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On today’s podcast we talk with Haley Grachico about her intense, fast birth experience at a freestanding birth center.

Haley and her husband, Dr. Ismael, are graduates of the EBB childbirth class with EBB Instructors Marnellie Bishop and Ali Buchanan. For the birth of their baby, Josefine, they hired Marnellie and Marnellie’s backup Ali Buchanan as their doula. Iz completed his general surgery residency at Oregon Health and Science University just 13 days before Josefine’s arrival. A week after Josefine was born, the Grachico family moved to Grants Pass, Oregon, where Iz joined a private practice general surgery group. Haley is enjoying time with Josefine and their two dogs, Duke and Bentley. Haley has since then started a new parents group in town and is exploring options to possibly become a doula and to support families in a different way in their new community.

We talk about Haley and Dr. Iz’ experience taking the EBB Childbirth Class, and the importance of them having a doula to help with their different perspectives on birth and medicine. We also talk about Haley’s intense, fast birth and how the influence of her empowering birth support inspired her in wanting to become a future doula to support other families in her community.

Resources

Learn more about the Oregon parenting group, “The Parent Trip” here

Learn more about EBB Instructor, Marnellie Bishop here. Listen to Marnellie’s EBB 191 episode here.

Learn more about EBB Instructor, Ali Buchanan here. Listen to Ali’s EBB 169 episode here.

Listen to EBB 15 on nitrous oxide here. View our YouTube video on nitrous oxide here

Learn more about the third stage of birth from our signature article here

Learn more about HypnoBirthing here.

Transcript

Dr. Rebecca Dekker: Hi, everyone on today’s podcast. We’re going to talk with Haley Grachico about her intense, fast birth experience at a freestanding birth center.

Welcome to the evidence-based birth podcast. My name is Rebecca Decker and I’m a nurse with my Ph.D. and the founder of Evidence Based Birth. Join me each week as we work together to get evidence based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice, see ebbirth.com/disclaimer, for more details.

Hi, everyone in welcome to today’s episode of the evidence-based birth podcast. My name is Rebecca Decker pronouns she/her and I will be your host for today’s episode. Today we are so excited to welcome a graduate of our EBB childbirth class to share her birth story. Before we get started, I want to make you aware that if there are any detailed content or trigger warnings, we’ll post them in the description or the show notes that go along with this episode.

And now I’d like to introduce our honored guest, Haley Grachico. Haley and her husband, Dr. Is, our graduates of the EBB childbirth class with instructor Marnellie Bishop and EBB Instructor Ali Buchanan was also along for that class. For their birth they hired Marnellie and Marnellie’s backup Ali Buchanan as their doula. They’re here today to share their story of giving birth to baby Josephine.

Is completed his general surgery residency at Oregon Health and Science University just 13 days prior to Josephine’s arrival. A week after Josephine was born, the Grachico family moved to Grants Pass, Oregon, where Is joined a private practice general surgery group. Haley is enjoying time with Josephine and their two boxers, Duke and Bentley. Haley has already started a new mom’s group in town and is exploring options to possibly become a doula or support families in a different way in their new community. Welcome Haley to the Evidence Based Birth® podcast.

Haley Grachico: Hi Rebecca, thanks for having me.

Dr. Rebecca Dekker: So it’s so nice to welcome you and baby Josephine. For those of you who are watching on YouTube, you can see Haley is rocking baby Josephine in the sling, as we talk. Tell us Hailey, how did you find out about the Evidence Based Birth® childbirth class?

Haley Grachico: Yeah, so I actually found my doula prior to finding the Evidence Based Birth® Class. So I had found out I was pregnant last November. About a year ago, almost to the day. And in Portland, there is this really unique group called The Parent Trip. And my doula who I eventually hired, Marnellie Bishop and Ali Buchanan ,are both really active members in this group called The Parent Trip. And so they were doing these online kind of events where they would talk about or bring in experts from the field. So had anything relating to pregnancy, childbirth and they call it The Beyond. So they had experts in like fertility and midwives and doulas who would come and give like maybe 15, 20 minute presentations about what they did and kind of their philosophy and how they ran their particular organization. And so I took down a few names of doulas from there and decided to start interviewing doulas.

So my husband and I interviewed doulas last December and Marnellie was one of the ones that we interviewed and we just kind of fell in love with her. Her personality, she just has a really high energy. She’s really contagious. We gravitated towards her and she spoke a lot about her Filipino identity and my husband is Filipino. So that kind of really spoke to him as well. So we decided to use her or to hire her. And then she gave us some options and how we wanted to proceed with our childbirth education. She kind of runs her own curriculum. She is an EBB Instructor, of course. And then I think she also does hypnobirthing as well.

