Ep 193. Birth Story: A Second Time Mom Declines All Ultrasounds

Join us as we discuss a unique birth story, the intricacies of declining ultrasounds, and the importance of support in fast labors. Plus, we unveil a brand new product we launched after you requested it! 

00:00 Introduction to Kelly and Tiffany's Podcast

01:09 Recording Together at Home

01:50 Sharing a Birth Story

02:43 Listener Review and Feedback

05:12 Client History and Prenatal Care

10:47 Declining Ultrasound: A Midwife's Perspective

16:31 Legal Regulations and Birth Timing

17:41 Second Birth Experience

21:46 Navigating Doppler Use During Labor

23:27 Establishing Baseline with Fetoscope

25:22 Rapid Labor and Birth Experience

31:40 Postpartum Care and Trailing Membranes

37:55 Introducing the New NOA Blend

41:49 Supporting the Show and Community

Links We Chat About

Our new NOA Tea Blend

Midwife Interview Guide

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Our Weekly Newsletter

Our Childbirth Education Course, use code RADIANT10 for 10% off

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Our Fullscript Supplement Dispensary, always 25% off MSRP

Be sure to subscribe to the podcast to catch every episode. Follow us on Instagram for extra education and antics between episodes at: @beautifulonemidwifery

Transcript

0:00

Welcome to at Home with Kelly and Tiffany, where we share powerful tools, exciting education, and relatable views about holistic health, physiological birth, and thriving in the female body. We are home birth midwives in sunny San Diego. Passionate about the alternatives that give women control and confidence in health, in birth and in life. We've poured a lot of love into creating very in depth and high value offerings. A monthly membership, a physiological birth course, and holistic guides for the women who really want to dive all the way in. But this podcast. We want to bring zero cost information about health and natural birth and make these important topics accessible always. Your support of the show is also zero cost and means everything to us. When you leave a review, share an episode and join our newsletter. It really helps us keep this space open, ad free and full of honest, valuable conversations. Now let's dive into today's show. You are at home with Kelly and Tiffany. I'm Kelly. And I'm Tiffany. And here you are at home with us. We are in a home. Yes, we are recording again together, which is a wonderful little gift to us in Tiffany's home. Have a beautiful view of the Boulder covered hills. Yep, that's right. Yep. Hills with boulders on them. Love it. Big rocks on a mound. Yes. Mounds on mounds. Mm-hmm. That segues us into pregnancy. Mounds on mounds. Mounds on mounds. Today we get to talk about, well, we get to share another birth story. This one, I know I say it about all of'em, but this one I'm really excited about. It just every little birth brings out these little details that seem, at first glance, just like, oh, yep, that was just her story. But there's so many places to talk about the normalcy of that happening, the physiological experience, the opportunity we have as providers to provide like the, the scaffolding for that experience. Yeah, it's pretty, it's pretty great. And again, some of the things that were like, oh yeah, yeah, that happened. But then to be able to step back and be like, Ooh, let's actually talk about that. Like why, or the story behind the story a little bit, I think is always, I dunno, enlightening. I love it. Mm-hmm. I hope you guys like it too. It's one of our favorite episodes to share. But before we dive in to that birth story, we have a review to share real quick. It's from Brianne Foe. Fo. Brianne Fo Brian Foe. Brianne Foe. She gives us five stars. The title says one of my favorites. Hmm. Now how many favorites do you have? Where do we fall on that list? I have questions. Brian Foe. You should have lied to us. My favorite podcast, my favorite, what she meant to say was my favorite podcast. I have many favorites, but this is the first. Mm-hmm. Favorite top. This is what Brianne Foe says. Even though I'm not pregnant at the moment, I truly enjoy listening to Kelly and Tiffany. I love how they don't just focus on pregnancy, but on holistic health. Their content is encouraging and inspiring, and I'm looking forward to taking some of the things I've learned from them and my midwife locally to make my body and mind as healthy as possible for pregnancy the next time. Plus, who doesn't love a good birth story? That is like the perfect segue, my friend, she says, I know I do. Mm-hmm. I do too. And with that. Thank you Brianne Foe. You can claim your free drink. It's on us. Thanks for leaving a lovely review. Send us a message on Instagram or an email that you heard us read the review on the show. And there's, there's a drink on us for you, my girl. Yeah, and if you are listening and you've never reviewed the podcast before, hop on over. Press the five star button. You don't even have to say anything, but we like it when you do say something. And if we, well, the only way to get the free drink is if you leave words in a positive form of a review and we read it on air. So go ahead and do that. But we have read one word reviews before. I remember one that just said, Kelly. Mm-hmm. So do I. And I was like, that deserves a free drink. And we did in fact award that person. That was actually one of my favorite review