’s almost magical that you’re able to take so much experience from your conscious mind and put that away and have your own experience.
Carson: Yeah. It was such a gift.
Elliot: Alright. So, you’re writhing around…
Carson: Writhing around. I got on all fours. I guess at some point, it kind of came to the fact that, “Okay. I am pushing. She is close. I could feel…” Again, not at all what I thought the ring of fire felt like. But I was like, “Okay. This is it! If I just keep pushing like this, I think this could be over soon.”
I remember getting on all fours and just bringing one leg up. In a way, it’s kind of the position that you would want to get into with the shoulder dystocia. I don’t know if I did that out of prevention. Look, I was like, “I’m just going to.” But I remember my midwife saying, “If you put your leg like that, it’s going to be the widest your pelvis will be open.” I was like, “Great, let’s do that! Whatever the widest.”
So, I was on all fours. I brought my leg up and just kept pushing. I mean, I don’t know what was happening but I kept doing my thing. I remember Jonathan getting ready, and he was so steady and like so confident. I could feel that energy, which was so soothing and just amazing to have him right behind me. And, of course, somebody who’s never given birth before thinks when you see the top of the head, that you really have to catch, little do they know, it could still be some time.
Elliot: Yeah. “You’re almost there! You’re almost there!”
Carson: Yeah. I think he was like, “Wait!” Even though I prepared him for that, he was okay.
Elliot: “Now? No.”
Carson: “You’re still pushing.” But I could feel there was patience, but that excited energy and he was just so ready right there. And then, her head emerged. I remember knowing that and hearing that. And then, of course, my first question like, “Is she okay?” I said that while her head was still out, my midwife and Jonathan laughed because, not only is she okay, she’s breathing and clearing her lungs and nose and everything on your perineum. So, before she came out, she started like crying and doing her thing.
Elliot: Oh, wow! Well, meaning her shoulders and body are…
Carson: Oh, yeah. Her shoulders and bodies were still inside, but she was clearing her throat or her lungs.
Elliot: Oh, wow!
Carson: That was obviously very reassuring to the birth team and everyone. Because they’re like, “She’s amazing! She’s doing her thing while still inside of you, half inside of you.” And so, I was like, “Okay.” And then, this was when I was like, “Okay, shoulders now.” This is the time and I was so nervous. But, she just came out with ease into Jonathan’s hands. There was a cord around the back of her neck, and Jonathan unhooked it or unwrapped it.
I remember the midwife saying to Jonathan, “Bring her towards you.” Which was her instructing him how to get the cord off and saying bring her out. But she didn’t know if it was a her, but “Bring the baby out towards you so that she’ll come out and can take the cord off.” I heard that. I thought she was out. And so, I was like, “No. Towards me. Towards me.” Like, I get to hold her first. And they’re like, “She’s coming to you. We just have to get her out and unwrap first.” So, I was like, “Okay, fine.”
And then, he quickly passed her to me because I was very impatient. I wanted her in my arms right away. We were holding her and we were like celebrating. So, excited. Paulie jumped up from out of the bed the minute he heard her cry and started three laps around the room. And then, we were both like, “Okay. We’re going to find out if it’s a boy or a girl.” And, of course, I was like, “Jonathan, you get to announce.” But he was taking too long, you know. He was like gentle and also just like was like in an excited cluster. I was like, “Fuck it! I’m looking.” And so, I did it. And I was like, “It’s a girl!” I just felt so strongly, like I said before in pregnancy, I just knew she was a girl. I knew it. I stocked her closet with all my dresses from childhood. I tried to get some boy things just in case because I didn’t want him to feel bad. But I just would have bet anything that it’s a girl. So, it was really funny, we all laughed because I was like, “Yep! There she is.”
Elliot: “Just like I told you.” So, you pushed on all fours.
Carson: Pushed, yeah, for the last part, and delivered on all fours.
Elliot: Delivered on all fours. Did you experience a ring of fire?
Carson: Again, the sensation from the muscles and the tailbone so overpowered whatever other sensations there are of labor that I thought would be there. That seemed like the least of my worries. It was so much more on the backbone for me.
Elliot: So, more there than your perineum.
Carson: Yeah. I don’t even remember any of that. It was all the bones. And I didn’t tear, so maybe that helped. And I crowned for a very long time because she had — the poor thing had a bruise on her head. But yeah, for me, the hardest part was just those bones.
Elliot: How big was birth?
Carson: Seven-four.
Elliot: Okay. You’re, like you said, pretty petite. So, you gave birth to a healthy-sized baby. No tearing.
Carson: No tearing.
Elliot: And it sounds like none of that intense pushing coaching.
Carson: No. I didn’t even know I was pushing. No one was coaching me. I didn’t even know I was doing it.
Elliot: Right. I’m just saying the contrast in my mind did, too. Like, you, a woman on her back, and you know her legs are up. There’s a bunch of people around. And people are just like, “Blah, blah, blah. How can I breathe?” “Don’t worry. Just push, push, push!” I feel like that’s where a lot of the tearing comes from.
Carson: Yeah. There’s an evidence-based birth article, review article, that talks about how the number one factor that impacts tearing or not is provider skill. Your provider. And I do have to credit my midwife I think in that.
Elliot: Meaning, was she doing something? Like, massaging or…
Carson: Definitely wasn’t massaging. But she was applying manual pressure.
Elliot: Oh, just slowly. Oh, okay.
Carson: Yeah. Helping to keep I think the tissues together more, which she was explaining to me later was very different than anything I’d seen, or kind of heard as an approach. I think the not telling me to, “Push. One. Two. Not.” Like all the other stuff, like the push, and of course the freedom and flexibility. But she was very hands-off in the way that I wanted her to be the whole time. But in that moment, she did step in with a skill that we had discussed before that she knew how to do to help support my perineum, which I was really grateful for.
Elliot: Wow. Intensely beautiful.
Carson: Yeah.
Elliot: A few questions here at the tail end, starting with the tail. Did you have like tailbone soreness afterwards?
Carson: I did. But it totally went away. I also feel like I was sitting so much in bed, which it was funny. I asked Allison Oswald, you know, pelvic floor therapist. I was like, “My tailbone hurts so bad. Do you think it’s from sitting so much?” She’s like, “I think it’s from the birth.” I was like, “Oh, okay.”
Elliot: I wonder, because you mentioned it so many times, I wonder if you ever injured it like in snowboarding.
Carson: That what people kept asking me. She did tell me. She’s like, “Keep stretching that area. Use the physio ball because it’s not going to like untighten.” But not that I remember.
Elliot: Do you snowboard?
Carson: No.
Elliot: I wouldn’t have guessed that. Okay. Did you eat during labor? And if so, what?
Carson: Yeah, but not as much as I thought. I love eating. It’s my number one source of comfort. But just didn’t cross my mind. I had lentils in early labor. That was what I had asked Jonathan to make.
Elliot: How was birthing your placenta?
Carson: Of course, birthing her was my favorite part. But I do have to say that that was a really special part for me, too. That’s a big fear I had. I was told in pregnancy that my iron was low and that I really couldn’t afford to lose blood. That really got in my head and really freaked me out and sent me kind of in a tailspin of trying to fix it. But then also, in my way of wanting to research and understand everything, I learned a lot for another podcast about iron. I also was really nervous. I was like, “Okay.”
I felt confident by the end because of the measures I had taken to prevent too much blood loss. But I was, “Okay. This is the time where you can hemorrhage after the baby’s out. This is more, I’d say dangerous, part of birth for the mother.” I was really on edge about it. I really wanted that part to just be over. And my midwife was so in tune and could so feel that I didn’t want her help. I didn’t want to rush the placenta, but I also wanted it out. I was really nervous about it and kept asking about it.
So, we waited a full hour before cutting the cord. And then, after an hour, she picked up on this. She said, “Why don’t you get in the shower and you can do it yourself? You can just squat over a bowl. In that way, you can know if the placenta is ready. You can feel the tension. I will not intervene in this process and cause a problem because I’ve seen that so many times.”
And so, I went into the shower, squatted down, and I talked to my placenta. I said, “Hey, thank you so much. I’m so grateful that you protected and supported Lou, and nourished her. But your work is done and you can come out now. You can come out in one whole piece.” And then, like talking to it on what to do and kind of just let that happen. I made sure Jonathan — because at this point, we’d cut the cord. I made sure Jonathan brought Lou to be there in my eye line so that I was connected to that oxytocin flow, to support it. And then, I just guided it out into the bowl, and it was perfect and I did not bleed at all. I mean, of course, I had some bleeding, but for the six weeks after. But there was no gush of blood or anything. So, yeah, that was a powerful part for me.
Elliot: That’s different from anything I’ve ever seen.
Carson: Yeah, me too.
Elliot: How was transition to breastfeeding?
Carson: That, surprisingly, I didn’t do right away. I was just like I’m too busy staring at her and like finding my feet. So, I waited a little bit. But my midwife, before she left, set us up side lie. And that was really nice because that [unintelligible 01:01:37]. That was amazing to just be able to stay and also good for my tailbone. I’ll be sitting that. I just side lie at her for like the first four days. And then, I was like, “Wait, I don’t think I know how to breastfeed sitting up.” I had this moment where I was like we’ve mastered the side lie, but it felt so funny to like get up and feed her because I was, “I don’t know what I’m doing.”
When my midwife came back, or I don’t know. At some point, I was like, “We’ll try it this way.” Luckily, she was a great feeder and there was one day when my milk came, that it just hurts so bad, my nipples. I called my sister who had three kids, her husband actually was so sweet and so cute. He clearly paid attention in all the classes and had been a great support to her. And so, he actually like helped coach me through it. And was reminding me things I know. And also, hearing my friends say, “People say it doesn’t hurt, but it could hurt.” It’s not that there’s anything wrong. The first few days, it’s okay for it to hurt. I was, “Okay then, it’s normal.” Once my milk came in the next day, it all got better. I wasn’t expecting that. I was sure that there’s been a terrible problem.
Elliot: That’s a very helpful important tidbit.
Carson: Yeah.
Elliot: Okay. Here’s my last couple of questions. Number one, how do Paulie and Lou get along?
Carson: They’re so great and I’m so proud of him. I know it’s tempting to look a cute baby’s face all day long. He’s really great. He’s really understanding that she’s very important and that you can’t go nuts on her all the time. There’s a lot of energy. But I’m excited for them to be able to interact more.
Elliot: Coming soon.
Carson: Yeah.
Elliot: And then, next, what, if anything, what did you learn about you, about birth for you, and about birth as a provider from your own experience?
Carson: Well, that’s such a big question. I think I learned — Yeah, obviously, I feel so like proud of the whole process and her, mostly, and what we’ve created. Jonathan, keeps teasing. “I highly recommend doing this with a birth worker. I highly recommend having a baby with a doula.” But we tease, and it’s not because I know something that anyone else doesn’t or you know have some greater capacity, it’s not that at all. It’s just I’ve been able to apply what I’ve really believed in for so many years, and really fully immerse myself in for so many years, and all this information, I mean experience. There’s something really rewarding to know that there’s benefit in that, and there’s value in that is most important.
So, it definitely makes me even more passionate about my work, knowing that the journey is a journey and you can’t take away the challenges or the sleepless nights, and all that. But there’s so much we can do with support to make it easier. I always knew that deep down. But now, having walked my talk of what I share with my clients, and got to see on the other end how good I feel, which I wasn’t fully expecting. A lot of that comes down to like we talked about whether it’s the first 40 days, the nourishment, the nutrition, the support, the way you choose to birth, and all of that. And so, that feels really good for myself, of course, and for my confidence as a mother. But my confidence in my work and knowing that what I do out there to be a value to people. And now, I kind of feel like I can really say it works when we take good care of ourselves.
Elliot: Yeah. It takes some effort, doesn’t it?
Carson: It does. But in many ways, it’s been effortless. And we’re lucky in so many factors. So many women can’t stay home for a long time or have access to that support, of course. But if you put the work in before, it does pay off ultimately.
Elliot: Is there anything that you wanted to share that I left out?
Carson: Oh, gosh, no. I feel like I blabbered on.
Elliot: No. It was so beautiful every minute. Carson, thank you so much for joining me and for sharing your story, and for all the incredible work that you do.
Carson: Thank you, Dr. Berlin. Thank you. That’s one part of the pregnancy and postpartum I wish I had had you out here, but —
Elliot: Yeah. When you moved, and then I found out you were pregnant, I was like, “Ugh!”
Carson: I know.
Elliot: Of all the people I would want to be there for.
Carson: Oh, my God! My tailbone would have been so happy.
Elliot: It wasn’t meant to be. Carson, where can we find you online?
Carson: carson-meyer.com is my website for my doula work. And “Growing Together,” we’re Instagram @ccmeyer. And then, candthemoon.com for C & The Moon products.
Elliot: For yumminess. Are there new C & The Moon products coming?
Carson: Eventually.
Elliot: In development.
Carson: Eventually.
Elliot: They’re just steady.
Carson: Slow and steady.
Elliot: Amazing. Alright. I will see you there. And then, who knows, you might also appear at some point on Informed Pregnancy Plus.
Carson: Yes, I’d love that! Do you want to meet little Lou?
Elliot: Yes, please.
Carson: Oh, it’s okay. Hi, baby. Here she is.
Elliot: A little yum. So, bakery fresh. Ah, she’s so sweet. Where did she get those cheeks from? Amazing.
Carson: Thank you so much.
Elliot: Alright. Everybody at home, thanks for listening, watching. We can also see you online at theinformedpregnancy.com.
by Informed Pregnancy and Parenting Project | Mar 21, 2023 | Labor and Delivery, Podcast Transcripts, Pregnancy
Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I am your host, pregnancy-focused chiropractor, Dr. Elliot Berlin. My guest

Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I am your host, pregnancy-focused chiropractor, Dr. Elliot Berlin.
My guest today needs no introduction. He’s an old, classic, and favorite guest on the podcast. He’s an OB-GYN and Maternal Fetal Medical specialist here in Los Angeles. We have some incredible episodes together talking about things like pregnancy over 35, and the arrived trial.
Today, we’re talking about umbilical cords. What are they? How are they formed? What are some of the variations and complications, and what do you do about them? Dr. Emiliano Chavira, welcome back to the podcast.
Emiliano: Thanks so much for the invitation. It’s been a while. You know, when you pitched this topic to me. It really struck a chord.
Elliot: Oh, wow! All right. Let’s jump into it. First of all, your background. Just in case anybody has been under a rock. You are an OB-GYN, did and specialize in Maternal Fetal Medicine. That means that you do a deeper, more closer analysis of things that need a steeper looking at. And then, whereas most of you stop delivering babies to sit in your office and look at MFM evaluations all day, you still love to go catch them.
Emiliano: That’s right. And the Maternal Fetal Medicine, it focuses on what some people understand is high-risk pregnancy. Although, I kind of despise that term, it involves things either it’s maternal issues maternal complications maternal medical conditions or it’s fetal things. It involves a lot of ultrasound. So, it’s a very ultrasound-heavy specialty, which is very relevant to the issue of assessments of the umbilical cord.
Elliot: Is it true that you can get an ultrasound that attaches to your iPhone?
Emiliano: Yeah. There are devices where there’s a handheld ultrasound probe, and then it Bluetooths to your phone. I’ve never used one, so I don’t know how good the quality is but they are out there.
Elliot: Wow! That’s pretty cool. I wonder if they’ll make that for hands for chiropractors. We can remotely, like you guys do the surgery with the gloves.
Emiliano: I’m sure it’s a matter of time.
Elliot: The robot, yeah. Because a lot of people, during the pandemic, work from home. I tried. Nobody wanted to lay down on my dining room table and get their little crack and stuff.
Emiliano: That’s only because you never invited me.
Elliot: Wait. You’ve been.
Emiliano: That’s true.
Elliot: Come back. All right. Let’s talk about the cord, the umbilical cord. Tell me in basic understanding of where does the cord come from, when does it develop, how is it made.
Emiliano: The umbilical cord is really the lifeline for the fetus, or the baby, during the pregnancy. It’s the connection between the mother, or the pregnant person, and the fetus. I think most people know that the umbilical cord is attached to the baby’s belly button, and then the other end of the cord is attached to the placenta, which is also attached to the uterine wall. And that’s where the vascular connection is between the baby and the mother.
So, the mother’s circulation flows into the uterus and it brings nutrients and oxygen into the placenta, which diffuses across into the fetal bloodstream that happens in the placenta. And then, this blood that’s rich in oxygen nutrients flows through the umbilical cord to the baby, bringing all this stuff to the baby, and it flows in through a single umbilical vein. Then, the baby uses up all the good stuff, uses the oxygen, produces carbon dioxide, uses up the nutrients, and produces some waste products. And those flow back out through the umbilical arteries, back down the same umbilical cord, back to the placenta, and back into the maternal bloodstream, and then the mother gets rid of those waste products.
