“Jodi’s Story, Part One: My First Two Births” – with Jodi Nussbaum RN, BSN, IBCLC

In this episode of Healthful Woman, Dr. Fox speaks with Jodi Nussbaum, a postpartum RN, lactation consultant, and mother of three in Seattle. She shares her journey from discovering her pregnancy to facing potential complications like a nuchal translucency test indicating chromosomal abnormalities, navigating genetic screening as an Ashkenazi Jew, and dealing with a breech baby and Rh-negative blood type issues during delivery. Despite these challenges, Jodi’s story ultimately ends with a healthy delivery after a long induction process.

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Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OBGYN and maternal fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness.

Jodi Nussbaum, welcome to the podcast. How are you doing today?

Jodi: I’m doing great. How are you, Dr. Fox?

Dr. Fox: I’m wonderful. And, you are phoning in from Seattle.

Jodi: That’s right.

Dr. Fox: The great state of Washington. Welcome. This is terrific. I really appreciate. How did you find the podcast?

Jodi: Well, I’m a birth nerd and I was just consuming, I think it was probably after my second pregnancy or after my first, just consuming tons of birth podcasts, and I ended up stumbling upon the high risk birth stories because I was working as an RN at a high risk delivery center in the Seattle area at the time, and I stumbled upon the podcast, and I just felt, like, all of the women on the story felt very familiar to me, and I felt, like, your voice as an MFM was so compassionate, I think, to the women, and I just got hooked and I couldn’t stop listening.

Dr. Fox: Wow. Love it. Thank you so much for that. That’s…We’re glad to have you aboard. And, what compelled you to volunteer your own story, or stories?

Jodi: Well, I’ve had three babies and I had three uncomplicated pregnancies. In my belief, I felt like they were uncomplicated. But with the first two, I was referred to MFM both times, and actually ended up feeling, like, I was sent down these rabbit holes with MFM a couple of times just from my regular OB and told that I was high risk in different ways that didn’t end up necessarily coming to fruition in any way. And, I just feel like a lot of women experience that. I’m a postpartum RN and lactation consultant, and I hear all the time about women’s stories that they’ve been scared by what they were kind of told throughout their prenatal experience. And, in the end, everything worked out fine, and I just feel like that’s such a common narrative and it was definitely my narrative, and it ended up causing me to make some different choices later down the road. So, that’s why I thought my story might be helpful to some other women.

Dr. Fox: Wow. That’s right. Now, I guess let’s get into it. Let’s go to your first pregnancy, your first birth. So, when was that, and at the time, were you already working in the field as a postpartum RN?

Jodi: Yeah. So, I graduated nursing school in 2017 then started, I thought I wanted to do labor and delivery because I was already really interested in birth at the time, but I ended up, I was doing a summer program in Israel that summer, and so I needed to get a job before I left, and I was hired in postpartum. And so I just decided, you know what? This is close enough. Let’s go for it. So, I started working postpartum in 2017, and I got pregnant in… I got married in the spring of 2018 and pregnant in the fall of 2018.

Dr. Fox: In the fall of 2018. Okay. So, tell us about that pregnancy.

Jodi: So, my first pregnancy, I found out I was pregnant, I think it was right around Christmas time or New Year’s, and I got my first positive pregnancy test and just couldn’t wait to get to the OB to figure out what was going on, and just see the heartbeat and I just had… Everything felt so tense during that time, like, I couldn’t believe that from 5 weeks to 10 weeks or 11 weeks I would have to wait to see what was going on with the baby and to hear what the next steps were. And, I finally, a couple days before my first appointment actually got in a car accident and went to the emergency room, and they showed me my baby’s little heartbeat on the ultrasound in the emergency room, and that was the first time that I saw our little baby, and I think my first OB appointment was two days later. And so, went in, saw her again. We didn’t find out if she was a boy or girl, but I’ll just refer to her as a girl because we know now, and after that first appointment, you know, went great. I actually knew my OB. She just kind of told me when to come back and when to follow up, and I did. I think the first follow up they had me do was the nuchal translucency test at 12 weeks. They drew some labs, I think at the first appointment and then we came back to do that, and that’s where things kind of started to take a turn for us.

