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Birth Center Birth Story
Today’s guest, Caitlyn, shares her experience giving birth at a birth center in Cary, NC called Baby+Co. She chose this birth center after not feeling supported in her hospital birth experience with her first child. Caitlyn had an amazing experience for her second and third children’s births at the Baby+Co birth center, and it was so great to hear her most recent birth story along with her midwife, Beth.
Caitlyn Kick Bio
Caitlyn Kick is a stay at home Mom to her 3 daughters, aged 3, 17 months, and 2 months. She attended East Carolina University, where she received her degree in Nutrition. She and her husband, Tyler, have been married 4 years. They live in Cary, NC. Watch this beautiful video from Caitlyn’s birth.
Elizabeth Tyson Bio
Caitlyn is joined by her midwife, Elizabeth Tyson, to tell this story together. Beth originally hails from Chicago, and recently relocated to Cary with her 26-month old son and husband to become part of the Baby+Co. family. She received her Master of Science in Nurse Midwifery and Master of Public Health in Maternal Child Health from the University of Illinois at Chicago. Beth has a particular interest in reducing disparities in low birth weight and preterm delivery. She has immersed herself in the well-being of women and families across the lifespan for many years, and takes great pleasure in assisting women in finding a place within healthcare where they feel valued, respected, and heard. Beth feels at home with Baby + Co., because they too seek to provide women with respectful care, and she is proud to help meet the needs of women and families in North Carolina.Baby+Company
Learn more about Baby+Co., including their model of care and outcomes by visiting their website. They are growing steadily with locations around the U.S.
Transcript – Episode 107 – Birth Center Birth Story told with Midwife, Caitlyn Kick
[Bryn Huntpalmer] I’m Bryn Huntpalmer and you’re listening to The Birth Hour. This podcast is designed as a safe place for women to come together to share their childbirth stories. Stick around and join us to hear informative and empowering birth journeys from women all over the world.
[BH] Today’s episode is brought to you by Baby & Company. Baby & Company is a modern birth center built on evidence, delivered with love. Go to http://www.babyandcompany.com or today’s show notes page for more information. Today’s guest is Caitlyn, who is joined by her midwife, Beth, who is a midwife at the Baby & Company in North Carolina. They’re going to share together Caitlyn’s birth story. I do just want to note that Beth, being a busy midwife, was in a coffee shop when we recording this, so there’s a little bit of background noise at the beginning. But then we figured out that if she just muted on her end, it wasn’t so bad. So just hang in there the first couple of minutes and then it will get a little bit better. Enjoy this birth story.
[BH] Caitlyn, let’s start with you, tell us a little bit about you and your family.
[Caitlyn] I’m Caitlyn, I’m married to my husband Tyler. We’ve been married for four years and we have three daughters. Aubrey is three, Kendall is 17 months and Jade is two months, and we live in Cary, North Carolina.
[BH] Great, and what about you Beth?
[Beth Tyson] Sure, my name is Elizabeth Tyson and I’m one of the midwives at Baby & Company in Cary. My family and I recently relocated from Chicago for me to join the Baby & Company team in Cary. We’ve been there about six months and love it.
[BH] Great. Caitlyn, can you tell me about finding out you were pregnant and planning for your birth?