And so when my husband and I were going through everything and decided how we wanted to move forward with our pregnancy and how we wanted that to look, EBB really spoke to us. We’re both pretty scientifically minded, obviously, my husband is a general surgeon. So having really evidence based backed information was really important to him. And being able kind of justify why we were doing what we were doing and to have like a real thought process behind everything was important to him. And then my background is in public health. So pretty similar. I had a pretty good idea of where I wanted to go with my birth plan and everything and how I wanted things to proceed. EBB seemed like the most straightforward way for us to both get on the same page and to get there with Marnellie’s support.

Dr. Rebecca Dekker: Awesome. So what was your experience like taking the class? Like what are some of your memories of taking the class with Is?

Haley Grachico: Our class, we did it kind of a hybrid model. We did online. And then our last class was a two hour long birth rehearsal in person with both Marnellie and Ali. They’re kind of walking us through, doing exercises and stretches and kind of ways that can help me in labor and kind of practicing all of those things. During the actual course itself, those were all virtual sessions with both Marnellie and Ali. We were fortunate enough to be able to get two doulas for the price of one, throughout the course of our pregnancy. Ali was along for everything and she was our backup if Marnellie couldn’t be there for any reason. And so we had really engaging conversations around the curriculum and then kind of just everything. I’m kind of a birth nerd prior to getting pregnant.

It was really engaging and really fun having these virtual sessions with them. It was a really unique and interesting experience for us because my husband was in the throes of his general surgery residency during his chief year. Which is the most intense. And so he would, I’d be on Skype at my house or Zoom, and then he would be joining us on Zoom from the hospital whenever he would have a free moment or spare moment. So Marnellie and Ali were very gracious and were able to schedule our virtual consultations or our virtual meetings around his really busy schedule. So we were really fortunate to have that experience.

Dr. Rebecca Dekker: Was there anything that you learned in the class that stuck out to you or to your husband?

Haley Grachico: Yeah, I would say actually one of the biggest things that was a really aha moment for me and really gave me some language to speak about a feeling I had had prior. And tried to convey to Marnellie at the beginning was, I really knew that I wanted to have as much of an intervention free pregnancy and labor and delivery as possible. I really wanted to deliver at a freestanding birth center.

Actually, I said from the beginning, I was like, “Oh, I could just deliver the baby in the bathtub upstairs.” And my husband, as a general surgeon, laughed and he’s like, “Ha ha, why don’t we just schedule your cesarean right now?” Right. So we had very different, perspectives going in and part of why I wanted a doula was to help us, for my husband and I to speak each other’s language, when it came to medicine and birth and labor and kind of all of these experiences that we were having.

And so of the things that we learned in the EBB class, I think it was in the first week was really learning how we engage with the medical system and the healthcare system. And so learning, are you high intervention or high technology? Or low technology and low intervention? And no surprise, my husband was very much high intervention and sees that as the way forward for medicine. I’m like, no intervention. No. As natural as possible, all of those types of things. And so it really helped us to kind of find each other’s space and where each other was coming from as we were moving forward with the pregnancy and developing our plans. With Marnellie’s help, of course we, of course, settled on the freestanding birth center and-

Dr. Rebecca Dekker: Which was kind of a compromise for you then?

Haley Grachico: Yes.

Dr. Rebecca Dekker: Because you were like, let’s just use the tub in our house and he’s like, let’s schedule a cesarean. So you kind of met somewhere in the middle with a freestanding birth center.

Haley Grachico: Yes, exactly. And we both felt very comfortable and safe with that option. And I think being in the EBB class really solidified those decisions for us. Because we had made those decisions pretty early on, but then being in the class and learning about the role of doulas and learning about the role of midwives and the various interventions, really-

And having a lot of evidence behind the decisions that we made. I think really comforted my husband in like, “Oh yeah, the safest route to having a baby isn’t a cesarean section or isn’t being in a hospital. Not necessarily under the care of a physician, if you don’t need to be,” in those kinds of things. So that really helped him kind of come to peace with those decisions and feel really comfortable and safe about it.

Dr. Rebecca Dekker: Yeah. So it sounds like you were able to see each other’s perspectives and then learn information together about the research on different birth practices and then kind of come together as a team.

Haley Grachico: Yeah, exactly. Exactly. Yeah. Yep.

Dr. Rebecca Dekker: So what was your pregnancy like?