stories. Okay, and this is one of my favorite, one of my favorite birth stories. Where does it fall? But if you are this client and you're listening, it is my favorite birth story, number one. Number one, I have many favorites, and this one is the first favorite. But if you're listening and you are a client of ours, and this is not your birth, your birth is also our favorite. Yep. Yes. Mm-hmm. Okay. It's just the way it works. So let's start off with the history on this particular family. I got to take care of this family with their first baby. They were, they were in the practice that I was learning as a student midwife, and I got to be a part of that birth and then. When they were pregnant with their second, they came and sought me out where I was practicing with you and asked the both of us to take care of them, and that has happened to us a few times, which is always so amazing. It's kind of wild because right, you're, you're learning underneath a more seasoned midwife no matter how old or how long they've, like, they're just been doing it longer than you have. That's why they are teaching you. But we get to get some of like the sweetest relationships. Like I loved so many of the families that I got to take care of as a student. And there's a piece of like, well, yes, you're learning and you are taking responsibility, but also the ultimate responsibilities on somebody else. There's like so many pieces there. But we've gotten to experience taking care of people on our own as like we are the midwives after taking care of them as students. And it, there's like a piece of freedom in that too, where we're like, oh, now like, I don't know. We can approach it the way we really want to. There's freedom in, I don't know, relationship and I don't all of the pieces. So it was a really sweet time, especially building our practice. I mean, this is like a couple years into our practice, but still like to be able to, I don't know, reconnect with families, but also like in this new way and step into some things. And I dunno, deepen relationships and stuff. It's, it's cool. It is precious. Okay, so one day we might have a student, I don't know, we haven't done that yet. That is like such a loaded topic. So loaded. Sometimes people just ask like, Hey, are you guys taking students? And then I give'em like a seven paragraph answer and I'm like, oh. I'm gonna keep working through that. Mm-hmm. Thanks for helping me realize that, but how would we feel if we have a client that we take care of and then our student goes on and creates her own practice and that client goes with, goes with that new midwife with her next birth? I can, so I feel like if this was a few years ago, I would be very prideful and be like, I want that. Like, or it feels like, oh, is that like a statement against me or something? But I feel like as we have sorted out the boundaries in our practice, I mean, granted, this is a hypothetical, so I dunno exactly in real life. But that's what we would have. We would've been like, we're picking the right students to connect with people that is like a good and right sign and training them well to go out and like flourish. And so that's. That just feels like what I would want. Like I would encourage that, and I know that is not always the case. I will say yes, that that can feel really complicated. Mm-hmm. For the student and the preceptor relationship. Uhhuh. Yeah. But I mean, ultimately, as we're serving women in this capacity, we need to check our hearts on. What are we doing? Do we want the best experience for ourselves as the midwife? And always have the comfort of the repeat client? Or do we want the best experience for the client? Mm-hmm. And for them to have the midwife and the connection and the whatever it is. Sometimes you can't even articulate what it is that is drawing you to a different provider. We want that. We want, we want women everywhere, whether they're our clients or not. To feel secure and really valued and known and heard, and understood and seen in that relationship. Yeah, I feel like something that you don't always see in birth work or like if you're not in birth work and you're seeing it from the outside or you're new to it. It can be, it can start to mess with your ID or it's very easy for your identity to get wrapped up in it. And you start to feel like you are the center of things and they need me, and I am why this is working and why, you know, all of a sudden as you take a step back, you're like, oh, it's, I'm not in, like, this is not about me, right? It's about, it's about the servant heart of it, and then that is what elevates the. Client and their experience, which is how that should be. But again, it can, it can get really confusing. I'm sure that's true in like a lot of different worlds that people work in, but it's just really interesting, I think because it's so intensely personal and. I dunno. The work itself is intense. So anyway, it can get confusing. It can. So if you are listening to this and it feels, and you feel confused by what we have shared. Hmm. Good. Yes. Okay. So then we got to take care. Kelly and I, in our practice together, got to take care of this same family with their second pregnancy and they were very educated clients working as alternative health providers themselves. Which is always fun for us because we get to skip over. A lot of here's how to research, here's how to advocate, here's how to find the, the, they're