So pretty early on, we went in and we were, my husband and I were so excited to see our baby again on the ultrasound and I think it was probably 12 or 13 weeks, and after just a few minutes, you know, the ultrasound tech, she was pretty quiet. She kept kind of zooming in on the baby a whole bunch and just kind of acting off, and by the end of the exam, she left the room to find the doctor and took a while coming back, and finally when she did, she said, “The doctor’s gone for the day, but I have to tell you there’s something abnormal,” which this is not her job to tell us, but she said, “The doctor will be calling you, but there’s a pocket of fluid on the back of your baby’s neck and that it’s bigger than it’s supposed to be and that can be a sign of chromosomal abnormalities, and the baby has a high risk of having Down syndrome or some other issue, and so the doctor’s gonna give you a call in a few days.” And…

Dr. Fox: In a few days?

Jodi: I think it was, like, a Friday evening for some reason. We had to wait. It was really bizarre, because… [crosstalk 00:06:17.347]

Dr. Fox: Okay. Yeah, that’s an unusual thing. Yeah.

Jodi: …to us in the first place, I think. But, both of our hearts sank, and we were just kind of beside ourselves. We were both also of the opinion and had been on board with each other from the get-go this is an important background, I think, that, like, if we would find out something’s going on with the baby, that we would continue on with the pregnancy and see what the situation was down the road. I had a friend at one point that had an experience where she was told her baby was not compatible with life and her baby is 7-years-old right now and living a good life. So, that experience, we just, we had our heads set on that, but it was still tough news to hear, and without any information surrounding it. So, I think my doctor called me a few days later, and at the same time, I can’t…you know, it was four years ago. So, around the same time, we’re both Ashkenazi Jews and so we had to do the genetic screening for carrier status. And so, we had both tested positive for a very specific mutation of congenital adrenal hyperplasia, and so we were sent to a genetic counselor. We were sent for more detailed anatomy scan and to talk both about the second NT and then also the carrier status and what that could mean for us.

Dr. Fox: Were you carriers of the severe form?

Jodi: No. So, that’s so interesting that you asked that because you actually know what you’re talking about.

Dr. Fox: Oh, thank you.

Jodi: I think the people that we talked to did not really know what they were talking about, because we’re both carriers to the non-classic type, which is non severe.

Dr. Fox: Right, right. Which means your child has a 25% chance of having irregular periods.

Jodi: Right. Exactly. But Dr. Fox, I wish I had known you at that time because we were not told that until my baby was 2-months-old.

Dr. Fox: Right. Oh, because there’s just, for our listeners, their congenital adrenal hyperplasia, there’s sort of a wide net of diagnoses, which is unfortunate that they don’t differentiate, because there’s a mild form, which if you have, it presents very similar to PCOS, you know, maybe irregular periods, you know, sort of that type of…sort of manifestation, which is annoying obviously, but not life threatening. And, on the other end of the spectrum, can be horribly life-threatening to newborn like life or death, can also have what’s called virilization turn a girl into look like a boy in utero and, like, horrible, like really scary, scary things, and it’s known when you get your results which one of those two it is, but not everyone has the wherewithal to differentiate those when talking to you about it, which is quite unfortunate.

Jodi: Well, you would wish that the genetic counselor would’ve known because when we went to speak with the genetic counselor about it, they counseled us about the severe type, and they had the results.

Dr. Fox: Oh, that’s weird. Again, unless it’s just some mutation where at the time was it known if it’s mild or severe? I don’t know.

Jodi: It was known. It was known and…

Dr. Fox: Wow. Well, that stinks.

Jodi: Yeah. It super stunk because I…yeah. We had no idea that there was any difference.

Dr. Fox: So, you think your baby A has a problem because the nuchal and B is a 25% chance of, like, a threatening condition.

Jodi: Exactly. And…

Dr. Fox: Good times. All right. So, that’s a stressful pregnancy. All right. Wow.