If you think about it the umbilical cord has to develop from the very, very beginning of the pregnancy because it’s the lifeline to the fetus. Pregnancy starts off as a single cell, and then it doubles, and then you got four, and then eight, and 16, and turns into this mass of cells which eventually separates away from the placental disc. And you have this connecting stock, which over the next few weeks, will develop into the umbilical cord which contains vessels. That happens between like the third and the seventh weeks of pregnancy. By the time you get to the seventh week, you have a formed umbilical cord.
Elliot: Wow. It’s mind-blowing. All the pieces of this whole thing, whoever puts us together, is mind-blowing.
Emiliano: Miraculous.
Elliot: But how that cord forms just the right way between the two parties and nestles itself in. Even just the whole idea of a placenta that you kind of make it a little command post for the nine months, and then just spit it out. It’s like disposable human organ.
Emiliano: Yeah.
Elliot: It’s very cool. Okay. The umbilical cord. I remember this back from a long time ago when I was studying anatomy and physiology. These umbilical arteries and veins are different than the like backwards to all the other arteries and veins in the body, right? Because arteries always carry blood away from your heart.
Emiliano: Right.
Elliot: They generally have oxygenated blood in them.
Emiliano: Right. After birth, you think of children and adults, your heart pumps oxygenated blood that runs through the arteries, out to the tissues, and then the tissues use up that oxygen. And then, the deoxygenated blood runs through the venous system back to the heart. And so, in the umbilical cord, it’s the opposite. Because oxygenated blood is running through a vein, returning from the placenta back to the fetus. And then, the deoxygenated blood is pumped from the fetus through arteries back towards the placenta.
Elliot: Right.
Emiliano: So, it’s backwards in the cord.
Elliot: That’s a little backwards. That explains my whole upbringing somehow. All right. Sometimes, when the cord forms, things don’t go exactly according to plan. Before we get into the different variations or complications that can happen, are there any things to do or not do to encourage a healthy cord?
Emiliano: I think the development of the cord — I’m not really aware of anything that a pregnant person could do to influence that. I think that just sort of the workings of Mother Nature and it’s going to happen how it’s going to happen. I think all you would really do is focus on healthy pregnancy behaviors, eating healthy, getting exercise, good night’s sleep, stress management, regular chiropractic treatments with Dr. Berlin.
There’s an interesting phenomenon that happens in early pregnancy, maybe from like week 7 to 10 or 12. The little fetal intestines are forming, the small intestine, large intestine, and they actually herniate into the umbilical cord for a period of a couple of weeks. You can actually see this on ultrasound.
Elliot: Wow.
Emiliano: Sometimes, it gets mistaken for an anomaly. Because you see this mass in front of the baby’s belly, but it’s actually part of the normal physiologic development of the fetus. This is called “physiologic herniation of the gut into the umbilical cord.” It’s thought to be that this is part of the way the bowel rotates inside the abdomen. There’s a normal rotation that happens.
And then, the intestines will all slide back into the abdomen, exit the umbilical cord, and development proceeds as normal. I’ve seen this multiple times where somebody looks at a fetal ultrasound and they see this mass and are concerned that it’s a birth defect, that it’s an anomaly. The patient gets referred to maternal fetal medicine, and everything later looks normal. It’s because what they were looking at at the time was this physiologic herniation of the gut in the umbilical cord.
Elliot: Well, that’s really interesting. So, when would you say that you said around seven weeks?
Emiliano: Yeah. Seven to 10 weeks, seven to 11 weeks, that’s when you might see that.
Elliot: In that early ultrasound, are you looking for any kind of evaluation of the cord or is it still too small?
Emiliano: You might be able to assess whether you have two arteries. Not necessarily looking at the cord, but you can see the arteries inside the fetus. They’ll be surrounding the bladder. In the first trimester, you can assess for the presence of the normal two arteries. But the cord itself is pretty hard to look at that early on.
Elliot: Okay. Well, let’s jump into the variations. But first, a little break. We’ll be right back. You don’t want to miss this.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We’re talking about Dr. Emiliano about the wonderful umbilical cord. All right. Tell me more about the normal anatomy of a cord.
Emiliano: Okay. A typical umbilical cord will have a single umbilical vein and two umbilical arteries. The vein tends to be larger than arteries. The vein is also a little more compressible, the arteries are stiffer. And then, surrounding these vessels, the vessels are running through this extracellular matrix, which is this gelatinous type of tissue called “Wharton’s jelly.”
Elliot: Yum.
Emiliano: The function of that is to protect the cord to protect the vessels in the cord against compression. So, as the baby’s moving around, and swimming around, and flipping around, interacting with the cord, the blood flow through the cord is not impeded from compression because it’s protected by the Wharton’s jelly. The cord tends to end up somewhere between 50 to 60 centimeters long. That’s pretty typical length. The other thing is it winds, it twists. So, when you see an umbilical cord, it has this twisted structure almost, you can imagine like a telephone cords. People, remember telephones with cords?
Elliot: Oh, yeah. I remember them getting tangled all the time.
Emiliano: Yeah. That’s a typical cord.
Elliot: It’s a little convoluted.
Emiliano: Yeah.
Elliot: Interesting. Okay. That’s a typical anatomy of the cord. Then, you have some variations and some complications from mild, where would you like to start?
Emiliano: Well, we could talk about those basic structures because there’s variation there. One variation that we commonly see is what’s referred to as a “single umbilical artery,” or sometimes two-vessel cords. So, instead of two arteries, there’s just one. One of the arteries either never forms correctly or it fades away, and it’s a fairly common finding. We might see this in 1 to 2% of pregnancies. If it’s one out of 50, I might, in the course of the week, see that every two or three days.
Elliot: Oh, wow. Out of curiosity, is the artery that does exist, is it bigger than a typical other?
Emiliano: No, it’s about the same.
Elliot: So, it can do the job?
Emiliano: Yeah.
Elliot: Like having two kidneys?
Emiliano: Yeah. It actually usually does the job just fine. So, when we have a single umbilical artery, there’s a few things we look for. You have to look very carefully for other birth defects, other malformations. Because sometimes, single umbilical artery occurs in the setting of other birth defects. And so, if you find that, that’s a more complicated pregnancy. It can be seen sometimes in association with certain chromosomal disorders; like down syndrome, trisomy 21, or trisomy 18. We’re usually very interested in what the genetic screening test results are for this particular fetus. But if there’s none of those other findings present, and everything else is normal, and you just have a single umbilical artery, those are usually healthy normal babies.
If you read the medical literature, you will see that there’s an association between single umbilical artery and growth restriction. On a certain superficial level, that may kind of make sense. Like, if the cord is what’s supporting delivery of oxygen and nutrients to the baby, and if the cord is not normal, maybe that baby’s not going to be able to grow normally. But in reality, I see so many single umbilical arteries, and a vast majority of cases, these babes are fine. They grow fine. They do fine.
Elliot: If the other tests are negative, is there anything different to do other than just keep an eye on them?
Emiliano: Keep an eye on them, that’s really it. Usually, we would perform serial ultrasounds over the course of pregnancy to just keep track of the growth and make sure there’s not a problem with the growth. Like I said, they usually grow fine. Some people might do this fetal monitoring in the end of the third trimester. Some people call it “antepartum testing.” Some people call it “non-stress test,” fetal surveillance. But, basically, it involves a quick ultrasound to check the amniotic fluid, make sure that’s normal. And then, you listen to the fetal heart rate for about a 20-minute period. And if those two findings are normal, that’s considered a reassuring fetal test.
Elliot: That’s kind of interesting. Because the arteries are taking blood away from the baby. You would think if there was some sort of decrease in capacity to do work bringing blood into the baby that would be a more substantial concern.
Emiliano: But it’s a circular flow, right? It’s a circuit.
Elliot: Something logical.
Yeah. So, that is single umbilical artery. At what point do you usually diagnose it?
Emiliano: Typically, that would be identified at the fetal anatomy ultrasound, which tends to happen in the neighborhood of about 20 weeks.
Elliot: Oh, that neighborhood.
Emiliano: Yeah. You’ve been there.
Elliot: I’ve been there, yeah. Okay. So, someone [unin 14:51]. If my summary here is correct, in the absence of other things, just wait and see. But, probably, going to be okay.
Emiliano: Yeah. It’s a pretty benign finding in general, I’d say.
Elliot: Sweet. Where do we go from there?
Emiliano: The next thing that we would look at typically is where the umbilical cord inserts into the placenta.
Elliot: Okay.
Emiliano: Typically, you would expect the umbilical cord to attach the placenta somewhere in the central region.
Elliot: Okay. What’s the quick overview of the placenta shape or structure?
Emiliano: They tend to be disc-shaped. Although, sometimes they can be ovoid. And sometimes, you can see what are called bilobed placentas. Almost maybe if you think about like a figure of eight, or an infinity sign.
Elliot: Oh, yeah.
Emiliano: Or a snowman.
Elliot: Snow person. Is the shape, does it mean anything?
Emiliano: I don’t think it has much significant, clinical importance.
Elliot: Okay. Even though like the bilobed? Because, sometimes, if you just hear things like that, I was like, “What? Is that a problem? Is that a concern?” They’re different shapes, different varieties.
Emiliano: Yeah. In general, I think so.
Elliot: Okay. Let’s say, just for visual, it’s a disc shape. There’s the outer part of the disc, and the inner part of the disc. You’re seeing the cord normally attaches somewhere towards the inner part.
Emiliano: Yeah. Or if you were to picture a target. There’s the outer blue ring, and then the red ring, and then the bullseye is the yellow ring in the center. The cord will attach somewhere in the center.
Elliot: Okay, yeah. When you said target, I was picturing only white and red rings.
Emiliano: That’s Target.
Elliot: Oh, so sorry. I didn’t understand. I’ll put it in the subtitles. That’s right. All right. We’re back. Okay. So, we’re looking for the cord to be towards the middle of the target. I guess there’s sometimes variations where it isn’t.
Emiliano: Right. Sometimes, the cord will insert closer to the edge of the placenta rather than in the center. We would call that a “marginal insertion.” You see that maybe 10% of the time, something like that. You might see it more commonly in twin pregnancies. That has been associated as well with growth restriction and preterm birth. However, what I would say about all these ultrasound findings, when you really start to dig into the medical literature, you find that the literature is somewhat scant, mixed results, and probably a lot of unaccounted-for confounders. In general, I think maybe more is made of these variations than really should be.
Elliot: You think the exit polls might be wrong?
Emiliano: I think it’s something to be thoughtful about. Mindful of the quality of the data could be better.
Elliot: Well, so many questions. First of all, you said twins. Is there sometimes two cords going into one target?
Emiliano: Yes. Let’s set twins aside for a moment.
Elliot: Okay.
Emiliano: But, yes.
Elliot: Tweaked my curiosity.
Emiliano: But, yes, absolutely. There’s the marginal cord insertion. And then, even more abnormal than that, sometimes the insertion point is actually not on top of the placenta. But it’s in the membranes somewhere adjacent to the placenta.
So, if we use our target example, you have the yellow ring, the red ring, and the blue ring. Well, you shoot the arrow and it doesn’t hit any of the rings, and it misses the target completely and hits the haystack that the target is hanging on. So, it’s off to the side somewhere. The importance of that, picture a thin tree and as the trunk reaches the ground — because you know that’s how trees start, right? They’re in midair and the trunk grows down toward the ground. When it hits the ground, then the roots spread out from there in all directions, right? You picture that.
The same thing happens with an umbilical cord. The cord is floating through the amniotic fluid, makes contact at the placental surface, and then branches out into vessels that then traverse across the surface of the placenta in all directions. All right? If you picture that example of the tree with the roots. Usually, that point where the tree is touching down the ground should be on top of the placenta. But in these cases, it’s off to the side. And then, the roots are running through the membranes to reach the surface of the placenta.
Elliot: Wow, okay. They’re not anchored quite as well?
Emiliano: Well, that’s exactly right. Because they are not protected by the Wharton’s jelly that’s in the cord itself. And they’re not on the placental surface, which you know also provides some protection of those vessels. So, they’re kind of these naked vessels running through the amniotic membranes, and they’re unprotected. This is probably a higher-risk situation than some of the other variations that we talked about. This is referred to as a “velamentous cord insertion.”
Elliot: Where’s that terminology from?
Emiliano: My guess, I mean it sounds like “velo sale,” the term “sale.”
Elliot: Okay. I thought like Velma from “Scooby-Doo.” Okay. So, velamentous, velamentous cord insertion. More concerning than the marginal cord insertion.
Emiliano: Yeah.
Elliot: Marginal cord insertion goes into the placenta the way it’s supposed to just off to the side rather in the middle.
Emiliano: Off the side, right.
Elliot: And the velamentous cord insertion doesn’t quite really —
Emiliano: Really off the placenta.
Elliot: Right. And then, the tentacles kind of make its way over there. Do they tend to run small?
Emiliano: There does seem to be some correlation with growth restriction. But it’s the kind of thing where you have a higher chance of seeing poor fetal growth than the general population. But it’s also not a guarantee that that’s going to happen. Most of these pregnancies will be normal. I’ll give an example.
One study that compared birth weights of the infants in this cohort of pregnancies found a low birth weight about 4% of the time. And when there was a velamentous cord insertion, it was closer to like 15% of the time.
Elliot: Oh, wow!
Emiliano: You know, three or four times higher. But on the other hand, that still leaves 85% of babies that were normally grown.
Elliot: With the velamentous cord insertion.
Emiliano: With the velamentous cord insertion.
Elliot: Right. Okay. One of the things — one of the many things that I love about is you present data, and then we can process it rather than just opinion.
Emiliano: Yeah.
Elliot: Thank you for that. So, with velamentous cord being a little bit more concerning, are there things during that pregnancy that one would do differently?
Emiliano: Well, there’s no formal published guidelines that I’m aware of. I think most Maternal Fetal Medicine Specialists would recommend serial ultrasounds. Since growth restriction is more common, you want to keep a close eye on the growth. If you do find a growth-restricted baby, those fetuses are at higher risk of stillbirth than the general population. So, it’s a finding that if it’s there, it’s worth being aware of it and probably increasing your monitoring. And then, whether or not to do the fetal testing that we talked about, the antepartum testing, that’s probably a matter of some controversy. In a baby that’s normally grown, it’s probably going to be a lot more controversial and there will be probably universal agreement if the baby’s growth restricted then you’re going to do the antepartum testing.
Elliot: With velamentous cord, it sounds like maybe jostling would be a bad idea. Is there any sense of like don’t be overly active or work out?
Emiliano: I think anybody that makes that kind of recommendation, it’s not evidence-based.
Elliot: It’s just like your brain thinking, “Maybe it’s a good idea.”
Emiliano: Maybe it’s a good idea. But in the history of medical interventions, a lot of ideas that seem like good ideas. Once you study them, didn’t pan out so well. You know me personally, just as a matter of philosophy, I, in general, try to avoid making recommendations that don’t have a good evidentiary basis.
Because on the other hand, there’s so much. If you tell a pregnant woman or a pregnant person that they need to start restricting their activity, well it’s very clear there’s tons and tons of research regarding the health benefits of physical activity, and exercise, and movement in pregnancy. If you restrict those things you may be potentially doing harm, and who knows whether there’s really any benefit to that or not.
Elliot: I know. I always have patients that are in some sort of restriction or modification along the way. And our patients love to work out. They get not just physically, but mentally, I think a little bit drained or sad that they can’t work out. And so, to make them feel better, I always commit to not working out also. So, they won’t be the only one.
Emiliano: That’s a 10 out of 10 on the empathy scale.
Elliot: Thank you so much. That’s why I get my 2-star up on reviews. All right. There’s a lot more cord here to talk about, to record. So, we’re going to take another break. We’ll be right back.
[break]
Elliot: Welcome back to the podcast. We’re talking to Dr. Emiliano Chavira. We were just talking about the velamentous cord insertion, where the cord doesn’t quite make it all the way in, solidly into the placenta. But it’s nearby and its little tentacles make its way in unprotected, semi-protected. There are different categories of that.
Emiliano: You can picture an umbilical cord that inserts like a centimeter away from the placental disc, as opposed to one that’s 3 centimeters away, another one 5 centimeters away. The farther away it is from the placenta, probably, the more dangerous that is. There’s a particular version of this that actually is very high risk, and it depends on where in the uterus the cord is inserting into the membranes.
If the cord is inserting adjacent to the placenta, somewhere up top near the uterine fundus, that’s a safer situation than if this happens down low somewhere close to the cervix. The reason for that is, when you eventually go into labor and the cervix start dilating, at some point the membranes are going to rupture and tear open. Sometimes, that happens spontaneously naturally. Sometimes, it’s done by the care provider artificially. But the membranes will rupture at some point or another. If there are fetal vessels running through the area that ruptures, those vessels can be torn. At which point, the baby’s just going to be bleeding into the uterine cavity, and the fetal blood volume is pretty low. So, it doesn’t take long for blood loss in this situation to become life-threatening for the baby.
