EBB 236 – An Unexpected Cesarean after an Unmedicated First Birth with EBB Parent Katie Kane

• Webster Technique: https://icpa4kids.com/training/webster-certification/webster-technique/ 
• Spinning Babies: https://www.spinningbabies.com

• EBB 111 – Positioning Breech Babies with Dr. Elliot Berlin

• EBB 127 – An unmedicated hospital birth with Katie Kane

• EBB 171 – The Experience of a Unique Vaginal Breech Birth with Janae and Andrew Rick

• EBB 172 – Breech Vaginal Birth with Dr. Rixa Freeze and Dr. David Hayes
• EBB 173 – Evidence on External Cephalic Version for Breeched Positioned Babies
• Watch Katie’s interview with Rebecca on YouTube here

Rebecca Dekker:

Hi, everyone. On today’s podcast, we’re going to talk with a returning EBB childbirth class graduate, Katie Kane, about an unexpected cesarean after an unmedicated first birth. Welcome to the Evidence Based Birth Podcast. My name is Rebecca Dekker and I’m a nurse with my PhD. I’m 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. My name is Rebecca Dekker, pronouns she/her, and I’ll be your host for today’s episode. Today we are so excited to welcome a returning EBB childbirth class parent, Katie Kane. Before we get started with the interview, I want to let you know that we will mention having an unplanned cesarean perinatal anxiety, and postpartum anxiety, postpartum rage, and thoughts or fears of death. If there are any other detailed content or trigger warnings, we’ll post them in the description or show notes that go along with this episode. And now I’d like to introduce our honored guest, Katie Kane, pronouns, she/her, lives in New Jersey, right outside of Philadelphia with her husband, two daughters, and a dog named Roscoe. Katie took the EEB child birth class with instructor Cat LaPlante in spring of 2019 to prepare for her first daughter’s birth. She shared that birth story, an unmedicated hospital birth, albeit after some problems with high blood pressure on a previous EBB podcast episode 127.          

Today, Katie is working as a high school counselor and is staying very busy with her young family. She enjoys reality television, spending time with her friends and family, and gardening. Katie is here today to share with us her second birth story, a cesarean that took place after pregnancy complications and to talk with us about how her second time experience was different from her first, which was an unmedicated vaginal birth and how Katie had to use all her research and self-advocacy skills. We are so thrilled to have Katie back as the first parent to be a repeat guest on the EBB podcast. Welcome back to the podcast, Katie.

Katie Kane:

Thank you so much for having me. That’s so exciting to be the first repeat guest for EBB, that’s awesome.

Rebecca Dekker:

And I loved your first episode where you shared your birth story and your pregnancy story, and we talked a lot about high blood pressure, and we were able to throw in a lot of evidence based information. So if you’re listening and you want to learn more about high blood pressure experiences during pregnancy, go back and listen to Katie’s first story. But how was your pregnancy like this with the second experience? How did that compare to your first pregnancy? Was it different or the same or what was going on the second time?

Katie Kane:

It was extremely different. I knew from the very beginning that this was going to be a very, very different pregnancy. So we got pregnant in July 2020, and we had just decided that we were moving. We had put our house up on the market and had put an offer in on a house actually on my oldest daughter’s first birthday and her birthday is June 30th. And then we decided to take a stop preventing, but unlike with Lucy, we weren’t really tracking or anything, but by July 21st, I was taking a pregnancy test and saw the faintest of faint lines, and that was our daughter Cassidy. And just from very early on, Cassidy made her presence known in my body. I started having pregnancy symptoms a week before my missed period. And I mean, it obviously wasn’t her kicking or anything, but I felt a lot of movement, a lot of pulsating and flutters, very, very, very early on, like 10 or 12 weeks.        

Lucy was a very, very mellow baby. She was head down starting at 20 weeks, which we’ll talk about more, it was a big issue for Cassidy. One of the fun things about this pregnancy is we decided that we were going to wait till delivery to find out if we were having a boy or girl, with Lucy, we did a whole gender reveal party. Really throughout the pregnancy I knew that this was going to be a very, very different pregnancy and delivery. And I don’t know why, it was just an intuition that I had. With Lucy, like you said, I had an unmedicated hospital delivery, had to use a lot of my advocacy skills for high blood pressure to avoid being induced. But honestly, the delivery was very textbook. I progressed beautifully, very few pushes. It just went extremely well.           

I used my doula, used the tub, used music. It was just a really beautiful delivery. And one of my biggest fears, the reason we went unmedicated with Lucy was because I have an extreme fear of, not needles, but of things in my spine like epidurals, I had a spinal tap in my twenties that resulted in a spinal headache. So I just had a huge fear of that. So that’s why we really went unmedicated. And my biggest fear was having to get an epidural, having to get a C-section really because of that. And early on, I knew that this was going to be different. So we went for our 20 week scan and one of the complications that she had, which really my OB said is the most common of complications is that she had a two vessel cord, which resulted in we were seen by maternal fetal medicine, just for growth scans.        