Haley Grachico: My pregnancy was long. It felt very long. This is our first baby. Of course we were anxious the whole time and excited to meet her. That feels very long. We had a lot going on in our lives, personally. My husband was finishing his residency. He was preparing to join his first job out of training.

We were also moving across the state. And so at 37 weeks we moved our entire life down to Southern Oregon from Portland. So that was exhausting and long because I was 37 weeks pregnant. And then we ended up coming back to Portland for the last week of the pregnancy. Cause I knew I wanted to deliver at the birth center in Portland. So the end of the pregnancy was long. It was also 117 degrees in Portland when I was about 36 weeks, 35 weeks, something like that.

Dr. Rebecca Dekker: That was in one of those big heat waves?

Haley Grachico: Yes. And we did have air conditioning in our home. My pregnancy was very healthy. I had slight anemia kind of towards the third trimester, but that was it. Everything was very healthy, but I had a lot of the annoying side effects. I had really bad heartburn towards the very end. I had a lot of edema. Just uncomfortable most of the time when I was pregnant.

Dr. Rebecca Dekker: So you were healthy but uncomfortable?

Haley Grachico: Yes, exactly. Exactly. Yep.

Dr. Rebecca Dekker: And what was your mindset like then? You went back to Portland in the heat wave, planning to birth at this freestanding birth center. What was your mindset like leading up to the birth? Were you ready, excited, scared, nervous?

Haley Grachico: I was ready and excited. We were just, at the 37 week mark, I told Marnellie, I was like, okay any day I’m just ready. She can come anytime now. She’s full term, I’m ready to go. We ended up delivering at 39 and 3. Exactly a week prior to her birth, we drove back up to Portland from Grants Pass. After we had moved our stuff down to our new home and on the drive back to Portland, I started having contractions. And so this is on a Wednesday night and I texted Marnellie and Ali. And I was like, I think, but I don’t know. I feel like I should know if this is really what’s going on. And I was just these really, really, really slight kind of twinges. Almost really like cramps, but they were happening really consistently every like 12 minutes or so.

And then we got home and we went to bed, woke up, they’re all gone. Every day, every night for about a week I had these contractions happening. So after maybe three or four days, I texted Ali and Marnellie and I was like, “Okay, can we call this prodromal labor now?” And they’re like, “Yes, this is prodromal labor. You’ve got… Things are happening.”

It was uncomfortable and I was just so ready to be done. And I was having a lot of cervical pain at that time. Really just felt like I could just feel her head pushing down on my cervix. It was really painful. It almost stopped me in my tracks. But it was just for a blip. So then Marnellie called me on Monday night, I think-

And so she had just taken a course with her about optimal fetal positioning for labor. And she said, “I think what’s happening is that Josephine is pushing down and she’s ready to come out. She’s not hitting the right spot or she’s not in exactly the precise… Her head’s not in the exact optimal position to kind of make things go forward, right now.” And she’s like, “So I just learned this whole kind of circuit I want you to do tonight and let’s give it a try.”

So I did. It took about an hour to go through this circuit. I got the bathtub and I raised my hips up with every time I was having one of those contractions. And I guess the intent was to kind of pull her out of the birth canal a little bit and then kind of push her back in. She came out and then there was a whole bunch of other, kind of like yoga moves or that I was doing. And then the very last move was this extended sideline where your leg is kind of laying off the side of the bed. And I did that for about an hour.

I was having a hard time falling asleep after that. Got in the shower, took a nice long hot shower. Laid in bed. My hips were aching, I was kind of swaying back and forth, kind of on all fours, kind of doing some cat cow positions. And I laid down into child’s pose. And as I went into child’s pose, I heard pop, pop, pop, pop, pop. And I felt it and I heard it. And I was like, my water just broke. And all of a sudden I felt the gush. 

Dr. Rebecca Dekker: Yeah. So interesting. So as soon as you did this circuit, your water broke?

Haley Grachico: Yep. Maybe about, just a couple of hours after I completed the circuit.

Dr. Rebecca Dekker: Couple hours after you did everything?

Haley Grachico: Yep. So my water broke and this is at 3:00 AM in the morning. And at this point my husband and I could have literally been a Saturday Night Live skit. I think we were just hilarious. We were like those classically first time parents getting ready to go to the hospital, to the birth center. My water broke. My midwife had given me pH strips to test any liquid. So my husband’s like, “Are you sure? Are you sure?” And I’m like, “I’m sure.” He’s like getting the pH strips and putting it in the water or putting it in the amniotic fluid. And he’s like, “Oh my gosh, it’s turning blue. This is happening. This is happening.” I’m like, “Yes, this is happening.” So I go to the bathroom and I’m cleaning up and everything.