So, when the vessels are running through the membranes between the umbilical cord and the placenta, and that is down low close to the cervix, that situation is referred to as “vasa previa.”
Elliot: What do you do about it?
Emiliano: There is some good news on this front. This is a scenario where the natural state of things, without medical interventions, this is associated with a pretty high rate of fetal loss. The survival of babies in this situation, when you don’t know the diagnosis, may be something in the neighborhood of like 60% or so. There’s a lot of fetal loss.
But when you know the vasa previa is there, typically, what happens is these moms are admitted to the hospital in the third trimester, and they are subjected to intense fetal monitoring. Usually, multiple times a day. And then, the fetus is delivered early, maybe somewhere in the neighborhood of around 34 weeks.
Elliot: Oh, really early.
Emiliano: By cesarean section.
Elliot: Right.
Emiliano: And when you have this intensive monitoring and medical management, the survival jumps up to something like 97, 99%
Elliot: Wow.
Emiliano: That’s very, very high. In obstetrics, there’s so many things that we don’t have good success stories. This is one diagnosis where you can really make a big impact.
Elliot: Wow. So, I guess people should go for regular OB checkups.
Emiliano: I mean, there are a lot of diagnoses that you might make with ultrasound that, in the end, you don’t really change the life trajectory of the baby significantly. In other words, if you discover the issue after birth, that’s just as well as you know discovering it in big pregnancy. But this is one of those exceptions where it makes an enormous difference to discover that situation and then manage it appropriately.
Elliot: Is that anywhere near or similar to a funic cord presentation?
Emiliano: Okay. Cord presentation is a different issue because vasa previa is fetal vessels that are running between the umbilical cord and the placenta. Those vessels are attached to the membrane. They’re running through the membranes. A cord presentation, or a funic presentation, is the umbilical cord that’s free-floating in the uterine cavity, finds itself down low above the cervix, between the baby and the cervix.
Elliot: Okay.
Emiliano: Or it could be adjacent to the fetal head, but it’s somewhere down low in the uterus. So, the risk there is when you labor, first of all, if the head mashes down on top of the cord, that could cause some cord compression. As you’re laboring and having contractions, and the baby’s sort of being pushed down onto the cervix.
The other thing that can happen is as the cervix dilates, and as membranes rupture, and as fluid flows out, the umbilical cord could sort of what we call “prolapse,” it could sort of fall out. And that can be a hidden cord prolapse. It may not be obvious. This is called an occult cord prolapse, which is maybe like adjacent to the baby’s head in the birth canal. But it hasn’t come out so far that you can feel it on exam or aware of it. You can have these occult cord prolapses, and then you can have a complete Frank cord prolapse, where a loop of cord comes completely out of the vagina and is sort of dangling there between a mom’s legs.
Elliot: That is dangerous?
Emiliano: Well, it depends.
Elliot: That may be dangerous.
Emiliano: In certain settings, it’s dangerous. When you have a term pregnancy, fortunately, this cord prolapse is pretty uncommon. They happen on occasion, but there’s pretty infrequent complication. But you have a term pregnancy and the baby is coming head first. In that situation, cord prolapse is a dangerous problem. Because the cord gets compressed by the fetal head. And so, blood flow circulation, oxygen delivery to the baby is cut off. And there are studies that show a very clear correlation, the more time it takes you to deliver that baby, the higher risk that the baby is going to be injured or even not survive that. Well, so it’s a time-sensitive emergency. There are certain breach presentations where cord prolapse may not necessarily result in cord compression.
There are studies looking at cord prolapse and the time interval between when the prolapse is diagnosed and how long the baby takes to be born. And there is actually not that much of a correlation between how long the cord is out and adverse outcomes. It’s because if you have a specifically complete breach presentation where you have the fetal butt and the fetal legs, there’s sort of places where the cord can pass through and not necessarily get compressed.
So, that little factoid is really only relevant to breach birth providers. In most obstetricians, they only do vaginal birth in head-down babies. And so, certainly, in that situation, cord prolapse is a dangerous complication. Usually, that’s treated by emergency cesarean section in most cases.
Elliot: Oh, as soon as they see the cord?
Emiliano: Yeah.
Elliot: But you’re saying for breach, if you have a bum down baby, it’s not as big a concern?
Emiliano: It depends on a specific type of breach. If you have a Frank breech, that means that it’s just the baby’s butt down there, it acts just like a fetal head. It completely fills –With a Frank breech cord prolapse is equivalent to a cord prolapse with a head-first baby. It’s a dangerous complication and you probably need to go right to the cesarian section. But if you have a complete breach, it may not result in cord compression the way it does with other presentations.
Elliot: Okay. Completely, the butt down but the legs are also down.
Emiliano: Right. Correct.
Elliot: Okay. But getting to the funic cord, is that something that you generally wouldn’t deliver vaginally?
Emiliano: In most cases, you probably wouldn’t. You would have to have a way of moving the cord, and I don’t know that there’s a real, obvious easy way to do that. Just sort of trying to think outside the box, maybe doing some kind of inversion exercises, and seeing if you can get things to shift around inside the uterine cavity. But you’d probably have to luck out for that cord to move out of the way. I’m not sure there’s a technique that could reliably move the cord out of the way for you. So, you’re probably delivering by C-section is the safest way to go in that scenario. Fortunately, that doesn’t happen too commonly.
Elliot: Oh, that’s good. Is there other presentation issues with the cord? I mean, besides like the cord presentation being down or the ones that we talked about. Are there any other places where the cord would be a concern?
Emiliano: There’s the issue of the nuchal cord, right? Where the cord’s around the fetal neck.
Elliot: Okay.
Emiliano: It’s a very, very common finding. In a term pregnancy, we’ll see this in one out of every three or four births. When you talk to the general public about this, there’s a lot of awareness about the existence of the phenomenon of the nuchal cord. And there’s a lot of anxiety about it, I found in general. That somehow, it’s very natural to perceive this as a dangerous circumstance.
Elliot: Well, I think if we picture ourselves with a cord around our neck.
Emiliano: Yeah. It’s funny because, for so many years as an obstetrician, my automatic thought was that people are concerned about compression of the cord. If it’s around the neck, you can compress the cord. It never dawned on me what people are worried about is asphyxiation of the baby because there’s something around their neck.
Elliot: Right. That they’re not breathing.
Emiliano: But they’re not breathing. They’re not breathing through the mouth or through the nose. They’re breathing through the umbilical cord.
Elliot: Not through the airway. So, if the airways compress —
Emiliano: I guess in theory, if you compress the neck hard enough, you have to press vessels that are going to the brain, the carotid arteries. I mean I think if it was that tight, you would probably also get some compression of the cord itself. But the real concern is compression of the cord. Because like we said, the baby’s not breathing through its nose and mouth the way we do, the oxygen is coming in and out through the umbilical cord. It’s entering through the belly button.
Elliot: And it has all that Wharton’s jelly.
Emiliano: It has all that Wharton’s jelly. There’s some science that is very well established about what happens when the cord gets compressed. And it’s reflected in the fetal heart rate. There are very immediate changes in the fetal heart rate that you see if something compresses the cord.
And so, let’s say a normal fetal heart rate is somewhere in the range of 110 to 160. Let’s say, it’s a little baby’s heart’s beating along 130 beats a minute, something squishes the cord, the heart rate slows down to 90 beats a minute. And then, when you release the compression, the heart rate comes back up to 130. When you see this traced out on a piece of paper, it looks like a V. The heart rate drops down and comes back up. That’s a very reliable physiologic response. If something compresses the cord, you see what we call a “variable fetal heart rate deceleration.”
So, conversely, if there is no deceleration, then you know that there’s nothing compressing the cord or obstructing blood flow through the cord. There’s a very interesting phenomenon you’ll see a baby born that may have the cord wrapped around its neck once or twice. Rare case is maybe even more. You look at the fetal heart racing during labor, and there just wasn’t much of any cord compression going on.
Elliot: So, it’s designed for that, seemingly?
Emiliano: Absolutely.
Elliot: Is it more concerning, like a three or four-time wrappage?
Emiliano: I don’t know if I’ve ever seen any studies on that.
Elliot: Okay.
Emiliano: You might think, intuitively, you’ve got a higher chance of having some cord compression with higher degrees of wrapping around, but I don’t really know specifically.
Elliot: Sometimes, the cord’s just short.
Emiliano: Yeah.
Elliot: And you see sometimes, the baby will come out. Instead of going to the chest, they go to the belly because —
Emiliano: Can’t reach.
Elliot: Yeah. The new extension cord. But could it be too short for them to come out?
Emiliano: I don’t think so. I’ve never experienced anything like that. I have experienced cases where the cord was so short that the baby couldn’t move away from the perineum. I mean, it’s literally that short. The baby could be born, but move no farther. I saw that happen once on a twin birth.
But a lot of times, people are thinking conceptually about the cord holding up the baby, preventing the baby from descending, preventing the baby from moving. But the thing that you have to keep in mind is that cord is not attached to a fixed structure. In other words, it’s not attached to the maternal ribs. That as the baby’s moving down that cord is not moving down. The cord is attached to the placenta, which is attached to the uterine wall, right? So, as the baby’s moving down, and the uterus is contracting and pushing everything out, everything is coming down together as a unit. As the top of the uterus is pushing down towards the maternal pelvis, the placenta is also coming down where the cord is coming down. Everything is moving as a unit. That make sense?
Elliot: Yeah. I can picture the analogy, but I can totally see it. It doesn’t really matter if the cord is short if the thing it’s attached to is moving along in the right direction.
Emiliano: Moving with the baby, yeah. I think for a cord to be so short that the baby couldn’t actually make it out the birth canal would have to be an extremely uncommon scenario. I’ve never seen anything like that or read any case reports like that.
Elliot: What about a knot?
Emiliano: Knot is pretty common. We see those here and there. I don’t really know a percentage, but it might be 1% of the time, half a percent of time. Whereas, the babies moving around and swims through loops, and the cord gets tied into a knot.
Elliot: Again, my logical brain says, “Okay. If the main thing is compression, a knot doesn’t sound ideal.”
Emiliano: It’s going to depend on whether it’s pulled tightly or not. If it’s loose, and again, the umbilical vein and the arteries are protected by this Wharton’s jelly, then blood will flow through there just fine. In fact, most of the time, we see a knot. It’s an incidental finding that was never seen on ultrasound. We discovered it at the time of birth, and the baby’s fine. There may be some cases where the knot gets pulled tightly, and then impairs flow through the cord. But that’s something that doesn’t happen often.
Elliot: At the end of the birth, when the baby comes out, people now talk about delayed cord clamping. Do you have thoughts on the idea?
Emiliano: I do. I think it’s a misnomer.
Elliot: Okay. Well, let’s talk about what it is.
Emiliano: Yeah. Okay. In traditional obstetric teaching, you show up for training and your senior resident teaches you how to catch a baby, the baby is born. And then, shortly thereafter, within a matter of seconds, you clamp the umbilical cord and you cut it. Basically, detach the baby from the mother. And then, the baby goes wherever. It goes to the baby warmer, to the mother, wherever it is. But you’ve separated the baby, the mother. And then, you start dealing with delivery of the placenta.
Historically, the cord is clamped immediately. Well, it’s become very apparent with multiple studies that that’s not the ideal management of the cord at the time of birth. There’s a certain amount of blood contained in the placenta that gets transfused into the baby after the birth, and that has some beneficial effects. And so, the current thinking is you should not clamp the cord right at the time of birth, but you should allow that natural transfusion to happen. And then, the cord gets clamped at a later point in time. Whether that be a minute, five minutes, 10 minutes, whatever the interval is. That’s the concept of delayed cord clamping.
Elliot: You’re not into it?
Emiliano: No. I think it’s a euphemism that if you describe “delayed cord clamping,” that sounds like it’s a maneuver. “I’m going to do something new for this birth. I’m going to delay cord clamping, and this is going to confer benefits on your baby.” Well, if you look at premature infants, the difference is tremendous. There’s like a 25% difference in intraventricular hemorrhage, which is bleeding in the brain. It’s one of the really dangerous complications that happen in preemie babies.
The way I think is appropriate to look at this is it’s not the delayed cord clamping that is a new maneuver that confers benefit, it’s at the way we were doing it previously which was premature cord clamping that’s causing harm.
Elliot: [unin 42:36]. Okay. So, you’re very into delayed cord clamping.
Emiliano: I’m very into delayed cord clamping.
Elliot: You just don’t like what it’s called?
Emiliano: Yeah. It obscures the fact that our traditional practice was harmful.
Elliot: Right. I see. You almost remind me of Mitch Hedberg, who used to say, “Why do we call it corn on the cob? That’s just been called corn. It’s the corn when we take it off the cob, that we did something to it.” Right? Anyways. I’m wondering anyway, none of the other animals take out a clamp and go for the cut right away. I wouldn’t do everything they do, like eat the baby. But, sometimes, we can learn from them.
Emiliano: Yeah.
Elliot: I have another very important question. What determines the innie or the outie?
Emiliano: Yeah. I don’t know. I think that’s something that is not determined by the cutting of the cord.
Elliot: Right. Okay.
Emiliano: Eventually, you cut and clamp the cord at whatever time point that is done. You leave a little bit of stock of umbilical cord. And so, that might be an inch or something like that. Eventually, that dries up, it desiccates, and it falls off. And then, the baby’s belly button is remaining. I know, sometimes, people will blame that on the care provider. That they didn’t do this cord right. But that’s really just Mother Nature.
Elliot: As always, when I have you on the podcast, I’ve learned so much. You could even tell by my line of questioning. Like, I don’t know anything about the cord. But now, I do. So, thank you.
Before we wrap it up, is there anything that you wanted to add that we didn’t cover?
Emiliano: I think the main thing is so many of these topics in these issues, and the experience of pregnancy itself is so anxiety-provoking. Particularly, with things like nuchal cord. I’ve seen women who were told by their obstetrician that it was dangerous to labor. They were delivered by cesarean section because of the presence of a nuchal cord seen on an ultrasound. It’s just absolute nonsense. It is heartbreaking that the natural process of birth and childbirth was interrupted and transformed into surgical birth over an issue like this. But it happens fairly commonly.
That’s not to say that the nuchal cord is never ever, in any instance, going to be a problem. In rare cases, it may be a problem. But if you’re going to do a C-section on every single mother that has a baby with a nuchal cord, that means we’re going to do a C-section on one out of every three to four babies for this reason. And then, you got to think about all the complications that we’re going to get from all those cesarean sections. So, we’re really just going to create a lot of complications that don’t need to happen trying to avoid this one rare case.
I think, in general, people need to feel comfortable that these things are safe. They’re not dangerous. You don’t need to have a C-section because of a nuchal cord. In fact, honestly, what you need to do is just sort of ignore that finding. Pretend like nobody ever knew about it, and just treat the pregnancy as normal.
Elliot: That’s what I do with my liver enzymes.
Emiliano: There you go.
Elliot: So, Doc, thank you so, so much. I’m already thinking about new topics to have you back for. Your manner of delivery and the way you break things down for us to understand them is really special. Thank you.
Emiliano: Well, I appreciate that. Thank you.
Elliot: Where can we find you online?
Emiliano: I am pretty old.
Elliot: Does this mean AOL?
Emiliano: So, let me give you my MySpace address. I have a very minimal social media footprint. It’s on Facebook. It’s basically my name and my degree, Emiliano Chavira, MD, MPH, FACOG on Facebook.
Elliot: Beautiful. MD, FACOG, is there something after that?
Emiliano: The in-between was the MPH, Master Public Health.
Elliot: Oh, Master Public Health. M-D, M-P-H, F-A-C-O-G.
Emiliano: Yeah.
Elliot: I guess that wasn’t taken. “Emiliano Chavira, MD, MPH, FACOG.”
Emiliano: Yeah.
Elliot: All right, Doc. Thanks so much. You can always find us online at informedpregnancy.com or on Instagram, @doctorberlin. D-O-C-T-O-R-B-E-R-L-I-N.
by Informed Pregnancy and Parenting Project | Mar 14, 2023 | Health Conditions, Labor and Delivery, Podcast Transcripts
Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I am your host, pregnancy-focused chiropractor, Dr. Elliot Berlin.

You’ve tuned into the after episode of about before and after birth story. My guest today is from northern Italy. She’s a muralist and sign painter. Her first pregnancy went well. But after the birth, she started to feel some awful tailbone pain. Turns out it was broken. She just had her second baby, and we’re going to see how the pregnancy and birth differed. Valentina Trentini, welcome back to the podcast.
Valentina: Thank you for having me.
Elliot: Congratulations!
Valentina: Thank you!
Elliot: All right. So, we talked a bit in the first episode about all sorts of things. How you met your husband, that you didn’t like him. But then, you met him again, and you did like him, and you had babies together. Your first pregnancy, and your birth and how afterwards. If I remember correctly, you said you injured your tailbone during a snowboarding competition first.
