Don’t miss an episode! Subscribe to our podcast:  iTunes  |  Stitcher 

On today’s podcast, we are talking with Evidence Based Birth® Childbirth Class parent, Kathryn Remivasan, about her experience giving birth to a posterior-positioned baby.

Kathryn and her husband, Dushyant, are graduates of the Evidence Based Birth® Childbirth Class with EBB Instructor and doula, Julie Fors. Dushyant and Kathryn are software engineers. They live in Chicago with their two cats, dog, and now beautiful baby girl, Elakshi, who Kathryn gave birth to in January 2021.

We talk about Kathryn’s use of a “marathon training” mindset to have an unmedicated birth during the pandemic. We also talk about Kathryn’s experience of including medical interventions during her birth, as well as how she coped with postpartum recovery after a long labor.

Content warning: We talk about COVID, infant/labor trauma, the use of medical interventions while in labor, and postpartum anxiety/recovery.

If you would like to watch the podcast on our YouTube channel, you can view it here.

 

Resources
Learn more about Julie Fors here (https://journeyforwardbirthandparenting.com/). 

Learn more about Rush University Medical Center here (https://www.rush.edu/). 

Learn more about Spinning Babies here (https://www.spinningbabies.com/).  

Listen to EBB 101 episode with Spinning Babies found, Gail Tully here (https://evidencebasedbirth.com/ebb-101-gail-tully-of-spinning-babies%ef%b8%8f/). 

Listen to EBB 165 episode with Ann Marie Gilligan here (https://evidencebasedbirth.com/fetal-position-during-labor-with-ld-nurse-ann-marie-gilligan/). 

 Listen to EBB 169 episode with Ali Buchanan here (https://evidencebasedbirth.com/the-importance-of-postpartum-doula-care-with-ali-buchanan/). 

 

Transcript

Rebecca Dekker: Hi, everyone. On today’s podcast, we’re going to talk with Kathryn Remivasan about her experience giving birth to a posterior-positioned baby. Welcome to the Evidence Based Birth® podcast. My name is Rebecca Dekker, 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. Today, I’m so excited to welcome Kathryn Remivasan to the Evidence Based Birth® podcast. Kathryn and her husband, Dushyant, are graduates of the Evidence Based Birth® Childbirth Class with EBB instructor, Julie Fors. Dushyant and Kathryn are software engineers. They live in Chicago with their two cats, dog, and now beautiful baby girl, Elakshi. They gave birth in January 2021 during COVID times, and Kathryn’s here to talk about their experience giving birth to a posterior-positioned baby. Welcome, Kathryn, to the Evidence Based Birth® podcast.

Kathryn Remivasan: Hi. I’m really glad to be here. I’m very excited. Fangirling over here.

Rebecca Dekker: Well, we’re super excited to have you here to share your birth story. Can you tell us how you found out about Evidence Based Birth® and the childbirth class and how you got acquainted with EBB?

Kathryn Remivasan: Yeah, absolutely. So it started probably a year or two ago, I was on the Reddit, the trying for a baby community, baby bumps, et cetera, and somebody had just posted about your podcast and was speaking really highly of it. And it was exactly what me and my husband were looking for, was just very factual, evidence-based information about the whole birth process, giving birth in a hospital, what our options are. And so from there, I just started listening to it, I love listening to the stories. And then when it was announced that there was a childbirth class, I knew that that would be the class that we would sign up for.

Rebecca Dekker: Awesome. And so how did you pick a class?

Kathryn Remivasan:  Honestly, it was just we listened to your podcast, we both really liked how you approached the science. We wanted something that would take off the rose-colored glasses and just be very factual about it, kind of take a lot of the opinion and prescriptiveness out of it and just say you know what’s best for you, you know what you’re looking for, here’s kind of the medical establishment, these are some of the options that you’ll encounter, here are the pros and cons, and kind of use that to build not a plan, but definitely a flow chart of the interventions that you could potentially come across and what you’re comfortable with. So, in looking at birth classes, yours was the one that was very evidence-based, and my husband and I are software engineers, we’re very rooted in evidence and facts and that just really aligned with the conveying of information to us.

Rebecca Dekker: So you end up taking the class with Julie Fors, who’s also kind of in the Chicagoland area. And what was your experience like taking the class?

Kathryn Remivasan:  The class was wonderful. It was post-COVID, so we did it completely online. We had the weekly Zoom sessions and the parents in our class were from all over the country, even though Julie was in the Chicagoland area. And we really enjoyed the class and we really enjoyed Julie. People would ask leading questions, ask, “Oh, is this better than the other?” and she really made sure to not give her recommendation, not give her opinion, really focus on the facts, this is what the science says. Here are the pros, here are the cons, you can talk to other people, see what their experience was, but ultimately this is what the science says, this is what the current research says. And so that was just really empowering.

And it was funny because we ended up delivering and I had my OB care at Rush University, which is the teaching hospital, and I’m gearing up to take all the evidence from your class and have the tough conversation and I walk into my OB appointments and they’re like, “Yeah, we already know.” It was just really refreshing that we would go from class, talk about the most recent research and we would go to Rush and they’d be like, “Yeah, we already know. We already incorporate that. No problem.” So it was just really nice to see the parallel between the class and the major hospital in the area and just already have a lot of our preferences be pretty standard, like the up to date protocol, so that-

Rebecca Dekker: That must’ve been pretty reassuring, because you do still hear bad stories from some hospitals. So what were some of the things that you went to your OB appointments concerned about and they were like, “Oh, we already do that,” and it alleviated your worries?

Kathryn Remivasan:  One of the things was positioning and support of attempting an unmedicated birth. They already knew about the induction of 39, 40 weeks. That’s not any sort of a hard cut-off. They said if we wanted to be induced early, we could, but they would let us go to 41 weeks and we’d re-evaluate. I was concerned about having to labor in bed or on my back or push on my back and immediately they were like, “No, we’ve got the birthing bar, we’ve got the balls. We don’t have a tub, but we’ve got the shower. We already have a lot of the tools available so that you can labor however you want, especially if you’re going for an unmedicated.”

Rebecca Dekker: Okay.

Kathryn Remivasan:  Obviously, if you have an epidural, which we’ll talk about later, but if you have an epidural, you’re confined to the bed in some aspects. But they tried to be supportive of going unmedicated and give me the tools-

Rebecca Dekker: Okay. So it’s interesting, they were supportive of some of those things, but they didn’t have a birthing tub at the university hospital.

Kathryn Remivasan:  Yeah. Not in the birth center, they don’t have a tub, and pretty much all of Chicago. From talking with Julie and looking at the area hospitals, no-one did. There was only one place that I found that was a specific-

Rebecca Dekker: Okay, so most hospitals in the-

Kathryn Remivasan:  Birthing center in the suburbs.

Rebecca Dekker: Chicago area don’t have any kind of tub to get into during labor? Okay.

Kathryn Remivasan:  No.

Rebecca Dekker: Good to know. So take us towards the end of your pregnancy. What was your mindset like? How had your pregnancy gone?