[C] Sure. So, Jade was a surprise baby. My second daughter Kendall was around seven months old when I started noticing that I was just really nauseous, especially in the mornings. I remember at first I thought that it was because I was drinking coffee in the morning, and not eating a big breakfast. But, I started eating a bigger breakfast and it didn’t help or anything. And then just the thought of drinking coffee started to really gross me out. Also around that time I started feeling really tired all the time, and I was nursing Kendall and I noticed that my supply was dropping. I remember one day, all the symptoms — I was thinking about them — and I was like, “Oh my gosh, I bet I’m pregnant!” So, I took a test, and I was pregnant. So, she was definitely a surprise, but a really good one. Once I found out I was pregnant, I knew that I would go to Baby & Company. With my first daughter, I had her in a hospital with an OB, and I don’t consider it a bad experience by any means. It was definitely a good experience, but I just didn’t feel supported in my desire to have a natural birth at the hospital. They were saying that they were fine with me having a natural birth. But I feel like they didn’t really expect me to even do it. I kind of felt like they were thinking, “Oh yeah, she wants a natural birth but we’ll see how long that lasts.” And so, I didn’t really feel comfortable with that. So, it kind of worked out perfectly when I found out I was pregnant for the second time. Within the same week, I found out I was pregnant and I saw on the news that there was a new birth center called Baby & Company that had opened up in Cary, where I live. I just thought that it would be a much better fit for me and the type of birth that I was wanting. So, I went there with Kendall, my second daughter, and my care there was incredible. I loved all the midwives that I met with during my pregnancy, and at her birth my midwife was so supportive and encouraging and really helped me to have the birth that I wanted. Really, all the staff at Baby & Company were awesome. The nurses were great, the girls up front are so awesome and they make you feel so welcome and like family when you walk in. There’s not even any formal check-in, they just know who I am and they tell the midwife that I’m there, and it’s very comfortable there. So, when I found out that I was pregnant with Jade, there wasn’t even a question, I knew I’d be going back. The pregnancy went along fine and at around 30 weeks I think one of the midwives mentioned that she was still head up, and I didn’t worry too much at that point because I figured that she had plenty of time to flip. Then, around 34 weeks, she still hadn’t flipped and that’s when I did kind of start getting concerned and nervous about it. So, I went to go see a chiropractor to try to get better aligned and see if that would give her the room to flip around. And then at 36 weeks, she still hadn’t flipped so I was really kind of stressing about it, because I didn’t want to have to have a c-section if she was still breech when it was time to deliver. So, I opted to get an ECV where they would manually flip her. So, I went to the hospital and had that done. That was really intense and a lot more painful than I really imagined it would be. But, it only took a couple minutes, then she was flipped and everything was good to go! Once she was head down, it was just a waiting game. The day she was born, I woke up at about two thirty in the morning with contractions and they were about five minutes apart, but really not that bad. The same thing had happened the night before, and the contractions eventually just got farther apart and just stopped. So I wasn’t really sure if it was the real thing or not and I remember I got up a few times, thinking that maybe my water broke. I was leaking a little bit but then I was like, no I don’t think it broke. So, I lay back down and contractions were still coming about five minutes apart and then I started shaking, which I remember I did the same thing during Kendall’s labor, but not until I was in transition. But once I started shaking, I was like okay, I think this is probably the real thing, but the contractions still weren’t really that bad. So I just continued lying in bed and tried to see if I could go back to sleep. Pretty quickly, though, the contractions started to get more intense, so I woke Tyler up — my husband — and told him that I thought we should probably go ahead and call Baby & Company. He was like, “Are you sure we should call already?” because at this point it was like a little before four am, I think, and 2:30 was when everything started. I was kind of thinking the same thing but I was like, “Yeah, let’s go ahead and call because the contractions are starting to get pretty bad.” So, we called and talked to Beth and told her what was going on and she told us to come on in. I’m so glad that we called her when we did, because right around that time the contractions started getting really intense and just started coming back to back to back. So we got our stuff together and I called my birth photographer and told her that we were heading in and that I didn’t think it would be too long before this baby was here. We left, and that was about 4:15 and we got to the birth center around 4:30, I think. Beth let us in and checked me and I was at around eight centimeters, I think, and negative one station and maybe like ninety percent effaced. I remember Beth saying something like, “Yep, this is happening pretty quickly.” Beth asked what room I wanted and I picked the same room that I’d had Kendall in, and she went ahead and got the bath running for me. I remember just feeling immediate relief when I got into the tub. The warm water being all around me and my belly just felt really good.
[BH] So Beth, did you have an idea when you checked her of, like, how long it would be or did you recommend the tub, or how did that go?
[BT] Usually when moms call if it’s not their first baby, I really trust their inherent capacity to know where their bodies are, so when she said she thought she needed to come in, I totally agreed. When she got there she was exactly eight ninety and minus one. Generally, I always give moms the choice of the birth room that they would like to to be in and then I do always recommend the tub, unless the mom is just thinking she’d like to walk around a little bit more. But given Caitlyn’s physical signs to me that she was very active in labor, I thought the tub would give her a chance to have breaks between contractions and kind of just prepare her mind and her body for how quickly her birth had progressed. So, I did suggest the tub and I was just really relieved to see that when she got in she was very comfortable and she was just able to kind of cope and wrap her mind around the fact that she was going to be having a baby relatively soon.