Jodi: And so, also our doctor, so there’s also the NIPT that comes along with that early NT test, and that’s the blood test that’s supposed to tell you what the risk level is of the NT, meaning something essentially. And, she didn’t really give us the statistics of what those two together might mean, which was likely that there was absolutely no problem.

Dr. Fox: That’s a hard one though. That’s difficult to know. It depends on just for, in all fairness, you know, if I’m gonna go after the genetic counselor, I’ll de… You know, I gotta call it as I see it. It depends how thick the nuchal is. Meaning if the nuchal is thick, just barely, like, 3 millimeters, and the blood test…

Jodi: It was three. It was, like, three. It was…

Dr. Fox: Yeah. Yeah. When I see that, you know, the nuchal being 3 millimeters, which is an increased risk in the NIPT, the blood test being normal, I usually tell people the likelihood is everything is fine. That’s the likelihood. But, a nuchal of three usually needs to be, or should be investigated or can be investigated. Obviously, you know, you’re talking about whether you would or wouldn’t terminate pregnancy might be part of it, how much you wanna do an invasive test or not, but it’s, because there are other things that are not on the NIPT that it could be, so the chance that it’s Down syndrome is gonna be pretty low given the blood test being normal, but the chance that it’s something is real. And so, whether you want to do an invasive test or not, to sort of look into that is obviously a personal choice. So, the counseling has to be pretty…and that’s high level, mostly OBGYNs aren’t faced with that circumstance that often. That’s more of an MFM type of counseling thing, so okay.

Jodi: And I was extremely anxious at this point about something just happening to the baby. Like, I did not wanna lose the baby and so I was, you know, the amnio or the CPS and I looked at the risk of miscarriage and I just said, “I don’t wanna do that.”

Dr. Fox: Not worth it. Which is fair. There’s no imperative to do it. It’s just, it’s how much information you wanna know before birth versus after birth, and different people feel differently about that, and that’s totally cool. I mean, I certainly wouldn’t have twisted your arm to do an invasive test. I would’ve told you why you may wanna do it, and if the answer is no, that’s cool. Like, you know, carry on. That’s probably gonna be fine.

Jodi: So, we continued on, we did some higher level anatomy scans. Everything looked normal. There was one where they were unsure. They said there was a hole in the heart potentially, which could also be another indicator of Down syndrome, and so then they sent us for a late, I think…

Dr. Fox: Echocardiogram. Yeah.

Jodi: A late, yeah. I think even on the late anatomy with MFM though, the MFM said everything was fine and he…I asked him if he would counsel someone to get an echo at that point, and he said likely not. He said it looked okay. So, I think at 22 weeks we finally said like, “Okay, everything’s likely fine. We won’t know about the genetic thing until later, and so let’s just go about our business.” So, that’s what we did.

Dr. Fox: Okay. That’s pretty healthy under the circumstances. That’s not, not everyone can pull that off to have that level of sort of calm under all of these results getting thrown at you.

Jodi: Yeah, I don’t know. I don’t know. But I wanted to enjoy the pregnancy to a certain extent too, because I felt really good.

Dr. Fox: Terrific. Terrific. Ultimately, how did the delivery go?

Jodi: It was a…well, first of all she was breech at 34 weeks, or 35 [crosstalk 00:13:41.215].

Dr. Fox: Troublemaker. This kid’s really giving you run for your money.

Jodi: I know. Yeah. So, 35 weeks I think, I had been dancing at a wedding and I felt her flip in the car on the ride home. And then the next day we found out she was breech and they won’t do anything about… I for sure was gonna get a version and in the meantime did all of the headstands that I could possibly muster. And so, we tried a version at 37 weeks at which I found out that I was Rh negative blood type and had not been given RhoGAM. So, that was another stressor.

Dr. Fox: Wait, what… It just got missed, you mean?

Jodi: I transferred care at 24 weeks because of insurance purposes, and when I transferred to the new OB, it just got lost in the shuffle. I assumed…

Dr. Fox: Lost in the shuffle, yeah.