Kathryn Remivasan:  So my pregnancy was completely uneventful. Worked out until … I did bar right up until labor, was walking. I was running well into the third trimester, so it was just really nice. The only caveat that I had was low platelets, which I really appreciated Julie and taking the EBB class. I brought it up and was like, “Do you know anything about this?” and she was like, “No, let me go find research,” and after the class, sent me an email of resources on low platelets. I had to have a consult with the anesthesiologist to make sure that they were comfortable potentially giving me an epidural and then making sure that my platelets didn’t fall too low, so I had extra monitoring for that. But other than that, very uneventful. The hospital only does two ultrasounds, at eight weeks and 20 weeks, so after 20 weeks, I just had my normal appointments and it was just kind of … You just go until you go into labor.

Rebecca Dekker: And what was your mindset like then, as you were getting closer to your due date?

Kathryn Remivasan:  My mindset was definitely naively optimistic from all of the … I was reading a lot about unmedicated birth stories, reading a lot of people’s experiences, listening to the podcast. It kind of seemed like okay, I’m in shape, I run marathons, I’m doing all these things to be healthy, I’ve a pretty uneventful pregnancy. My labor … Julie kept saying, “24 hours. Put 24 hours in your mind.” And so I was like, “Great, I can do 24 hours. Not a big deal.” So it’s really in the mindset of I can do anything for 24 hours, this’ll be fine.

We were practicing a lot of the comfort measures, the tub, we were getting some of the mood lighting, I was getting podcasts together because those always help me training for marathons. I would just listen to podcasts and zone out, and that always really helped. So I was queuing up a bunch of podcasts, queuing up relaxing music. We have a TENS machine, so had that ready to go by the side of the bed. But other than that, we were just really psyching ourselves up for we can do this and we’re getting close. And final weeks were just a lot of what can we do now before we have a baby? Yeah. Just making complex meals, going for lots of walks with our dog, just spending a lot of time just the two of us at the end.

Rebecca Dekker: So it sounded like you had a lot of confidence going into birth and that you felt prepared.

Kathryn Remivasan:  Yes. A lot of confidence.

Rebecca Dekker: That sounds interesting. You took some of your training as an athlete and kind of applied that same focus to preparing for birth, kind of like-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: You would for a marathon.

Kathryn Remivasan:  Yeah, absolutely. So much of the birth and even now, just in early parenthood, so much of it is the stamina. I equate the stamina of doing things, of continuing to breastfeed, even when we had challenges, getting through the birth. So much of the stamina of training for marathons and the lengthiness of that really translated mentally and … Just keep going. Just focus on one step in front of the other, and then it gets better and you kind of get through the hump.

Rebecca Dekker: Okay. And you were planning an unmedicated birth in the hospital with an obstetrician?

Kathryn Remivasan:  Correct. With Julie as our doula.

Rebecca Dekker: Oh, okay.

Kathryn Remivasan:  So Julie was wonderful.

Rebecca Dekker: So you end up hiring your EBB instructor to be your doula as well?

Kathryn Remivasan:  Correct.

Rebecca Dekker: Okay. So you had a doula lined up and everything, your pregnancy was going smoothly, so you’re just waiting for labor to start. So tell us your birth story. How did labor begin?

Kathryn Remivasan:  Yeah. So at 38 weeks, I was checked and just to kind of … I know they don’t really tell anything, it could be the next day, could be multiple weeks later, but a very big data, numbers person and so after weighing the pros and cons, I was like, “I want to get checked and just kind of see where we’re at.” And so, 38 weeks, I had begun to efface and dilate. I think I was already one centimeter and 50 percent effaced or so. And the OB had made a comment of, “Oh, wow. You’re not even going to make it to 40 weeks.” And so I’m skipping out of my appointment, because all my appointments, I had to go to alone because of COVID. Yeah, I’m coming out. And my grandmother had given birth early, I think my husband was early and so we were like, “Oh, yeah, this is great. We got a New Year’s Eve baby, or we have a New Year’s Day baby. I’m not making it to 40 weeks.”

And 40 weeks comes and I go for my 40 week appointment. And I’ve been a little concerned about positioning. I was doing some of the Spinning Babies moves and something told me, just intuition was like, “Look at positions. Look at optimal birth positions.” I just kept coming back to the Spinning Babies circle of optimal birth positions. And it was like if they’re certain positions, that’s great, but if they’re obviously breach, but if they’re kind of turned on each side, it was less optimal. And every time I felt, her back was always on my right side and her feet were always kind of up in my left rib and she basically hadn’t moved from that position for a couple of weeks. Everything was in the exact same spot. And I had brought it up at 40 weeks. And, again, we don’t have ultrasounds after 20 weeks, so other than the doctors and nurse practitioners feeling and confirming that she was head down, I had no visibility into her positioning, other than-

Rebecca Dekker: Did your care provider have any concern about … The position that you’re describing sounds like right occiput posterior, which could then lead to a posterior-positioned baby more easily. Did they show any concern or not?

Kathryn Remivasan:  They did not show any concern. I brought it up and I was like, “It sounds like it’s this ROP. I’m a little bit worried about positioning,” and this was the only gripe I had with the whole pregnancy. I brought it up and they were like, “No, babies move in labor, it’ll be fine. They’ll rotate. It should be okay,” and I was like, “Okay,” but something just kept clawing at me of, like, this position and the Spinning Babies nap. But I don’t think the birth class went into positioning as much or something just … Nothing had really triggered me to say, “Can we talk about this more?” I just took the information at face value with them and was like, “Okay, she’ll move in labor and it’ll be fine.”

So 40 weeks comes and goes, I opt to do the membrane sweep. OB had set my induction for 40 and one, but I was like, “I am not getting induced.” I just wanted as little intervention as possible, and mostly just kind of thinking post-birth recovery time, it’s only me and my husband in the city. My mother-in-law, his mom, wasn’t joining us until a week or so after the birth. So it’s COVID and also we’re alone, we don’t have family in Chicago with us, so just trying to think about the short-term labor versus a much longer term recovery. How do we get to that a little bit, potentially, hopefully, easier recovery?

And so did the membrane sweep, I went home and I had this theory that doing things that triggered oxytocin would help get labor started. So, went for a walk, we had some good food, we put on Pitch Perfect and we just sat and danced and sang along and tried to just do really happy things that night, and it worked. Went into labor that night, 2:00 AM. I woke up with the first set of waves and was like, “Is this it? Maybe. Let me just rest a little bit.” And then they just kind of kept coming and I was like, “Okay, I think they’re starting. I think we might actually be in labor.” I don’t think I ever had any Braxton-Hicks contractions. I had twinges, but really nothing that stopped me in my tracks, nothing that took my breath away. So when labor started, I was kind of like, “I think this is it.” I was just kind of feeling the pain radiate down my legs and so it seemed like this was actually starting.

So from there, I woke my husband up. We started timing them and right away, I was like, “This is weird, the contractions are already five minutes apart.” Again, from reading about birth stories, chatting with a few friends, it was like those start 15, 20 minutes apart. You’ll go finish packing the car. You’ll go for a walk. You’ll go make a frozen meal. And instead, at 2:00 AM, my contractions were five minutes apart and 30 to 45 seconds long and I was like, “Wait, hold on, these are way too close. What’s going on?” So from there, we were like, “Okay, let’s try to go back to sleep.” So I was able to sleep from 2:00 to 3:00 AM until about 6:00 or 7:00 AM. And I had put the TENS machine on, was able to go back to sleep with the TENS machine on. And so we woke up and we’re like, “Okay, these are still coming pretty close together.” They’re not long and they’re not overly take my breath away, excruciatingly painful, but they are coming five minutes apart. I don’t think they were ever longer than maybe eight minutes the whole time.