Valentina: Yes, when I was 18.
Elliot: When you’re 18. And then, after you gave birth, it felt similar but nobody believed you.
Valentina: Yes, correct. Absolutely. It was horrible.
Elliot: Eventually, eight months of recovery later, you finally started to feel like yourself again after seeing an Italian osteopath.
Valentina: Yeah, absolutely. After like three sessions with her, it went back in place and the pain went away. Thank goodness. Because it was almost eight months of pain.
Elliot: It was such a critical eight months trying to take care of your newborn.
Valentina: Yeah. The first eight months, it was really terrible. I wouldn’t go back in time again and do that all over again.
Elliot: And even though you’re one of the world’s nicest people, and we need more of you, the planet made it difficult for you to have your next baby.
Valentina: Yes. I lost three babies between my older daughter and my current daughter. It was not fun. I went through a lot of pain and a lot of anxiety. I was really discouraged, but everything turned out fine. Thank goodness. I was really lucky.
Elliot: I mean, if you were finally doing IVF, and then right before you went in for your injections, you found out you were pregnant.
Valentina: Right the day before.
Elliot: Yeah.
Valentina: The day before I found out I was pregnant. I took two different tests to make sure that I was really pregnant.
Elliot: In your case, I probably would have taken 20. In your fertility testing, did anything ever come up as a reason why too much [unin 02:58] pregnancy?
Valentina: Absolutely not. Both me and my husband were completely fine. Nothing happened. Nothing at all. We were completely normal. And we never had a single problem. Even the fertility doctor was like, “I have no idea why you’re having these recurring miscarriages. But it’s kind of let’s say normal at your age because you’re past 35. And it can be kind of normal.” Nothing came up.
Elliot: During your pregnancy, understandably, you had some anxiousness, some fears. Did you have those in your first pregnancy?
Valentina: No. My first pregnancy, I was super chill. I was never anxious. I never had a single doubt. Like even with that doctor at the beginning told me, “Oh, you’re pregnant,” and was four weeks pregnant what he told me when we found out. He was like, “Well, we need to wait until eight weeks, we’re going to talk. And in four weeks, if something happens, it’s kind of normal.” I was like, “What can happen? Nothing is going to happen.” In my mind, I was like, “Well, I’m pregnant. I want to have a baby and it’s going to be done.”
Elliot: It’s going to happen.
Valentina: Yeah.
Elliot: So, this anxiousness that started to kick in, was that related to what?
Valentina: Well, at the beginning, I was anxious that I was going to have a miscarriage early. In the middle of it, I was anxious that my baby would have had a brain damage. And toward the end, I was anxious that I would have had a stillbirth. I think that when my brain started to understand that everything was going well, my brain was finding something wrong. Because I think that the pain that I went through with the three miscarriages was too much for me that my brain was trying to like put me in a safe place and be like, “Okay. Something is going to happen. You need to be prepared if something is going to happen.”
Elliot: Expect the worst.
Valentina: Yeah.
Elliot: Literally. I guess during pregnancy would say expecting the worst.
Valentina: Yeah.
Elliot: How did you deal with that anxiousness during the pregnancy?
Valentina: I did a lot of therapy. I was seeing my therapist every week. I was doing with you, a lot of sessions. And I was doing acupuncture, and I was doing a lot of physical exercises because I was trying to release all the stress and all the anxiousness. But it never went away. It was always in the back of my mind and my head. I was dealing with it. Like, living with it. Living with the fear, that living with the anxiousness, living with all these horrible feelings that I was trying to be happy and enjoy the pregnancy. Now, looking back at my pregnancy, everything was perfect. I never had a single problem. But it was a very hard nine months. I felt like I was holding my breath for nine months. That’s what I was feeling.
Elliot: You’re also concerned about that tailbone.
Valentina: Yeah. That was one of my biggest fear. At a certain point, I started to ask my doctor if I should have had a C-section instead of vaginal birth. Because I was like, “Maybe I have less chance of breaking my tailbone with a C-section.” My doctor is amazing. He was like, “Let me talk to a specialist that is a good friend of mine and ask him what you should do.” And even the specialist was like, “I will not do it if I were you.” My doctor was like, “I would not recommend that you have a C-section. Because yes, you’re going to recover in two months instead of eight.” But at the same time, it’s still like a major surgery. It’s still like something that your body is going to have to go through, and there can be complications, and you never know.
Elliot: And, of course, there’s a chance that your tailbone wouldn’t break.
Valentina: Yeah.
Elliot: All right. How was the very end of your pregnancy?
Valentina: The very end of my pregnancy was — I was still very anxious. But, actually, I started to feel a little bit more at peace. Because I was just counting the days. I was still thinking, “Oh, my God. I’m going to break my tailbone. I’m going to be in pain for so long.” But, at the same time, I was like, “Okay. We’re very close to giving birth. The baby’s still fine. She still kicks.” It was a mix of feelings. I was in a glass of emotions.
Elliot: When in the 40-week count there, and how did your labor start?
Valentina: The labor started when I was 39 weeks, 38 or 39? I think 39, yeah. Because I was six days early. I didn’t sleep that well the night before. My husband had a sore throat. He kept me up all night, and I was like, “Well, great. I cannot sleep.” Then I kind of like woke up at 7 a.m. I was like, “Something is like hurting.” I was like, “Oh, maybe it’s a contraction.” I started to time them, and I was like, “Oh, yeah. I’m having contractions.” I called my sister-in-law. She came from Oregon to help me and be in the room with me. I was like, “Okay. I think it’s time.” I told my husband and he was like, “Well, it’s 7 a.m. I need to go to work. Do I have a couple of hours?”
Elliot: Oh, wow!
Valentina: I was like, “No more. Not more than a couple of hours.” So, then, I called him at 9:30. I was like, “Why! They’re three minutes apart. I think it’s better if you come home right now.”
Elliot: Wow! Three minutes apart.
Valentina: Yeah. Let’s say, three to four minutes. Most of the time, there were three minutes apart.
Elliot: Also, what did they feel like?
Valentina: It was weird. Because with my first pregnancy, I was at home for seven hours and I just remember the worst part, the painful, painful part. This time, it was not bad. I was like, “Wow! This is actually not painful. So, I can do everything without an epidural. Like, this is easy.” I started to feel like contractions in my back, and I think that the adrenaline kicked in. I was just so happy. I wasn’t in that much pain.
Elliot: You were home with your sister-in-law?
Valentina: I was home with my sister-in-law, with my mother-in-law, with my niece and nephew, and my daughter.
Elliot: Oh, my goodness. It’s a big crowd of [unin 09:23].
Valentina: Everybody was around?
Elliot: Yes. And then, I was like, “Well, I looked at my daughter.” I was like, “Mimi, mommy is going away for two days. I’m coming back, and I’ll bring you a sister.” She was like, “Okay, mommy. I’m going to see you in two days.” I was like, “Okay.”
Elliot: She’s 4 years old?
Valentina: She’s 4.5, yes.
Elliot: Okay. So, she understands?
Valentina: Oh, yeah. She fully understands, big time.
Elliot: Well, let’s take a quick break. When we come back, we’ll find out what happens when you head to the hospital. We’ll be right back.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We’re talking to Valentina Trentini. She is in our story now in labor, a long journey to get there, and a lot of heartache and anxiousness going into it. But labor starts. Surrounded by a lot of family, except for your husband, who’s at work, and it’s not too intense. And you decide though to go to the hospital. Is that because the pattern changed?
Valentina: Because my doctor was like, “When you’re like less than five minutes apart, just come to the hospital. Just don’t stay home. We’re going to check. And then, if you need to go back home, we’re going to send you back home. If not, we’re just going to keep you here.” But the good thing is that I got there, I opened the door of the room where you check-in, and my doctor was there. It was the day that he was on call.
Elliot: Oh, wow. How nice.
Valentina: Yeah. I was the happiest person. It was amazing because a week before, he told me like, “Well, if you give birth on Friday or on Monday, that’s when I’m on call.” Actually, I went into labor on Friday. So, I got there. He checked on me. He was like, “Well, you’re 3 centimeters dilated. Usually, we keep you in the hospital at 4 to 5. But, I know you. I know you know your body. So, if you tell me that you prefer to stay here, I’m going to keep you here.” I was like, “I think that it’s changing really fast.” He was like, “Okay. Stay here.”
Elliot: Three centimeters. I mean, how was that news to you? Is that what you expected?
Valentina: No. I thought that I was more than that. But I was like, “Something is changing so fast.” The contractions are going so fast, and they’re more intense now that I was like, “Oh, I’m going to dilate faster than everyone thinks.” Actually, less than an hour later, I was at 5.5.
Elliot: [unin 11:55] quick.
Valentina: Yeah. I was screaming, and everyone got into the room. They were like, “Are you giving birth right now?” I was like, “No. Just in a lot of pain.”
Elliot: Okay. But your husband’s with you now?
Valentina: Yes. My husband was with me.
Elliot: Anybody else with you?
Valentina: I mean, his sister?
Elliot: Oh, your sister-in-law came also.
Valentina: Yes.
Elliot: Okay.
Valentina: The two of them.
Elliot: All right. When it got a lot more intense, do you remember where you felt it, and what about it was more intense?
Valentina: Actually, I was in the room, in the waiting room. I don’t know how you call it in English, but it’s like the room —
Elliot: Triage.
Valentina: Yeah. Triage, thank you. That one. When I was in the triage, the contraction started to get closer and closer together and very, very intense. But the thing is they had to put the monitor on my belly, and they had to monitor the baby for 20 minutes in a row. They didn’t tell me, so I kept moving because I was in a lot of pain.
Elliot: Restarting the count?
Valentina: Yes. So, every time, they were like, “No. We have to redo it. We have to redo it.” I was like, “No!” I was like, “Give me an epidural. I can’t deal with this anymore. I need an epidural right now.” And so, they put me in the room. And within an hour, they gave me an epidural. Thank goodness. I was in heaven. I was so happy. So, so happy.
Elliot: Did the first time you tell me the epidural slowed everything down for you?
Valentina: Yes. That’s what I think happened the first time. My doctor thinks that that was not the epidural. Because the epidural actually accelerated everything.
Elliot: Yeah. Speed things up.
Valentina: But I think that the first time the fact that my body was in shock. I was in so much pain, and my body just shut down. My body was like, “I can’t deal with this anymore. You need to relax. You need to rest for a little bit, and then we can continue to do this.” So, this time actually, the epidural, I was like 5.5, 6 when I got the epidural. And then, within like a couple of hours, I was already at 8. Everything was going perfectly.
Elliot: Fast-moving train.
Valentina: Yeah.
Elliot: Now, at this point, is there any of that anxiousness, or you feel calm? Is there any concern, talk about how to protect your tailbone for what’s coming next?
Valentina: At that point, I started to like see all the nurses coming in. All the nurses. The two nurses that I was assigned to, and the midwife, and my doctor. We all talked about, “Okay. Last time, I broke my tailbone. What can we do for this not to happen again?” The nurses were incredible. They were seriously amazing. They were all super understanding. They were like, “Okay. When it’s time to push, you’re going to push on your side, and you’re going to push on your hands and knees. We’re going to try to like not put any pressure on your tailbone.”
Elliot: Nice.
Valentina: That was my biggest fear, and I told them. They were seriously very understanding, and they were very sweet with me. To the point that I was talking to the nurse because she was asking me the questions, routine questions. She asked me, “Are you anxious, or any bad thoughts that you had during the pregnancy?” I was like, “Well, I’m scared that I’m going to have a stillbirth. But, you know, that’s me.” I try to put make a joke about it because I was kind of uncomfortable. Because every time that you tried to tell something like this to someone, they are very uncomfortable with you saying that.
Elliot: Sure.
Valentina: And she stopped. She walked around the bed because I was on my right side, and she was behind me. She looked at me in the eyes and she was like, “This is a different pregnancy. Nothing is going to happen to you. I’m here for you. Anything you need, you tell me. I’m here for you.”
It was the first time in almost two years that someone in the medical field really talked to me on a human level. And really made me feel comfortable. She was listening to me. She didn’t just say like, “Oh, yeah. You know, it’s fine. Everyone thinks that.” Or like she really thought that something was wrong, and she needed to tell me that she was there for me. It was amazing actually. And so, that really calmed me down. Then my doctor came in. It was like around 2 p.m. He was like, “Well, I don’t have any nurse right now to be with me, like to start to push, and I have two emergency C-section.”
Elliot: Oh, my goodness!
Valentina: Yeah. He was like, “Would you be comfortable to wait a little bit?” I was like, “I am on vacation. I have my epidural. I am not in pain. I have my bed. Don’t even worry about it. Do what you have to do, and come back when. If it’s time, I’m going to let you know.” And then, at 5 p.m., I was ready. And then, at 5:30, we started to push. I actually pushed on my side. And like last time, the pushing part was amazing. I felt empowered. I felt strong. I felt like, “Oh, my God! I can do this. This is really what I’m good at.”
Elliot: You’re a pusher.
Valentina: Yeah, I’m a pusher.
Elliot: Because of the epidural, how much could you feel or not feel?
Valentina: I felt everything.
Elliot: Did they deliberately turn it down?
Valentina: No. Because with Kaiser, they give you the remote so you can push the button and give yourself as much epidural as you want. But after a certain point, they tell you, “Okay. You’re almost there. You cannot push the button anymore. No more epidural because we need you to feel a little bit.”
Elliot: Yeah. You felt a lot.
Valentina: I felt a lot. Actually, when I was on my side, I was feeling more. So, she wanted me to go on my hands and knees because the baby wasn’t turned in an ideal position. The nurse, actually, she was amazing because she asked my husband and his sister to be on both sides. And then, you have this blanket and to wrap this blanket on my belly.
Elliot: A rebozo.
Valentina: Yes. She was like, “I saw this midwife doing it to another patient. Let’s see if this works with you.” They rub my belly for like, I would say five minutes. Something like that. And the baby turned. She was like, “Great. The baby just turned. You can be on your back, and then we can push her out.”
Elliot: Oh, wait a second. Did you feel the baby turn?
Valentina: I don’t remember that.
Elliot: Okay.
Valentina: I was like so in the moment that I don’t know if I felt a baby turn.
Elliot: Two more questions. One is because you said you could feel a lot with the epidural kind of wearing off. What sensations did you feel?
Valentina: Pain. Pain on my right side. Because she was pushing on my right side.
Elliot: Oh, like in your right hip?
Valentina: Yeah. The right hip, back, and a little bit in the front was where I was feeling it the most.
Elliot: That’s interesting. Because in pregnancy, you kind of had some discomfort there.
Valentina: Yeah, that’s true.
Elliot: Okay. So, then, the baby rotated into a better position. Do you still feel the pain at that point? And also, is it only with a contraction or you feel it all the time?
Valentina: I was feeling it all the time. But I knew that she was so close to coming out that it wasn’t a problem. And then, actually, when I was on my back, I thought that the nurse was giving me a perineal massage. I almost told her, “No massage. I don’t want that massage.” And I saw her that she wasn’t even close to me. I was like, “Oh, that’s the baby’s head.”
Elliot: The baby gave you a perineal massage.
Valentina: Yeah. The best part was that my sister-in-law told me, “Oh, I see some eyes. Oh, I see a chin. Oh, I see some shoulders.” And when she was telling me that, I was feeling everything. I was feeling the shoulders coming out. I was feeling everything coming out. It was like, with my daughter, I wasn’t feeling that, with my first daughter. That was incredible. I was like, “This is amazing!” It was seriously the most amazing feeling in the world.
Elliot: Wow, that’s great! A lot of people talk about burning during that time. Did you not feel burning?
Valentina: No. I felt a lot of pressure because her head was halfway out, and they kept her there for what felt an eternity. But, for sure, it was a few seconds. But, when she was coming out, I wasn’t feeling pain or burning sensation, nothing. I was just feeling her coming out.
Elliot: Literally, her body parts coming through you into the world.
Valentina: Yeah. And then, when they put her on me, I just asked everyone if she’s breathing, is she alive. “Is she breathing? Is she alive?” That’s what I was asking everyone.
Elliot: I mean, emotionally, how did that feel? When they put her on your chest and you were there, and she was healthy.
Valentina: I felt like a giant rock that was not on my shoulders anymore. I felt light. I felt this relieved. I felt that I could breathe. I remember that I was breathing, like deeply breathing. I was like, “Okay, she’s here. It’s done. It wasn’t that bad.” My head did everything. I was just relieved. I was seriously relieved and happy that I could breathe.
Elliot: All right. Let’s take one more break. When we come back, I have a few more questions about what happens next in the moment and after you get home. We’ll be right back.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We’re talking to Valentina Trentini.
Okay. A long, long road to get to that beautiful finish line. It sounds like a really gorgeous finish line for you. And also, sounds like the weight that had been sitting on you for nine months, on your shoulders, released as soon as the weight’s sitting on your pelvis is also released. You talked about how during pregnancy, the game plan was to sort of be on your side or all fours. But it sounds like when you actually push the baby out, you were on your back.