And just to monitor that two vessel cord, which in the end really turned out not to be an issue for Cassidy. The issue with two vessel cords is the concern about if the baby is growing properly and she was growing fine, she was a little bit smaller than my daughter. My daughter was nine pounds, five ounces at birth, and Cassidy was eight pounds, eight ounces. So she was a little bit tinier, but eight pounds is a great size for a baby. But we were followed closely by maternal fetal medicine because of that. And just really at that 20 week scan, they kept making comments like, oh, she’s in an odd position. It’s kind of hard to see parts of her. She’s just in a really odd position. And I don’t know what it was, it was just such an off the cuff comment.      

There was no concern whatsoever about her positioning at that time. Like it’s 20 weeks, the baby’s moving all around, but that just stuck with me. I always was like, I just have a feeling about this baby. I have a feeling about this delivery and her positioning is just really strange. So, like I said, we were doing a lot of scans because of the two vessel cord and her growth. I had had previous high blood pressure like you said with Lucy, but I didn’t have any blood pressure issued with Cassidy, which was wonderful. I was on baby aspirin since I think they had me start at 12 weeks. So I’m not sure if that ended up helping with the high blood pressure or if it was just a change in diet and activity, but no blood pressure issues with Cassidy. Normal pregnancy things that a lot of moms say they experience in their second pregnancy, lots of fatigue, but you’re also keeping up with a toddler which contributes to that. But really at that point, at that 20 week scan, the two vessel cord was the only complication.

Rebecca Dekker:

As you got towards the end of your pregnancy, what kind of things were happening?

Katie Kane:

So I had been seeing my chiropractor. I started seeing my chiropractor who’s certified in the Webster technique, which is what you should always look for if you’re going to be doing chiropractic care during pregnancy. And she’s amazing. And I started seeing her probably around the 20 week mark talking to her about my concerns with the baby’s position. And so Cassidy was not head down until I went for a scan at maternal fetal medicine around 30, 31 weeks, right at the end of my 31st week. And she was finally head down, which was really exciting because she hadn’t been head down since that point. And everyone really thought that, okay, she’s head down, we’re good to go, no issues. But then later that weekend I remember my stomach completely changed. I was laying in bed and I felt this big movement, my stomach was kind of protruding out.         

It was a completely different movement. I remember saying to my husband, does my stomach look different to you? And he was like, yeah, I guess a little. And I was like, I think that she flipped again. And I think that she’s back to being head up. At that point, we didn’t know if it was a boy or a girl. So I went in right at the end of my 32 week appointment and I said to my doctor I think that she flipped again. She was head down at my last ultrasound, but I think that she flipped again and he was kind of like, and this is the oldest doctor in the practice, and he’s just a legend. And he was like, that’s really unlikely. I don’t think that she did and he was feeling, but I’m heavier.

So it is harder for the doctor to palpate exactly where she is. So he ended up doing an ultrasound and sure enough he did an ultrasound and he is like, yep, that’s a butt, she flipped again. At that point, he really reassured me. He’s like, you’re only at 33 weeks. Clearly if she’s moving, she has room in there. Your fluid looks great because that’s one of the things that they’re always monitoring with babies if they’re moving around. If you have too much or too little fluid, that can really complicate baby getting into the right position. So he really reassured me that if she was head down, she knows how to get head down, she should make her way back, head down. You’ve had a previous baby that was head down.       

We know that there’s not a uterine complication that’s keeping the baby from going head down. She’s been there before. At that point though, I was like, I have this intuition that I think that something’s up with her positioning. I really want to get proactive about this. We hired a doula who was amazing and she was really there for me emotionally, supporting me, hearing my concerns, validating my concerns, because really the data shows that like babies want to be head down. Only I think it’s a super small number, like three to 5% of babies end up being breech at delivery. So babies want to be head down and oh, that’s what everyone was saying to me, she’ll end up head down, babies are supposed to go head down. That’s what my doctors were saying to me. But she really helped me start investigating, what can we do?       

So we did a lot of Spinning Babies, Spinning Babies has this really nice guide that you can purchase. That’s like a 20 page list of exercises that you can do. And I think it’s a six week program that you can do if you find yourself late in pregnancy with a breech baby. So she purchased that for me and sent it over. I also went and started doing acupuncture. So I had done a round of acupuncture with Lucy to go into labor, but we started doing acupuncture earlier. I went back to the same acupuncture, which is South Philadelphia Acupuncture. They’re wonderful. And we started doing Moxibustion sticks, they look like black crayons and you light them and you hold them at your pinky toe, and that’s one of the things that the acupuncture recommended.       