And so we texted Julie and she was like, “Okay, great. I’ll come over in a couple hours. Just keep laboring.” But I think she had given me some criteria of, like, let me know when they get to this point and I’ll come over, but it’s 7:00 AM, she was like, “Eat, keep trying to sleep, keep trying to relax.” And kept laboring at home a little bit. My husband had made me a lot of protein, carb rich … I think I was eating scoops of peanut butter and tofu scrambles and oats and just trying to kind of do a lot of the same marathon meal prepping and just trying to eat as much as I could before we would have to go to the hospital. Again, thinking okay, plus 24 hours, we might be having our baby this day. This is January 14th, it’s the morning, everything’s already five minutes apart.

Julie came over around 11:00 AM, I would say, so I’ve been in labor maybe around 10 hours or so, 11 hours, and she’s helping me do some of the moves, she’s doing acupressure, I’ve got in the tub for a little bit. She’s kind of taking over, so Dush can finish putting the car together, get our dog picked up and make sure the cats are all settled, et cetera, and make sure the house is kind of in a state of, like, we can leave and come back with a baby. So we are doing that for a couple hours and it got to be 1:00 or 2:00 PM and finally, I was like, “I’m having trouble talking through them. We’ve now been doing this for 12 hours. They’re getting to be closer.” They’re still not lengthening, but they are getting closer and the hospital’s just down the road. So I knew I really wanted to make it to 3-1-1 if I could, just because the hospital was so close and, again, going unmedicated, that would’ve been the best way of try-

Rebecca Dekker: So when you mean 3-1-1, you’re saying you wanted your contractions to be three minutes apart from the beginning of one to the beginning of the next, at least one minute long and this going on for an hour?

Kathryn Remivasan:  Yes.

Rebecca Dekker: Is that what you were aiming for? Okay.

Kathryn Remivasan:  Yeah. Yeah.

Rebecca Dekker: Because you live so close to the hospital and it’s your first baby, you thought that would be … Get you there closer to the end?

Kathryn Remivasan:  Yeah, correct. So yeah. And in talking with my OBs, they were like, “Yeah, if you want to go unmedicated, labor at home as long as possible. That’s kind of the best way of getting to that goal. First-time mom, it’s going to take a while. You live down the road from the hospital, there’s no traffic,” and I don’t have to go over a major highway or anything, so that’s a pretty safe bet. So we got to roughly 3-1-1, got in the car, got to the hospital. I walked in, because they still weren’t so excruciatingly painful and I’m very stubborn and they were like, “Hold on, do you want to just sit and we’ll get you a wheelchair?” and I was like, “No, no, no, I’m going to walk in. This’ll be good for it.”

So I’m walking myself into the hospital, we get to check-in, they give me a wheelchair. I have to go alone to go over from the hospital check-in to the actual labor and delivery unit. So had to do that alone, unfortunately. They’re trying to do the insurance, they’re trying to have me sign all these things and I’m like, “Can this wait? Do I really need to be signing all these forms? I’m by myself, literally in labor.” But I get through that, I get through the intake ultrasound, intake check, I was about five centimeters. Get my COVID test, that comes back negative and it takes about one to two hours. Apparently-

Rebecca Dekker: So they make you wait alone while you’re waiting-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: For the results of the COVID test? Were you in a-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Triage room or a labor and delivery room?

Kathryn Remivasan:  I was in a triage room. But yeah, for most of it, I was alone. Yeah. Thinking back, I’m glad I didn’t have a panic attack or get scared, but I was-

Rebecca Dekker: Yeah.

Kathryn Remivasan:  Alone for a good chunk of that.

Rebecca Dekker: I mean, if you had gone in eight or nine centimeters dilated, I wonder if they would’ve made you wait alone. It seems like that’s a bit of a flaw in their plan.

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Really? Can your partner not be with you while you’re waiting for your test results? That’s definitely something that is one of those irrational hospital policies from COVID times. That doesn’t even make sense.

Kathryn Remivasan:  Yeah. Definitely, looking back, it doesn’t make any sense. In the moment, you’re just kind of like-

Rebecca Dekker: You just do what you have to do. 

Kathryn Remivasan:  “This is how it is.”

Rebecca Dekker: And you were in labor, so-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Yeah.

Kathryn Remivasan:  Yeah, you do what you have to do. And we did a strict quarantine, starting at 36 weeks. We were like, “We’re not leaving any room for error.” Yeah. We did ask, on intake, what happens, the COVID test, protocols, et cetera, and they were like, “Yeah, yeah, you’ll go, you’ll be by yourself,” but I don’t think I really understood what being by myself meant.

Rebecca Dekker: That it could take a couple hours of-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Yeah.

Kathryn Remivasan:  I don’t think I understood. There was no way for me to know that oh, that could be two hours of-

Rebecca Dekker: So word to the wise, ask your birth setting if they’re going to test you, if you get to keep your support person with you while you’re waiting.

Kathryn Remivasan:  Or if a nurse is with you. It would’ve-

Rebecca Dekker: Yeah.

Kathryn Remivasan:  I was in a very tiny room by myself, laboring and-

Rebecca Dekker: In active labor.

Kathryn Remivasan:  In active labor and-

Rebecca Dekker: Was there just a stretcher in the …

Kathryn Remivasan:  Yeah. Well, it was still a bed because they did an intake ultrasound to estimate the wait, but after that, I was by myself until someone came and told me-

Rebecca Dekker: It’s funny that you said they did an ultrasound when you came in. I’ve heard that, in the Chicago area, that’s a tradition, a routine, that they kind of come in and present this, “You need to have this ultrasound.” It’s not required. You can refuse it, but they often don’t tell you you don’t have to have it. But were you in bed, then, the whole time you were in triage or did they have other upright props for you to kind of labor upright?

Kathryn Remivasan:  No, I was just in a bed. Yeah.

Rebecca Dekker: Yeah.

Kathryn Remivasan:  There was no props, it was just a bare bones … Yeah, they didn’t tell me I could refuse it, I didn’t even know that it was going to happen.

Rebecca Dekker: That’s something … The problem with triage, right? They stick you in there for a couple hours sometimes and they basically expect you to lay in bed, which isn’t necessarily good for the positioning of the baby, which we’ll get more into in a little bit. So what happened next, after you got your test results back?

Kathryn Remivasan:  So everything came back negative. I met up with Julie and Dushyant  in the labor and delivery room. So I was all set up in there, they came to join me. And that kind of kicked off the labor. It was maybe 4:00 or 5:00 PM and we just started doing the things that we had practiced, so the acupressure, we got in the shower, doing a lot of the hot water on the belly was super helpful, sitting on the ball, kind of leaning over on the bed, trying a bunch of different things.

And at one point, I had to go to the bathroom and felt like I had to poop and they were like, “Oh, no, that’s like pushing. It’s probably pushing,” and I was like, “No, I just really have to go to the bathroom. Can I just go to the bathroom?” They’re like, “No, no, no. Definitely, that’s pushing. We have to check you,” and I was like, “Okay, but I really … I think I just have to go to the bathroom.” I agreed to get checked and I found out that I hadn’t made any progress, and I think, at this point, it was later into the night, so maybe closer to 10:00 or 11:00 PM and going on almost 24 hours of being in labor, a good chunk of that awake-

Rebecca Dekker: So you got there that afternoon and by that night, you were still five centimeters and hadn’t changed?