[BH] Can you explain what the stations are? I think that’s one thing that people aren’t super familiar with.
[BT] Yes, so the station is basically the baby’s position in relation to the pelvic bones. It goes from minus three to plus three. Minus three is the highest station that a baby can be when it’s inside the uterus, so its head is very far away from the pelvic inlet. And then plus three, the baby would be pretty much outside and being born. So, Caitlyn was minus one, her baby was almost engaged with its head completely in the pelvic bones, and it was just a matter of the contractions continuing to work the baby down towards the birth canal, and then her effort to push.
[BH] So is plus three like crowning?
[BT] About plus two.
[BH] OK. Caitlyn, you take it back over.
[C] OK. So, I had a few contractions in the water, I think, and pretty quickly I felt the need to push. At this point, Beth was still the only one there so she was having to do it all, I feel like. She was helping me, and then also I guess they have to call someone to tell them when someone’s in labor there. So, I remember she was talking on the phone, telling them that they had a woman in labor, and I remember her saying that she expected delivery any minute now. I remember thinking to myself, no, it’s probably going to be a little while, because with my first daughter I pushed for over an hour and then with my second, I pushed for an hour, and I just started pushing. So, I just expected that I’d be pushing for a long time again. But, it was probably during the next contraction or two that I felt her coming out. The position that I was in, in the water, I was like kneeling and kind of leaning forward in the tub. So, once she was all the way out, Beth told me that she was going to push her through my legs and I could pick her up out of the water. Reaching down, and picking her up and bringing her to me was just an incredible experience. I can’t even describe just how awesome it was. It was… great.
[BH] Did you plan that ahead of time — to catch your baby — or did it just happen in the moment?
[C] It just kind of happened in the moment, yeah.
[BH] Cool. Well, you just powered through that. Do you want to talk about delivering the placenta and what the postpartum experience was like at the birth center?
[C] Sure. So, they had me get out of the water to deliver the placenta. I don’t really remember a whole lot of that, I was just basically holding Jade and bonding with her and stuff during that.
[BH] Do you want to talk about that, Beth, maybe the reason for getting out of the water?
[BT] It varies between midwives, so you can actually have a water birth and then some midwives will deliver the placenta with the mom still in the water. I just choose to have moms out of the water, just as a monitoring measure, because it’s easier to assess blood loss when the mom is not submerged in water. It makes it a little bit more apparent, what is actual bleeding versus dilution in the tub. So, I waited until Caitlyn had an opportunity to bond with Jade and, you know, just focus on her, and let her know that she was glad that she was born. I usually wait until the placenta gives me signs that it’s ready to come out. Increasing bleeding that we see, which is normal, that just lets me know that the placenta is ready to be delivered. Caitlyn’s husband helped support her, and she stood up so I could place a towel between her legs and just had her exit the tub. Then we walked over to the bed. Mom is holding the baby and initiating skin-to-skin, from the moment of birth until two hours postpartum. And we got her over to the bed. She continues to bond, and if the baby was interested in breastfeeding, we encourage starting the first latch after birth. Then, while they’re bonding and initiating the first breastfeeding, I’m checking to make sure that her bleeding is adequate and whether there are any lacerations present, and whether or not they need repair.
[BH] Thanks for sharing that, Beth. Caitlyn, can you talk a little bit about what the immediate after-birth was like?
[C] Sure. In the birth center, it’s a lot more comfortable. I had my first baby in the hospital and she did come to me immediately and I got skin-to-skin time. But then, pretty quickly, they take her away and they do all the weighing and stuff. At Baby & Company, they give you plenty of time before they come in and do the weighing and all that, to bond with the baby and be with her.
[BH] How many people are coming in and out of your room, would you say, when you’re there?
[C] Not many. It’s the midwife, and your nurse, and they don’t really come in a lot, just every now and then to check vitals and that kind of thing. But definitely less than in the hospital.