Valentina: Yeah.
Elliot: Was there a conscious change in choice?
Valentina: No. At that point, I was in the hands of the nurse and the doctor. I was just trusting them. Because they won my trust, and I was like very comfortable with them. The nurse was like, “Don’t worry. Even if you push, the last push is like on your back, everything is going to be fine. Nothing is going to happen to your tailbone. I promise you, we’re going to do everything we can for you not to be in pain anymore.” So, I just trusted them.
I think that I was feeling that everything was right. Because I could feel more than with my first daughter. I think that my body knew what was going on, and I knew what I was doing. That’s why I was like, “Okay. You want me on my back, I’m just going to be on my back.”
Elliot: Nice. How is your placenta delivery?
Valentina: It was fine. Even with my first daughter, it came out right after. They didn’t have to do anything. I didn’t even get any stitch. No stitching. Nothing.
Elliot: No tearing?
Valentina: Nothing. It was clean, perfect.
Elliot: Were you worried about what would happen on the epidural totally wore off?
Valentina: Yes, absolutely. When I started to feel way more. When I started to feel my legs again, I was like, “Oh, my God. Is everything fine? Am I in pain? No, I’m not in pain.” So, that’s great. Actually, they wanted to give me Motrin, the painkiller, for the pain. I didn’t even take it. I was not in pain. I was happy that I was not in pain. Very happy.
Elliot: Okay. So, no tailbone injury.
Valentina: Nope. Thank goodness, nope.
Elliot: All that worry.
Valentina: For no reason.
Elliot: And like you said, I think it was your nervous system trying to protect you.
Valentina: Yeah. I think that your mind is so powerful. I was in so much pain during the miscarriages. Three miscarriages in a year, it’s a lot for anyone.
Elliot: Yeah. I mean, one is scary.
Valentina: Yeah. The problem is that not being able to talk to anyone, and not being able to have a lot of support. Yeah. I had my therapist, and I had you, and my acupuncturist. But, other than that, none of my friends had to go through that. None of them. So, it can feel lonely. That’s why I think that my mind was like, “Okay. Let’s have a plan for the second pregnancy. Let’s find something that for sure it’s going to be wrong. Believe that it’s going to be wrong. So, then, if it’s going to be wrong, you’re going to be protected.”
Even if something goes wrong, it’s not that because you’re prepared it’s going to be less painful. Actually, it’s even worse. I was telling myself during my miscarriages, “See, I told you. You should have prepared yourself for like the worst. So, then when the worst was coming, you could have been prepared and not be in pain.” But then, you’re in so much pain anyway, and it’s really bad.
Elliot: Well, I’m sorry that you had all that pain and suffering, emotionally and physically. I can only imagine how much more you are excited to hug your little baby and to hear those cries, 24/7, whenever they happen. Just squeeze a little harder. How is postpartum and the house, having a toddler and a newborn at the same time?
Valentina: Well, it’s very hard. I think that she’d never prepare for this. I’m very lucky because my daughter, she’s 4.5 and she understands everything that is going on. Actually, she’s not really jealous about her sister. Actually, she’s super happy. She wants to cuddle her, and kiss her, and be with her all the time. But still, she’s still a toddler and she still wants my attention. And a newborn requires a lot of attention.
So, I have help. I’m really lucky that I have help. With my first daughter, I didn’t have anyone. I was home alone with her, and it was very, very hard. I promised myself that if I would have another daughter, another child, I would ask for help, which is the most important thing right now for me. Yeah, it’s great. It’s actually everything I wanted. It’s very tiring. It’s very hard. But I’m very happy. She’s here. Then, everything went well, and the pain is gone. That’s what I’m happy for.
Elliot: So, happy to hear that. What are you doing for your self-care now in the postpartum phase?
Valentina: I take long walks, which is what I really needed the most. I work in my studio, which is very relaxing. That’s my space. That’s my time. Nobody comes in my studio. I paint and I relax. For me now, that this is working and it’s the most important thing for me right now. I’m going to go back to therapy, for sure. Because I really need it. Because I think that the trauma is still there. I really need to deal with it, even if I’m feeling good.
Elliot: Sure.
Valentina: Yeah, painting is what makes me feel happy and relaxes me. So, that’s what I’m doing right now.
Elliot: I’m going to get paid for it.
Valentina: Yeah. Not bad.
Elliot: Are you still back to hanging off at bridges, and ropes, and things painting giant murals and banners?
Valentina: Well, now, no. Not yet. But now, I’m going to paint a couple of vintage cars. A couple of Porsche. I’m going to — what do I have again? I have another, some coffee shops, and some gold signs that I have to paint, which is very awesome. I love painting that stuff.
Elliot: I guess, my last question for you is does your family feel complete now, or do you see yourself expanding again in the future?
Valentina: That’s a good question. I’ve always wanted to have three kids, with my husband. When I met my husband, I was like, “I’m sure I want three kids with him.” I think that now, my family feels complete. I don’t know if I want to go through pregnancy again. Because it took a big toll on my mental health. For now, I’m fine. For now, I have two beautiful daughters and I couldn’t be happier. I don’t know. Maybe in six months, I’m going to tell you, “Well, I want to have another kid.” But I don’t think so. I think that holding my breath for nine months was enough for me.
Elliot: Yeah.
Valentina: To say, “No, I don’t want to go through that again.” Never say never, but that’s what I feel right now. I don’t think that that’s my path.
Elliot: Yeah. I mean, it’s good that you feel associated, but that also that you have an open mind. So, nothing’s final.
Valentina: Yeah. Nothing is written in stone. But I told my husband, “If you want another kid, maybe we’ll get a dog.” Maybe the dog is going to complete the family. I don’t know. We’ll figure it out. But I think that for now, we’re fine. We’re happy. It’s a happy ending. It was a very horrible story that has a happy ending, and I’m very lucky and very grateful that I can say that.
Elliot: I’m so happy for you. You’re the nicest person and very passionate. Every time I talk to you, I get hungry for pasta and pizza.
Valentina: Me, too, actually.
Elliot: Valentina, thanks so much for joining me and for sharing your story. Tell us again where we can find you online.
Valentina: You can find me @brushettasigns on Instagram, and brushettasigns.com. If you want to see my signs, and my murals, and my art, you can go there and I share everything. Every week, there is a different project.
Elliot: I can’t wait to go take a peek. I’ll see you there. At home, thanks for listening to our podcast. If you want more content like this, I would go to informedpregnancy.com.
by Informed Pregnancy and Parenting Project | Mar 7, 2023 | Podcast Transcripts, Pregnancy
Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I’m your host, pregnancy-focused chiropractor, Dr. Elliot Berlin.

Today, I’m talking to an Italian-American artist, painter — we’re going to find out more about that; and soon to be mother of two, and her experiences with her first birth where she fractured her tailbone. And then, secondary, infertility and now, pregnant and about to have a kid, Valentina Trentini. Welcome to the podcast.
Valentina: Hi. Thank you for having me.
Elliot: How many weeks are you with this kid?
Valentina: Thirty-eight and half.
Elliot: Thirty-eight and a half. So, we have plenty of time?
Valentina: Yes.
Elliot: All right. Let’s start at the beginning. Where are you from originally?
Valentina: I’m from Bologna in Italy, in the north. And then, I moved here about 10 years ago for work.
Elliot: Welcome.
Valentina: Thank you.
Elliot: What’s it like in northern Italy?
Valentina: It’s like a crazy part of Italy because it’s not mellow and chill, like the rest of Italy. It’s fine. The food is great. The wine is amazing.
Elliot: When you say “Italy,” I gain weight every time.
Valentina: Yeah.
Elliot: Just thinking about what the food could be like. What brought you to the U.S.?
Valentina: Ten years ago, I received an offer, a job offer, as a store manager for an Italian shoes company. They were opening a new store in L.A., so they asked me to manage the store. I was like, “Why not? I always wanted to live in L.A.” They accepted and I moved here. I didn’t have any friends. I didn’t know anyone. And then, slowly but surely, I started to meet tons of people. Now, I’m here.
Elliot: Did you meet your husband here?
Valentina: Yep. I met my husband here in L.A. at a photography exhibition.
Elliot: Oh, wow. Okay. You’re also an artist.
Valentina: Yeah. I’m a muralist and a sign painter.
Elliot: How did you get into that?
Valentina: I’ve always been very artistic since I was a kid. And then, I went to art high school, and then I became a graphic designer. And then, when I moved here and when I was working at the store, I got a little bit bored. I was like, “Let me do something more artistic.” I started to learn calligraphy on my own on the side. And then, I wanted to do something more, and be more and more artistic. And then, I found about sign painting and murals, and that’s how I got into it.
Elliot: It’s so amazing to me because I have a hard time with big pictures in general. It’s incredible to me. I couldn’t make anything like that even in a small space. But to map it out, and plan it, and get all that, it’s incredible. We’re going to have to put up some of your beautiful artwork on the socials when this comes out.
Valentina: It’s very fun. It’s very, very fun.
Elliot: And then, how you met your husband is kind of fun. How did that come about?
Valentina: I met him at a photography exhibition at the Sunset Marquis here in L.A. And then, I didn’t like him at all. I was with my best friend. He was with his best friend. He was talking, and I just geared up and left, because I was like, “This guy is not interesting.”
Actually, a month later, my best friend was like, “Oh, you need to start dating. You need to download this app. It’s called ‘Hinge.’ It’s friend of your friends on Facebook.” I was like, “Okay. Let’s do it.” Italians at the time we’re not really into dating apps, but I did it anyway. The first person I saw in the app was him, and I texted him. I was like, “I know you.” He was like, “No. I don’t think we know each other. But do you want to hang out?” I was like, “Okay.” And then, after five minutes into our dinner, we realized that we talked a month and a half before, and we laughed. And then, we live like we lived together and we’ve been together for like eight years.
Elliot: Look at that? Love at second sight.
Valentina: Yes, absolutely.
Elliot: That could be a whole book. Okay. Kids, did you talk about kids early on? Was there a decision, “Hey, this is a good time we talked about it.”
Valentina: We talked about it around like a year, year and a half since the start of the relationship. We wanted to have kids, and we started to like try to have kids. We tried like for like three to four months. No more than that, and then I got pregnant, basically, right away. Never had a problem with that pregnancy. Never had a like — nothing. Everything was perfect. The first pregnancy was amazing.
Elliot: What was your form of birth control before that?
Valentina: I took a pill for like 15 years, 17 years. I started very early when I was 14 because I had acne and that was the only thing in Italy that the urogynecologist was prescribing you to treat it. I continued to take it for 17 years. It was a lot.
Elliot: Dual purpose.
Valentina: Yeah. It wasn’t that great. I wasn’t feeling that good. That’s why when I met my husband, like when I was around 30, 32, I stopped. I was like, “This is too much. I don’t want to continue anymore.”
Elliot: Was that when you started to have kids or before that?
Valentina: No. It was before that. It was like, let’s say eight months, 10 months before that.
Elliot: Okay. After that, you said, “Let’s have kids.” And then, three months after that, you got pregnant?
Valentina: Yeah.
Elliot: Something like that. What did you do for the 10 months to prevent pregnancy?
Valentina: We use a condom, and [unintelligible 06:04].
Elliot: Did you have regular cycles?
Valentina: Yeah, very regular. I’m like a Swiss clock. That’s what we say in Italy. When you’re on point every month of 28 days, I get my period and it’s, “Oh, I was getting my period.” It was always five days. No more than five days.
Elliot: Wow! That sounds more German than I am.
Valentina: Yes.
Elliot: So, then, you get pregnant. How was that first pregnancy?
Valentina: It was amazing. I was very relaxed. I was very calm. I really, really enjoyed it. I was still working, but I was going to the pool every day to do laps, and I really, really enjoyed it. It was very easy. Very, very easy pregnancy.
Elliot: You sound European.
Valentina: Yeah.
Elliot: Okay. What happened was like for birth, did you have a particular plan? A thought on how you wanted it to go? Did you do any prep?
Valentina: I did. Because I lost my mom in 2014, I moved here and I didn’t have anyone here. I just had my husband’s family. I decided to have a doula to help me navigate through like late stage of pregnancy, and then birth, and then postpartum. It was very, very helpful. We decided, “Oh, maybe let’s not get an epidural if I can. Let’s stay at home as much as I can until my water breaks.” My plan was stay home as much as you can, don’t get an epidural, basically, go with the flow, and see how it goes. But, of course, births never goes to plan.
Elliot: Okay. How did it start?
Valentina: I woke up at 2 a.m., excited to have contractions and actually they were pretty close together. Called my doula I would say like around 4:00. Because I was like, “Oh, maybe it’s not that bad.” Like, I could handle it. And then, she showed up at 4:00. She was like, “Your contractions are very, very close together. You should have called me before.” But I was like, “I could handle it. No big deal.” And then, we stayed home until 9 a.m. I was at home until 9 a.m. And then, at 9 a.m., I was like, “I cannot take it anymore!” I was having a hard time breathing and my contractions were not minutes apart anymore. They were next to each other.
Elliot: No breaks.
Valentina: No breaks at all. I was done. I got to the hospital and I couldn’t take it anymore. I was in a lot of pain. I think my body went in complete shock because of the pain. The doctor was like, “If you don’t want to take it get an epidural, don’t do it. Because you’re two hours away from giving birth.” But for me, I reached my limit.
Elliot: Do you remember where the pain was, that was sort of overwhelming you?
Valentina: I think it was in my back.
Elliot: Your lower back.
Valentina: Yeah, in my lower back. I couldn’t even stand straight. I think that the fact that I was overwhelmed by the contractions and I was having a hard time breathing, that for me, was like a little bit too much.
Elliot: Sure.
Valentina: I started to get scared.
Elliot: How was the epidural for you?
Valentina: When they put the needle in, I didn’t even feel it. I was like, “This is the dream.” But then, a little bit, they give you a remote that I could control the dosage of the epidural. I think I got too much because I was in a lot of pain.
Elliot: What kind of pain from too much epidural?
Valentina: When I got to the hospital, the pain was unbearable for me. I think that…
Elliot: Oh, you’re saying you overdid it with the epidural because of that.
Valentina: Yes. I did overdo with the epidural. I think I made a mistake because I couldn’t feel my left leg anymore. My right leg, I could still feel it. But for me, my body was in shock, it just shut down. I went to the hospital that I was 7 and 1/2 centimeters dilated.
Elliot: Wow.
Valentina: My body was like just shut down. My body was like, “I cannot do this anymore. You need to relax. You need to stop.” It’s just becoming too much.
Elliot: So, labor stopped happening?
Valentina: Labor stopped. I completely stopped for 10 hours.
Elliot: Was that like restful for you, at least? Recovery-wise?
Valentina: I could rest a little bit. I was very lucky, if I have to be honest. Because I was at the Kaiser hospital, and they offered you a midwife during the day. My midwife was really good. She was very, very, very, very, very amazing. She was like, “I’m not going to call the doctor. I want you to have a vaginal birth. I don’t want to give you a C-section.” Because by the time that I got to the hospital, they broke my water two hours later. I was for a few hours in the bed with my water.
Elliot: On the clock?
Valentina: Yeah. Seriously. She was like, “I have the feeling that you need to be alone for a little bit.” So, everyone went out, left the room. I was alone. I had put some music on. I started to breathe. Around, well, let’s say 40, 45 minutes later, she came back. She was like, “Well, you’re there. We’re almost 10 centimeters. We start pushing now.”
Elliot: Okay. So, you didn’t need to augment your labor with like Pitocin?
Valentina: They did. It didn’t work.
Elliot: Oh, it didn’t work.
Valentina: Nothing worked.
Elliot: You just had to wait for your body to be ready again?
Valentina: Yeah.
Elliot: How was pushing?
Valentina: Pushing was actually the best part of everything.
Elliot: How do you mean?
Valentina: It was easy. It felt very natural. It felt like, “Okay, I got this.” Actually, it felt like 10 minutes. I thought 10 minutes went past. The doctor came in. I was like, “What do you mean the doctor is already here? It’s just 10 minutes.” They’re like, “No, honey. You’ve been pushing for an hour.” I was like, “Oh, okay!”
Elliot: Still kind of quick for a first birth.
Valentina: It wasn’t bad. I felt empowered. I was like, “I got this.” That was really good.
Elliot: Was the epidural turned down? Could you feel things?
Valentina: I actually could feel things because I stopped like giving myself epidural I think two hours before.
Elliot: You stopped adding on?
Valentina: Yeah. I could feel it because also the doctor, when the head came out, left the head like halfway?
Elliot: Yeah.
Valentina: She was like, “I’m going to leave her here for like a second because I don’t want you to rip.” I was like, “Okay. We got this. It’s fine.” After a little bit, I couldn’t take it anymore. It was like very painful, but that prevented me from tearing.
Elliot: You didn’t tear or just a minimal tear?