Kathryn Remivasan:  Yeah. Yeah. So by the night, through the shift change and everything, I had gotten checked and was still only five centimeters and that was just really defeating because I was like … We were kind of expecting things to had already have progressed at this point, had made more progress and I was just kind of stuck. And for us, we had talked about what’s our cut-off point when we would ask for the … Or when I would ask for the epidural? And in my mind, it was like I can do anything for 24 hours and so 24 hours is going to be probably that cut-off point, depending on what it’s looking like.

Rebecca Dekker: Right.

Kathryn Remivasan:  If 24 hours comes and I’m in transition-

Rebecca Dekker: And you’re almost there … Yeah.

Kathryn Remivasan:  Of course. Great. But if it’s 24 hours and I’ve been stuck at five centimeters all day, then it became a conversation of okay, I will need to get the epidural. I’m tired, I really need to sleep a little bit. We have a long birth ahead of us. And some of my friends who also had long labors, they went 24 plus hours, they got the epidural, they slept, they woke up, they pushed and the baby was out, and I was like, “Great, that’ll happen to me.” Again, very naively optimistic. Okay, no. I did the 24 hours, we’ll get the epidural, we’ll sleep and then we’ll be ready-

Rebecca Dekker: You’ll wake up and have a baby.

Kathryn Remivasan:  Yeah, wake up and have a baby. It’s going to be great. So we slept a little bit-

Rebecca Dekker: Which does happen sometimes. Sometimes it’s all people need, right? They need to-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: And get a break and while they’re sleeping, they dilate and they wake up and they’re ready to push. But that didn’t happen to you.

Kathryn Remivasan:  That did not happen to me.

Rebecca Dekker: So what time did you get the epidural, then?

Kathryn Remivasan:  I ended up getting the epidural around midnight or 2:00 AM maybe. Definitely in the dead of night, got the epidural, was resting a little bit and then it stopped working. So at one point, I was like, “I can feel things in one of my legs,” and they were like, “Okay, let’s rotate you to one side,” and they were doing this ice test on my leg of, like, “Can you feel this? Can you feel this? Can you feel this?” And so they’re like, “Okay, that’s weird. We have to just adjust the needle,” so, like, okay, that’s fine, adjust the needle, and it went back to working.

And then I started getting this excruciating back pain, but it was more upper and closer to my ribs kind of pain and they were like, “Well, it’s not back labor because it’s not low, so we’re not really sure what’s happening.” They tried a lidocaine patch. That did nothing. And so they were like, “Okay, maybe we need to reset the epidural.” And I think, at this point, maybe the epidural had failed again because the conversation became we have to take the epidural out and reset it. Originally, it was the physician, but now the next level up, so maybe the attending had to come take everything all the way out and reset the whole epidural.

Rebecca Dekker: Okay. So a resident had put in the first one …

Kathryn Remivasan:  Yes.

Rebecca Dekker: And then they kind of adjusted it when it wasn’t working and now they took the whole thing out and an attending physician, who’s one of the physicians in charge, came back to put it in?

Kathryn Remivasan:  Yes.

Rebecca Dekker: Okay.

Kathryn Remivasan:  Yeah, to redo the whole thing. So yeah. Because the hours are a little bit hazy, but roughly, they tried to move it and then they took it all the way out and reset it. I mean, thankfully, this whole time, the nurses were absolutely wonderful. Some people get online and some groups will get a little bit like, “You don’t need a birth plan. Happy mom, happy baby,” but I think calling them a birth plan is the wrong thing. I’m not planning how this delivery is going to go, I’m trying to prepare. So we had written out a birth preferences, preparation wish list. Given certain parameters, this is what we’re going for. If things change, this is what we’re okay for. If this changes and we need to do something else, this is what we’re okay with.

And I think because we had written that and had written from the beginning in big letters at the top, “We’re attempting unmedicated, but ultimately we’re just trying to limit interventions and so as things change, we just want to have conversations.” And I’m really happy that we did that because I’m convinced that we were paired with all of the nurses who attend a ton of unmedicated births. One of our nurses was absolutely wonderful. She was a midwife before coming to this hospital, she’s trying to get midwives hired at Rush. She’s on a committee to investigate C-sections and how to reduce them at the hospital, she’s certified in Spinning Babies, so she was-

Rebecca Dekker: So they don’t have any midwives at the Rush University hospital?

Kathryn Remivasan:  They don’t, but I believe they are hiring them now. So they are now adding them, but at the time when I was going through the practice, there weren’t any midwives, unfortunately.

Rebecca Dekker: Okay.

Kathryn Remivasan:  But now, I think they do have them.

Rebecca Dekker: So they’d say things like, “We support unmedicated birth,” but yet they didn’t have any midwives on staff, but they had some in their nursing staff, so-

Kathryn Remivasan:  Mm-hmm (affirmative).

Rebecca Dekker: And I think what you said about getting paired with nurses who are skilled at unmedicated birth is really important, even for people who have epidurals, because number one, the epidurals don’t always work, and number two, sometimes those skills that they have for labor support can still be useful with an epidural and then helping prevent a caesarian. So it sounds like you had a really good match with the nurses that they assigned to you.

Kathryn Remivasan:  Yes. They were wonderful. When I was having the back pain and we weren’t progressing, the nurse who had gone through the Spinning Babies certification came in and was like, “We’re going to try a few different positions. We’re going to … Leg on the peanut ball and turn this way and we’re going to try and see if any of these positions will help get her turned into a better position and kind of descend a little bit better and help you progress,” so that was super wonderful. We just had such a wonderful experience with all the nurses there. We felt really supported. We never felt like there was a time, a clock hanging over our heads, and that also was really important to find care and nurses and providers who would not put us on a time clock, who would say-

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  Because at least, for me, that definitely would’ve caused me to tense up even more.

Rebecca Dekker: That would’ve stressed you out. Mm-hmm (affirmative).

Kathryn Remivasan:  Yeah, it really would’ve stressed me out if I was against the clock. Instead, I could just say I’m here for as long as I need to be here for and relax.

Rebecca Dekker: Okay. So they came in to do the epidural. What happened next?

Kathryn Remivasan:  Yeah. So they reset the epidural, we’re resting a little bit and by morning … And, again, the back pain had gone away for a little bit, but it had come back and eventually they needed to give me … I think it ended up being fentanyl that they needed for my back pain because it was so excruciating and it was too high for the epidural, but it was stopping me from being able to labor.

Rebecca Dekker: Mm-hmm (affirmative). So they gave you an injection of opioids for the pain?

Kathryn Remivasan:  Mm-hmm (affirmative). Yeah. And so, then, by morning, I was like, “Okay, let’s …” My water still hadn’t broken, so that was nice. Her heart rate had never dipped. She was just chilling in there, having a good time, so there was no concern for her. But in the morning, I had gotten checked again and we realized I still had not progressed at that point.

Rebecca Dekker: So you were still five centimeters after all that?

Kathryn Remivasan:  Yeah. I think maybe had gotten to six, but it was something where … I was already really upset about having to take the epidural and now I’m going off little sleep and there’s no food. They were giving me sugar, because they had popsicles and they had soup, but other than that-

Rebecca Dekker: They had you restricted to clear liquids probably.

Kathryn Remivasan:  They had said there’s no restriction on food, but they didn’t provide any food.

Rebecca Dekker: Oh, okay.

Kathryn Remivasan:  So we had brought in food and I was eating it when the nurses were out, just-

Rebecca Dekker: Okay.