[BH] Yeah, that’s one thing I was most surprised about with hospital births. I didn’t have my babies in a hospital, but my friend recently did, and you have, you know, the baby nurse, the mama nurse, the charge nurse — everyone’s coming in and there’s someone in like every 15 minutes. That was just really surprising to me, but I know it’s just how it has to be done there. But, I think that might be one of the bigger differences you have with a birth center or homebirth that people don’t necessarily think about. You have more time to… rest. (laughs)
[C] Yeah, definitely.
[BH] So then how long did you stay at the birth center?
[C] With Jade, I had to stay 12 hours, because I was Strep-B positive with Jade. So, I think you’re supposed to have antibiotics during labor. But, everything was just going so quickly that it didn’t happen, so we had to say for 12 hours for monitoring for Jade. But, with my other baby I stayed for four hours.
[BH] So, Beth, is that something that you guys could do at the birth center? Could you do the antibiotics or not?
[BT] We definitely do administer antibiotics to a mom if she’s Group B Strep positive. But, Caitlyn was admitted to the birth center at 4:30 am, and her baby was born at 4:45 am. So, given her significant progress into active labor, we need at least four hours for it to be considered adequate time for the antibiotic to move from the mom’s blood stream across the placenta to the baby. So, in order to preserve the safety of Jade after her birth, we monitored her for 12 hours. They get the normal postpartum assessment, which is: every 15 minutes, we check the mom’s uterus for bleeding, twice, and then we do it every 30 minutes. Then the mom and the baby go on hourly vital checks, so we really do try and allow moms and babies as much time as possible with the dad and other siblings, if they’re there. For most families, like Caitlyn mentioned, the general recovery time is about four hours. For Caitlyn, it was 12, so we had a little bit more room to do assessments, but during that initial part they still get the same frequency of assessments as any other family. Then, that last eight hours of observation is for the baby. So, we checked Jade vitals every four hours until they were discharged. But, generally, yes we are able to give antibiotics. So, we have options for moms that are penicillin-allergic or moms that are not. Depending on what their health history dictates, that’s the type of antibiotic we give. Ideally, we like to get one dose in within four hours of birth, but because Caitlyn was such a rockstar in her labor, we didn’t really have that opportunity. We just made sure that Jade was safe after the birth by assessing her a little bit more often.
[BH] Gotcha. So then, what is the postpartum care like with Baby and Company once the mom goes home?
[BT] After a mom is discharged — well, prior to that — in the birth center we go over the discharge teaching. That can vary in its depth based on whether or not it’s a first-time mom, or a mom with her third or fourth baby. Like Caitlyn, this is her third baby, so her level of teaching was a little bit different, especially because she had had her second daughter with us at the birth center. So, she was kind of aware of the follow-up, but we go over some standards of care in terms of: signs of infection for the mom and baby, how to care for the umbilical cord, signs of engorgement or mastitis in relation to breastfeeding, what type of bleeding is appropriate or more concerning, and when you should reach out to the midwife. And then, at 24 hours after birth — and sometimes not exactly 24 hours, like because she was born at 4:45 in the morning so we would definitely not call a family at 4:45 — but, sometime around 9am, we may call to just follow up. We ask how many breastfeeding sessions the baby has had, if the mom is comfortable that breastfeeding is going well, which is most often assessed by the number of wet or dirty diapers that a baby has. We talk about the mom’s comfort with breastfeeding and the differences between transitional discomfort — just because her body might not have done that recently — versus things that could be related to the latch or if the baby has a tongue tie, things like that. And then we are available for questions that the mom or family may have, and then at 48 hours we do a home visit and complete all of the normal assessments that would have been done at a hospital birth. So, we would do the metabolic screening, we test the baby’s skin for its bilirubin level to determine the risk for jaundice. We weigh the baby to assess weight gain in the postpartum period. Then, we check the vitals of the mom and baby, we check the position of the mom’s uterus to make sure that it’s getting smaller and moving lower and lower into the abdomen as it should be doing. And then we will also check baby’s vitals and we chart all that information in our electronic medical record system. Upon arrival to the family’s home, we do provide the family with a paper copy of all the medical records from birth until the time that we visit them, and then we update their chart once we return to the office. Then, we fax those medical records over to the pediatrician of choice, so when the family arrives for their first pediatric visit everyone servicing the baby is now informed about what happened during the birth and in the two days since the baby has been born.