So we would do that multiple times a day. My husband and I, and then I was going into for acupuncture I think twice a week and starting around like 34 weeks. I just wrote down my dates here. So at 35 weeks I went in and she was still breech. And this was at my maternal fetal medicine appointment, And at this point I had started asking around, I was talking to different people that I knew from the birth world. I was still in touch with Cat, talking a lot with my chiropractor, my doula, because like most areas, my practice won’t deliver breech babies. It’s an automatic C-section and I had listened to a birth hour podcast about a woman who I think it was her fourth baby and it just was a surprise breech baby.    

And she went through great lengths in order to be able to have a breech delivery. And one of the things that she talked about that her provider talked about with her was for a breech delivery to be successful, mom’s the one doing the pushing, mom has to be confident. Mom has to feel safe doing that. Mom is the one making it happen. And at that point I was nervous about doing a breech delivery. I had done a lot of research and you have a great episode. I think it’s a kind of an older episode and I listened to that episode. And it’s just that everyone says that breech deliveries are really scary but that’s not the truth.       

I mean, there’s a lot of great evidence that breech deliveries can happen and there’s not necessarily a ton of contradictions for breech deliveries, if you have the right provider. But at my practice, they don’t do breech deliveries. So there’s a hospital nearby that people were saying like, if you’re going to have a breech delivery, the likelihood of you having it in this area is at this hospital with this practice. And the way that my MFM works is that it’s rotating doctors. So at my 35 week appointment, I actually had a provider from that hospital. And so I had a long conversation with him and they say that if you’re going to have a breech delivery, you need to find an older provider because they’re the ones that were actually trained in breech deliveries. They don’t really train doctors in them now. And so I spoke with him and he said yeah I do breech deliveries.       

He said that the way that it would work though, is that I could join his practice, but it’s doctors and it’s whoever’s on call is going to be the one delivering. And he said the likelihood of it working out that he was on call to do the breech delivery, it’s a one in seven chance or however many providers that they have. And he said there’s not many providers in his practice that do do breech deliveries. And so it’s when I go into labor, I would have to see if he was on call and it just that sounded extremely stressful to me and also going to a hospital, I wouldn’t be able to deliver at the hospital where I had Lucy and I liked the hospital that we delivered at.     

And so that was running through my mind. So it was just a very, very, very difficult time. I was preparing for the idea of having a cesarean birth, but then also had this in the back of my head that she could flip head down at any time. It’s in my head I was preparing for two different deliveries and I couldn’t get comfortable. I couldn’t find a space where I felt confident and safe with planning for the delivery. It was just a really, really challenging time. So I had that long conversation with him and he explained to me that at my next appointment, if she was still breech that they would probably talk about an ECV and that he felt really confident that she would flip. And so at that point, I decided that I was not going to try for a breech delivery if she was breech at the time, because the idea of having to find a new provider, switch hospitals, the chance that the doctor that does breech deliveries might not be there for the delivery when I went into labor.    

And then also just my fear of if I was going to have a panic when I went in to deliver her. I wasn’t confident that I would be able to overcome that. So I went in at a 36 week appointment and she was head down. So everyone around me was so excited. My husband was so excited.

Rebecca Dekker:

Did you feel your baby flipped?

Katie Kane:

I didn’t feel her flip at that time, no. But she was head down and it was confirmed by ultrasound. I did not feel her flip that time. I was shocked when they said that she was head down. My husband was relieved. My doula was so happy for us. The providers were happy, but I wasn’t, I did not feel the relief I expected to feel. I still felt this sense of gloom like something wasn’t going to go right. And so in my head, I was like, something’s not going to be right. Something’s not going to go the way I want it to go with this delivery. And so when she was breech, I was like, that’s going to be it. I’m going to have a C-section. This is what I’ve been feeling this whole time. This is what I’ve been feeling that’s so different this whole time.        

And when she went head down, I was like, so what is it? Like if I’m feeling this feeling about this delivery and now she’s head down, what’s going to happen? And I had a hard time. I thought that something else was going to happen at delivery. I thought that I was going to have maybe a postpartum hemorrhage. I thought that a placental abruption, it’s so different with your second one, because you know so much more. I was so educated going into Lucy’s delivery because of the EBB course.       

But then once you have your first baby, I feel like you come across so many other women’s birth stories and you just know a lot more, you know a lot more that can happen and I just had so many fears because I had this entire pregnancy, I had this feeling in my gut to the point where my doula came in. So she still is head down at this point. So my doula was like, okay, let’s have our final meeting where we’re going to talk about delivery. And she comes to our house. She talks about all the comfort techniques that we can use. She gives us our Rebozo. She gives us our… What is it? The machine that you can put on your back?

Rebecca Dekker:

Tens unit.

