During her first pregnancy, Ashley planned for an unmedicated hospital birth at her hospital’s natural birthing center. Ashley only has one kidney as a result of a Wilms tumor at birth and received close monitoring for pre-eclampsia due to gestational hypertension. She was induced at 39 weeks, 5 days due to consistently high blood pressure readings. She was induced with Pitocin and labored well for 15 hours with the support of her husband and doula. Her water broke on its own around hour 8. She didn’t know her son was posterior, which caused the nurses to be unable to successfully monitor his heart rate with the traditional monitor. After 3 failed attempts to place an internal monitor, the OB on call required Ashley to labor in the hospital bed. At that point, she requested an epidural after learning she was only 4-5cm.
Labor progressed fairly quickly at that point and she was ready to push around 3pm. During this time, the OB on call was rushing back and forth between Ashley’s room and the ER. Another patient of the practice had come in with an ectopic pregnancy and needed emergency surgery. This was rather chaotic and most of the 2.5 hours spent pushing was with the nurses and her doula. Due to his posterior position and the epidural wearing off, Ashley experienced excruciating pain during transition and pushing.
Because the OB on call ended up in emergency surgery, her OB rushed in from her home an hour away to come deliver her baby. The nurses didn’t think her OB would make it in time, so they called an attending and resident in to deliver Ben. They attending didn’t think Ashley could deliver the baby without help, so she received an episiotomy without her consent from the attending as her OB ran into the room. The baby was crowning at that point and he was delivered quite quickly. The resident nearly dropped her son as he was delivered. Ben was born at 8 lbs 4oz. Ashley lost as significant amount of blood and had to have retained placenta extracted manually. She also tore in addition to the episiotomy.
Ashley had a pretty rough recovery from the episiotomy and tears. Benjamin struggled to gain weight in the first few weeks home from the hospital. He was diagnosed with a lip and tongue tie when he was 2.5 weeks old. Ashley struggled with breastfeeding throughout the first year. We were blessed by donor milk and nursed until Ben was 14 months old. Between his traumatic birth and their breastfeeding struggles, Ashley waited until Ben was almost 4 to get pregnant again.
Ashley’s Second Birth
Ashley got pregnant with Cara in September 2019. The pregnancy was pretty similar to Ben’s with blood pressure issues, but nothing terribly concerning. We went into quarantine as Ashley neared the 3rd trimester. She feared her husband and doula wouldn’t be able to join her for delivery as many hospitals restricted visitors. She shared her concerns on Bryn’s zoom calls and received immense support from the Birth Hour community. Protocols changed regularly, but she was able to have her husband and doula attend Cara’s birth due to executive orders signed by New York’s governor. Ashley was induced again at 38 weeks 2 days for high blood pressure.
Labor went much quicker this time and lasted exactly 6 hours from the start of pitocin to Cara’s arrival. Pitocin began at 6:30am and her doula arrived at 9am. Her OB broke her water at 9:30am at 4cm and her husband arrived shortly thereafter. She asked for an epidural around 11am and it was placed by 1130am. Her OB checked her once the epidural was place and she was already 8cm. By noon Ashley was feeling intense pressure and thought her catheter wasn’t inserted properly. Her doula went to look for the nurse and her OB came running in and told her to stop pushing. It turns out the baby already was crowning. Cara was delivered in a few pushes and no tearing. Ashley hardly pushed and felt her body did nearly all of the work on its own. Cara was 8 lbs and 6oz.
Ashley had an easy recovery and felt amazing postpartum. They were discharged at 24 hours post-delivery as a result of Covid protocol. Cara ended up having jaundice and being admitted to the NICU for two days to get her bilirubin levels back to normal. Between Cara’s lip and tongue tie and the unexpected NICU stay, Ashley struggled again with breastfeeding. Thanks to the support of her amazing IBCLC and donor milk, they’re still nursing two weeks before Cara’s first birthday.
Ashley Espejo Bio
Ashley lives on Long Island, NY with her husband, five year old, Ben and almost one year old Cara. She also has a 19 year old stepdaughter, Darlene. She is a tax manager at a private equity fund in New York City. Ashley loves hanging out with her family, going to the beach, coffee and riding her peloton. You can connect with her on Instagram at @Mrs_espejo and on Facebook.
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Cara and her husband, George decided they wanted to begin their family immediately after getting married in 2019. They were shocked at how quickly they fell pregnant in October. Cara is a medical student so during the beginning of her pregnancy, she was taking classes like human anatomy which involved dissecting a human cadaver all while being 10 weeks pregnant.
Cara’s pregnancy was uneventful until around 28 weeks when her husband and parents all came down with COVID, which caused her to miss several appointments with her Ob/Gyn.
When she finally got back to the doctor, her blood pressure was high and they knew she was most likely developing preeclampsia. Cara was diagnosed with preeclampsia around 31 weeks of pregnancy. This led to her needing an induction at 37 weeks. Cara’s labor was long, and involved multiple interventions, like cytotec, a foley bulb, and epidural, until ultimately she went forward with a c-section due to suspicion of chorioamnionitis (infection of amniotic sac and placenta). Prior to the decision to go ahead with the c-section she developed a high fever which was indicative of an infection in her uterus. After 47.5 hours of labor, she and her husband welcomed their son, Lucas into the world on June 2, 2020 at 5:26 pm weighing 7 lb 10 oz and measuring 21.5 inches.