like already on board with some of those, with many, many of those things. In fact, sometimes when we work with some of these families that have these backgrounds, they're coming to us with new information and education and stuff, and we're like, oh, thank you so much. Same time next month. Great. Great. Yeah. This this is interesting. You're paying us, but a part of their informed consent process and understanding their options and stuff. They declined ultrasound in pregnancy, and so we started care with them right away at eight weeks, but they chose not to hear fetal heart tones until 17 weeks is what we charted. We typically can hear with a Doppler around 10 to 12 weeks. But they chose not to have ultrasound in their pregnancy, so we had to wait until we could use the fetoscope, which is like, it's a, it's a zero tech tool that is like a stethoscope, but you are, it has a special attachment that helps you listen to the baby's heart rate, and I mean that. Was an interesting part of their prenatal care. Yeah. And you know, again, they came in very educated and they knew exactly what they wanted. And so being able to say like, well, if you would like to hear your baby's heartbeat, sure. Or if you would like to see your baby. Some women really want the early ultrasound to like confirm. Okay, I can't feel anything yet, but I know that everything's okay. You know, and they just, they just decided that they didn't want that. And we kind of had to the early ultrasound, I'm like, fine, fine, fine. The, I think this was the first client who declined in our practice, at least the anatomy scan, which was these like, you know, the halfway mark checking on all parts of baby and where the placenta is and all of that good stuff. And so working through that and recognizing this was their choice. Very educated choice. I think, I don't remember necessarily the conversations that you and I had around that, but I know that I was like, I don't, I don't, I think that was, even throughout my studentship was the first time that anybody had declined that one. And so it, it made me have to consider what are the benefits, what are the risks as the provider? I understand as a mom, you and parents, like this is what we're deciding, but as a provider, what am I comfortable with? What are the potential things that we might be missing? What should I be looking for? Because we don't have this information. So it, you know, it grew me quite a bit as well to have her be so convicted of what she wanted to choose. So, yeah, and I think like for women who are listening, thinking, oh, I didn't really realize that was an option. And you know, some women thinking like, why wouldn't you want an, I mean, I guess that's a whole nother topic that we could talk about one day, maybe. I don't know. But being able to work through how the provider goes about offering these types of things, and is it truly an offer or is it a requirement because. Many midwives, they're all about informed consent. I'm not saying this is wrong, I'm just saying this is, this is the way of the world, and it's important to know what you're walking into. A lot of midwives are all about informed consent, but when it comes down to it, they are gonna actually require certain things in their practice because that's what makes them feel safe. That's what makes them feel like they can keep you safe at the birth, to know for certain. That there's only one baby in there to know for certain that the placenta is away from the cervical oz to know for certain. Right. And I mean, when we say for certain, that's a, that's a really, I mean, we, there's nothing to know for certain. But it's a, it's a very, it's clinically significant. And so we are, we can have those conversations with our clients and say here's the reason we would like you to have an ultrasound. This is how it helps us. Let that be a part of your decision making process. There's nothing, I don't think there's anything wrong with this is the, this is how I can use this information to take care of you the best. And then on the flip side of that, the client says like, I actually really, I understand that. I appreciate that. I feel strongly enough about it that I still wanna to climb. Then we can say to them, well, here's the information that we're gonna miss, and we're both comfortable with that. Okay, interesting. Let's do that. And. This is and we like, and for us, we don't require you have an anatomy scan, but we do say if something comes up later in pregnancy and ultrasound is the best way to check on that further, can you tell us now that you would be willing to do that? Because. We feel, we feel really flexible in this way, but if you feel really inflexible when some another sign comes up that we should probably check on and we're saying, Hey, we actually do need to get an ultrasound now, and you're saying, absolutely not, I'm gonna refuse under all circumstances, then let's chat about if we're still the best fit for you. Mm-hmm. Yeah. And it is okay. If that is not the right fit, whether you're a birth worker listening to this or a mom listening to this, right? Like it is okay if you decide, hey, what I want out of this relationship, like I'm just not gonna get it here. And that I think partly is the fact that they were so educated and knew exactly what they wanted. You might decide as you are pregnant and learning things or being exposed to certain things that you may be like, oh, actually