Jodi: Like, being an RN, I assumed, “Oh, they didn’t say anything? I must be positive,” and I didn’t even think about it. Yeah. And so then when it came time to do the version, they were looking over my labs and they said, “Did you get RhoGAM?” And I was like, “No, why? Do I need it?” And they were like, “Yeah, you should have gotten it.” So, that was a whole ordeal. Luckily I wasn’t sensitized and then we just did the version and gave me RhoGAM and all in the same shot and it was fine. [crosstalk 00:14:58.678].

Dr. Fox: Okay. And the version worked?

Jodi: No.

Dr. Fox: Didn’t work.

Jodi: It didn’t work the first time and my OB wasn’t the one to do it. And so she, my own OB said, you know, if she can’t do it while I’m outta town, I’ll try again in a few days. And so when she tried on the very last try, she was going to, she flipped and it was great. It was successful, it was great, and then I was like, “Get this baby outta me while her head is still down.” But, that was, like, at 38 weeks and she wouldn’t consider an induction because everything else was normal until 41 weeks. So, at 41 weeks I went in for a 45-hour induction. I labored 36 hours without an epidural because I really wanted to have that experience, and then finally got one the morning she was born and yeah. It was a long ordeal.

Dr. Fox: But ultimately…

Jodi: Ultimately [crosstalk 00:15:58.678].

Dr. Fox: After, before vaginal delivery, she was healthy. Everything good?

Jodi: Yeah. She came out fine, everything was fine. No lacerations even, just like…

Dr. Fox: Really?

Jodi: Yeah. Just [crosstalk 00:16:10.908] after the long labor.

Dr. Fox: Yeah. You’re probably tired with, like, smoke coming outta your ears, but otherwise.

Jodi: Exhausted. So exhausted. And everything ended up fine, and the plan was to draw the genetic screening for the CAH out of the cord blood. And so, that was great. So, I mean…

Dr. Fox: That frequently doesn’t work.

Jodi: Yeah. No, it didn’t work. They didn’t do it. They didn’t send it and we found out weeks later that they didn’t send it, and ended up having to take my baby into Children’s hospital, get poked four times to get a vein and draw blood, to just check for not even the genetic, but just like the metabolic kind of signals of CAH, and they…so it was just kind of a miserable experience and everything came back normal, so they determined it was very unlikely that she had any kind of high risk, and then they referred us to endocrinology just so we would have a relationship for her or for future children. And, the endocrinologist now with a 2-month-old baby was able to tell me, “Hey, you guys are not carriers for the scary type. You cannot worry about this pretty much.” And so, it was at that point that we were able to be like, “Oh, that would’ve been nice to know six months ago.”

Dr. Fox: Wow. Wow. All right. Well, you know?

Jodi: But it worked out.

Dr. Fox: All’s well that ends well.

Jodi: Right, right. For sure.

Dr. Fox: Wow. All right. Well, that’s quite an ordeal. All right. And then, you have your first baby, a little bit of a rocky pregnancy, but thank God, a healthy delivery.

Jodi: Thank God.

Dr. Fox: What’d you do for round two? Did you go same place, same doctor, same everything or did you mix it up?

Jodi: Yeah. So, I was working at the same hospital still, so I decided to deliver at the same hospital, and I wanted to see my same OB again, and so I initiated care with her. I got pregnant, like, eight months postpartum, and this was two months into COVID pandemic working [crosstalk 00:18:14.213] in a hospital.

Dr. Fox: Oh, how nice. Wonderful.

Jodi: Yeah. So, it was a stressful time.

Dr. Fox: That’s not stressful at all.

Jodi: Yeah.

Dr. Fox: Yeah. That’s not at all stressful. All right. Oh my… All right.

Jodi: Yeah. And on top of that, my husband and I were opening a restaurant, and [crosstalk 00:18:26.654].

Dr. Fox: Oh, a restaurant?

Jodi: Yes. So, we were, yeah.

Dr. Fox: Wait. That’s a pivot.

Jodi: Well, so that’s what he does. So, we have a hummus restaurant actually in Capitol Hill in Seattle, and we were opening a second location that was based around shawarma.