Cara continued to struggle with an elevated blood pressure due to preeclampsia even after she gave birth, but was able to completely stop taking blood pressure medication at 12 weeks postpartum.
Connect with Cara on Instagram at @caragrudziak___ .
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During her second year of residency Lisa and her husband decided to expand their family. Her pregnancy was uncomplicated and she went into labor on her own. Labor and delivery were also pretty uncomplicated for a first time delivery, other than a pushing stage of a little over 3 hours and a fever. She was able to deliver without other complications and was surrounded by her co-residents. Breastfeeding had a hard start though mostly from the baby having a tongue tie that was released at about 1 week, which greatly improved her nursing journey.
After graduating and working as a full spectrum family medicine doctor in rural Maine, her family decided to try for a second child. This time she and her husband decided they would like to have a home birth. She again had a routine pregnancy. Her labor started on its own again and progressed much more quickly this time. After 3 hours of active labor, she experienced a fetal ejection reflex. She really enjoyed the postpartum recovery at home.
Lisa Stout Bio
Lisa lives in rural Maine with her husband Jeremiah and their two boys, ages 7 and 5. She practices full spectrum family medicine. Her husband stays at home with their sons. Connect with Lisa on Instagram @stoutberger.
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Natalia was camping when her water broke in the middle of the night at 34 weeks pregnant. She’d planned to birth at a birth center but instead had to go straight to the hospital, a place she’d avoided since the onset of Covid early in her pregnancy. She initially felt empowered & positive about the unmedicated birth that followed. After a challenging two-week NICU stay, her postpartum recovery seemed to stall. The physical results of birth — including pelvic congestion, hypertonic PF, urethral hypermobility & prolapse — have led to a slow journey of healing from birth’s physical & emotional tolls.
Natalia Hurt Bio
Natalia met her husband a decade ago while backpacking in Nepal. He’s from Luxembourg & she’s half German, so they’ve lived in Europe for most of their relationship. They now live in Portland, Oregon, with their son Tristan & are excited to share the beauty of the Pacific Northwest with him. She’s not very active on social media but can be reached via her instagram account: @afarcorner.
This episode is sponsored by Wumblekin. Life’s busy and there’s a lot of noise out there, that can be especially true during pregnancy. Wumblekin breaks down pregnancy, labor and birth with evidence-based education and expert-curated products for mom and baby. Easily buy or gift single boxes, or subscribe to receive them throughout pregnancy, birth and postpartum. Be informed and prepared by ordering Wumblekin pregnancy, birth and postpartum essentials, today! Get 15% off your first box by using promo code BIRTHHOUR at checkout. Visit wumblekin.com to order or subscribe, today!
At the 35 week mark, Joelle, her husband, and her birth team made the mutual decision to transfer her care away from a home birth practice to a midwife-led OB/GYN practice that her midwife also practiced through due to concerns about mental health & preparation for home birth. From that point on, she experienced some regular episodes of prodromal labor. At 38 weeks and two days on January 19th, Joelle unexpectedly went into spontaneous labor. She tried some lower pain interventions including hydrotherapy, partner support, counter pressure, and IV pain medication. In the end, due to exhaustion, Joelle opted for an epidural and went on to deliver her daughter shortly after noon on Inauguration Day.
Joelle Hamilton Bio
Joelle Hamilton lives with her husband Ben and daughter Iris in Grand Rapids, Michigan. When she’s not studying or making sure Iris gets her daily conversations with the mirror in, she loves playing video games, journaling, crafting, writing, and experimenting with tarot, astrology, and all sorts of other weird stuff. Connect with her at @hamilton.joelle on Instagram.
Mom’s Bloom Postpartum Support Program in Grand Rapids Michigan
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Sara became pregnant with her first child at the very beginning of the pandemic. Her pregnancy was smooth until the end of her second trimester, when her doctor recommended a growth scan since her fundal height was measuring quite low. The scan showed that the baby was measuring very small – under the third percentile for weight. However, weekly scans showed consistent growth and that the baby was healthy and active. At a routine MFM appointment at 35 weeks, it seemed that growth had drastically slowed down, and she was sent to be induced immediately.
Sara’s induction began with a foley bulb, inserted overnight, and then Pitocin for the next 24 hours. 36.5 hours after being admitted (but after only 20 minutes of pushing!), Liora was born. Her husband announced the sex, and it was the most beautiful moment of Sara’s life. They were also shocked by the baby’s weight – 4 lbs, 5 oz, about half a pound larger than predicted by ultrasound. Sara and her baby got a few minutes of skin to skin before the baby was taken to the NICU.
Sara and her husband were able to stay overnight in the NICU in a “couplet” room until Sara was discharged. They were blown away by the care and compassion of their entire care team. Liora stayed in the NICU for a total of 17 days to put on weight and regulate her temperature and is now a healthy and chunky 6-month-old.
Sara Gottlieb-Cohen Bio
Sara lives in New Haven, CT with her husband (Andrew), daughter (Liora), and their mini goldendoodle (Moose). Sara and Andrew both work at Yale University. Andrew is a clinical social worker at the Yale Child Study Center, and Sara works in the library providing data and statistical support to scientists across the university. Sara can be reached on Instagram @sara.gottlieb or on Facebook (Sara Gottlieb-Cohen).
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