what I wanted at the beginning is starting to shift and being able to actually communicate about that. Is important. Totally. And you, when you have the information education, you can go into your consultations with that and say, Hey, I'm pretty keen to decline all ultrasound in this pregnancy. How would you handle that in your practice? Mm-hmm. Or, I'm undecided on this, but I'm pretty interested in what my options are about whatever. Fill in the blank So following along, digressing from the ultrasound rant. This was a pretty uneventful pregnancy. Our last prenatal with this family was at 36 weeks and six days, which was the home visit. So we scheduled our home visit right before she went into her due window where she can have a baby at home with midwives in California at 37 weeks. And that's the last time we saw her before she went into labor. Yeah. And so in California, right, we're this, that's where we practice everybody out. Midwifery is looked at differently in different states and has different regulations in different states, or no regulation, just depending on like the state that you're in. But in California, we do have a due window between 37 weeks and 42 weeks. So that's when we are legally allowed to be the care provider for a mom having her baby at home, oftentimes, I mean, she went into labor. Early in that window or earlier in that window. Usually the issue is towards the end of that window that we have more of, like a bit of a, you know, struggle or discussion with. But that is one of the things that's kind of like overriding. Us here in California, which again is a, is a conversation too about midwifery regulations and who's putting them into, you know, place and all of that. But there are other things too, right? Like known breach, babies, twins things like that, that we have to consider legally for us to be able to be the provider or not also a part of a prenatal conversation. Yes. Or potentially consultation before even working together. Conversation. Mm-hmm. Yep. So she went into labor at 37 and five and her first birth, I don't remember the details of it. I remember it feeling early, especially for a first time mom. And we wrote down 37 weeks. I think I'm kind of remembering back to that first birth thinking. She just was barely, it was like the first day of her 37th week. And so I think we were really taken off guard as the team of like, oh, that's so uncommon to have your first baby at 37 weeks. But her first birth with also really straightforward, and by the note in our chart we had said that first birth was 14 hours of labor, which is like relatively quick for first. First baby for sure. And I think also it's helpful because no matter what your first birth looked like, right, it may be really straightforward or it may have been very long. There is something about that second time mom also that like has to get in this different mindset of this birth versus last birth. So it's kind of daunting going into your first birth'cause you're like, I don't really know what birth is gonna be. Like, I don't know what my body's gonna do. I don't know what my baby's gonna do. I don't know what this is gonna be like. And then you kind of start to think. Well, however, the first birth went down. This is probably how my body does it, right? Like I, this is probably how I labor. This is how it felt when I was this far along. This is what happened before I started, you know, moaning and pushing or something like that, right? And we kind of have to unravel that with second time moms to be able to say okay, that was, that, that was that experience, right? This is something completely different, right? It ha it simply has to be, and it will unfold. Differently, even if there are similarities, right? And so we, we constantly, especially in terms of communication in labor, we are like, don't wait until that point that you felt, oh, I'm, I got checked last time it was five centimeters. Now I'm gonna, that's what I felt like then I, now I'm gonna call my midwives or something. Like, feel what you are feeling now. Engage with what your body is experiencing now. Trust what's happening in your body now. And certainly. Obviously like the physical, you know, textbook things of labor. Hey, I'm having contractions, this is interesting. They're this far apart, yada yada. But that emotional signposts of labor too are like, can be wildly different, second go round. And so we kind of do have to unlearn some things, but also encourage moms in other ways to be like, yes, you learned lessons in your first labor. That's important, but also allow this to be its own experience too. So that would, I remember kind of going into that with her because of. Because of how straightforward that first labor. I mean, I wasn't there, but you know, her telling of it how that, how much that was. So yeah, and I'm bringing it up in the timeline because this might have been one of the fastest, maybe I can think of a faster one. This might be the second fastest birth we've ever attended and we got there somehow. It's so crazy. So she calls us at six 30 at night and she's like, you know, I have been having contractions on and off for a couple of days, and we may, she may have let us know that over the weekend, I think given us a heads up, but it, she's like, no, it's not real labor. It's not real labor. But over the past hour when she called, she said, so like the past hour I've been having