I come back, my husband’s sitting in a chair, reading the book, Heading Home With Your Baby. I’m like, what are you doing? We’ve got to get ready. Get our stuff ready. And he’s like, I didn’t do my homework. I’ve got to read everything before we go. So, that was kind of comical and I’m getting things together. We left everything in Portland that we wanted to bring to the birth center with. But in all the chaos of the move and worrying about the move, I didn’t have any actual bags packed. And then of course we had dirty laundry and all these things. I’m running around, doing laundry, packing things up, getting the dogs settled, all these things.

Dr. Rebecca Dekker: And are you having contractions during this time or not?

Haley Grachico: Yes. So about an hour after my water broke, my contractions started. So about 4:00 AM in the morning. I had called the midwife at, let’s see my water broke at 3:00 AM, so I called her probably about like 3:30 AM. After I had time to clean up and kind of get things settled and whatever. I called the midwife and out of everything I have to say, this is the only negative experience I had with my birth center.

The midwife who was on call seemed to not be happy that I was calling and with reporting a birth. And I came to learn, after the fact, that the midwives at the birth center change shifts at about 7:00 o’clock or 8:00 o’clock in the morning. I think that she was kind of holding out, hoping there wasn’t going to be a birth that night. Because I called and I’m like, “I think my water just broke” and I kind of started talking and she’s like, okay, we need you to hold on for a second. I need to get out of bed and start taking notes. And I’m like, oh. I’m all excited, waiting. Happy to report that this is going on. And she seemed to kind of halt everything a little bit. So we record everything and she’s like, “Okay, labor at home for a little while, give me a call back around six in the morning” or something like that. Okay.

In the meantime, I had texted Marnellie and Ali letting them know that my water had broke. And I’m getting all these things ready, in the meantime. My contractions picked up really quickly. For the first three hours or two hours, I suppose. Because they through around 6:00 AM is when things really started to pick up Marnellie called me about 6:00 AM. And she’s talking to me and listening to me and she’s counting my contractions, in the meantime. And talking to Is, And she’s like, “Is, what does her face look like right now? How does she sound? Tell me what you’re seeing, from your perspective.” And as he’s talking, she’s like, “Yeah, I think it’s time to give the midwife another call back and see what she wants you to do.”

She’s like, “I think you’re closer. I think we’re soon to head to the birth center,” is kind of like how she made it sound. And she’s like, give me a call back in about an hour and let me know what you want to do. So I’m like, okay. So I called the midwife back and I let her know that things were picking up. We also, I think this is an important part of my story is that, we lived at the clear other side of town. We lived towards one suburb. The birth center was almost to the other suburb across town. And this is early in the morning, so, of course, I’m worried about rush hour traffic. And having contractions in the middle of traffic and being stuck there for an extra half hour or 45 minutes.

As I was talking to the midwife, I was having a hard time talking through the contractions at that point. So I was like, “I really want to come.” And she was like, “Okay, I’ll meet you there in about an hour.” So we did. We got our stuff ready to go. We got to the birth center about 7:30 am. The midwife got there about 7:45 AM. At that point I was having a hard time coping. So I had texted Marnellie on the way and I said, “Meet us at the birth center. Hopefully you can get there sooner rather than later, because I’m having a hard time coping through these contractions right now.” And she said, “Okay, I’m on it. I’ll be there as soon as I can.”

And then of course this is just a funny side note. Marnellie had car issues that morning. So she wasn’t able to get there until about, actually 9:15 AM. So it was only two hours, which normally I don’t think that is unreasonable, but my birth happened very fast. We got to the birth center at 7:30 AM and the midwife got there about 7:45 AM. She came in and she did a cervical check. And at that point I was about a three. And she, again, this is the same midwife had talked to you on the phone and she kind of put the brakes on me. And she actually, as I reflect back on this now with a lot of time afterwards, took a lot of power away from me or I gave her more power than I wanted to let her have.

Because she was like, “You’re only a three. And at this point we don’t normally admit people to the birth center, but I understand about the traffic and you’re having a hard time coping, so you probably don’t want to go home.” And I was like, “Nope, I’m staying here.” And so she let me stay but she wouldn’t admit me, at that point, because I was only three centimeters. Once I was there and in the room, things really started to pick up quick. And so I had a hard time coping. I went into the bath right away and I hated it. I felt really cold for some reason in the bathtub. So I got out and I was like in the shower and then out of the shower and then in the shower and out of the shower. So it was every other contraction I was just kind of, I needed to just move.