Valentina: Nothing. Not even a stitch.
Elliot: All right. Well, let’s take a little break because something didn’t go exactly according to plan. Let’s take a little break and come back and find out what that was all about.
[break]
Elliot: Welcome back to the podcast. We’re talking to Valentina Trentini. You have the baby, pushing was easy. But then, what happened afterwards?
Valentina: What happened was they put me in a different room, and the epidural started to slowly leave my body.
Elliot: Meaning, you start to feel everything again?
Valentina: Yes. I started to feel everything again. I was starting to feel this like super sharp pain in my lower back and in my tailbone. I told everyone. I was like, “There is something wrong. There is something wrong. My tailbone is hurting really bad.” Everyone didn’t believe me. Not a single person believed me. They were like, “No. You just gave birth. You don’t know what it is.” “I know my body, and the pain is different.”
Elliot: Can I just go back a second before that? Because you do seem to know your body really well. Some people do more than others, or some people are a little more connected than others. There’s a lot of noise and clouding around. Sometimes, we’re not so in tune. But in terms of your connection with your body, were you, prior to pregnancy, healthy? Did you exercise and were you like a worker outer? Were you a healthy eater?
Valentina: I’ve always been very healthy. I’ve always been a very active person. I was a snowboarder through my teenage years until I was 25. Previous to that, I was a gymnast. I always eat very healthy. Italians are like, we eat a lot of pasta and pizza but we’re healthy people.
Elliot: Because you drink a lot of wine.
Valentina: Yeah. Because we drink a lot of wine.
Elliot: I was a gymnast one time when I tried to go ice skating, but that’s a whole [phonetic 14:23].
Valentina: For me, I knew the pain. Because when I was 18, during a snowboarding competition, I broke my tailbone. I knew the pain. I knew how bad it is and I knew exactly where the pain is. I got really upset when nobody was believing me.
Elliot: I also wonder, did you tell them that you had a previous tailbone injury and this is what it felt like? They still weren’t buying it?
Valentina: Yes, I did. The thing is I don’t think that anyone would actually think that I would break my tailbone during giving birth.
Elliot: No. It does happen. It’s kind of rare, but it does happen. Especially if you have a previous fracture, and you know what it feels like. Again, you’re someone who has always been athletic and in touch with your body, so why not believe you? Okay. So, then, nobody did anything to help treat it?
Valentina: No. I went to my previous gynecologist. She was like, “Oh, I’m going to assign it to a physical therapist.” But the regular physical therapist, they don’t know what to do. They were giving me exercises. I was like, “This is not an exercise for the kind of pain. This is something different.” So, I went through like a physical therapist here for like six to eight months, and nothing happened. Nothing. I couldn’t hold my baby. I couldn’t sleep on my side. I couldn’t sleep on my butt. I couldn’t sleep. Period. When I was sitting down, I was feeling my tailbone popping in and out which was the worst thing.
Elliot: Painfully?
Valentina: Painfully, yeah. I was hearing it. I was hearing like, “Pop!”
Elliot: All right. Can I ask a question? When you entered snowboarding, was there anything specific you did for recovery then?
Valentina: No.
Elliot: They will just be going to let it heal?
Valentina: Yeah. Basically, when I went to the hospital, they were like, “We can put you a cast from your neck to your knees, and just you stay in a cast for like a month in a house. But if not, there is nothing you can do about it.”
Elliot: Well, I’ve never even heard of that. That’s crazy.
Valentina: “Thank you, no.” I was 18, so it was like 20 years ago. Maybe things have changed.
Elliot: You pushed through it and just deal with it.
Valentina: Yeah.
Elliot: Yeah, maybe we have a better remedy today, I don’t know.
Valentina: Hopefully.
Elliot: And then, the physical therapist that you were seeing here in the U.S. was not a specialist, not a pelvic health physical therapist.
Valentina: Not a specialist. I didn’t even know. If I have to be honest, I didn’t even know that you can see a specialist for your pelvic floor for that specific area. I didn’t know, and nobody told me. Not even my doctor told me. That’s why she’s not my doctor anymore.
Elliot: I mean, not being able to hold your baby. You’re such a passionate mama, that must have been really challenging.
Valentina: It was. It was really challenging because I couldn’t do anything. I really couldn’t do anything. Not only I broke my tailbone, but the bone was not in place. So, for me, it was like a struggle. I struggled for eight months, then it’s a very hard recovery.
Elliot: That was such a long time, and it’s such a painful situation, physically. But then, emotionally, those eight months or the months you want to be doing everything for your baby. I’m so sorry. How did you eventually resolve?
Valentina: I finally decided to take my baby, went to Italy to visit my family for like a vacation for two weeks. I saw this physical therapist and osteopath. She’s treating my family for years, and she was amazing. Three sessions with her and my tailbone went back in place. Still hurting, but at least it was in place and I could like sit. I could do everyday stuff. It was very painful.
Elliot: What did she do?
Valentina: Basically, she started to massage all the muscles around my vagina. Because the muscles were so tight that they were holding everything.
Elliot: Your pelvic floor muscles.
Valentina: Yes. If I have to be honest, that’s the only thing I remember because it was so painful. I just remembered after the third session, I could walk. I could put tight jeans on and bend over, and not feeling pain. It was a little bit like I could feel it, but I was not in pain anymore after eight months.
Elliot: Those pelvic floor muscles run like a hammock from behind your pubic bone in the front to in front of your tailbone in the back. When it’s super tight like that pulling so hard, it’s very difficult to recover. It sounds like she went internally to find those muscles and release them manually. And then, you could start to heal.
Valentina: Yeah, that’s exactly what it was.
Elliot: Here, that’s a specialty, pelvic health physical therapy. All right. Then you recovered, and at what point did you start thinking, “Yeah, let’s do this again.”
Valentina: I started to think about it two years later. During the pandemic. It was 2020, September, I got pregnant again.
Elliot: Right when you started trying?
Valentina: I started trying like — even then, it was two, three months.
Elliot: Okay.
Valentina: And then, I got pregnant. It always been kind of easy for me to get pregnant.
Elliot: It’s a gift. Everybody has some things that come easy to us and other things that we struggle with.
Valentina: Yeah.
Elliot: Thankfully, at that time, it was a gift.
Valentina: Yeah. But after that, I had my first miscarriage. I was five and a half weeks, which was very traumatic because I didn’t understand what was going on.
Elliot: Okay. Before we jump into that, I have a few questions, if you don’t mind. Number one, you were trying to get pregnant; how did you find out that you were pregnant?
Valentina: I was taking tests all the time.
Elliot: Did you have your cycle back, your German Swiss clock cycle?
Valentina: Oh, yeah. I started to get my cycle back after my daughter was five months. A perfect cycle at five months.
Elliot: Wow. Okay. My cycle’s been off kilter since the first baby came. The male punctuation is real. Okay. You figured out you were pregnant. You must have figured out somewhere around four weeks.
Valentina: Yeah. Because with my first daughter, I found out that I was pregnant with her at four weeks. Because I wanted a gynecologist for a regular checkup, and they were like, “You’re pregnant,” without checking you.
Elliot: Surprise.
Valentina: I was like, “Okay.” I did that. I took a test, and I was positive right away.
Elliot: Excited?
Valentina: Very excited. Because me and my brother are four and a half years apart, and I wanted to have my kids a little bit closer.
Elliot: But then, you said you miscarried at five and a half weeks. About a week and a half later five.
Valentina: Yes. Five and a half weeks, I miscarried. I found out on a Thursday or on a Tuesday, more or less. Five days later, I found out that I was having a miscarriage.
Elliot: How did you figure it out? What was happening?
Valentina: In the morning, I saw a little bit like pink when I went to the bathroom. I was like, “Well, it’s normal to have a little bit of pink in urine when you’re at the beginning.” I was like, ” I don’t want to you know pay too much attention.” Went out with a friend. And then, when I came back home in the afternoon, I went to the bathroom again and I was like, “This is a lot of blood. I need to go to the hospital right away.”
And then, when I went to the hospital, they were amazing with me. They were super understanding, very nice. I did all the tests that they had to do. They did also an ultrasound to see if something was still inside my uterus, which was the most painful thing. Yeah, that’s how.
Elliot: Oh, it’s a vaginal ultrasound?
Valentina: It’s a vaginal ultrasound, Yeah.
Elliot: But it sounds like more than physically, it was emotionally painful for you.
Valentina: It was really because I never expected it. Nobody ever really talked about miscarriages. You also feel that there is something wrong with you. I did something wrong, and that’s why I had a miscarriage, which is not your fault. But at the same time, everyone always talk about how amazing pregnancy is and how great this time is, but they don’t ever talk about the worst part of it, which is like when you have a miscarriage, what you’re going to do? You feel very lonely. Very, very lonely.
Elliot: Yeah. It’s unfortunate. I think it’s starting to change a little bit. But still, so many people have miscarriages. It’s sort of a natural part in the early phase. A natural part of having kids, your body has to figure out is this compatible or not. It sort of puts an end to the ones that aren’t going to be compatible, or they just aren’t compatible and don’t thrive. It doesn’t mean you did anything wrong at all. In some ways, it means you did something right.
Like, if two kids eat something that’s toxic, and one of them turns green and throws up and the other one doesn’t, the one who turned green and got rid of it is going to be healthier than the one who did it right. They’re going to struggle down the road. But it just is not talked about very often.
Right now, it’s interesting we just put up on Informed Pregnancy Plus, a series out of Australia called “You Are Not Alone.” It is all about miscarriage and how lonely people feel and trying to get the dialogue going so that you don’t have to be alone when that happens.
You didn’t have to do anything surgical there, right?
Valentina: No.
Elliot: Because your body expelled the baby naturally.
Valentina: Yeah. Thank goodness, yes.
Elliot: Did you just pick up the pieces and say, “Let’s try again”?
Valentina: I just think, yeah. I was like, “Okay. This can happen. It’s fine. Let’s just like try again in a month. Like in a couple of months, and let’s see how it goes.” Actually, a couple of months later, I was pregnant again. If I have to be honest, we didn’t really try. It was like one time, and I was pregnant again. I was like, “Okay. Let’s see how this goes.” But we were in 2020, in the middle of the pandemic. And then, when I called the hospital, they were like, “Oh, you can have an ultrasound at 12 weeks. We don’t see anyone before 12 weeks now.” I was like, “Okay.” I’m going to wait the 12 weeks. But then, I knew that something was wrong because my body wasn’t really doing its thing. My breast wasn’t really sore. I don’t know, there was something off. I knew that there was something off.
When the 12 weeks in, I want to get an ultrasound. The first thing that the doctor told me, which was a nurse practitioner actually. It was not even a doctor. She was like, “Well, there’s something wrong. You’re having a molar pregnancy.” I was like, “What are you talking about? I don’t even know what that is.” She explained to me that it happened soon, one in a thousand. Basically, the fetus is not growing, and I had to have a DNC, like a surgery.
Elliot: Yike. What was that like?
Valentina: I did not understand what she was saying. My brain was just not functioning. I was like, “Okay. She said something, but I don’t understand.” This was the biggest trauma I ever had. Which is like seeing in that little computer all these like roots, what I call them “roots” in my uterus. It looked like that a tree was growing and all these roots were in my uterus, and it wasn’t clean. It was like pretty traumatic to see. To the point that every time I had an ultrasound after that, I always like looked at the screen and like panic because I didn’t want to see that ever again.
Elliot: Wow.
Valentina: I was supposed to have a surgery three days later. But then, with COVID again, everything was delayed. Three days later, Christmas Eve, we got COVID all of a sudden after eight months of not seeing anyone. On a Monday, I was supposed to have my surgery. What happened is that I had to call in the hospital and be like, “Okay. I have COVID. My husband has COVID. I’m still negative, but I don’t think it’s okay, it’s appropriate for me to come.” They were like, “Okay. We’re going to call you in two weeks.” I was like, “I don’t think I have two weeks. I feel that there’s something that has to be done right now.” They’re like, “Okay. We’re going to call you tomorrow.” But actually, nobody ever did.
A week went by, and at 3 a.m. on a Sunday, I started to have contractions like I was nine months pregnant. It was painful. I was losing tons of blood. Then at 8 a.m. to five hours later, I decided to go to ER. I called the hospital, and they were like, “Run to the ER. We’re going to tell them. Even if you’re positive for COVID, we’re going to tell them. They’re going to take care of you.” I ran to the ER. Thank goodness there was nobody. I was the only one in ER. They’ve been in a separate room. I had three nurses and a doctor. Who is now my gynecologist, which is the best person I ever met in my life. He was like, “We need to like give you an emergency DNC because you’re in so much pain that three doses of morphine didn’t do anything.” That’s what happened.
Elliot: Wow. That’s so intense on so many levels and also complicated by the pandemic. Did you turn out to be positive?
Valentina: Oh, yeah. I turned out to be positive. I had COVID. When he told me, “You have COVID.” I was like, “What is going to happen?” He was like, “I’m going to take care of you. It’s just that I have to put you in a different room.” Because at the time, it was like a surgery room for COVID patients, a surgery room for non-COVID patients. That’s how it worked at the time.
But the most scary part was they took me down to the ultrasound lab. The person who does the ultrasound asked me to stand up. When I stood up, all this blood came out and I saw her scared. I was like, “Oh, my gosh! Something is wrong.” I was alone, completely alone. Not a single person with me because nobody could come in.
Elliot: So, hard. Not even your partner?
Valentina: Nobody. Not a single person.
Elliot: He was positive anyway. But even if he wasn’t, I don’t think they were letting them in at that time.
Valentina: No. I’ve seen 2020, nobody could go in.
Elliot: Obviously, you’re pregnant now, 38 and a half weeks. Still, so heartbreaking to hear. Let’s take a little break and find out what happened after that. We’ll be right back.
[break]
Elliot: Welcome back to the podcast. We’re talking to Valentina, and wow! After the first time, you just got pregnant quickly and had a great pregnancy, great birth, a rough postpartum. Then your first pregnancy was a five-and-a-half-week miscarriage. A couple months later, you got pregnant with a molar pregnancy. That’s because of the pandemic, you didn’t get treated right away. You had a very intense DNC. And now, you’re pregnant. Everything’s going great, but there was more in between.
Valentina: Yeah. For six months after I got my molar pregnancy, I got shot every month and everything went fine. Then in August 2021, I got pregnant again. Everything seemed fine. Even then, we didn’t even try. It happened once. All my friends got pregnant. Like, “Oh, we did it once and we got pregnant.” I was like, “Well, it doesn’t really work like that for me.” But, actually that time, it worked for me.
Elliot: When you said, he did it once, was that like a conscious choice. “Let’s see if we can get pregnant again”?
Valentina: Yeah. Let’s say, yes. It’s just that we really wanted to have another kid. We’re like it doesn’t matter if we use contraception or not because we want another kid. Actually, it worked out pretty well. But then, around nine weeks, I got another miscarriage. We heard the heartbeat at seven and a half weeks. I went back in at nine, and no heartbeat.
Elliot: So, somehow I thought everything was good.
Valentina: Yeah. And then, nine weeks, gone.
Elliot: Does they have any idea why?
Valentina: No. My doctor was like, “Listen. Because of your age, because of everything that happened to you, this can happen. It happens to one in four women.” It was like, “Actually, I have the feeling that it happens in one in three.”
Elliot: They don’t always get reported.
Valentina: Yeah.
Elliot: Do you want to say your age?
Valentina: Yeah. I’m 38. I was 37 at the time.
Elliot: Pretty young.
Valentina: Yeah. But I think the [unintelligible 20:53].
Elliot: Over 35, I get it. But also, you also have to take into account you are a super healthy person. Even though your age is over 35, which I don’t think is a magic number, your clinical health profile is very good. You don’t have diabetes. You don’t have hypertension. You don’t have obesity. There’s a lot of great things working in your favor.
What’s going on your mind at this point? That’s three strikes, so to speak. I’m just thinking, emotionally, each time, is it harder to pick up the pieces and try again?
Valentina: I think that by the third time, I was exhausted. I looked at my doctor and I was like, “I’m not even going to try anymore.” I remember him saying, “You should not say that. This happens. But you never know. Because after a few miscarriages, 80% of the women get pregnant and they have a full-term pregnancy.” Actually, he was right. But, at the same time, when you’re in the moment, you’re like everything is happening to me. I’m alone. Everyone is getting pregnant really easily and is keeping the babies. You always think that you’re the only person in the entire world that is going through that, which is not true. But, at the same time, that’s what you feel like because there is no support available or you have to really look for it and search for it.
Elliot: Yeah. It’s not obvious, but it’s there. What’s your courage talking about it so openly and freely and passionately. Hopefully, that’ll help change that landscape for people.
Valentina: I really hope so.
Elliot: Especially, since you always change the landscape with your artwork.
Valentina: Yeah.
Elliot: Thank you very much. All right. Now, you’re pregnant.
Valentina: Yeah.
Elliot: How did this pregnancy come to be?