them, they're getting stronger. And they're like, every three to four minutes. So I think now I'm like finally going into labor. I got there in 30 minutes. I'm sure you got there really quickly. She lived in the same town as us, like we all lived in the same town at the same time, which probably helped us to get there faster. And when I arrived she declined a vaginal exam, which was very typical. Of course, like we offer it, we sometimes we don't even offer it. Some, sometimes we talk about it prenatally and we're like, if you want an exam at your birth, you might need to say. Can I have one please.'cause otherwise we're just there. And we're gonna observe for like, a few hours before we're even thinking about, I think Marianne, she is dilated or not. But she, she, so she declined her the vaginal exam on intake. But she, and we did all the other vitals and stuff, but she also declined the Doppler. And we did talk about this in her prenatal time because I remember being at her first birth, she was surprised that we got the Doppler out. At her birth. And she was like, what? No, I don't want Doppler. And we're like, wait, you, you don't want Doppler at the, at the birth, at the la Like we were trying to work through that while she was in labor. So this time she was like, tell me my options about Doppler use in labor. Yeah. And I had, had, I had a birth when I was a student. Where she declined for most of it until it got uncomfortable to get in the positions that she needed to get into for us to actively listen as long, you know, or as often as we needed to. And I remember talking with her about that of like, yes, we are willing absolutely to support you in what you desire. With that being said, it is a lot harder to listen with a fetoscope in labor than it is. Laying here on our couch in, you know, your 36th week of pregnancy or something like that, right? And so we said, we will, we will, we'll do it. But at the same time, if we're not able to get the tones for, you know, as loud or as long as we actually need to, or you are in a position where like we just simply can't, or you are like, I cannot stay in this position for as long as you need me to, that kind of thing that we were gonna say. This is something that we, we need to check in on your baby. This is a huge way that we can tell that baby is doing well, you are doing well. Like we are all, all is well still here. So it was a bit of, not a back and forth, but it was just a space of education where she was able to say, okay, I'm being heard. And us too, to be like, we know what you want and we will try to provide it until something tells us clinically like, Hey, we do need to kind of. Pivot. So yeah. Yeah. And then so we, when we arrive at a birth, we like to listen for like five minutes or at least through a few contractions. And so we did with the fetoscope, she got in a position that was easy for us to listen. We listened through. Two contractions to establish a baseline to determine the baby was tolerating that point in labor really well. But we eventually did get the Doppler out for her comfort. Later she was like, go ahead with the Doppler, like, I'm not moving again. I'm not gonna lay down again. I'm not gonna, and so that, that worked out for her. That was a good compromise and I felt great being able to provide that 19 minutes later after I arrive, she said she felt pressure and. Kelly, you must have arrived in that period of time too because now your name is showing up on the chart and this is what you, this is what your chart taking off. Sweatpants and underwear. Voiding in bed. Pan on bed. Gonna have a baby any second, has no cares. Getting naked. Yeah. Peeing in a pan. Important points. To really tell the story of where she was at in her labor. Yeah, it totally does. And I, I kind of wish that we ha that there was a way, well, maybe not, maybe we don't want this to be a legal record but I would love to look back on text messages from that time where like. I'm saying'cause we're always communicating a whole lot as we're arriving to a birth. I'm leaving my house. This is my ETA, I'm pulling up, I'm coming, I'm getting out, and I, if I get to the birth first, I'm like, I'm here. I'm setting up baby. Sounds good. You know, I left the front door unlocked. Like all these little things that we're just like blip, blip, blip, blip, blip, blip, quick text, text, text. I would love to read through some of those when we know we're like, things are moving really quickly or. You know, one of us misses it because it just took longer to get there or whatever. It would be so fun. But so she started pushing 30 minutes after I got there. I got there 30 minutes after she called me. She was in labor for an hour. Like thought she was in labor for like about an hour before that. And the notes say that she vocalized at this point of feeling really pushy, that she wanted it to be slow and controlled. And she reaches in to her vagina. She feels her baby's head. And then three minutes later we charted that her water broke, and two minutes later we chart that the baby's head was born, which doesn't sound slow and controlled. But I sp I specifically do remember her saying that and thinking, how can we best like support that? And I think a lot of women want that. And this is the time where a lot of providers are like, okay, speed things up. Push, push, push really hard. Your baby's almost here. Like, let's get to the other side of