And so I was just literally from the bed to the shower, from the bed to the shower and just moving and moving and moving. The midwife shift changed at eight o’clock. I was very thankful for that. Cause I just did not have this great connection with the initial midwife. Oh I should say, at my free standing birth center, there were I think five midwives. And the intent is for you to cycle through each midwife to see one at each appointment. And I had never seen that particular midwife, that I had a tough time connecting with, and she was the only one I had never seen. So that might also be part of why that connection didn’t happen.

But then the new midwife, Michelle, came on and she was everything I needed in that moment. That was great. She came in at about, I want to say 8:30 AM, 8:45 AM. So about an hour later. And she was like, “I’m a little worried about how you’re coping, as well. Can I do another check? Let’s just see where you are. Let’s see if things are progressing really fast.” She’s like, “That could be happening.” So she does a check and I’m a five and a half. So I went from a three to a five and a half within 45 minutes or so, a little bit later.

And at that point I had asked, or I had been asking for the nitrous oxide. That was part of my birth plan that I had created with Marnellie, that I was open to it. It was supposed to be kind of my last resort and I had asked for it. And the midwives were really resistant to giving me the nitrous oxide. Because again, I’d only been there for a really short period of time, for about an hour at this point. And they were like, “You really want to hold off. You really want to hold off and save it towards the end because we don’t want to exhaust all of our resources, right at the beginning of your labor.” I wasn’t given the nitrous until probably about, after Marnellie got there. Marnellie got there about 9:15 AM.

Because then I looked at Marnellie and she’s like, “How are you doing it?” And I’m like, “I can’t do this.” And she’s like, “Yes, you can. You’re already doing it. We’re here, we’re doing it.” We’ve got this. And I was like, “I want the nitrous.” And as soon as Marnellie got there, she kind of took control of the room. Which I needed, somebody to be like, “Is somebody going to get this for her?” So they got the nitrous. That was amazing. I loved it. It changed everything for me and how I could manage and cope through the remainder of the labor.

So I got the nitrous and then once I got the nitrous Marnellie asked if I wanted to get back in the bathtub and try that again. I did. We got in the tub and that felt amazing, once I had the nitrous in the tub and the jets. And that felt like everything was great.

Dr. Rebecca Dekker: So you were using nitrous while you were in the tub then?

Haley Grachico: Yep. They had it kind of standing on a, I don’t know, one of those poles, draped around that. And I was controlling the mask and so it was just down next to me. So then at one point my midwife came in the room, just kind of watch and see what was going on and how I was coping. And she turned to walk out and I took the mask off and I remember looking at her straight in the face and being like, “I wouldn’t go very far.”

And she’s like, okay. And she’s like, I’m going to go get my computer and I’m going to go chart notes in the bathroom or whatever it was. I’m like, “Okay.” So she goes in the bathroom with her laptop. She came out a few minutes later. I don’t know. She was going to go grab something I think. And I took the mask off and I look at Marnellie and I was like, “Where is she going?” And she’s like, “It’s okay. She’s going to be right back.” And I was like, “Doesn’t she know the baby’s in my pelvis right now?” And Marnellie’s like, “Oh, okay guys, I think it’s time to get her out the bathtub.”

So got out of the tub. As I was getting out of the tub, they could see that Josephine was crowning. So got me onto the bed. I pushed for five minutes and she was out. And so it happened really, really fast. We got to the birth center at 7:30 AM and Josephine was here at 10:25 AM.

Dr. Rebecca Dekker: That is really fast for a first time for-

Haley Grachico: Yeah.

Dr. Rebecca Dekker: Were you planning a water birth or did you want to give birth in the bed? Did you have preferences around that?

Haley Grachico: The birth center I was at, you cannot deliver in the tub. You can labor in the tub as much as you want. And apparently, I’m not sure all of the rules around it, but you kind of need to have a specific license or something to be able to deliver in the bathtub.

And that birth center was working on it and almost had it. And then COVID happened kind of all of these things came to a halt. They might be able to do it now. I know they were actively working on being able to deliver in the bathtub. But I could not. That was the only kind of stipulation.

Dr. Rebecca Dekker: Okay. So that’s why they were getting you out of the tub. I was just wondering if you had a preference either way. Yeah. So what was that moment like then, when your baby came out?

Haley Grachico: Oh, it was amazing. It was everything. Kind of everything surrounding that, I’ve had these memories be filled in by my husband and by Marnellie. My husband was able to catch her, which I think was really awesome and really special for him. So he got to help catch her with the midwives. She was just placed onto my belly and I just held her. We waited, we did delayed cord clamping. We waited until the court turned white.