[BH]: Do you guys work with an OB as well?
[BT] We do, we have a collaborating physician, his name is Dr. A.J. Koehler, he’s with Wake Physician Practice, and they have an office adjacent to our location in our medical mall. Basically, when we have a mom admitted for labor, as Caitlyn spoke about, I do call Labor & Delivery to let them know her name, age, how many weeks of pregnancy, and what number of pregnancy this is for her. So, in the event that a transfer that needs to occur, the hospital is already updated of the mother’s information so we can just make that transition as seamless as possible. Dr. Koehler isn’t always notified of a mom in labor unless we need him for additional consultation, but he does collaborate with the Labor & Delivery floor. So, if there is a transfer, we we contact him first and then we also follow up with Labor & Delivery. But, in Caitlyn’s case, her capacity to allow her body to do what it needed to do worked amazingly well, and her birth was pretty seamless. It was amazing because after she gave birth and then was able to bring her baby up from the water, her face just looked so impressed — I’m not sure if it was a little bit of shock — because it had gone so well. Her mind just wasn’t ready to believe that it was happening, 15 minutes after arrival to the birth center. But, it’s really awesome to be involved in such an empowering experience, and sometimes it’s not anything that we as midwives do. It’s really amazing when moms just realize how powerful they are, especially when they trust their bodies. It was just really amazing.
[BH] I love that feeling when you have the midwife there for support, but it’s almost like you feel like you’ve done everything on your own. Obviously, the prenatal care and everything is so important, and having that person there with you to check you and whatnot. But that moment of just, oh my gosh, I just did that so fast and here’s my baby!
[C] Yeah, it was really incredible. I mean, I really was kind of in shock because, like I said, with my other two I had pushed for so long and this time I pushed for like a couple of minutes. I kind of was in shock at first, like, whoa she’s already here!
[BH] That’s awesome. So was there anything different for you about this postpartum experience, compared to your other children?
[C] You know, I can’t think of anything right off hand. It was pretty similar to the other two. Aubrey was the first, so everything was new and stuff, but I feel like with Kendall and Jade the postpartum experience was pretty similar.
[BH] Very cool. Well, are there any resources that you recommend to your mom friends to check out, like books or anything like that?
[C] I always recommend watching The Business of Being Born. I remember watching that when I was pregnant with Aubrey, and it just really opened my eyes to what birth could be like. With Aubrey, I remember, when I first got pregnant with her, someone asked me what my birth plan was. I was like, “I don’t know.” I didn’t know that was like, “a thing.” And I was just like, I guess I’m just going to go to the hospital and go with the flow. But, once I watched The Business of Being Born, I realized what kind of birth I really wanted. So, I always recommend watching that.
[BH] Yeah, it’s probably one of our top recommendations on the podcast, for sure. And what about you, Beth, are there any of resources that you want to share with my listeners? Especially for the ones that might be considering a birth center birth?
[BT] I always recommend Evidence-Based Birth. It’s the website that has, you know, medically-based resources but at a lay level so you don’t have to have significant medical understanding to actually interpret the information that’s available. But, because Baby & Company is a birth center that’s based in evidence, clients can go back and understand everything we do and the perspective that we’re coming from. So, that is why we offer in our resource library, with our clients through Maternity Neighborhood, an area where they can insert a search term in our resource library and it will give back information that we know is coming from unbiased sources. It’s evidence-based, so clients are being informed appropriately. And that’s the thing that we encourage most: giving ownership of prenatal care back to the client, so when they come in it’s always an open dialogue between themselves and the midwives. In our birth center, we always respect our families enough to trust them to make the final decision in terms of what’s best for their baby and their families. But, we want to encourage them to do as much research as possible on their own, so that at the end of their pregnancy experience they feel as empowered as they did when they first walked through the doors with us. We don’t coerce them into doing something that they didn’t agree with, which I think to me is the most important part of pregnancy care: that clients at the end feel respected and valued and understand that we respect their autonomy and capacity to make the best decisions. So, a lot of the times when we recommend resources, we really encourage questions. We’re really glad when clients come in and say, “I was reading this, and what do you guys think about, you know, vaccines or vitamin K?” so that families really understand the decisions that they’re making and always feel that we trusted them enough to engage in informative dialogue and then allow them to make the best decision.