Dr. Fox: Oh, my God. That sounds delightful. Delicious.

Jodi: Yeah. It was great. So, we signed the paperwork when my eldest daughter was 6-days-old and then six months later COVID happened. So, we were kind of locked in and COVID kind of threw everything through a loop and two months, three months later I found out I was pregnant as well.

Dr. Fox: Right. Did you guys at least have a good infrastructure for takeout and delivery?

Jodi: Yeah. Yes, we did, and luckily our first restaurant is still around, but the second one was based on kind of the offices in the downtown area in the South Lake area around Amazon, and Amazon haven’t been fully back in the office today. So, that one didn’t stick around, which was unfortunate, but…

Dr. Fox: Yeah. Okay. So it’s COVID, new restaurant, new pregnancy, and not only is it COVID, like, everyone has COVID, but you’re also working in a hospital during COVID, which is you’re the, whatever we were called the first responders, the heroes, the health-care workers, all the things they said about us that was really nice until COVID ended and they hate us again.

Jodi: Right. Exactly.

Dr. Fox: All right.

Jodi: I couldn’t have said it better myself. So, we found out I was pregnant, planned to see the same OB. And the first appointment where we did a confirmation of pregnancy ultrasound, she saw something. She called it a synechiae I think. I tried for the life of me to research what that meant and what it could imply and whatever, but she seemed to think that it could cause preterm labor, that it was some sort of attachment of the membranes or something to the placenta. Something bizarre that I don’t… You can maybe explain it better.

Dr. Fox: Synechiae, which is a really strange word, it’s basically scar tissue in the uterus. And so if you’re looking at, almost like if you’re in a room, like, cobwebs in the corners, and so you sort of, you can see those and if that’s what it is now, I don’t know why you would really have those, it’s unusual to have it unless you had a procedure like a D&C or a hysteroscopy, but you can get it after any delivery. But having synechiae is generally completely harmless to you and to the baby, and we essentially ignore them. There are rare instances when it’s important if they’re in, like, the very bottom of the uterus, but that’s the exception. Sometimes people confuse them with something called amniotic band, which is not scar tissue of the uterus, but that’s when the inner bag, the amnion breaks internally and has, like, flaps floating around inside the water. Those can be very dangerous to the baby, because they can sort of wrap around a limb like a rope and cut off blood supply, but that’s much, much, much less common and very different. So, if they thought it was synechiae, we would’ve just ignored it.

Jodi: Okay. So yeah, I was told I have this thing. It was a mystery to me what it could mean. Even Dr. Google couldn’t really help me out with it, and I… So, yeah. I was pretty distracted during this pregnancy with everything else going on in my life, and I just wanted to go in, get good care and leave. And the doctor that I had was somebody who I worked with and I knew, and she kept canceling my appointments to schedule C-sections. Like, it happened like, three or four times. And, at one point she had referred me for an ultrasound. I think it was just, maybe it was the 20-week ultrasound, and it just got lost in the shuffle. Like, she forgot to send it, so I arrived that day to do the procedure and it wasn’t actually scheduled and something, you know? I just felt like she was dropping the ball with my care, and so I decided to transfer again during that pregnancy. And so, I think at the 20 weeks, everything with the baby seemed fine, and then they noted that I had, like, borderline high fluid. I think it was somewhere around like 24, 25, maybe 20…I can’t remember exactly. It wasn’t super high, but they just wanted me to continue following up, so I got sent for another follow up ultrasound for fluid, and then on one of those follow up ultrasounds for fluid, they saw something on his brain, like, a cyst or something, some kind of black spot, and so I had the same experience again of, like, the ultrasound tech taking way too long, taking pictures of one part of the baby and stressing me out and then going and finding the doctor who then tells me that there’s something wrong with my baby’s brain. So, they referred me time and time again, and I went in and just the doctor did the ultrasound and said, “I think this is probably a common finding. I don’t think that it’s very likely to be anything serious, so I wouldn’t worry about it. There’s probably lots of people walking around with little cysts on their brain like this one.”

Dr. Fox: Did they give it a name or just cyst? Like, generic cyst?