Kathryn Remivasan:  To limit the conversation. So I was trying to eat, but it’s already really hard to eat in labor and then the food that they had was popsicles and ICEEs and something else, but it was definitely liquids, sugar, water. So, now, it’s the next morning, I’m tired, I haven’t eaten in a long time and still hadn’t made very much progress. And so, then, we had the talk with the OB of okay, what are our next steps, because nothing’s really moving along? So, thankfully, we had chatted and I think the first step was to break my water. And so we were chatting with Julie about it, Dushyant  and I were chatting and we were like, “Okay, yeah. We’ll need to have this done,” because it still hadn’t broken and it’s probably providing some sort of barrier and we’re not progressing. So I agreed to have my waters broken and we just kind of sat with that for a little while.

And after a few hours, I think we maybe had … Maybe I had dilated another centimeter, but it really … It basically was another check of there was no progress whatsoever and all of us are kind of scratching our heads because the epidural has failed a couple times, I’m not progressing. So now we’ve got the anesthesiologist, the OB-GYN, everyone’s like, “What’s going on?” The nurses are like, “You’re still here? What’s going on, hun?” And so we’re like, what do we try next? What’s the next thing to try? And, again, thankfully, we had a really wonderful team, they knew that we were trying to avoid a C-section unless absolutely required and so they said, “We can try to manually turn her. Let’s get an ultrasound. Let’s see what her position is and we’ll manually turn her if needed.” 

So that was the next step, was … The room was filled with teaching, the students and the anesthesiologist and the OB-GYN and all of a sudden, we have this whole party in the room. And there’s two OBs, one was on the ultrasound, trying to find her and confirm that she was sunny side up and just basically stuck, she wasn’t going anywhere and so they tried to manually turn her. So they’re watching on the screen and they’re trying to turn her and-

Rebecca Dekker: The sunny side up, for those of you who are listening, is another way of saying the baby’s posterior, meaning the baby’s spine, was back up against your spine and the largest diameter of their head is coming through the pelvis. So, they can’t get really low in the pelvis to kind of pass through and put pressure on the cervix like they normally should. And then manually means they insert their hand up the cervix and use their hand to manually turn the baby into a better position. So that’s what was going on with you.

Kathryn Remivasan:  Yes. Yeah. And at this point, we reflected later, because we had been undecided on a middle name if she was a girl, and this is kind of the deciding moment of they’re watching her on the screen, they’re trying to manually turn her and they’ll turn her a little bit and then we see on the screen, she’s just shaking her head and puts herself back into the position. And so we’re like, “This child does not want to be told what to do. She really wants to be-“

Rebecca Dekker: Stay where she’s comfortable.

Kathryn Remivasan:  Yeah, she’s very comfortable. She wants to be in the position that she said. I think, eventually, they did get her to about 50 percent and they were like, “Okay, we’re not able to move her any further. We’ll do a few more Spinning Babies positions,” but ultimately they couldn’t get her completely turned. They did get her turned 50 percent and that helped progress a little bit. We eventually had to have the conversation about pitocin and get the monitor of … First, I think we had the conversation of the monitor, where they check for the strength of the contractions, because, again, I wasn’t dilating and we weren’t sure what was going on. So they inserted-

Rebecca Dekker: An internal monitor?

Kathryn Remivasan:  The internal monitor to check the strength of the contractions and we found out that, I guess, because of her positioning, the strength was just never going to be enough to make any progress. And so because of that, we had to get started on pitocin. And, again, I was very forthcoming with them of, like, whatever the minimum number is, whatever the little … I think he was trying to …

Rebecca Dekker: Yeah, we’ve got Dushyant –

Kathryn Remivasan:  In the background-

Rebecca Dekker: He’s Zoom-bombing us.

Kathryn Remivasan:  We started with pitocin. I was like, “Minimal level. What is the lowest level that you can give me?” And I had to get started on the water, the IV fluids. They started the pitocin, very low level. I think it was a sixth … I think maybe it goes up to 18 or something. This is the fuzzy recollection, but they kept it at a pretty low level. The contractions were getting to the level that was making progress. So after all of those interventions, thankfully, a couple hours later, I finally was at nine and a half and this was, like, 5:00 PM. So I’ve been in the hospital for 24 hours, I’ve gone through multiple shift changes, multiple epidurals, multiple interventions-

Rebecca Dekker: You’ve been in labor for about 36 hours at this point.

Kathryn Remivasan:  Yeah, been in labor for about 36 hours and at this point, it’s about 4:00 or 5:00 PM and they’re like, “You’re nine and a half, you’re 100 percent effaced, we can stretch you the rest of the way,” and I was like, “Yes, let’s go. Get in there. I’m going to push. It’s going to be great.” And so they finish it, we get the all clear to start pushing. And from there, we do a few practice pushes. I’m on my back because of the epidural and I’m like, “This is horrible. I cannot push in this position.” I was like, “Can I get into a squatting position? Can I try that?” and they’re like, “Well, can you? You have an epidural.” And so I tried and I was like, “Yeah, I can feel my leg. I can stand. This is fine.” So even with the epidural, I was in a squatting position, on the bar. Tried that for a few pushes and that didn’t work. It didn’t work in the sense that it wasn’t comfortable for me. I just didn’t really feel like I could get a really good handle on it.

Unfortunately, during all of this, the back pain comes back and is so excruciating that I have to stop because it’s so much more excruciating than anything else. And so, then, we have to stop for an hour for them to redo the opioid to give me a little bit more so that way I could actually push, because at this point, I couldn’t push because the pain was so excruciating. And in talking with the nurses and the OB later, they think that because of her positioning, because, I guess, she was pushing on something in my back and that that’s what was triggering the back pain. Skull must’ve been pushing on something on my spine or maybe she kept pushing the epidural out of the way.

Rebecca Dekker: Maybe it was creating some kind of nerve pain-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Shooting up your back. Okay.

Kathryn Remivasan:  Yeah. Yeah. She was pressing on something and it was creating nerve pain. So got the fentanyl again, was able to push again, but at this point, I was like, “I need to try something new.” So I get on hands and knees. And so, again, I’m really thankful for Julie, Dush being there, the nurses, because I’m in an epidural. I wanted to avoid an epidural and all the interventions because I had something on every single part of me. I had the monitor for the heart rate, monitor for the contractions, I had the fentanyl, the epidural, blood pressure cuff, the fluids and then they put compression on both … They had put compression-

Rebecca Dekker: Compression stockings on your legs?

Kathryn Remivasan:  Yeah. They put a … Not stockings, but they were the air where it presses-

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  And releases.

Rebecca Dekker: Yeah. Yeah.

Kathryn Remivasan:  So-

Rebecca Dekker: Sorry, that’s what I meant. Yeah. Uh-huh.

Kathryn Remivasan:  Yeah. Yeah. So I had those on both legs to help with blood circulation. So, literally, I’m in this bed, every single part of me-

Rebecca Dekker: Every limb was tethered to something.

Kathryn Remivasan:  Was tethered to something and I was like, “This is not what I wanted.”

Rebecca Dekker: And you’re like, “You want to flip me over” so it’s like …

Kathryn Remivasan:  Yeah, exactly.

Rebecca Dekker: …people to flip you over, huh?