And then, this is where my birth turned a little bit. And this is where actually I think having a doula was the most important piece for me, was after she was born. When they were trying to deliver the placenta, it wasn’t coming out on its own. And so the midwife gave kind of a slight tug on the placenta to help it kind of start coming out. And when she did that, the cord avulsed. I think that’s the correct word. It broke away. Then the placenta was stuck in, remained inside of me without the cord.

And I think it just happened so fast. I don’t think anyone else in the room was worried, but I felt worried. Because everybody was kind of making things happen pretty fast. At that point, I remember distinctly hearing the midwife say or asking who was the physician on call?

My freestanding birth center was connected to women’s health clinic and it’s a part of a larger group called WHA. And they do all things, OB GYN, high risk OB, regular OB, GYN OG, adolescent gynecology, all of those things. And so they have a specific physician who is able to assist in the birth center or who would be the physician to take me if I were transferred to a hospital for any reason. When I heard that, that’s when I got like a little nervous.

Dr. Rebecca Dekker: Nervous, yeah.

Haley Grachico: Yeah.

Dr. Rebecca Dekker: That would make me anxious.

Haley Grachico: Yeah. I was like, why are we asking for a doctor? And all of these things kind of flood through your brain, even though you’re not processing it. I remember feeling really relieved though, when I looked through the door and instead of one of the physicians walking through, it was another midwife who came in to assist. And this midwife, I had a really great connection with, during my obstetrical care. I was relieved to see her and to have two midwives who I had already really connected well with, in the room.

And I remember Marnellie being like, “Okay, Haley, I’m going to take Josephine and Is is going to come help you.” and I was like, “Nope, give the baby to Is and Marnellie, I want you on the bed with me, helping me through this.” That was really helpful to me that Josephine didn’t go to a stranger. She wasn’t just put into a crib or whatever. She was with her dad. And then Marnellie was there to help me through this process of getting the placenta out. And all in all, it was super uneventful.

Dr. Rebecca Dekker: How did you get the placenta out then? Did you just push it out?

Haley Grachico: Yeah. They brought in a birth stool for me and it was one of the ones that’s more like kind of a plastic or an inflatable type. And they put it on the bed and then I sat on it and then Marnellie got behind me and I looped my arms through her so that I could push behind her. Cory, the other midwife came in and she pushed down on my uterus and pushed it out while I was sitting spontaneously pushing, as well. Michelle, the other midwife, was able to grab it on the other end.

All in all, it really was not that eventful, I don’t think. But it was really interesting though, because after they inspected the placenta for any missing pieces or all of that. They were like, “It’s really bizarre that this happened because your placenta looked really healthy. There was no missing pieces. Everything is exactly how we would expect it to look.” So it was a really rare occasion, I suppose, that the cord avulsed.

Dr. Rebecca Dekker: And it’s funny that you had what we call “land birth.” You gave birth on the bed and you had a cord avulsion. When often, some people think of cord avulsion as happening in water births. But there’s actually no research that I’ve been able to find on the percentage of cord, some people call it cord snapping or cord avulsion in land births. Nobody’s ever published, as far as I can tell, how often it happens.

Haley Grachico: Interesting.

Dr. Rebecca Dekker: Yeah. If our listeners want to learn more, if you want to learn more about the third stage of when the placenta comes out and the different options, including sometimes they tug gently on the placenta or sorry, tug gently on the cord. That’s all at our signature article on the third stage, just go to evidencebasedbirth.com/third stage. And you can learn more about all of those different interventions for the third stage.

But I can totally identify with that because with my second birth, for some reason, I just, I kind of struggled to push the placenta out as well. And I ended up needing a shot of Pitocin to help me do it. And that was the one kind of negative memory from that otherwise uneventful birth.

Interestingly enough, the next time with my third baby, I was kind of nervous about the third stage again. Actually, at the time, I was kind of emailing back and forth with the founder of hypno babies, Kerry Tuschhoff, and she wrote me back some advice and told me to visualize the third stage going smoothly. And when I was doing my self-hypnosis practice into visualize it coming out easily. And that really helped with my anxiety for the next time. And the next time I went, perfectly fine.

Haley Grachico: Interesting. Yeah, we’ve already talked about with the next baby that we’re planning to probably do the hypno babies, and see. Now that we have all of the tools from EBB to utilize the tools of hypno birthing and see if we can, if that-

Dr. Rebecca Dekker: Yeah. I think self hypnosis is really powerful if you practice. I think the key is practicing the techniques. But that sounds like a wonderful combination.