Jodi: If I say a name, it might be the wrong name. But yeah, they did give some.

Dr. Fox: Like, arachnoid cyst?

Jodi: Something about like arachnoid, yeah. Something like that.

Dr. Fox: Oh, probably an ar… Yeah. Arachnoid cyst. It could be that. Okay.

Jodi: And so, I just decided, you know, like, “I don’t wanna worry about this, so I’m just not going to.”

Dr. Fox: Who did you transfer care to? Another OB or an MFM or a midwife?

Jodi: It was another OB in the clinic that I was at who actually was another family friend. Yeah. It was somebody who I had met before who I really liked and had a good relationship with, and then she had started working at my hospital. They had just returned from living in Israel or something, and then they came to the hospital where I worked. So, I said, “Great, I’ll transfer care to you, and maybe I’ll pay the time of day.” And she really did. And she would like come to me on the unit sometimes to discuss what was going on, which was good in some ways, and then what ended up happening was I got close to term and I was pretty committed to not doing an induction again. I had started kind of to delve into the natural birth world a little bit, and in terms of, you know, my birth nerdiness and podcasts and things that I was thinking about, “Okay, if I can go into labor naturally, maybe I can avoid a 45-hour induction again, and I think that if I am not…” I was trying to approach the birth, as like, if I go in not expecting to deliver at 37 weeks and thinking I could go over a little bit and just let my body do it, then it’ll happen and it’ll be fine and there’ll hopefully be…like, labor will go smoothly and there won’t be as many complications. And that was my hope, and I also, you know, pairing that with the fact I was working up to my due date and my life was such chaos that I had not even really processed being pregnant or having a second child at that point, I really wanted to go. I was kind of expecting, like, I’ll finish working at 40 weeks, I’ll have a week, maybe two to really think about having a baby right now and bonding with him and nesting a little bit and then everything will be good.

And so, that was my plan, and I felt comfortable going post date because I had done it before, and my previous OB hadn’t even allowed me to schedule an induction until 41 weeks and had said that 42 would be fine as long as monitoring was in place. And so, I felt good about that. And, at the end of my 38th week, I think I was turning 39 weeks that day, my OB texted me at 6:45 a.m. as I was arriving at the hospital for my shift and asked me why I hadn’t scheduled my induction yet.

Dr. Fox: Was the fluid still high or was this just as a routine thing?

Jodi: It was never, like, super high. It was always borderline, I think.

Dr. Fox: Okay. Meaning, so your understanding was they wanted to do it just because you’re 39 to 40 weeks and not that there was a problem specifically?

Jodi: Right. Right. Exactly.

Dr. Fox: Okay. Yeah. Yeah. Understood. Now, it would be highly unlikely even if you did have an induction for it to be 45 hours on baby number two. So, that was probably off the table at that point. Thank God they go quicker second time around. But all right, so basically she wants you to be induced because she wants you to be induced.

Jodi: Exactly. And she came to the unit and she tried to tell me, “There’s no point in being pregnant after 39 weeks. There’s no benefit to the baby, and I want you to schedule it and why don’t you want to,” and really just put the pressure on. And, I had been wanting to kind of not have pressure because I thought if I have pressure then I’m not gonna go into labor because I’m gonna be stressed, and the oxytocin’s not gonna be flowing, and I wanted the oxytocin flowing, and so just by doing that, like, I felt was…

Dr. Fox: Turn off.

Jodi: Right. It was just not what I wanted or needed. I didn’t even want to get, like, any membrane sweeps or anything, but once she said that to me and she kind of started acting like I had to schedule an induction, she was like, “Why don’t you just put one on the calendar?” Then once I had to do that, I felt like if I’m not doing something to try to naturally induce, then I’m just giving into a medical induction again.

Dr. Fox: It’s so interesting. Unless it’s a COVID thing, I’m trying to… I mean, there’s data that it’s not bad to deliver at 39 weeks, but it’s not, like, the recommendation is therefore, to deliver at 39 weeks for everybody, and there’s nothing else going on it’s… It’s…I don’t know. It’s an unusual…like, if you said to me, “I wanna be induced at 39 weeks,” I’d say, “All right, that’s fine,” but I would say or otherwise like, “Fine. Let’s wait.” Like, it’s unusual to me. I’m not sure why they really wanted to do it. I don’t know.