Kathryn Remivasan:  Yeah. So I was like, “I’m getting on my hands and knees. This is just really how I think I need to push. Everyone needs to hold the wires and help me to flip over.” So we get that thrill, I’m on my hands and knees, pushing and that was wonderful. It was so productive for me to be pushing in that position. Julie was doing warm compresses to limit any tearing and, I mean, the positive part of pushing for five hours, it goes so slow, you don’t care. So that was the one added benefit of pushing basically pretty slowly. But yeah, I’m pushing on hands and knees, I’m getting very tired, I’m starting to kind of pass out from the exhaustion, but we’re just going, we’re going.

At some point, at the four hour mark, an OB comes in and was like, “How long has she been pushing for?” And from taking your class, I was like, “Nobody tell her! Nobody tell her. Nobody tell her what happen.” And I was like, “Well, you got to discount … I stopped for an hour because of the back pain and I’m taking breaks and blah, blah. It’s three, two, it’s not four or five hours.” So I’m trying to give them the discounted … And she leaves, she’s like, “Okay. Okay.” She leaves, and both Dushyant  and myself and Julie look at the nurse and are like, “Don’t let anyone in until I’m literally getting ready to deliver. I can do this.” So that was kind of the push I needed because 30 minutes into that, the nurse is like, “Okay, so her head is finally out of position that unfortunately you do have to get back to your back, but she’s in a position that … We are about to deliver this baby. You made it. You got it there. You got over the hump. She’s coming.”

So flip back over, they call everyone in. Unfortunately, when they broke my water, they did see that it was stained with meconium, so the NICU team was ready. I had been so exhausted that I had asked for the vacuum to be ready just in case I needed it. Don’t think the class touches … I tried to go through the book after the fact to see if vacuums were touched. I don’t know. I don’t think-

Rebecca Dekker: I think it’s something we added in early 2021, so it might not have been in the class last fall, when you took it. But we added it to the caesarian videos, we had an OB-

Kathryn Remivasan:  Okay.

Rebecca Dekker: Who explains it. So yeah, it might not have been there when you took the class.

Kathryn Remivasan:  Yeah. So that was the only thing I was going to bring up to you was add it, because I went afterwards, after we got home and I looked at the docs and was like, “Oh, no, this wasn’t in any of our docs.” So I knew about it, but I didn’t really-

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  Kind of understand the-

Rebecca Dekker: And it is pretty rare. I think it’s less than one percent of US births.

Kathryn Remivasan:  Uses it?

Rebecca Dekker: Yeah. It’s pretty rare. Mm-hmm (affirmative).

Kathryn Remivasan:  Okay. Yeah. So I had known about it and so I was like, “I’m exhausted. Please have it get ready to go.” But I had gotten to my back, we were at the home stretch, I was passing out from just being so tired. And I had two OBs, the whole NICU, pediatricians, they were all in the back corner, the room was filled with people. And finally, I got her most of the way out, they used the vacuum, they pulled her out. I think her shoulder got stuck a little bit, but they got her out.

Unfortunately, because of the long labor, because of the trauma, she was taken … I think her Apgar scores didn’t do super well right at the beginning, so they whisked her, they called for Dad and they left, so I actually didn’t get to meet her until about three hours after the birth. And I have no recollection of seeing her come out or what she looks like or anything because everything happened so fast. I lost a good amount of blood. They started asking me about things that definitely didn’t matter, like birth control and they asked about the placenta and blah, blah, blah and I was like, “Where’s my child?” Just-

Rebecca Dekker: They were asking you about birth control?

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Right after you pushed out your baby, they’re like-

Kathryn Remivasan:  Yes. Yeah. They were like, “Have you thought about it?” and I was like, “Get away from me. What are you talking about?”

Rebecca Dekker: Oh, my goodness.

Kathryn Remivasan:  I was like, “That’s not an important-“

Rebecca Dekker: That’s-

Kathryn Remivasan:  “Conversation to be-“

Rebecca Dekker: That was-

Kathryn Remivasan:  “Having right now.”

Rebecca Dekker: That must’ve been a student who’s like, “This is on my checklist. I need to ask you about this,” right?

Kathryn Remivasan:  I think so. I think it was a student going through their checklist.

Rebecca Dekker: It sounds like something that somebody with not a lot of experience would do or say.

Kathryn Remivasan:  Yeah. And I am so incredibly thankful that we got a doula. It is beyond worth it to have, because now Ila’s gone, my husband is gone, they’re at the NICU getting her all checked out.

Rebecca Dekker: So your husband went with the baby to the NICU and Julie, your doula, stayed with you?

Kathryn Remivasan:  Yeah. So I’m by myself, and it took three hours to get wrapped up, recovered, unhooked from everything. I’m still on the IV fluids. They had to switch it to a mobile stand. They brought a pump right away, so I’m sitting there. The nurse, bless her heart, I had been talking about food and she’s like, “Literally, until you deliver, I can’t …” But I was like, “We have peanut butter and jelly sandwiches, but until you deliver, I can’t give it to you.” After the birth, she’s sneaking me a peanut butter sandwich.

But now it’s me, it’s Julie, I need to pump to get the colostrum out. I have no hands left. Julie has one flange in one hand, I’ve got the other one. I’m eating the peanut butter sandwich. A nurse, I think, came and explained what happens, but, again, I’m an hour post-birth, everything’s really hazy, I haven’t slept, I’ve barely eaten. She’s running me through all this list of what’s going on with her, with Ila, at the NICU and I’ve no idea what she said. It wasn’t written down, it wasn’t … Nothing. I have no idea what she told me, other than baby’s in the NICU, someone help me get there. And so-

Rebecca Dekker: So you were trying to rush to recover so that you could get up to the NICU so that you could meet your baby?

Kathryn Remivasan:  Yeah. Not rush per se, but there was just a lot of confusion afterwards-

Rebecca Dekker: Okay.

Kathryn Remivasan:  Because the OBs wrap everything up and they’re like, “Okay.”

Rebecca Dekker: And they kind of leave you-

Kathryn Remivasan:  You’re like-

Rebecca Dekker: In the room.

Kathryn Remivasan:  They leave. And someone transfers you to the mother and baby unit, and at this point, I’m like, “Where is my child? What’s the expectation of getting her back? What’s going on? How long is she going to be in the NICU? What’s happening?” My husband’s with her. Thank God, I have Julie. She’s with me. I’m getting everything wrapped up and prepped and gow … Had to change the gown and do all the dressings and-

Rebecca Dekker: Go to the bathroom and-

Kathryn Remivasan:  Get all the bags together. Yeah, attempt to go to the bathroom. So I delivered her at 11:00 PM on the 15th. So went into labor the morning of the 14th and I delivered her at the end of the day, the very end of the day on the 15th. And so, then, at 1:00 AM, finally, I was all wrapped up, I was in the wheelchair, I had the mobile units of everything and finally we’re able to go to the NICU. She was on the CPAP, she was just getting some routine monitoring. But she ended up being in the NICU for three days. She never joined us in the mother/baby unit.

Because of the vacuum, they were monitoring the bleeding and she had to get a CT scan on her head, they were monitoring the blood sugar, which they hold steady. She was on half formula, half colostrum from whatever I could get to her. And she was on the CPAP, but thankfully she came off that pretty quickly. I think within three hours. But yeah, finally got to see her, got to hold her. Our first photos together are me in a wheelchair and her just with the CPAP and the head wraps and all the wires. And she’s very bloated from birth. They estimated seven pounds, eight ounces from the ultrasound, which, obviously, is not super reliable, but I was seven, eight. I was expecting probably roughly what I was and she came out at nine pounds, but she was so bloated. It was just very clear.