Valentina: This was the hardest pregnancy. Very anxious pregnancy. I have to be honest, I didn’t enjoy it. I enjoyed from 30 weeks to 35 weeks. I was very happy. Now, I’m 38 and a half and I’m exhausted. The pregnancy was very, very, very hard because it took me six months, not that much, to get pregnant again. I went to this fertility doctor. She’s amazing. We found out that I got hit by secondary infertility, which I have three follicles left. She had the feeling that these follicles were in great shape. We started this treatment with this hormone that is called DHA.
Elliot: Yeah.
Valentina: It wasn’t easy because I had to take pills for six months. It took a toll on my body. But everything is fine now. But I think that since day one that I found out that I was pregnant — because the other front story is that I got pregnant the day before starting IVF. On a Monday, I was like, “Let me take a test just in case.” Because tomorrow morning, after starting the medicine, the injections for the IVF, because that’s what the route that we wanted to take. Then I was like, “Well, I’m pregnant. Let me take another test. Well, I’m pregnant again.” Okay!
Elliot: Nobody ever trusts the first test.
Valentina: Well, if I had another one, I would have taken it.
Elliot: That should come as a 10-pack.
Valentina: Yeah. So, what happened is that I got pregnant. But since day one, I was like very, very anxious. Very anxious. It was not easy. Again, there’s no support if you are just at the hospital. Even the nurses, they don’t know how to talk with you. They just assume that you’re at the happiest person on Earth because you’re pregnant, which I wasn’t because I was just a nerve-wrack.
Elliot: Is it different in Italy?
Valentina: In Italy, it’s different just because we have our doctor since we are babies. It’s very hard for us to like change doctors, especially like the family doctor or gynecologist. You have them for like 20 years until they retire, or until you want to change because you found someone that you like more. But the thing is my best friend’s mom was my gynecologist for 20 years, and she’s always been a gynecologist. Here, I had to change to five different gynecologists because of health insurance.
Elliot: So, you don’t develop that kind of relationship.
Valentina: No, you’re just a number.
Elliot: You don’t know each other very well.
Valentina: No. You’re just a number. You’re just a patient that shows up at 10 a.m. in the office, that’s it. You’re no more than that, and that I think is the hardest part. I, personally, feel very lucky because my gynecologist doesn’t make me feel like I’m a number. He really cares about me, and really listens to what my body is telling me. He listens, and that’s the most important thing for me.
Elliot: Two questions, because you’re going to come back and share this birth story with us on the other side. Two questions. One is, what are some of the things you did to help you conquer the anxiety during pregnancy? It sounds like it was running high. The other one will be, what are you doing to prepare for this birth, especially in light of your tailbone injury last time?
Valentina: Well, I did and I’m still doing a lot of therapy. Once a week, I talk to my therapist about all my anxiety because it’s really helping me a lot. Since day one, I wanted to have a good team of physicians and people that could help me. I found, like for me, what is the best acupuncturist, the best chiropractor, which is you, or the best gynecologist.
For me, the most important thing is I cannot be in control of this pregnancy, but I can be in control of other stuff. For me, being control of the team that is taking care of me is very important for my mental health. That’s for me is the most important thing. It can happen that my tailbone is going to break again.
But this time, I’m seeing a doula every week and we’re doing Pilates together and pelvic floor exercises to strengthen my pelvic floor even more. Hopefully, this time, I’m going to be able to push in a different position that is not on my back. Hopefully, if I get an epidural, they’re going to allow me to get a walk-in epidural, so I can feel my legs and still try different positions. If not, I need to see what’s going to happen when I’m in the delivery room. But I got my donut pillow, just in case if I’m on my back. I feel stronger and I feel better this time because this time I took all these steps to make my body feel stronger. To make my body feel like, “Okay. We can do this. It doesn’t have to happen again. Let’s see how it goes.” But I’m pretty positive that this time, it’s not going to happen.
Elliot: Okay. Well, you’ve been through a lot. Hopefully, when the pendulum swings in your favor, it swings at least as far, if not further than when it was against you. And, hopefully, have a really beautiful birth and no injury.
But now, you know there is pelvic health physical therapy in the U.S. I know you’re very close to the end. It just occurred to me though you might even want to do a visit before your birth. Because while you’re strengthening your pelvic floor, if it’s too tight going in, they could also release it a bit so that you’re strong but not tight. And maybe that added layer of function could be helpful for you.
All right. I feel super blessed that I ever got to meet you and hang out with you. The energy that it comes shooting out of you, just the passion for life and maternal energy is so inspiring. Especially after you’ve been through all these hardships. I just thank the universe for somehow crossing our paths and just honored to play a tiny role in your epic journey here and look forward to hearing the rest of the story on the other side.
Valentina: Thank you. Very grateful to all of you.
Elliot: I hope you get your power back.
Valentina: Thank you.
Elliot: You’re in the middle of the power outage. Valentina, where can we find you and your beautiful artwork online?
Valentina: You can find me @brushettasigns on Instagram, and that’s where I have all my artwork.
Elliot: Oh, my goodness. Bruschetta just makes me so hungry.
Valentina: Yeah, that’s what it’s there for.
Elliot: I’ll check you out, @brushettasigns on Instagram. We’re over there too, @doctorberlin, D-O-C-T-O-R-B-E-R-L-I-N.
by Informed Pregnancy and Parenting Project | Feb 28, 2023 | Labor and Delivery, Podcast Transcripts, Pregnancy
Elliot: Welcome to the Informed Pregnancy and Parenting Podcast. I’m your host, pregnancy-focused chiropractor, Dr. Elliot Berlin.

My guest today is a mom, and she’s here to discuss her life-changing experience dealing with her full-term newborn daughter’s health issues and put her in and out of the NICU from day one. This led to her leaving the hospital without the baby right away, and that led to a new career path. Keira More, welcome to the podcast.
Keira: Thank you so much.
Elliot: My goodness! You’ve been through a lot. I was sort of there as this new career path unfolded, and it’s quite the journey. Your struggle is really helping a lot of other people. Let’s get into it. Where are you from originally?
Keira: Originally from New York, but moved to LA when I was about 5. So, grew up in LA.
Elliot: Welcome to LA.
Keira: Right.
Elliot: All right. How’d you meet your partner?
Keira: Oh, we were double booked for a lunch with my oldest and closest friend, Oliver. He actually wanted to introduce me to my husband probably like six months before we actually met, and I wasn’t interested. And then, I met him and became very interested.
Elliot: Quite interested. And how long was it from there till you realized, “Wait a second. This might actually work out.”
Keira: This is it. It was about two minutes. It was really weird. I just knew. When I saw him, I knew that it was almost like a feeling of, “Oh, there you are.” You know? I felt immediately at home with him. He didn’t know that, and I don’t think he felt that way. But I decided that I was right and just hung out for a while.
Elliot: Oh, wow! Okay. And then, was there talk? Like, when things were heating up, was there talk about family and kids?
Keira: Always. Even before we were like really serious, we always talked about family. I come from a big family. He comes from a big family. We’ve both always knew that we wanted children, whether that was — I mean, I knew it was with him. But, you know, it was always a very easy conversation to talk about children.
Elliot: How long did it take for him to get on board with the whole relationship?
Keira: A couple months, and that was nine years ago. So, we’ve been together basically ever since.
Elliot: A decade. Are you generally a quick decision-maker?
Keira: Kind of. I mean, once I know something, I just know. I kind of really listen to my gut and intuition, it’s very loud. And once I make a decision, I make a decision. That’s it. Nothing is going to change my mind.
Elliot: But sometimes, it takes more than two minutes.
Keira: Sometimes. [inaudible 00:03:24]
Elliot: Gosh. I was like, “If you can decide that in two minutes, like the pair of shoes.”
Keira: I mean, I can’t pick a restaurant, but I can pick a partner in two minutes.
Elliot: Okay. I’ll pick the restaurants. That’s my strong point. So, you guys got married and then had a kid.
Keira: Basically, that’s how that happened.
Elliot: Were you planning to get pregnant when you did?
Keira: Yes, and no. I feel like if you aren’t actively not trying to get pregnant, then you’re trying to get pregnant. But we knew that we wanted to have a baby right away. I didn’t think that it was going to happen quite as fast as it did. Because everyone around me seemed to be taking a little bit longer. So, we started trying, I got pregnant the first try, which was much faster than I had anticipated.
Elliot: Were you both surprised by that?
Keira: Oh, yeah! We were both like, “Oh! Okay. ” The stars were aligned.
Elliot: How did you find out?
Keira: No. I wasn’t even late. We actually went on a road trip. We went to Laguna, and I was so tired. I couldn’t stop falling asleep. I thought I was sick. I had like a prescription of antibiotics that I just was like pushing off. I didn’t want to take it. I didn’t want to take it. And then, for some reason, I was going to take it because I felt so awful. I had a little voice that told me, “You know what? Just take a pregnancy test, just in case.” I hadn’t missed my period yet. And it was positive.
Elliot: Wow.
Keira: We went to the doctor. We double-checked it, and it was positive there, too.
Elliot: What did pregnancy feel like for you?
Keira: I didn’t love it.
Elliot: Are you allowed to say that?
Keira: Am I allowed to say that?
Elliot: I don’t know.
Keira: I’m a doula.
Elliot: You’re certainly allowed to say that to me, and I’m here. I just feel like people are so judgy.
Keira: Yeah. I loved feeling both of my children move inside of me. I loved the fact that I was able to do that. But I just didn’t feel great pregnant.
Elliot: From the beginning?
Keira: From the beginning. With my daughter, I gained a lot of weight and I was really swollen. I thought I was going to be like this glowing goddess, and that’s not what I was.
Elliot: Was it different things at different stages of the pregnancy?
Keira: Yeah. I think just like the exhaustion in the beginning, and the nausea, and everything was so new and unknown. I felt really nervous. I guess in the second trimester, I felt pretty good. In the third trimester, I just blew up. She was born in September. It was very hot.
Elliot: Third trimester.
Keira: Oh, yeah. And just like sweating and puffy. Yeah.
Elliot: You’re not selling it well.
Keira: I’m not selling it, but it’s amazing. It’s funny because I know, intellectually, that I didn’t love it but I miss it. If that makes sense.
Elliot: That almost sounds like the yes/no of “Were you trying to get pregnant?” But it sounds like you’re saying — if I’m hearing you right, you liked being with child. You just didn’t like how that made your body feel.
Keira: Totally. That’s exactly it.
Elliot: Did you have family and friends that were pregnant around the same time? Did you have exposure to pregnancy and childbirth?
Keira: Not birth, not really. Most of my friends either had children way before me or didn’t want kids. I felt kind of isolated in the pregnancy. I didn’t have like a partner in the pregnancy. It wasn’t like I had a girlfriend that I could go like on walks with. I didn’t have that. Everyone was kind of busy living their own lives. I have older siblings and they had children. But their kids were so much — like my nieces and nephews were so much older already. [inaudible 00:07:19] distance.
Elliot: And when your siblings were pregnant, were you around them?
Keira: Yeah. But I was just a kid. Like, my niece who’s closest in age with my daughter is 14. And my daughter 4.
Elliot: Okay. So, long before you were in that storybook.
Keira: Yeah.
Elliot: What were your sources of information?
Keira: The Informed Pregnancy Podcast.
Elliot: Oh, I strongly recommend it. Wait till you hear about my episode with Keira More. Life-changing. All right. I want to take a little break. When I come back, we’ll talk about your plans for birth and how things went. We’ll be right back.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We are talking to Keira More. So, picked your husband right away, then pregnant right away, and not a glowing goddess. At least, that’s how you felt. The third trimester in the Los Angeles summer. That’s brutal for me, and I’m not pregnant. Obviously, we can’t complain too much because there are places that are a lot worse. But to be dragging around that extra weight and just hot and humid and sweaty; no good. What were your plans for the birth?
Keira: I wanted to have an all-natural birth. And all-natural meaning, in this sense, unmedicated. But in the hospital, my husband and I decided that that was right for us. I really thought that that’s what I was going to do.
Elliot: What was important to you? Because most people have their baby in the hospital today. A small percentage don’t. But also, most people are medicated during their birth, especially at the hospital. What about not medicating was appealing to you?
Keira: I think I wanted to experience it. Also, my mom had really fast labors. And the way it was talked about was very like you can do it. “You’re fine,” which is how she is about everything. And also, I’m a little bit afraid of needles, and I was afraid of getting an epidural.
Elliot: Afraid of all needles? Like, some people are afraid of things going in, some people are afraid of things coming out, like blood draws.
Keira: I’m not afraid of blood. I’m not queasy or anything. I was really afraid of needles going in. Not on other people. That doesn’t bother me, it’s just myself. And also, just the idea of having something in my spine was scary to me. Yeah, I felt really nervous about that.
Elliot: Yeah. More so than the intensity of childbirth without medication.
Keira: Yes.
Elliot: Okay. And how did that go?
Keira: I didn’t. I ended up having really very high blood pressure toward the end. It was pre-preeclampsia. I was 39 weeks, and I ended up getting induced right away. I got all the things.
Elliot: So, did you have the epidural before the induction?
Keira: No. But I went in and I got induced. They gave me all the different medications. I think it was maybe around 14 hours in that I got the epidural. My daughter was born after 24 hours.
Elliot: Okay. You got the epidural because it started to become overwhelming?
Keira: I did some kind of math equation in my mind. I felt like I was uncomfortable, but I realized that I had so much longer to go. I think I was maybe 4 centimeters at that point, and I just knew that I needed to be able to rest. Otherwise, I wasn’t going to be able to do it. I kind of like pulled the trigger on that. After they had broke my water — and after they did that, with the Pitocin and the contractions were really kind of unbearable. I just decided that I needed to be able to rest to have the vaginal birth that I wanted.
Elliot: That makes sense. How was the epidural compared to how you thought it would be?
Keira: Well, it only worked on half of my body.
Elliot: Okay. I guess that’s not how you thought it would be.
Keira: That’s not how I thought it was going to be, but it was okay.
Elliot: The placement was fine.
Keira: Yeah.
Elliot: Okay. Now, how is it with half of your body numb during that? Because you just described a very intense, not a natural labor pattern, but one sort of fueled by Pitocin, and then they took away your kind of cushion by breaking your water.
Keira: Yeah. It did. I didn’t know what I need to know, you know. The epidural only working on my left side, it was crazy. The nurse was kind of yelling at me to lift my leg. I guess my leg had fallen off the side of the bed.
Elliot: The one you couldn’t feel?
Keira: The one I couldn’t feel. She kept kind of yelling at me to lift my leg back up. Because I think we were about to push or something, and I couldn’t. I told her. I said if I knew where my leg was, I would try to lift it. But I don’t even have a leg, as far as I’m concerned.
Elliot: You feel nothing.
Keira: I felt nothing on that side, but felt everything on the other side.
Elliot: Oh, my goodness.
Keira: It was very disoriented.
Elliot: How did that feel pushing the baby out?
Keira: I wanted to feel something, you know. I was happy that I had that, in some sense. But it was very strange. It was very strange. Luckily, she came out very fast.
Elliot: Thank goodness. You know, I can’t picture what it feels like to push a baby out in the first place. But if I’m thinking about doing something that’s overwhelmingly intense to me, that feels to me like it’s too much for me, and I want to numb it — some, but not all the way. This does not sound like that at all. This sounds like completely having all of the overwhelmingness that I didn’t want on one side, and being eerily disconnected on the other side.
Keira: Yeah. I mean, really, I feel lucky. I don’t know what would have happened had she not kind of flown out on her own. She really did.
Elliot: Was there half a ring of fire?
Keira: I guess.
Elliot: Wow! That’s so weird. Okay.
Keira: Half ring of fire.
Elliot: Half ring of fire, yeah. Okay. Well, thank God she came out quickly. And then, what happened after birth?
Keira: It was kind of a whirlwind. Everything seemed okay. She was fine. It wasn’t until we went into recovery that I had put her down in the little bed that they gave you. Like, the little bassinet. I put her down for a few minutes, and I looked over. And she kept like kind of coughing and she was spitting up a lot of fluid. Well, now, I know that it was the amniotic fluid that was still in her lungs. I guess she couldn’t get all of it out on her own. They normally say that babies can pass it on their own. But I laid her down, and she turned blue. She [coded]. We called the nurse. They took her. I mean, I was still like half off numb from an epidural and trying to chase them down the hallway. But that was kind of the first of many crazy things to happen.
Elliot: Have you already latched?
Keira: Yeah.
Elliot: So, you’ve already latched. Maybe you’re already in some, and then you put her down.
Keira: I put her down. I remember my sister-in-law coming by, and she saw the baby. She was really nervous about the coughing. And like, the kind of like the spitting up of the fluid. You know, when you’re in labor for that long, you’re just kind of out of it. You know, I was not thinking clearly. And yes, I put her down. I guess she was choking under the fluid, and she turned blue. They hit the code button on the wall.