Jodi: I had no real understanding or explanation as well, but my understanding today is that, you know, I’m Jewish, she’s Jewish, anxiety is our birthright, and she felt personally responsible I think for making sure that I had a safe delivery.

Dr. Fox: Okay. All right. Fine. So, it’s either, yeah. Because it’s either gonna be anxiety or gluten intolerance that’s gonna drive us somewhere. All right.

Jodi: Right. I really felt like that was the reason in the end, like, when I went back and thought about it.

Dr. Fox: Okay. All right. So, well-meaning, but not aligned with what you’re looking for?

Jodi: Right. Exactly. And so, I went in, I did like, I did a membrane sweep. My mom called me. Oh, I didn’t even wanna, like, I didn’t want them to check me because I didn’t them to tell me that I was not dilated enough. So, I told her, “Even if I’m not dilated enough, to do a membrane sweep, don’t tell me. Just tell me you did it.” And then I’ll, like, not think about how dilated I’m or not. And then the next day my mom called me and said that her manicurist would give me an ankle massage and send me into labor, and so I went and I was like, look, if I don’t go into labor, at least I got an ankle massage. So, I did that on Tuesday evening and then…was it later? Yeah, it was later that night I went into labor. Yeah.

Dr. Fox: Wow. Sign her up. Send her to New York. I want this ankle masseuse working for me.

Jodi: Yeah. So, it was Tuesday, like, at 10:00 p.m. I started having regular contractions. We were watching a show, and really pretty quickly they went every five minutes, about a minute apart. They were bearing between, like, 30 seconds to a minute long and they were just not painful.

Dr. Fox: And just, were you currently just so, you know, were you before your due date, after your due date? Like, where were you sort of date wise in terms of the pregnancy, at this point?

Jodi: I think I was 40 and 3.

Dr. Fox: So, right after the due date. Okay, got it. So, you’re having some early labor stuff. Okay.

Jodi: Yeah. So, early labor stuff started and it was getting pretty consistent, but it wasn’t painful. And since I had never experienced natural labor before, I was like, “I don’t know if I’m close or if I’m not close. Like, I don’t know.” And, I knew it wasn’t painful, but I was like, “These are consistent enough. That’s what they said to do, so I’m just gonna go in.” So, by 5:00 a.m. my mother-in-law came to stay with the baby and we went to the hospital, and they were like, “Yeah, you’re 4 centimeters, but we’re not gonna keep you because you’re not in active labor. I mean, look at you. You’re not like…”

Dr. Fox: Did you say 4 centimeters?

Jodi: Yeah.

Dr. Fox: Nice. All right.

Jodi: So, they sent me away, or they let me hang out to see if I would progress while they were doing it at a theater, whatever and then they sent me away when the morning shift came on at 8, and they gave me the option of doing morphine and I was like, “No, I can sleep.” And so I just went, but I didn’t wanna go all the way home. For some reason I had it in my mind that if I went all the way home and I was too far from the hospital, that, like, something bad would happen. I don’t know why, but I did not go home. I went to the restaurant that we were building and I…

Dr. Fox: Nice. Well, the shawarma will help.