this. Whether that's for your own comfort or. Oftentimes their own comfort, like the baby's out, and now that makes me feel better. But being able to, for her to say, here's what I'm feeling. I'm feeling the head myself. We don't have to put our hands in there to tell her Yes, what you're feeling is correct, or yeah, you're almost there. Like she recognizes how she feels. But sometimes we do have to give some encouragement to say. Okay, yes. The pressure is so much, breathe along with that, like blow your breath out, slow in controlled breaths, reminders that like you are in control of your breath right here. When moms still do, you know, are still in control, there are some situations where like a baby is coming and a baby is coming and no matter what, breathing baby's just gonna fly out. And that's just what it is, which is not bad whatsoever. It's just the way that it is. So. Anyway, it was it's important to remember the birth team that you have around you too, and not like, oh my gosh, we're so great, but that's going to impact this part of labor in particular. And I know a lot of women are just, I don't know, nervous, scared of the stretching and the potential tearing and all of that. And so being able to communicate that, not, you don't have to necessarily communicate it in labor the way that she did, but having conversations about that. To feel like, yes, I am gonna get the reminders that I need. I am going to feel like I have the control. Within reason of, you know, how you're feeling at the time and all of that at the moment, like that really does, it really does matter whether or not the tissue tears is its own thing, but to be able to feel reminded and supported and slow that moment down a little bit can be really powerful. Yeah. And I think just like, honestly, being able to articulate it, getting it outta your head and just saying it out loud or even making that a part of the plan. Mm-hmm. Like, Hey guys. This is something on my mind. I don't know if it's possible, but if I can, I'm gonna try to slow this part down this time or whatever. Right. I mean, it's just, it's a cool thing to note. Mm-hmm. But there's also a note in the chart, and I don't remember this or I forgot about it until I was reading it in the chart, that this is what is charted half of baby born into father of baby's hands. First cry or first breath and light cry while being born, and then 30 seconds later, the rest of the baby comes out. So it wasn't half a baby, a half of the, it was a whole baby. Yeah, the whole baby came out. A whole baby was there, but it was only born to like its umbilicus probably. And then she stopped pushing maybe. And it didn't just slide out. And so I think I, I don't remember it exactly, but that must have been kind of awkward. The, the, the times where if baby's head is out or you know, part of baby whatever, and they are looking around or making noises or clearing sali, whatever I think that is, I don't know, it's not like fun. It's just crazy to me. I'm like, you are, you are undergoing this entire experience and you are so. Oh, like you are here? Mm-hmm. You're here. You're not fully here yet, though. I don't. It blows. My mind, it's a how quickly they can transition. Mm-hmm. Right. Like I was at a birth, I probably have shared this on the show already as a student where the baby's head was born and then we waited for the next contraction. Three or four, you know, minutes later, very normal. But while we were waiting for the rest of the baby, the baby started crying with just the head on the perineum. And I was just like, this is the funniest thing in the world to me.'cause everyone's quiet mm-hmm. And reverent. And she just worked so hard to push that baby's head out and then it starts crying and breaks the silence and you're just like, and you're not even born. You're like, not even all the way born and you're already breathing. Yeah. Your lungs are like the part of your chest. It's crazy. Ugh. So nuts. Wild. So this. Labor from the time it became active when she called to the birth was an hour and 24 minutes. Dang girl. So crazy. And I don't think that when we process that with her. That she was like, oh my gosh, like freight train. I feel like taken over by that. So sometimes really fast births can feel like that, where you're like, I just got hit by a train and I had no control. And it, like, my body's still catching up, but she was very present and I think her hormones like worked with her really well on that to bring her into that space, but Interesting. Yeah, and I think that like, it, it kind of matters that they didn't have to. Drop their kid off somewhere on their way to the hospital and have a baby in the elevator, or that the people who arrived at the birth were like, oh yeah, this is happening right now. Okay. How can we help you? Instead of like, oh my God, this is going so fast. Oh, you're pushing already. Oh. Right. Like, I mean the, that matters. You picked an environment and providers that were gonna be cool and calm and collected and I mean, I'm sure there's birth we've been at before where we're like not our best calm selves, but in general, even when we're having a complication or emergency, we're like. Let's remain calm. Mm-hmm. Let's just, let's at least remain calm. So her placenta comes out at seven minutes and she had trailing membranes and there was a slew of birth with trailing membranes. Kelly's gonna explain what that is