[BH] I love that. I also wanted to mention — and you might have something to add — how helpful your website is. The Cary, North Carolina, Baby & Company website is a little bit different than some of the other ones, and just it’s really intuitive and has lots of great information. It kind of takes you through the whole pregnancy and a tour of the birth center and stuff like that. Do you send moms to the website, as well, to get more information?
[BT] We do. Clients have often heard of us either through word-of-mouth from other clients who were family or friends, or just do a google search because they are interested in birth center options, and we’re one of a few birth centers that are available in North Carolina. So, they just come to us out of common inquiry and then are very impressed that we’re very transparent in our transfer rates and c-section rates. We really do want clients to understand that Baby & Company functions well because we are transparent in our care. We do want families to know how we function with our collaborating physician at his office, that we do have a working relationship with Cary Wakemed Hospital, where we would go in the event of a transfer. So, our website is really valuable in that way but also does allow clients to dig a little deeper through our FAQs section about conditions that would allow you to birth in the birth center, which I think is also a very valuable tool. When clients do express interest in birthing at the birth center, they are aware that it works best because we do accept low-risk moms and families, not in a way to lessen our capacity to serve as many people as we can, but in order to preserve the service and care that we’d like to deliver. We have to be very honest in what type of clients would be best served by a birth center experience. So, I think our website kind of familiarizes our clients or potential clients with our level of care. Caitlyn mentioned a birth plan with her first daughter, and was like, “What is that?” Actually, a lot of our families still don’t write birth plans. That’s not something that we discourage, but our level of care in terms of our standards of practice regarding delayed cord clamping, and uninterrupted direct skin-to-skin for the first two hours, are often things that people would normally have to write down and advocate for in a birth plan. But, because that’s what we seek to do from the onset, people would have very little to write on a birth plan, because we’re kind of meeting them where they hope to be in terms of their health care and prenatal and postpartum care. So, all they have to worry about is bonding with their baby, establishing breastfeeding and being successful at parenting.
[BH] It sounds like you guys have a pretty good relationship with the hospital too. If there is a need for the transfer, a lot of those things would probably be honored there as well.
[BT] Absolutely. And Dr. Koehler is very supportive of our birth center families. Caitlyn probably got the opportunity to meet with him when she had her version to turn her baby, you know, head down. He really understands what our families come to the birth center in search of, and so he really tries to honor as much of that as he can in the hospital, when it’s safe and appropriate.
[BH] Well, thank you so much to both of you for coming on and sharing that story and all that awesome information there at the end. Is there anything else you wanted to add?
[BT] Um, I’d just like to thank you for the opportunity to share my experience, the midwife perspective of Caitlyn’s birth. She was really amazing. In fact, we have a picture of her after having the baby in our birth center, just because it really captured the essence of what we try to do at our birth center. We really try to just be present in the birth space, but we give total control to our family. Really, thank you both for letting us share what we hope is a really awesome experience with your listening audience.
[C] Yeah, thank you so much, Bryn.
[BH] Thank you again so much to Caitlyn and Beth for coming on today to share the birth story, and to Baby & Company for sponsoring this episode. Head over to thebirthhour.com to find their show notes page, where I will be sharing some images from Caitlyn’s birth as well as a little bit more information about Baby & Company. You can find me on instagram @thebirthhour or facebook.com/thebirthhour and please, please go sign up for the email newsletter. If you’re interested in sharing your birth story, I’m going to be opening that up on Thursday, so i’ll be announcing that in the email newsletter that goes out with Thursday’s episode. Thanks so much for listening. If you enjoyed today’s show, head to thebirthhour.com to sign up for our newsletter. And if you really liked the show, please subscribe and leave a review in itunes. I’m Bryn Huntpalmer and you’ve been listening to another episode of The Birth Hour. Thanks again.