Jodi: Yeah, exactly. So, ate some shawarma, took a nap. We had, like, a little family room there. And then when I woke up, it was kind of the same situation. My mom and I walked from, like, just imagine a giant hill. We walked from one restaurant to the other basically, and we walked for three hours up and down a giant hill in Seattle to try to get labor to happen from like 11 to, I don’t know, I think it was like 11 to 3 or 4. We got back and my contractions were spacing out and they weren’t even…they weren’t strong and they were not even as close together anymore. They were getting so like, every 10 or something. And so it was already, like, not quite 24 hours later, but I was feeling pretty discouraged that we had done all that hard work and nothing was happening. So, we went to see our daughter for a little bit and then we went home, because I knew that if I went to the hospital, they would just wanna do some sort of induction since it had been a while and my water’s still intact. Like, there is no reason to. I just, that’s what I had in my head. So, we went home and ate some pizza and watched a comedy special and just hunkered down for the night, and really nothing was happening. Nothing was changing. And I thought back to my senior practicum that I did in L&D where I learned some, like, spinning babies move, and back to my first birth and some different positioning with a peanut ball that they did with me to try to get my OP baby to turn, and within five minutes, I started being in active labor from just like doing those different things. And, it was 0-60. Maybe it was like 12-60, but it was really like intense all of a sudden. So, we got to the hospital. They said I was sick with a bulging bag and I was like, I felt like I had to pee with every contraction. It was really uncomfortable, and it was clearly going pretty fast at that point and they…I had been texting one of my friends who I had mentored when she was postpartum nurse and was now a labor and delivery nurse, and I had been texting her and she had been waiting for me to be my nurse when I was in labor, so that was great that I gotta be with her. And, they brought me to the room and I just, my hope of having this epidural-free natural birth, I think suddenly I just realized that, like, I had still not had time to process having this baby, and to think about being his mom, and I couldn’t do it in the intensity of the contractions. And so I just, they were like filling up the bath for me and I said, “Wait, I need a few minutes. I actually think I need an epidural so I can just think and, like, open my heart to this new human that’s coming.”

And, it was the fastest epidural I’d ever seen. They were in and I was comfortable in 15 minutes, and it was great. We spent like, a couple hours, I think, from there just chitchatting with my mom and my nurse and my husband and I think the OB joined us at some point. And then he started having decels, and I knew because the pushing phase of my daughter was only 45 minutes, it really wasn’t that bad. I knew that I could push him out, but the doctor, like with the very first decel, came up to me and said, “If this keeps happening and his heart rate’s not recovering, we’re gonna have to take you to the back.” And I looked at her and I was like, “What about a vacuum? Like, I know I can push him out.” And I gave her that suggestion because I felt, like, “What do you mean? Like, this just started happening and we were able to get him to recover easily.” For some reason with my epidural, I was able to completely independently change positions, get on hands and knees and recover his heart rate just fine. And so, I really felt like, okay. Well, that doesn’t need to be our first line of defense. Like, I knew enough about fetal monitoring, but that just didn’t seem right to me. And so, I asked her if that was possible and he kind of kept having decels and then at a certain point he would, you know, she said that I was nine and a half or I think maybe the nine and a half was before. Anyway, she knew I was nine and a half when she told me that, and then I was like, “I know I can push him out.” So, she told me it was okay to start pushing. I think my water broke or something, and then she told me it was okay to start pushing, and I pushed on hand knees for a while and then turned over for the actual delivery. They did the vacuum and it was fine. And he came out and everything was fine.

Dr. Fox: Amazing.

Jodi: Yeah. I think he was, like, a little bit stunned at first. His Apgar’s were, like, five and eight, but I wasn’t worried about it because I knew that that could happen.

Dr. Fox: Yeah. Right. So, what I wanna do actually is we’ve gone through your two first births and then there was these experiences led you to choose something different for your third birth. What I wanna do is we’re gonna take a break. We’re gonna end part one here, and then what we’re gonna do is we’re gonna come back and you’re gonna tell part two of your story, which is gonna start with your thought process after your second birth, and how it led you moving forward in your third birth and then ultimately in your career. But this has been great. I’m loving this. Thank you for your part one of your birth story, Jodi.

Jodi: No problem, Dr. Fox. It’s been a pleasure.

Dr. Fox: Thank you for listening to the “Healthful Woman” Podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com, that’s H-E-A-L-T-H-F-U-L-W-O-M-A-N.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day. The information discussed in “Healthful Woman” is intended for educational uses only and does not replace medical care from your physician. “Healthful Woman” is meant to expand your knowledge of women’s health and does not replace the ongoing care from your regular physician or gynecologist. We encourage you to speak with your doctor about specific diagnoses and treatment options for an effective treatment plan.