Katie Kane:

Yeah. She goes to our tens machine. She has her 37 week meeting. And I just started crying during the meeting because she’s talking about all these things and I was like, this isn’t going to happen. Something’s going to go wrong. I just feel like something’s wrong and this isn’t going to go the way that I want it and I’m hoping that it will go. And I was really concerned at that point about my health. I was worried something’s going to happen. So that was a really difficult time. I was having a hard time. Now looking back at it, I’m able to really articulate it. But at the moment, I couldn’t explain what I was feeling.

Rebecca Dekker:

It sounds like you were having a gut feeling or intuition that something was going to go wrong, but you also were being overwhelmed by anxiety about that intuition.

Katie Kane:

Yeah.

Rebecca Dekker:

Because it’s one thing to have an intuition that things won’t go as planned, but it’s another to be really hyper aware of it and focused and anxious.

Katie Kane:

Exactly. Yeah, exactly. I even got to the point where I wrote my husband a note if something had happened to me, I wrote him a goodbye letter, which sounds very morbid, but I had to really put it down and by writing it really took a weight off of me. And we also had contacted a lawyer, which we were planning on doing for a while, but I felt this urgency to get it done so that our state stuff was in order and that all of our health stuff was in order. So that happened the last month of our pregnancy. And then I was laying on the couch again at right at the end of my 37th week and I felt a huge movement. And I was like I think she flipped back to head up.      

And so that 36th week I was having a lot of braxton hicks. I was having a lot of pelvic pressure, just things that you experienced in that last month as you’re gearing up. But then when she flipped, it all stopped. So I went in for right at the end of my 37th week and I said I think she flipped again and they said that’s very unlikely, but we’re happy to check. And they checked and sure enough, she was head up again. She was breech, which is very unusual for babies to be flipping this late in pregnancy. And I had a bunch of ultrasounds right at the end and she was in all kinds of different breech positions. She was in a complete breech, a frank breech. She was in an incomplete breech, at one point she was transverse, she had a lot of movement in there and we’re really still not sure why my fluids were always good.   

But at that point, when she flipped back to head up, I was like, okay, I need to plan for a cesarean. I cannot continue to think, I just need to plan for cesarean and if she goes head down, that’s great. I forgot to mention to back it up. We did talk about an ECV, I guess we must have talked about it at right the same time I talked with my maternal fetal medicine doctor. So the ECV procedure is where they try to flip the baby from the outside by pushing on your stomach and they oil you up. At my doctor’s office, they do usually recommend giving you an epidural to do it, which I don’t think everyone does that, but my provider does recommend doing an epidural. So we talked a lot about that and this was before her last flip.

And it’s a little bit higher than a 50/50 chance of it working. And if you’ve had a previous head down baby, your chances are a little bit higher. My maternal field medicine doctor did say because I’m heavier, it might be a little bit harder to do just because he explained that you really need to feel how low the baby is and if you have extra fat that it’s a little bit harder to feel. I don’t know if that’s evidence based or just his experience as a provider for many years. My doctors at my OB-GYN were very on board with trying it. They thought that it was worth trying, my husband and I talked a lot about it. I talked a lot about it with our doula and I just really felt that if she wasn’t staying head down, there was a reason she wasn’t staying head down.

And I just decided against it really for that reason. And I would rather have a planned cesarean than an emergency cesarean. So my fear was that something could go wrong with the ECV and then we have an emergency cesarean versus having a planned cesarean. And I’m glad that we didn’t end up doing it because my provider, if she was still breech, they wanted to do it earlier. So I guess there’s two schools of thought that you either do it early, around the 37th week, and then they bind your belly. I guess I’m not sure what the exact term is, or you do it later, like your 39th week and then you’re induced at that point to make sure the baby stays head down. My provider would’ve wanted to do it at 36, 37 weeks.   

And at that point she was still flipping. So I’m glad we decided not to do it. So now we’re back up to my 38th week. And at that point she was breech. I decided that we had to plan for a cesarean. We were still doing some spinning baby exercises. I did stop going to acupuncture at that point, but we were doing the moxi sticks at home. So we decided to plan for a cesarean. And what happens is that my provider, they want you to have it as close to 39 weeks as possible, just so that you don’t go into labor for a couple of reasons. They don’t want you to go into labor because if the baby starts to descend, this is what my provider explained to me that if the baby starts to descend that it can be a little bit more traumatic if they have to then pull the baby out if it started to descend.   

And then also just like logistics. If you start going into labor, then it becomes a little bit emergent. It’s not as calm as you would like it to be. So they called me, the scheduling office called me to schedule the cesarean. And I asked to schedule it later in my 39th week just for the off chance that she would flip back. I wanted to give her as much time as possible. So they scheduled it and we scheduled it, they told me the doctor that would be doing the cesarean because I’m in a practice of eight doctors. And what I did was is I then called up my doctor’s office and I said I would like an appointment with this doctor, she’s doing my cesarean and I’d like to speak with her before doing the cesarean, which I’m really happy that I did and I would really recommend that to anybody that’s in a similar situation as my practice.