in a minute, but it was always when I was the primary midwife and I'm like, I'm delete. I'm delivering placenta wrong. This is a me problem. Why is this always ha? It was like half of the burst that year that I was the primary on. We had trailing membranes. Yeah, I mean there was a, there was a go on it too where placenta were coming out like an hour plus. Do you remember that? It's like season two, where we were like, wow, what is, what exactly is happening? But for those of you who don't know, trailing membrane, so the placenta itself right, has attached to all this different layers. And so the membranes themselves are like the amniotic sac, basically of what is surrounding baby. And that's the part that ruptures as you know, their water breaks, all of that. And as the placenta is being born, we really wanna make sure we're not rushing it, we're not pulling. We're not yanking things out because it's a very easy for some of that amniotic sac and those membranes to get left behind. And so as as she was pushing her placenta out, it's basically saying that some of those membranes, some of that amniotic sac rate is still inside of her. And that means we need to, again, slow things down, not rush to pull out, because if we do that. And we leave some of that behind. That puts her at much higher risk for things like hemorrhage and infection and things like that. And so we wanna make sure we get everything out when it does come out, when it's ready to come out. But sometimes we do have to get a bit creative at this point, like light kind of twisting or of the actual like sack itself or having mom cough a bit just to get that little, you know, bit. Left in there to make sure that we feel like, okay, yes, we got it all. And are very, I mean, we're always looking at the placenta afterwards, but looking as well to kinda like put the pieces back together a little bit like a puzzle, like, yes, this looks like we're, we're good to go. Yeah. And I, I'm thinking of birth two where we did not note trailing membranes with the placenta birth and. It. Everything looked totally intact, and a couple days later our client sends us a picture and she's like, this just came outta me. What is this? And we're like, oh, that's some of your membranes. Interesting, interesting. That happens like Yeah, sometimes that, I mean, sometimes that happens. Mm-hmm. And most of the time it's fine, but like we do our due diligence to. Be watching for some of those particular things. So in this postpartum time, the baby we charted was flow to transition, and I think that just meant that it was just a, maybe because the birth was so fast, sometimes those babies just come out a little bit stunned. And our Apgars for that baby at one minute were seven. So you're like, oh yeah, you were probably. Just taking some slower breaths. Mm-hmm. And we did listen to the respirations for this baby, which we don't always, we usually just watch them. Yeah. But, but, I can't, it's a girl. I think it was a girl. She must have been slow enough that we were like, oh, let's just listen. Make sure that she's doing some good breasts. And then she turned that around really quickly. Her Apgars at at five or nine minutes, and 10 was nine minutes. And so she did great and we didn't do any other interventions besides that. And we also charted that she did the breast crawl 30 minutes postpartum. And that her first latch happened like 20 minutes after that. So the mom was really patient to. Allow that physiological experience to happen, which was sweet. We did chart that. She had a labial tear and declined sutures. And we use trace minerals topically to clot the bleeding for that, which is a fun little trick that sometimes I forget because we don't get to use it very often, but. Just drop some trace minerals on anything truly, you could just keep it in your first aid kit at home. And the mineral content helps to clot the blood and keep it from keep from continual bleeding, which is so much nicer than closing something up of sutures or glue or whatever. Right? Yeah. I remember learning that and being like, that's, that can't be right. And actually seeing it in practice and being like, oh, actually this tool now helps me not have to like. Get in there and, you know, mess around with the air, I can actually see it much more easily because the blood is clotting now and it's not just like an actively bleeding site. I don't know. Yeah. And on that soft tissue, sometimes, like, I mean, we won't, we, we won't suture it if it looks like it's gonna heal fine on its own. It's just a little tear. But sometimes when we have to sit there and apply pressure for a while just to be sure that it's done bleeding. And it just kind of keeps our hands outta there. And it's a tool, a tool to try out for that. And then that was the end of this birth, but we also got to care for this client at the very beginning of a third pregnancy before they ended up moving during that pregnancy. And then also got to support them virtually for a fourth pregnancy. And so. Just noting that because it's really sweet and a really special part of midwifery care. Having that continuity even when you're not there pre, you know, not there present and you know, able to continue to support a family and be a part you know, get to be a part of their story and a part of their network even when you don't get to do all of their births with them. Yeah. And just thinking like they went and