Rebecca Dekker: She was full of fluid.

Kathryn Remivasan:  She was full of fluid. I’m sure that didn’t help with the birth either, because I had been on fluids for so long. That was it. We hung out in the hospital for two days. COVID made it so much worse because only one parent could go at a time. I had to keep asking for transport because my husband couldn’t push me in a wheelchair over and us go to the NICU together, only one parent was allowed at a time, so I had to keep calling for hospital transport and that is its own thing. I was still hooked up to IVs for 12 or 24 hours afterwards. Because of the pitocin, you have to wean off of everything, so I was still hooked up for quite a bit after that. I’m extremely thankful for your class and extremely thankful for having some sort of birth preferences plan because it could’ve been so much more traumatic, especially with her being in the NICU, and instead it was only slightly traumatic, that I never-

Rebecca Dekker: Because you were familiar with all the interventions and how to speak-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Yourself and how to ask for things and …

Kathryn Remivasan:  Yeah. It’s being part of the decision-making process.

Rebecca Dekker: Right.

Kathryn Remivasan:  So nothing happened to us that happened really without our consent. We knew the pros and cons, we knew what the risks were and what the positives were, we knew what we were getting with each … What we were hoping to get with each stage. And so each one was a conversation and a decision and that-

Rebecca Dekker: So you never felt like you lost control, even with all of … Needing … Like you said, I think, in your email to us, you had basically every intervention you could’ve-

Kathryn Remivasan:  Yeah.

Rebecca Dekker: Without a caesarian. But you felt like you were in control every step of the way.

Kathryn Remivasan:  Yeah, absolutely.

Rebecca Dekker: With the exception of maybe during triage, when they left-

Kathryn Remivasan:  Yeah. Except triage and except when they took her to the NICU, which was absolutely needed, but it’s still upsetting to not have her with us in the hospital.

Rebecca Dekker: Yeah.

Kathryn Remivasan:  It’s still really hard for me to look at friends on Instagram who had babies after me and they have all the beautiful photos within the hospital and the announcements, and it’s all really-

Rebecca Dekker: You didn’t have that bonding time together as a family for those first three days.

Kathryn Remivasan:  Yeah. Yeah. Those first three days-

Rebecca Dekker: Separate visits.

Kathryn Remivasan:  Were just us. It’s-

Rebecca Dekker: Yeah.

Kathryn Remivasan:  Yeah, we had to have the separate visits. We didn’t get to FaceTime anybody from … We brought the iPad and we brought the outfit and we brought all these things and everything just sat in the bag and never came out and-

Rebecca Dekker: Mm.

Kathryn Remivasan:  They left baby bassinet in the room as well and-

Rebecca Dekker: With you and there’s an empty baby-

Kathryn Remivasan:  Yeah. So the whole time I’m in the hospital, there’s just empty baby bassinets that’s sitting between me and my husband and just like a reminder that she’s not with us. And we ended up having to check out, go home and come back the next day. I don’t know how people do it, who have babies in the NICU for a long time, because we only had to leave for 12 hours. So did checkout, get one last night of sleep and come back and we got her in the morning and that was brutal. We were just so upset the whole time. And I don’t know how people do it when babies are in the NICU for a lot longer than ours was.

Rebecca Dekker: So, finally, your baby came home about four days after the birth. And then how did your postpartum recovery go? And what was it like having baby with you all the time after being separated in the hospital?

Kathryn Remivasan:  Yeah. So postpartum, healing-wise, thankfully, that was super easy. Definitely given a lot of what you can handle, I think it would’ve been a lot worse if I had a really rough postpartum recovery and had to deal with the trauma of I was not with her for the first three to four days and now she’s home. I already have a panic disorder and I knew, going in, I was trying to limit interventions and epidurals because I was worried that they would trigger panic attacks.

And my panic disorder’s really under control, but the anxiety that you feel postpartum was unlike I could’ve ever imagined. And it was to be expected. I knew that there would be crying, I knew that there would be a lot of emotions, but the anxiety really takes hold of … Because you’re both a new parent and so there’s no manual and so you have a ton of questions, just millions and millions of questions and there’s no real answer, everything is it depends. I would have questions and I would read things and it would be like, “Well, could be the best or could be the worst. We don’t know.”

Rebecca Dekker: Mm.

Kathryn Remivasan:  And so coming home postpartum, there’s a lot of already anxiety of am I going to know what to do? Is this decision that I’m making right? And then there was the added bonus of she was taken and I never got to see her from right after birth, and that just keeps replaying in your head. And so, then, you get home and you put her down to sleep or someone else … Once my mother-in-law finally joined us … It’s COVID, no-one else is seeing us, except for my mother-in-law. But even just letting someone else hold her, I just couldn’t.

It was just so upsetting to be away from her, even when I needed to get out of the house. I hadn’t been out of the house in a couple days. Even showering. It was a lot of anxiety around just leaving her side and kind of getting over that. And thankfully, my husband is just so wonderful and it was a lot of talking, psyching myself up, regaining confidence, getting confidence, like, “You can leave the house. Just do a quick walk.” He was just really wonderful about breaking it into bite-sized pieces, like, “You don’t have to go out for a five mile walk, just go outside to the front gate and come back. Just step outside. Okay, now you did that, go to the corner, come back,” right? It’s a lot of breaking it down into bite-sized pieces.

And it’s still something I’m struggling with today. I’ve never been shy with the caregivers and the people that I love in my life about my anxiety and panic troubles. So my hospital does a two week postpartum mental health check, that was really wonderful, and I told them right away, “My anxiety’s really bad. Do you have someone I can talk to?” But the issue I kept running into is the waitlist to get into the places that they were referring me to were months long. And also, the onus was on me to get help and to be able to leave the house. I had to go home with the referral and call the clinic and say, “Can I get an appointment?” and then they would say, “Yeah, in four months.” I don’t have-

Rebecca Dekker: “I just had a baby.”

Kathryn Remivasan:  I was like-

Rebecca Dekker: … anxiety.

Kathryn Remivasan:  Yeah. Postpartum anxiety. I don’t have four months, so I was like, “I need someone now.” And ultimately, it’s become that I haven’t gotten help for it. And thankfully, I’ve gotten a lot better and everything is manageable and the load of anxiety are much farther apart, but it’s gotten to the point where I haven’t been able to talk to anybody because every time I would, the bar to entry was too high.

Rebecca Dekker: Oh, wow.

Kathryn Remivasan:  That’s definitely been one of the harder or more challenging parts of postpartum, but … Yeah. But other than that, she’s wonderful. Ila is just a wonderful baby. She’s independent, but she’s cuddly and she’s very smiley and she sleeps really well, all things considered. She was born with torticollis, so that was something that we were … She was in PT right from birth. She couldn’t latch because of the torticollis, so I’ve been basically exclusive pumping her entire life, which comes with its whole-

Rebecca Dekker: A whole set of-

Kathryn Remivasan:  A whole other-

Rebecca Dekker: Difficulties. Yeah.