Rebecca Dekker:

So did you meet with your doula or did you do research on how to have a better experience with the cesarean?

Katie Kane:

Yeah, so this whole time I was in constant contact with Mallory who’s my doula. We were constantly texting. She sends a lot of stuff, which is great. So her and I had had a long conversation. She said, so this was March 2021, COVID restrictions at my hospital were in New Jersey, doulas are considered medical personnel. So they don’t count as one of your support people. So at my hospital you are allowed to have one support person and then your doula, which didn’t count as a support person. So she would’ve been fine coming in for me before I went back to the operating room and then for post-op and then she said she could come and stay with me even after delivery if I wanted to. So she talked to me about that and she said you can ask if I can be in the OR, I would be happy to be in OR, I just don’t think it would happen.

And then her and I had a lot of conversations about what I wanted the cesarean to look like. So I wanted to be able to play my own music. I wanted to have skin to skin in the OR. What were some of the other things that we did? Oh, clear drape. And I wanted just the doctors to be aware of how nervous I was. And I really wanted to make sure that they were clear on where I was at emotionally. So I got extremely, extremely lucky with the doctor that was doing the cesarean. She’s extraordinary. She’s very open-minded. She does not medicalize delivery and less necessary. She’s very, very wonderful. So I went in for my appointment which was with her and I wanted to talk about the cesarean and I asked her, I said, could we have my doula in the room?    

And she said, yeah, sure, I don’t see why not, which I was like, oh, okay. I was ready for this big, well, I’d have to advocate for myself to give why I wanted this. And then she said, sure, why not? And I just couldn’t believe it. She said the only thing she has to do is check with anesthesia to make sure they’re okay with it, but she doesn’t see a problem. So we talked about that. And then in that meeting, we talked about the other things that I wanted and she was super supportive. She was very understanding. We talked a lot about the spinal tap for the cesarean. So when you have a planned cesarean, you don’t actually get the epidural. The epidural is a tube that stays in and continues to give you the medication with a planned cesarean.  

You get a spinal tap. They just put in one injection of the medication, so nothing actually stays in. So she explained that to me, she explained the timing to me. She explained the recovery to me. And told me what to expect, which I was really thrown by what to expect for the recovery. She said that I couldn’t really pick up my daughter for four to six weeks. She talked about doing stairs really only wanting to do stairs once a day, if I had to, not driving for two weeks. So I was extremely anxious about the recovery. And I talked to my doula a lot about that. Talked to my husband a lot about that. We’re really fortunate in New Jersey that we have paid family medical leave. So my husband works in New Jersey and I don’t, so I was on my school’s short term disability plan, but my husband was actually able to take family medical leave to take care of me after my C-section. So we were extraordinarily fortunate in that from the state of New Jersey.

So we get the C-section planned. My doctor actually called me a few days after my appointment. And she was like, hey, I just want to let you know I’m at the hospital. I just talked to anesthesia and they’re totally cool with your doula being there, which I thought was awesome that she called me and she was just so kind and supportive, really understanding that this was so difficult for me. So at that point, Cassie ended up staying breech the whole time. Like I said, she flipped between frank and complete, but she stayed breech the entire time. I had a couple of more appointments after that to check. So we were all set for the C-section. We had the C-section scheduled. It was an early morning C-section and it’s kind of cool. So like my daughter was born, Lucy was born on June 30th at 39 weeks and five days.

And then Cassie was born on March 30th at 39 weeks and five days. So I feel like there might be something there with the numbers. So yeah, my husband and I drove to the hospital that morning. We still didn’t know what we were having and we were still talking about names and he wanted to do Cassidy and Cassidy is a grateful dead song. And so we were listening to that song on the way and just talking, we got to the hospital, it was very calm, way different from when I was actively in labor with Lucy going into the hospital, just very calm. We went back, they take you back to your triage area. One thing I forgot to mention is they actually called me the night before a nurse from the labor and delivery calls you the night before.

And she spent about 20 minutes on the phone with me, just talking about the logistics of the day, talking about what time to get there, what to expect. Talked to me about my doula. Talked to me about any questions I had, which was really, really nice. So backing to the delivery day, we get to the hospital, my doula is there, my husband’s there, we go back to triage, they get you set up, they get your IVs in, they take your blood. They give you a couple of medications. I asked her at the point, but I think there was something for your stomach to settle your stomach a little bit, just some other different medications before you go into the surgery. So then we’re back in pre-op and I went back to the operating room first to do the spinal, my dual and my husband weren’t there for the spinal, which was really hard.

The spinal was extremely difficult for me, just so my fear of things and needles in my back and the anesthesiologist was amazing. He was the attending. I mean, he was so caring and patient with me.