Haley Grachico: I should add. You reminded me when you said your story. I did get Pitocin in the third stage and they had asked me that when I was in labor in the tub, because I had anemia during my third trimester. I was on iron and they were kind of monitoring that.

And that was really helpful with Marnellie and Ali. We had created a birth plan prior to, obviously, going into labor, several weeks ahead of time. And that was on my list that they might offer Pitocin in the third stage. And so we already said that we wanted to do it. My birth happened so fast that my midwives didn’t get the whole run down of my birth plan and what was okay. So they were asking me and telling me about it, kind of trying to get informed consent. And I remember her starting to talk about it and I was just like, uh huh, whatever you want. I’m just like-

Dr. Rebecca Dekker: You’re like, I already got the information. I already know what I want.

Haley Grachico: Yes. The answer is yes, just move forward. And then they did give me a shot of something else. And I can’t remember the name of it, when the placenta wouldn’t come out. I got Pitocin and something else for kind of managing the bleeding and trying to get the placenta to come out. But I don’t remember what that was.

Dr. Rebecca Dekker: How long did you stay in the birth center before you went home?

Haley Grachico: We were there until I want to say about 5:30 PM that night. And then we were home by dinner, that the same day. So had a baby and we’re home by dinner time.

Dr. Rebecca Dekker: Just a normal work day, right.

Haley Grachico: Yeah.

Dr. Rebecca Dekker: What was your postpartum experience like?

Haley Grachico: Postpartum was wonderful in the sense that I had very few complications of birth. I had minimal tearing and everything kind of happened really easily. The one really nice thing about my freestanding birth center was, they sent a midwife to our home the next day to do Josephine’s newborn exam, to do her heel prick for her-

Dr. Rebecca Dekker: The genetic screening.

Haley Grachico: Yes. Thank you. Yep. And to do all of those things. And so that was really helpful for us. We didn’t have to go anywhere. We didn’t have to do anything. We were able to just stay home and someone came to us and kind of loved on us for a little bit, loved on the baby.

And when I was at the birth center and then also when the midwives came to our home, they did a lot of coaching for breastfeeding and kind of support in that sense. That was really helpful having that experience, someone coming into the house. Other than that, we moved exactly a week after she was born. That was stressful. Moving when you have a seven day old baby, I don’t advise that.

Dr. Rebecca Dekker: So had you already moved lot of your stuff?

Haley Grachico: All of our stuff had been moved. What made it complicated having… Well, we physically moved with a seven day old baby, but then all of our furniture had been moved down. We were literally sleeping on an air mattress on the floor and had chairs, lawn furniture, in our living room, postpartum. And so that was uncomfortable for me, for sure. Having just had a baby.

Other than that, our postpartum was really great. And I have to attribute, probably a lot of that, to my doulas. Both Marnellie and Ali, especially who is and specializes in postpartum doula.

Dr. Rebecca Dekker: Before you even gave birth, Ali and Marnellie had kind of talked you through preparing for postpartum and getting physically and emotionally prepared for it?

Haley Grachico: Yes. Yep.

Dr. Rebecca Dekker: That’s awesome. Haley, do you have any advice for people listening who are planning on or entering pregnancy or parenthood soon?

Haley Grachico: Yeah. You’re already in the right place. You’re already listening to the podcast, which I’ve listened to religiously. And Ali always talks about postpartum in this way, that you prepare and you plan so much for a wedding, which is one day of your life. Mothers should be preparing for this postpartum experience, or for their birth experience in the same way. And I think that that really resonated with me and I really treated planning for my labor like training for a marathon really. This is a monumental event that was going to be important for the rest of my life. And so I really took it seriously. And I would encourage really any mom or laboring person to prepare as well as they can just to soak up as much information as they possibly can, before it happening.

Dr. Rebecca Dekker: Yeah. And Ali came on the podcast on episode 169 about the importance of postpartum doula care. Definitely check that out. And since you mentioned nitrous, I wanted to let everybody know. We do have a YouTube video about nitrous oxide, as well as a podcast from a few years ago. It’s actually number 15. Which you can’t find the oldest podcasts on iTunes, but you can find them on Spotify really easily. And some other podcasting platforms. Itunes only lets you show the most recent 100 episodes.

Kind of cool that our listeners are learning about all these different options from you, Haley. You said you listened to the podcast, do you have any memories of anything that stuck out to you that were helpful to you when you were pregnant that might be helpful for other listeners who are pregnant?

