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On today’s podcast, we’re talking with EBB Childbirth Class parents, Luciana Arraes and Jonathan Moyer, about their preterm birth experience in Brazil and how their preparation and knowledge paired with a “Golden Ticket” birth team provided the birth of their dreams.

Luciana (she/her) is a Brazilian violinist who plays in the National Theater Symphony in Brasilia, Brazil. Luciana is married to Jonathan (he/him), who is an American pianist who has a large studio of piano students. Together, they welcomed their baby in July at 35 weeks gestation.

We talk about their experience taking the EBB Childbirth Class with Ali Buchanan, where they learned how to recognize all the phases of labor, and having a a “Golden Ticket” birth team helped them get exactly what they wanted in the birth of their baby. We also talk about supporting the baby, by providing care for the birthing parents. 

Content Warning: Pre-term labor, jaundice, infant weight loss, bodyfeeding supplementation with a cup, advocacy, and gendered language.

Resources

Find us on Instagram (https://www.instagram.com/ebbirth/ ), Pinterest (https://www.pinterest.com/ebbirth/ ), and TikTok  

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Transcript

Rebecca Dekker:

Hi, everyone. On today’s podcast, we’re going to talk with EBB Childbirth Class graduates, Luciana Arraes, and Jonathan Moyer, about their surprise preterm birth and dream birth experience in Brazil.

Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD, 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. My name is Rebecca Dekker, pronouns she/her, and I’ll be your host for today’s episode. Today, I’m so excited to welcome EBB Childbirth Class graduates Luciana Arraes & Jonathan Moyer. Luciana is a Brazilian violinist who plays in the National Theater Symphony in Brasília, the capital of Brazil. Luciana is married to Jonathan, who’s an American pianist, who has a large studio of piano students. Together, they took the EBB Childbirth Class with instructor Ali Buchanan, then welcomed baby Oliver in July of 2022. We’re so thrilled that Luciana and Jonathan are here. Welcome both of you to the Evidence Based Birth®  Podcast.

Jonathan Moyer:

Thank you so much for inviting us. We’re thrilled to be here to talk about our story.

Luciana Arraes:

Yes, thank you. We’re very excited.

Rebecca Dekker:

I was so excited to get the message that you were coming on the podcast, because we’ve never featured a birth story from Brazil before, so I just feel really honored that you’re here to share your story with us. And I was wondering if you could start well telling us how you found Evidence Based Birth®, and how you went to take a class with Ali Buchanan, who is one of our important team members at Evidence Based Birth®, and an instructor who lives in Oregon in the United States?

Luciana Arraes:

Yes. So, I think in my preparation for the birth, I had gone to Instagram and kind of soaking up a lot of information there, and I think I found through a Brazilian midwife who is in São Paulo, and she shared a podcast or something from EBB Birth, and I thought it was very interesting seeing birth in this scientific way and based on evidence, because I was kind of getting a little worried about how much information there is out there based on nothing quite that I could grasp and see, “Well, I will do that because.” And so, I thought that it was interesting that she shared, and I looked at the information, I was like, well, this is scientific research, and me, I’m a doctorate, but of music, we are academics. So, for me as an academic, it was really important to find academic information about birth, which I didn’t know exists, so that was very interesting.

Then looking on Instagram, I saw that you had childbirth classes, and I was getting childbirth classes here in Portuguese, so I felt like I knew a lot, but I was feeling that Jonathan was being kept away from all the information, because it was all in Portuguese. He speaks well, but it’s so specific, and I was like, well, that would be interesting to do that in his native language, and with all this information. So, I sent a message on Instagram, and I think Ali, she saw the message and she’s like, “Oh, I will teach in those weeks,” and I was like, “Well, online, that would be perfect.” And the time was different, I think it was like 7:00 PM for us, but it was good, and it was the middle of the afternoon for her. That’s how I found it, and so, Ali guided us to the childbirth classes. Yeah.

Rebecca Dekker:

Yeah. And what was your experience for both of you taking the class?