Rebecca Dekker:

But it would’ve helped to have your family there.

Katie Kane:

It would’ve helped, yeah. It would’ve really helped. Yeah. And I think if I had pushed more that it could have happened. So even to the point where he was just feeling my back to see where to put in the needle, I started sobbing. It was just really hard. So my doctor actually came over and was holding my hand, was talking to me and it was really nice because I think one of the things that really overwhelmed me was when you get a C-section, there’s a million people in the room and they’re all preparing for their part of your delivery.

There’s a mom nurse, there’s a baby nurse. There’s lots of people in there. And so it was like everyone around me was working and doing their job. And I’m sitting here having one of the most difficult moments of this pregnancy. And when my doctor came over and started talking to me the room really calmed down and that’s what I needed. I needed the room to stop moving and stop working. I needed everyone to really see that I was having a very difficult moment and that’s what it did when she came over, everyone really calmed down, which was nice. So the spinal is like, it’s crazy. So he put it in, it was very smooth. The actual putting it in was fine, but you immediately go numb and it’s all the way up to your chest.         

You almost feel like you can’t breathe, but you are breathing. It’s a very, very crazy feeling. So then once the spinals done, they immediately brought in my husband and my doula and everything moves really, really quick at that point. So I had listened to a lot of cesarean birth stories and was really prepared for some moms really experience even though you’re numb, they still feel the tugging and the pooling and the pressure. I didn’t feel any of that and I was really surprised because I was prepared for that. And the nice thing is, so my doctor was there doing the cesarean, but assisting her was the doctor that caught Lucy, which was pretty cool. So she knew me really well. And that was a nice moment that she was there. I was happy to see her.       

And so they had the clear drape up and I sent some pictures of this. I’m not sure if they’re too graphic for the website, but I really love these pictures. So they had the clear drape up, I think they drop it after the baby comes out and they’re holding her up and I’m putting my hand next to the drape, and then my doctor actually dropped the drape so that I could touch her as she was holding her up, which was really nice because it’s just for a mom to have to touch her baby through a clear drape the moment that they’re in the world, no one wants to do that. You want to hold your baby and you want them to be close to you. So the fact that she did that was just such a beautiful for me and really took away the pain of not having the vaginal delivery where she would’ve immediately been put on my chest.

So yeah, at that point we didn’t know if she was a boy or a girl, but they held her up and my husband said, it’s a girl. And I had thoughts that it was a girl the entire time, but I was really happy that it was a girl. I think my husband was definitely helping for a boy, but I think we’re both happy to have two girls, especially so close in age. So it was a little bit of a back and forth with the labor and delivery nurse to be able to do skin to skin in the OR. So I had asked her before we went back for the surgery, if we could do skin to skin and she was not having it. She was like, oh, it’s so cold in the OR.

Rebecca Dekker:

And this is the nurse?

Katie Kane:

This is the nurse, yeah. Okay. So my doctor had said we could do skin to skin. And so that’s why I told her, I said, oh, the doctor said we could do skin to skin. And so she wasn’t really super interested in facilitating that because they’re trying to get you out of the OR, they’re trying to get you back to recovery and that takes time. And then the nurse, since you’re all numb, a nurse has to be nearby.

Rebecca Dekker:

I was going to say it interrupts their normal way of doing things.

Katie Kane:

Exactly.

Rebecca Dekker:

It’s not really that much more inconvenient. It’s just not what they’re used to.

Katie Kane:

It’s not what they’re used to, exactly. So we did do skin to skin, which was really nice. And to be able to just have her on my chest while they were finishing up the surgery, it wasn’t as long as I had hoped it had been, but my husband held her the rest of the time. And then one of the things that happened. So you’re still open on the table, you’re still having major surgery while everyone’s in the room while you’re meeting your baby for the first time. So they’re sewing everything back up. One of the things I did ask her, I was like, did you see a reason why she would’ve been breech? Was her cord short? Was there a weird placenta placement?

I did forget to mention I had an anterior placenta with Cassidy. I didn’t know if the placenta was in an odd spot and keeping her. And she said, no, I didn’t see anything. I can’t really tell you why she was breech or why she was flipping so much. I didn’t see anything that stuck out to me. And that was hard. I wished there was this moment of like-

Rebecca Dekker:

Oh, that’s why.

Katie Kane:

Yeah. Like, oh, good thing we didn’t do the ECV because otherwise this would’ve happened, but they didn’t see anything. But I’m so glad I trusted my mom gut with that. Because just because they didn’t see anything doesn’t mean there wasn’t something there or some other reason. So we are at postpartum and we’re in the recovery room and we had the baby, everything was good. The rest of the surgery went well. One thing that does happen and I don’t know if this is at every hospital, but when you have a cesarean, they have dad and baby leave the room and meet you in recovery while they finish everything up. So moving you from the operating table to your hospital bed and then they have to put the bind, there’s this big thing that wraps around you to bind your belly.  