Haley Grachico: Yeah. I really, when I say, I took this on as my job preparing for labor. And I had organized all of your podcasts. I, of course, read your book and we had our book for preparing and our workbook and everything.

Dr. Rebecca Dekker: The workbook for the childbirth class.

Haley Grachico: And I had organized all of the podcast by, essentially by category, which you had done on your website a little bit. And so it was like I went through and I listened to all of the birth stories from graduates of the EBB class first.

And then I went and listened to all of the stories from doulas. And then I went and listened to all of the stories from the midwives. And then I went and listened to all of the evidence. My husband and I did those together. He would come home in the evenings and we’d eat our dinner as we were just like hanging out and chilling on the couch, we would listen to an EBB evidence episode. We’d listen to the evidence on doulas or the evidence on freestanding birth centers or whatever it was.

It was really fun to do together, as a couple. Especially listening with my husband, because he would be digesting of this research and he’d be like, “Wait, go back, go back 30 seconds. What was the evidence on that?” It was really fun to kind of nerd out in that sense, as we were making our plans for everything.

But it was really fun to go through kind of systematically and take on everything that you had to present. Because it can be a lot of information, can be overwhelming at first, but when I really took it on as my own, it was really, really helpful.

Dr. Rebecca Dekker: Yeah. It’s really cool. Congratulations on educating yourself. It sounds like you got a graduate degree in giving birth.

Haley Grachico: I’ve always been a birth nerd. My background is in public health and I had spent some time in Africa for a while and did my internship there. And I was supposed to work for a hospital and they ended up placing me in a midwifery center. And so I did spend most of my time there and that was awesome. Being able to see all of these births and how it happened.

Dr. Rebecca Dekker: Oh yes. That makes sense then, that you entered into this pregnancy with kind of that mindset, because you’ve been exposed to it.

Haley Grachico: Yep. Yep. And then I had right prior to meeting my husband, actually I had been accepted to UIC to do my Masters in Nursing, in Nurse Midwifery. Or I guess a DNP in Nurse Midwifery. And then of course after being accepted, I met my now husband and my whole kind of life kind of flipped on its head and I ended up not going to pursue a midwifery degree. But that was a part of my plan for a really long time.

A lot of the things were not new information to me, but it was fun to delve back into that again and to really be in that world. And then during one of my sessions with Marnellie and Ali, Ali paused me for a second, because we were talking about Rebozos and cultural appropriation and birth work and all of these different things. And Ali pauses, and she’s like, “Wait a minute, wait a minute, wait a minute. Do you want to be a doula?” She’s like. And I was like, “Maybe.”

Dr. Rebecca Dekker: Advanced topic.

Haley Grachico: Yeah, yeah. So I was like, maybe. So, Ali’s kind of put that seed into my brain again.

Dr. Rebecca Dekker: Wow. Well even if you don’t work as a quote, “professional doula,” it sounds like you’ve learned so much over the past year and a half that you could definitely support other people in your community with your knowledge and the information you’ve gathered.

Haley Grachico: Yeah. It’s really cool once you’re inside or around birth workers, there’s kind of this energy that’s put out that’s contagious, I think. Especially going to these events that were held in Portland. The Parent Trip events they’ve got lactation specialists and doulas and pelvis floor therapists, and all of these people who are just really kind of coming together to ensure the health and wellbeing of all of these laboring folks. And I just think it’s just a really cool energy to be around.

Dr. Rebecca Dekker: Well, you’ll have to keep us posted through Ali. Ali is on team EBB here as our content team manager and operations coordinator. Keep Ali posted and Ali will keep us posted on if you pursue birth work. I’d love to-

Haley Grachico: Absolutely.

Dr. Rebecca Dekker: Hear what you end up doing. And thanks to Josephine too. Who’s now awake and kind of looking at the camera.

So if you haven’t seen our podcast on YouTube and you want to get a little bit of a baby fix, go check out baby Josephine on our YouTube channel. And so wonderful again, having a graduate of the childbirth class on the podcast. We appreciate you sharing your story.

I did want to make a quick announcement that we, this is a rough copy, but we now have the EBB childbirth class workbook in Espanol. And we have several instructors who already teaching in Spanish. That’s a new addition of the class that we’re really excited about. It was a long time coming to get all the materials and captions on all the videos in Spanish and everything. Thank you Haley so much for coming on the podcast and Josephine too.

Haley Grachico: Thank you. Thank you for having us.

Dr. Rebecca Dekker: All right. Thanks. Bye.

 

Listening to this podcast is an Australian College of Midwives CPD Recognised Activity.

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