found a new provider and whatever, but to still like, care about oh, like what your feedback is or thoughts on certain things or trying to feel the best they can or whatever. It's like pretty cool to be like, you know, still a part of that experience even when somebody's seeing, seeing somebody else. Oh, you're seeing somebody else. I see. See how that is seeing? Mm-hmm. Mm-hmm. Mm-hmm. Well, great. I just, I always love going through births and this one was like a great, this was right. So also context. This was right before COVID like really happened, right? So it was like a while. It was obviously a while ago, but just really interesting to be like the, before, I think this was our last normal birth before we were trying to sort out. What to do. COVID. Yeah. COVID stuff. Fascinating. Something else that is fascinating, ladies, you've heard us talk about our Nora Tea blend that we have live on our site. We have talked about it a ton on Instagram in particular. So if you follow us there, you will have heard about it. I am sure, and we talk about it so much because it is so impactful and we see a lot of things, particularly in pregnancy. I'm thinking back even on this client. Pregnancy in general, all of the things that Nora actually can really be supportive with, right? Blood volume expansion that happens during pregnancy. Especially for, you know supporting for women who, you know, you might trend towards anemia or something like that. Super helpful nervous system regulation. Taking good deep like just nourishment for that part of our bodies that just it's really easy for them to get up and uptight and wound up. And the research on norty is like so wonderful to be able to help support that. Placental development. One of the reasons that we love it, prenatally also, like if you are, you know working towards getting pregnant, a great reason to have that on board and be supportive of your uterus, but also again, during pregnancy. Reducing nausea, reducing fatigue, reducing again, that nervous system kind of overwhelm and it's just incredible the amount of micronutrients. That it supports and can provide like a reserve basically for the rest of your pregnancy. I was talking recently on Instagram about my third pregnancy, which I was so depleted in. And I would a hundred percent recommend even if you are not. Thinking about getting pregnant yet, but you may, you may be in the season where it could happen, right? Getting some herbal support on board can just be an incredibly nourishing thing to do for your body for a million different reasons. So we have that on our website, right? And we have been asked multiple, multiple times. This is actually one of the first days that we're sharing with. The vast majority of people that we have actually heard your requests to turn this into a NOAA blend. So the R in Nora is Red raspberry leaf and. We recommend to delay that until the second trimester, right around 16 weeks. Say, Hey, go for it. But a lot of women, especially in this first trimester, right, we're feeling nauseous, we're feeling fatigued. We need some, you know, micronutrients, we need some minerals in our body. This is a great way to get it. So we said, we hear you. Let's take that out of this blend so that women earlier in their pregnancy, or again for if you're trying to get pregnant, you can just continue to drink this through that, you know, first trimester of your pregnancy. But it is live on our site now. So we have your Nora Blend, which is for all these other seasons and this Noah blend that is particular for early conception and early pregnancy. I don't know if you were gonna say anything. I, I guess I should say something else. Yeah, I dunno. Yeah, we're excited to offer that. We did say we were not going to put any more herbal products together, but this feels like adjacent, you know, it feels very adjacent. It feels very, you know, it's like a sidecar. It's like Nora's little kid's sister coming along and you're just like, fine. Get in. Fine, we'll take you along. It's less work for us. Three blending, three herbs instead of four. It's a, it's a good exchange. I don't know. Can't explain it.'cause while I'm saying this, I'm like, well, there, there's something else that I do wanna make. Yes. And who knows what will come ahead. But it is available for you now. We hope you love it. We know a lot of women have been asking us for it, so we said. We will hear you and we will do a thing, which I'm pretty proud of us for doing a thing. Good for us, hearing and doing. That's us here at Beautiful One Midwifery. It's our tagline. Well have a great week ladies, and we will be back with you next week. Hey ladies, if you're loving the show and want to help us keep it ad free so we can keep talking about all things birth and women's health, without cutting to an ad about electrolytes or grass fed beef sticks, here is how you can support us. First, leave us a quick review or a rating. It helps more women, new moms, and birth enthusiasts find our show. And it honestly means so much to us to be reminded that you love what we are doing here. Second, share this episode with a friend, with a doula buddy, or anyone who is on their own holistic health or natural birth journey. And third hop on our newsletter list. This is where we share. Bonus goodies behind the scenes stuff. Fun little extras you just won't hear on the show. 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