So they were putting that on, but they have dad and baby leave for that part, which I was really, really happy my doula was there because otherwise I would’ve been alone in the operating room again. And she was there and she was able to talk with me and it would’ve been really hard if I was alone. Because again, people are around you are doing their jobs and there wasn’t really anybody else not paying attention to me, but like not, yeah… [inaudible 00:40:26]. Yeah. Like focusing on getting me out of the room, getting the operating room turned over. So I was super glad that she was there. Yeah. So that’s how Cassidy came into the world. I can talk a little bit about recovery too.

Rebecca Dekker:

Yeah. How was your recovery? Because I know it was something you were worried about.

Katie Kane:

Yeah. So in the hospital it was tough. I have a hard time with anesthesia. So when I had my wisdom teeth out, I got really sick from anesthesia. And then I can’t remember if I mentioned this in my last episode, but I have endometriosis and when I was like 25, I had surgery for endometriosis and I actually had a misshaped uterus. It wasn’t like a full by coordinate uterus, but I had a septum at the top of my uterus that they ended up removing during that surgery. And then they removed the endometriosis and I got really sick from that surgery as well just coming out of the anesthesia. My blood pressure drops really low. I get very nauseous. Funny enough, I don’t know if anyone is going to go back and listen to the episode.

But in my last episode I said that I was planning on for my next delivery moving to a midwife practice and delivering at a birth center. But I found out that I couldn’t deliver at a birth center because-

Rebecca Dekker:

Because of your history of surgery there.

Katie Kane:

Yeah. Yeah. They treated it like a VBAC. So that’s why I ended up staying with that practice. So, again, the same thing happened, my blood pressure dropped really low and I was in recovery longer than expected and I got really sick, really nauseous. I was throwing up from the anesthesia and then I was super itchy. So I’ve heard other women with C-sections talk about this, but I guess it’s the medicine or something. Some people have a reaction to it. I was so itchy. I just kept having to rub my face and rub my nose.

I was just extremely itchy. And then another thing that was happening, when you’re opened up, gas and air gets trapped in there and so it’s trying to get out and sometimes it travels up and so gas was traveling up into my chest and my neck and I just almost felt like I was having a heart attack or something. It was extremely painful. So that was all while in the hospital. So because of COVID, they used to keep C-section moms for three days, but now you can get out after two days. And so we got out after two days and we were home and the recovery was really long. I ended up doing pelvic floor physical therapy and it was just difficult. I just felt like the lower half of my body wasn’t in sync and wasn’t connected anymore to the upper half.

I felt like it was really difficult to do things that were so common before I had the baby. Before I had Cassidy, I would be able to squat down at my toddler’s eye level and talk to her and I couldn’t do that at all. And, I mean, it probably took close to a full year. I’m about a year right now postpartum. And I would say it took close to 10, 11 months to really feel like my body was connected again. It was an extremely difficult postpartum experience for my body. I actually had postpartum rage and postpartum anxiety after having Cassidy. And I experienced it a little bit with Lucy, but I ended up going and talking to my OB, but it wasn’t until Cassie was 10 months old and ended up going on Zoloft, which has truly changed the course of my life. 

I mean, it’s been amazing, and I really wish I had talked to her sooner because I was trying to really white knuckle it for a long time and Cassidy has some health issues and I just was contributing to the stress of that, but I’m so glad that I did that. And my provider was amazing about it and I truly had a chemical imbalance and just needed it and it’s been absolutely wonderful. Yeah. So Cassidy, she had a tongue and lip tie, which made breastfeeding extremely difficult. So I pumped for a while, probably until she was six or seven months old and she’s just such a different kid. She had RSV and was in the hospital for a couple of days and she actually has this thing called FPIES, which is where she can’t eat bananas.

When she eats bananas, she ends up throwing up for like days on end, which was really hard to figure out because most baby foods have bananas in it because it’s a thickening agent and that’s one of the first foods, most people give babies. Luckily my pediatrician had experienced it before, so she knew it right away. She had chronic ear infection. She just had ear tubes in. So it just was a really difficult postpartum year. And we’re just coming out on the other side at this point, but it’s definitely been a lot better now that she’s past that year mark and everyone’s taken care of themselves.

Rebecca Dekker:

Yeah. And I think you raised a good point talking about the… It sounds like you had perinatal anxiety. Like anxiety during pregnancy and postpartum, either you can have it at any of those time points and the importance of talking with your healthcare provider and your support team about that and getting treatment if needed because, in general, things like anxiety don’t tend to just go away. You have to do something to address it.