Kathryn Remivasan:  Yeah, a whole other set of difficulties and specialists and people to talk to and things to do. And just getting that whole breastfeeding journey … A lot of the postpartum period has been coming to terms with I thought it was going to go this one way and then nothing has been as I expected. Thank goodness I mostly planned … Whatever the saying is of expect the best, prepare for the worst. And so I had set us up of okay, I’m going to breastfeed and everything’s going to go great, but also I was like, but, realistically, things happen, so I … My pump was there. I mean, we didn’t have bottles, but we had a bottle-ish type thing, so at least we could give her food before we could Amazon Prime the proper latest bottles that she could use. And we only had one set of flanges, whatever came with-

Rebecca Dekker: The pump.

Kathryn Remivasan:  The pump, but I had no idea that there was sizing and you have to try a few different things. So we’re frantic, trying to get set up on this pumping journey. We had formula as a reserve just in case we needed it, but, thankfully, my husband was home for two weeks, my mother-in-law was with us for a month, so I had at least enough help that we were able to get set up on the pumping and go that way. But yeah, so much of postpartum was just coming to terms with this is our story, this is how it is.

Rebecca Dekker: Yeah. And COVID didn’t make anything easier, right? Because that-

Kathryn Remivasan:  No.

Rebecca Dekker: Probably had something to do with either the wait for mental health services and difficulties in getting lactation support and other kinds of issues.

Kathryn Remivasan:  Yeah, absolutely. Everything’s a lot harder in the support aspect. And everyone was set up to help the baby, everyone cares about the baby and making sure that they were healthy, but I found that if the parents want help and want support, the onus was really on them to go and, one, have the education, but also the means of finding support. And that’s really hard, especially when you live in a city and you don’t have family help.

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  You have to rely on all these different avenues. I mean, eating one meal was an accomplishment in and of itself.

Rebecca Dekker: Right.

Kathryn Remivasan:  We were eating a lot of protein shakes and prepared meals and whatnot just because we don’t have that port of … Thank goodness my mother-in-law was able to stay with us for a month, and she was doing all of the cooking, just absolutely feeding us so we could focus on some of the other aspects that we needed, in terms of the PT for our daughter, the health appointments. She ended up having a soy allergy, so we’ve been going to GI and I’ve had to pump for most of this time, so getting all of those lactation feeding specialists, all those that … Thankfully, we had a little bit of support there, so we could kind of focus on these other things. But-

Rebecca Dekker: Yeah.

Kathryn Remivasan:  The parental support is really lacking, unfortunately.

Rebecca Dekker: Yeah. I think, in the United States, that’s a really big problem in terms of almost neglect people after they have babies. And I would encourage our listeners, if you want to learn more, in Episode 169 of the podcast, we talk with Ali Quiñones, who’s one of our employees at EBB, about the importance of postpartum doula care and she shares her own journey in terms of how hard it was for her to get postpartum support and why we need more help with that. And there was another parent interview we recently did, where we talked about the importance of postpartum justice and the inequities of postpartum care, and we’ll link to that in the show notes as well.

Also, I wanted to point out a few … For those of you who are thinking about what if I have a sunny side up baby or a posterior baby, we have a couple of episodes that might be helpful for listeners. One of our most popular episodes was Episode 165 of the EBB podcast, where we talk about positioning of the baby with EBB instructor and labor and delivery nurse, Ann Marie Gilligan. Super helpful. All about posterior-positioned babies. What are the warning signs? How do you know if your baby’s posterior-positioned? What can you do if that happens? What are some ways to prevent it? So I encourage you to listen to that. And I know, Kathryn, you were talking about Spinning Babies. We interviewed the founder of Spinning Babies in Episode 101, so you can listen to an interview with Gail Tully, all about the Spinning Babies philosophy.

So thank you so much, Kathryn, for sharing your story. I know things didn’t go exactly the way you planned, but it sounds like you and Dushyant really worked hard as a team to get through this experience. And it’s been fun, as I’ve interviewed you, in the background of the video, which you can watch on YouTube, Dushyant sometimes did some dancing in the background and is obviously a very attentive, loving dad to your baby, so it’s really sweet to see the two of you working together to raise your child.

Kathryn Remivasan:  Thank you. Yeah. I’ll leave it with obviously the maternity leave for this country is abysmal and shameful, but we’ve been extremely lucky that so many of the hardships and stressors and whatnot, postpartum, that we faced were not made worse by the fact that we had to immediately go back to work. I had about four months off and now Dushyant is off for three months. And just the fact that we are able to take the leave has made everything so much more manageable. And we need to do something, one, to actually get women the leave that they need, but also the dads. Not being the default parent is only because he’s not on leave and he’s the default parent. And so now we both know how to be an equal-

Rebecca Dekker: A parent.

Kathryn Remivasan:  Caregiver-

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  Yeah. A parent to our child. And it’s frustrating that our jobs are what gave us this luxury and it’s upsetting to us and something that we advocate for whenever we can of … Moms, obviously, I wish we had better leave, but separate from that, dads, if you have leave, take your leave. Do it. He’s loving it, he’s having so much fun, he’s bonding, but he is learning how to run the schedule, run her day.

Rebecca Dekker: Mm-hmm (affirmative).

Kathryn Remivasan:  Look for the cues. And so now we just … We’re equal parents. Our relationship is better, our relationship with Ila is better. They say you can’t fill up someone else’s glass from an empty … I’m so bad-

Rebecca Dekker: From an empty cup.

Kathryn Remivasan:  Yeah, from an empty cup. And being equal parents means that each of us have a chance to refill our own cup and come back and be a better parent when we’re back to being on. And so I know that really helps my anxiety, it’s definitely helped our family. And I really hope we, as a country, in the United States, can get to a point where we have parental leave and parents are able to take some level of equal leave so that we can really be a better family-centered country.

Rebecca Dekker: Yeah. Exactly. Thank you for ending on that note, Kathryn, and thank you for coming on to share your story. We really appreciate it.

Kathryn Remivasan:  Absolutely. Thank you so much for having me.

Rebecca Dekker: This podcast episode was brought to you by the Evidence Based Birth® Childbirth Class. This is Rebecca speaking. When I walked into the hospital to have my first baby, I had no idea what I was getting myself into. Since then, I’ve met countless parents who felt that they too were unprepared for the birth process and navigating the healthcare system. The next time I had a baby, I learned that in order to have the most empowering birth possible, I needed to learn the evidence on childbirth practices.

We are now offering the Evidence Based Birth® Childbirth Class totally online. In your class, you will work with an instructor who will skillfully mentor you and your partner in evidence-based care, comfort measures, and advocacy so that you can both embrace your birth and parenting experiences with courage and confidence. Get empowered with an interactive, online childbirth class you and your partner will love. Visit evidencebasedbirth.com/childbirthclass to find your class now.

 

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

Stay empowered, read more :

The State of Maternity Care in the U.S. – Updated

The State of Maternity Care in the U.S. – Updated

Welcome! Over at ImprovingBirth.org’s blog, I discussed how I wrote this 2012 Labor Day post about the State of Evidence-based maternity care in the U.S. I also posted an updated table about the state of maternity care. I was actually sick on Labor Day. I was lying in...

A Doula Facilitates Skin-to-Skin in the Operating Room

A Doula Facilitates Skin-to-Skin in the Operating Room

August 21, 2012 by Rebecca Dekker, PhD, RN, APRN © Copyright Evidence Based Birth®. Please see disclaimer and terms of use. Today's interview is with Sharon Muza, a certified doula, lamaze certified childbirth educator, and birth doula trainer. This interview is a...

Pin It on Pinterest

Share This