Elliot: Oh, my goodness. That’s horrifying.
Keira: Yeah.
Elliot: And then, what did they do for her?
Keira: They rushed her to the nursing station where they used this vacuum into the lungs and suck up all the extra amniotic fluid.
Elliot: Did they realize right away that was the issue?
Keira: You know what, I don’t really remember. Because my husband ran with the baby, and I was behind them. It took me a minute to get over to where they were.
Elliot: Oh, my goodness. Had you walked before that?
Keira: Yes. I think I had. You know, they make you go to the bathroom and all that. I think I had done that. It’s kind of a blur now, but I think I had gotten up. But I wasn’t like moving, you know.
Elliot: So, after they sucked the fluid out, normal breathing and color came back?
Keira: Yeah. They brought her back.
Elliot: I don’t know if my normal color would have come back.
Keira: No, I certainly wasn’t normal.
Elliot: Oh, my goodness. How scary. Okay. So, then, what happened after that?
Keira: We were discharged. We went home. And then, the next night, we had our first night at home, which was like pretty magical. I tell everybody that that’s like the most surreal moment, like bringing your baby home. And then, we got a call the next day saying that her jaundice was out of control and that we needed to bring her back to the hospital.
Elliot: What do you mean her jaundice was out of control? You’re already home.
Keira: We were already home.
Elliot: They were just bilirubin results?
Keira: I guess, yeah. Our pediatrician had us — because we saw the pediatrician the next day. Our pediatrician told us to get her blood taken for a bilirubin test, and they called us later with the results. I was in the shower, and the hospital called me and said that her bed was ready. And that was how I found out we had to go back.
Elliot: Wow! Oh, my goodness.
Keira: Yeah. I had no idea.
Elliot: This is one day after you came home?
Keira: Yeah.
Elliot: Oh, wow. So, also scary.
Keira: Yeah.
Elliot: Especially if you don’t really understand what’s going on.
Keira: Right. And I didn’t. I really just didn’t know, you know. And so, we went back to the hospital. And they kept her under the lights for 16 hours, which was not ideal. Because when they’re under those lights, you know, they really make a big deal about you not removing them. Like, they wanted you to pump and wanted me to pump.
Elliot: Oh, you couldn’t feed her?
Keira: I couldn’t feed her. I couldn’t hold her. She had to stay under the lights. That’s what they told me.
Elliot: Continuous.
Keira: Yeah. It wasn’t until I kind of lost it, and said I’m taking her home. I found out then that there are actually companies that will run to you the bilirubin lights.
Elliot: Like, you can do it at home.
Keira: Yeah. It’s a biliblanket, and you can do it at home. That’s what we ended up doing, and it was fine.
Elliot: And in California, we have so much sunlight.
Keira: So, much sunlight. It was like late September, it was beautiful. Like, there was no reason to do all of that. I just didn’t know.
Elliot: I’m so sorry.
Keira: That’s okay.
Elliot: All right. Let’s take a little break. At some point, this has to turn around. Because I know she’s good.
Keira: I know.
Elliot: Let’s take a little break, and we’ll be right back.
[break]
Elliot: Welcome back to the Informed Pregnancy Podcast. We are talking to Keira More. So, you come home. And then, you get called right back to the hospital. Then, they put the baby in bili lights, out of reach for you for 16 hours. You pump, and then they bottle feed?
Keira: Yeah.
Elliot: Did your milk come in?
Keira: It had come in on that day.
Elliot: Oh. So, like every fiber of you just wants to latch that baby and feed, and you can’t. And then, you went home.
Keira: And then, I went home again.
Elliot: Did she still need lights?
Keira: Yeah. We had the blanket. She did the blanket. Truly, I did indirect sunlight and just kept feeding her.
Elliot: Okay. And then, one would hope everything was just jolly after that.
Keira: One would hope.
Elliot: What happened?
Keira: She started vomiting green, which felt very weird. But I was assured that it was the green juice that I had earlier. And then, she started sleeping longer stretches. I called the pediatrician.
Elliot: Wait. You thought that because you drank green juice, the baby was —
Keira: I had a newborn care specialist tell me that the reason why she was vomiting green was because I drank a green juice.
Elliot: Again, this is the baby that coded at the hospital. Then, came home and got brought back to the hospital for what they told he was extremely high jaundice. Now you’re home, same day or next day?
Keira: I think it was the next day. She started spitting up green. It just got progressively worse. And like, she would sleep much longer stretches. I called the pediatrician and told him what was happening. And he told me that I was overfeeding her. I called him three times. By the third time, it was like the morning after, and she was still vomiting green. That was when I said, “I’m either coming to your office or I’m going to the hospital, you tell me which one.”
Elliot: And?
Keira: He said to come in, and I did. I went in and the other partner in the office, he really was trying to convince me that I was just overfeeding her. Which, as a first-time mom, about four or five days postpartum, I wasn’t overfeeding her. My milk had just come in, you know. Like, there was no —
Elliot: And you were only feeding milk.
Keira: Yeah. There was no way I was overfeeding her. But, again, I didn’t know. So, my husband and I took her to the pediatrician’s office, and they saw that her stomach was distended. They saw the color of her vomit, and they sent us to the ER.
Elliot: It wasn’t spinach?
Keira: No.
Elliot: What happened at the ER?
Keira: They took us right in, and they performed every test except the test that my pediatrician asked them to perform.
Elliot: Why?
Keira: I don’t know. I think there were some young doctors who were curious about other things and wanted to do different tests. They told me that she probably had a stomach bug, a virus. And I really had to fight very hard to just get the test that the pediatrician had asked them to run.
Elliot: What test was that?
Keira: I forget what it was called.
Elliot: What was it for?
Keira: It was to see if there was a blockage in her digestion. So, they gave her a bottle of liquid. And under like an X-ray machine, you could see the liquid. Like, she’d swallow it, and then —
Elliot: They could see through. Did they eventually do it?
Keira: Yes. After like three and a half, four hours, they did it and it stopped. I could see the liquid come down and it stopped. After that, they called the surgeon and they booked her. It was one of two things. They just took her and said, “We’ll figure out what it is once we have her open, and we can see.”
Elliot: Oh. Meaning, the only way to really figure out which one of the two things is to literally cut her up.
Keira: Yeah.
Elliot: Take a look, and then treat it?
Keira: Yes.
Elliot: Were they reassuring that it was treatable either way?
Keira: Yes. They said either way, we can fix it. But we just don’t know which one it is yet.
Elliot: Wow. This is less than a week.
Keira: Yeah. It was like day five.
Elliot: So, intense. Okay. They do the surgery, and what do they figure out?
Keira: They do the surgery, which was crazy. But they figured out that she had duodenal atresia. And what that means, basically, is that there’s a little opening into her stomach. It was like very, very small. Much too small. I think what it was is that when I just had colostrum, it was fine. Because it was just such a small amount of milk going through. But once my milk actually came in, she could swallow it but it just wouldn’t go down.
Elliot: So, it wouldn’t go into her – oh geez. Okay.
Keira: With the bile.
Elliot: Green.
Keira: Created like a bypass with that. And then, removed her appendix and kind of like reorganized the way things were.
Elliot: Removed her appendix to make more room?
Keira: They removed her appendix because there’s a 15 to 20% chance that she might need surgery again, and they didn’t ask my permission for this, by the way. But they didn’t want any confusion. So, if she was an adult and she went in for stomach pain, they didn’t want anyone to say, “Oh, it’s an appendicitis,” or it’s something like that. She would just be able to say, “No, I don’t have an appendix. It’s because of my –”
Elliot: That seems like a crazy reason to take out. Even though you could live without it and we’re not quite sure how much she made it.
Keira: Yeah.
Elliot: I mean, it seems like she should just be able to say, “Oh, I have this thing.”
Keira: Right. They made that decision for us.
Elliot: Duodenal atresia. Did the surgery do the trick?
Keira: Yes, so far. She’s fine.
Elliot: How old is she now?
Keira: She’s 4, almost 4.5.
Elliot: Okay. How was the recovery? Was it a laparoscopic surgery?
Keira: No. It was —
Elliot: An incision?
Keira: Yeah. It was [inaudible]. It was very challenging. I feel really lucky that she was full-term. And I also still to this day feel really lucky that we caught it so early, and that it didn’t become infected or there wasn’t an infection. There wasn’t anything like that. She wasn’t completely malnourished. She was probably slightly dehydrated. But it could have been a lot worse. Recovery from this is normally about a month. And she did really well, she really did. Newborns are amazing. And the NICU staff is amazing. Yeah, she healed very fast. I think it was harder for us in a lot of ways. But, yeah, she’s okay.
Elliot: I’m just wondering, are these things connected at all?
Keira: I don’t know. I still don’t know.
Elliot: The coding and the jaundice.
Keira: My son had jaundice. I had jaundice. I think jaundice is fairly common. But the coding, I’m not sure. When I was pregnant, I had a lot of amniotic fluid. And they never said anything about it. Normally, in pregnancy, he’ll see a duodenal atresia in the growth scans. They look for it because it’s normally a marker of some sort of chromosomal issue. They missed it with my daughter.
Elliot: You looked more closely with your son.
Keira: Very. I looked very, very closely, yeah.
Elliot: But he didn’t have it?
Keira: No.
Elliot: Wow, Keira. And then, this changed your career path. What were you doing career-wise before having a baby?
Keira: Before I had a baby, I was in the clothing industry. And then, I stopped working and I was planning on staying home with my daughter. I just felt like there was so much I could have used. I needed more support. It wasn’t there, it wasn’t offered. It just didn’t exist. I really felt called to do something different and to help people that are in my situation, had been in my situation. The parents that will go through what we went through. Because our health care system is not built for the emotional support and hand-holding that needs to be done for families that go through things like this. I didn’t know how I wanted to give back, but I knew that I wanted to, that it felt very important to me. It started out just talking to, you know, different friends, friends started reaching out to me, and kind of looking for that support when they were pregnant. And then, I started volunteering with an organization that pairs NICU mom to NICU mom. As kind of like a peer-to-peer support.
Elliot: Current NICU with former NICU mom?
Keira: Yes. People who have all already gone through it are just kind of being there and talking to people that are currently going through it.
Elliot: That’s great. What’s that called?
Keira: “Hand to Hold.”
Elliot: Appropriate.
Keira: Yeah.
Elliot: And so, now, you’re a doula. You help people while they’re pregnant through the transition.
Keira: Yes.
Elliot: I’ve seen your clients, and they love you. It almost seems a little bit like, you know, we had a bunch of miscarriages before we had our first kid. And then, we had our kid and I think it’s just a different kind when you hear a kid scream at 2:00 in the morning. It’s like comforting. Whereas, for people who didn’t have that experience it may not be as comforting. And so, you’re helping people ideally go through typical childbirth and postpartum experiences. But your personal life experience puts you in a position to really support in a way that someone who hasn’t had that experience, couldn’t do it quite the same way you do. I know your clients feel that deep, heavy, holistic support, full well-rounded support. So, kudos to you for making a [big, old lemonade 00:28:41].
Keira: Thank you. Thank you. It’s very nice of you to say.
Elliot: I’m sorry you went through that, all of you. But I’m glad she’s healthy now. And you have the courage to do it again.
Keira: I did.
Elliot: Now, was that one also like sort of “not trying, trying”?
Keira: Yeah. You know, it was super healing. Actually, I was really nervous during my pregnancy with my son, my second child. Because of everything that we’d gone through. It was also the beginning of COVID, and it was just a very stressful time. But it ended up being totally fine and normal.
Elliot: Epidural?
Keira: Epidural.
Elliot: Both sides?
Keira: Both sides, yes! And I appreciated that because he was 10 pounds.
Elliot: Oh, wow!
Keira: Yeah. But that pregnancy and birth and postpartum period, I think just really healed that wound. Because there was a lot of grief of what I felt I lost. And recovering from birth in the NICU and not able to hold your baby, and not able to nurse. And just like everything that goes along with that experience, it really felt like full circle after my son was born and knowing what it’s like to take the baby home and stay there. I kept waiting for someone to call me, but they never did. I was really happy about it.
Elliot: Now, this is good news. Yeah, I was just thinking actually just how people, culturally, a lot of cultures stay home for 40 days so that you can heal physically, and emotionally, and transition in your bubble. I didn’t even think about that with all the running back and forth to the hospital and supporting a surgery, and you’re literally just recovering from the intensity of childbirth. Wow. Even more intense than I had previously pictured.
Keira: Yeah. It was a lot, but I’m happy that I wasn’t thinking about how much it was at the time. It was only after that I realized like, “Oh. That was really wild.” And didn’t like set me up for success in a lot of ways.
Elliot: But you succeeded.
Keira: I did, yeah. I mean, I had to go find the help and I did. And thank God for all those people that carried me, you know.
Elliot: Wow. Very powerful. It’s so crazy that a hole that’s a little too small could lead to all of that chaos. And also, equally kind of amazing that we now know how to diagnose and treat it. So, that a baby can grow into a healthy child and adult.
Keira, thank you so much for coming on and for sharing your experience. And it sounds like there’s some take-home messages here. What would your key take-home points be?
Keira: I think for the mom that is going through it or will go through it, I think the take-home message is that you just kind of have to hold on. And that there are people that want to love you and hold you up. You just have to find them. And I think my message to people that are, loving people that are going through that, is to just kind of hold on and let them have their process and be there with your arms open to catch them when they’re ready to be helped.
Elliot: Yeah. Actually, a friend/client who’s going through this right now. It’s slightly different, but same idea. In their case, beautiful healthy birth, and then the next day things didn’t seem right. So, they went back to the hospital, and it’s been a whirlwind. A lot of testing and uncertainty about what’s going on. Literally, the baby is coming home right now from the hospital a couple weeks after the birth. I don’t think they know 100% what happened or what is happening. But they got all the symptoms under control. So, clear to go home. Either way, I saw that someone set up for them a WhatsApp group. They also have a toddler, so that’s even more complicated. They’re good about saying what they needed. So, friends and family could be extra supportive in the ways that they needed support.
But in events where that doesn’t happen so black and white, what would you say to someone who has a friend going through a NICU experience like that? I think a lot of times, we don’t know what to say, we don’t know what to offer. From the other side, what would a piece of advice be and how we could be supportive?
Keira: I think if the family that is going through a NICU stay has older children, going and helping with the older children so that they can be with the baby is super helpful. Because I imagine that there would be a lot of guilt. So, kind of making sure that those older children are taken care of and maybe having fun, and distracted from whatever is going on at home. In a situation like that, I think that’s the most helpful you could be.
If you don’t have other children, I think, obviously, allowing them to vent or talk about whatever is going on without judgment or kind of that like toxic positivity. Where you’re like, “Oh, but everything happens for a reason,” or “Everything’s going to be fine.” Like, that’s really not helpful in situations like this. I think being an ear, food is always a good thing. Like, coming home from the NICU and not having anything in the house. If a friend wanted to bring some food over, just so you had something.
We had a friend who actually delivered lunch to the hospital for us. Like made us care packages with snacks that we could just keep there. Because they knew we were there for like 16 hours at a time, you know.
Elliot: That’s so thoughtful.
Keira: Yeah. Just like making it so easy. We had people that would help clean up our house after us, really just carried us in that way and took care of everything so that we could just focus on taking care of our baby.
Elliot: That’s really good advice. I think a question that we want to ask is, “Oh, hi! What do you need?” And a better answer would be just like, “Here.”
Keira: “I did this.”
Elliot: “I did this,” yeah. “Check this off your list. It’s done.”
Keira: Exactly. I think it’s so natural to say like, “How can I help you?” Like, “What can I do for you?” But the truth is, you may be unknowingly putting more of a burden onto that person and expecting them to explain what they need. Rather than just like, “Hey, I dropped off dinner at your doorstep. You don’t have to come outside or anything. I just left it there. It’s there for you.” You know, something as simple as that. Also remembering that the mom is in postpartum. She’s healing. She’s recovering. She’s likely an emotional wreck. She might not want to see people. She might not be able to properly articulate what’s going on. You don’t know what the doctor said to her today. I always think that acts of service are the best things you can do for people in need.
Elliot: Yeah. Well, that’s a helpful message for both sides friends and family, and then people going through the difficult time. So, thank you. Keira, where can we find you online?
Keira: I have a website called Noa Doula, N-O-A-D-O-U-L-A.com.
Elliot: Where’s that “noa” come from?
Keira: Oh, that’s my daughter’s middle name. Do you “noa” doula?
Elliot: Oh, I know a doula. Oh, cute. Okay. And you post cool stuff on Instagram.
Keira: I do sometimes. Sometimes, not. But whatever. My handle is @noa.doula.
Elliot: @noa.doula. Again, thank you so much for being here. I’m going to find you on Instagram because you do post interesting things, informative, and also delivered in a way that catches your eye. So, I’ll see you there. We’re also on Instagram, @doctorberlin. That’s D-O-C-T-O-R-B-E-R-L-I-N.