Katie Kane:

Yeah. Yeah. And I think as moms, we put a lot of pressure on ourselves to do things for our kids and make life good for our kids. And there definitely can be a stigma with medication. But since I went on Zoloft and started talking about it, a lot of women I know are on some sort of medication and our bodies have been through so much. I mean, since October 2019, I’ve been pregnant, breastfeeding or postpartum, that’s a long time and that’s a lot of hormonal changes in your body and life changes and then sometimes we don’t take care of ourselves as well as we take care of our kids. And we really should because we’re the best things for our kids and we got to be here and we got to be the best versions of ourselves. 

And I think that’s a hard thing to realize that to swallow the fact that you can’t be the best version of yourself without medication I think is a difficult thing for women to think about. But it’s been life-changing, it really, really has been life-changing. I probably should have gone on it after I had Lucy and stayed on it while I was pregnant with Cassidy. Because just some of the thoughts I was having with Cassidy were just the thoughts that I was going to die, those I should have had under control.

Rebecca Dekker:

Yeah. You were having severe anxiety symptoms it sounds like.

Katie Kane:

Yeah. For sure.

Rebecca Dekker:

Was there anything from taking the EBB Childbirth Class for your first birth that you felt really helped you the second time around?

Katie Kane:

Yeah. I mean, I think I definitely used my EBB skills much more than I did with Lucy just because I had to. I mean the fact that I was even able to have all these conversations with my providers and advocate for myself, that came from the EBB course. And just with the resources that you offer, because I think that for women looking at research can be so overwhelming, but just the quick EBB articles that are offered that really synthesize everything and has up to date research are life-changing. I mean, I know that you have articles and, like I mentioned, you have the podcast on breech deliveries. Another thing that we had this pregnancy was I was GBS positive and I wasn’t with Lucy. So when I thought I was having a vaginal delivery, we started talking about that and looking at the research for that.

And then another thing, after I had Lucy, my hospital’s standard procedure is to give Pitocin after delivery. And I had long conversations with my doula about that just because it was really inconvenient. I was hooked up to an IV for almost 12 hours after delivery and it just didn’t feel necessary. And I was able to talk with my doctor about that and come up with a different plan for if I had had a vaginal delivery. I can’t remember if I was on Pitocin after Cassidy to be honest. I can’t remember.

Rebecca Dekker:

It sounds like it was a little bit of a blur for you.

Katie Kane:

Yeah. I can’t remember how long I had an IV in, but I remember with Lucy it was really annoying to still have an IV in after because I just had the head block during delivery with Lucy and then I was hooked up to an IV after delivery. It just didn’t really compete with me. So that was very helpful to be able to research those articles and just the network that I was able to create. I still kept in touch with Cat. Cat actually recommended Mallory to me who was my doula. Knowing to go to a chiropractor, knowing to go to acupuncture. Also, there is a section in the EBB course about planning for a cesarean.   

So I was able to advocating to have my doula there, advocating to have my own music playing in the OR, and I think that one thing we talked about in our EBB course was making sure to set the tone for the OR, so the idea of having everyone introduce themselves to you and explain their role to you, that didn’t necessarily happen at my delivery, but that’s something that would’ve been helpful at my delivery. And I think with Lucy, I put the idea of having a cesarean out of my mind. I didn’t want to think that it would happen, but we did talk about it in the EBB course because it is something that can happen with delivery. And just the idea of knowing that there are times where you have to have cesareans and there are times that they are medically necessary and being at peace with that and knowing that it’s not your body failing, it’s not anything wrong with you or your baby, it’s just your baby needed to come into the world.  

And honestly, the EVB course helps you avoid the cascade of interventions, but that’s not what happened with Cassidy. She was one of those three to 5% of babies that were breech. And, of course, we could have a bigger conversation about not having vaginal breech deliveries in this part of the country, but I wasn’t willing to negotiate, I didn’t want to go that route.

Rebecca Dekker:

No, it sounds like for your anxiety, the need to have a plan that wasn’t constantly changing was really important for your mental health.

Katie Kane:

Yep.

Rebecca Dekker:

So it sounds like you made the decision that was most empowering for you and healthy for you.

Katie Kane:

For sure.

Rebecca Dekker:

And we really appreciate you coming to share your story, Katie. I wanted to point out, you mentioned a couple of podcast episodes, Dr. Elliott Berlin came on episode 111 to talk about breech pregnancies from the chiropractor. And then we have a mini-breech series that we did, episodes 171, 172, and 173. We have a vaginal breech birth story. We talk about the evidence on ECD for turning breech babies. And then we have Dr. Freeze and Dr. Hayes come talk about the evidence on breech birth. So, I’d encourage our listeners who are experiencing a breech birth to make sure you check out that mini-series. But Katie, thank you so much for sharing your story and it was really a delight to hear from you and that your advocacy skills still came into play even with a very different pregnancy and birth.

Katie Kane:

Thank you and thank you so much for having me. Thank you for all the work that you do. We really appreciate it.