Jonathan Moyer:

Yeah, well, like Luciana said, it really was great for me to be able to do a class in English. It was important for me, really, and we both think in this way, we’re looking for answers based on facts. We wanted to learn as much as we could about the whole process, about all the options, about what each stage means, and what all our options would be in each stage, but really based on facts and evidence. And really, we ended up arming ourselves with a lot of knowledge, and we felt very good after the class that we were well positioned to be able to make decisions throughout the process, based on what we learned.

Luciana Arraes:

I think the introduction really, that was a seminar on failure to progress. That was our first introduction to EBB, really, and we were so impressed in how organized it was and how the information was organized. The PowerPoint, we were like, “Oh, this is great.” I think we are nerds at heart, and also for us, it felt really good. The information was clear, the way that you guys organized everything on that seminar. So, I thought, “Well, that class is going to be good,” because I wanted to make sure that the class was going to be organized enough that we could understand. And so, that failure to progress or failure to wait, and so, the facts that we learned in there, we were like, “Wow, I’ve never heard about this,” and things about in the United States. And so, Jonathan was really impressed.

It was the way of me introducing, “So, I found these people,” and so they did this amazing work, so we took the seminar and we put it on our TV, and had our notepads, so we actually had fun learning that way. So, it started from that seminar, which was free, and then that gave us enough confidence to just like, “Oh, okay. I think they will give us a good base.” And then the class, Ali was very organized, and the booklet was great, the videos, we watched them. And so, I joke that because he came in as a surprise, but we didn’t have one single piece of clothing clean for him, but like you said, you have to pack for maternity to go to this hospital. We didn’t have anything, but we had so much knowledge. We joked that we had all the knowledge packed, and that was what supported us. Yeah.

Rebecca Dekker:

Yeah. So, when did you start the class then? How many weeks pregnant were you?

Luciana Arraes:

I think I was 23.

Rebecca Dekker:

Okay. So, you started a little early, which ended up being a benefit, because you went into labor early. So, take us to the end of your pregnancy, maybe after you took this class, after you finished the class, you were in your third trimester, and what kind of birth were you planning?

Luciana Arraes:

Right. When I started the class, I had some ideas of what I wanted. I really wanted an unmedicated birth. I really wanted that, and I didn’t want to induce because here in Brazil, there’s this thing of inducing naturally. Even if you don’t have an indication for it, when it hits 39 weeks, people start taking castor oil or things like that, and that never really resonated with me, because I thought, and the people of our team, we also talked with them, because it’s giving an eviction notice to the baby anyway. It’s kind of having a cesarean mind to an actual birth. So, I was like, “Do we need to do that?”

And so, when I took the class and I went to look at my notes, but there’s an acronym, that’s BRAIN, and the N was for nothing, and I said, “Ali, so I can’t do nothing and kind of wait for him, and give him his time to come?” And she’s like, “Yeah, but make sure that you compromise. There’s also the compromise, just be open.” So, we decided to be open to what was going to happen, but I really wanted us to do nothing, no inductions, and see, and if we needed, okay. And then with the class, with the video on inductions, for example, we learned what each one does and the benefits of it, and what can happen. So, that was really good, so we could balance it out, so I knew exactly what are the benefits, and-

Jonathan Moyer:

What are the side effects, right?

Luciana Arraes:

… what the side effects were. And so, having that information, for example, I knew that okay, if the labor is really long and I’m exhausted, so then, okay, I’ll be open to that. But when he came preterm, I knew it would be better for him if I could have an unmedicated birth, if I would not take the epidural or anything, because that can slow down the birth, and him being early. So, I had that in my mind, I was calculating, “Okay, maybe I can do this,” and then after the class, I got very enchanted with the idea of a water birth, because how it was explained, and then here in Brazil is different. You can actually have the baby on the water in the hospital. Yeah, because I think Ali explained it in the US, you have to get out of the water, the water is just for soothing or something like that.

Rebecca Dekker:

In most hospitals, there’s just a couple of hospitals that support that in the United States. I was always under the impression that cesarean rates are very high in Brazil. So, what hospital did you choose? How did you know that you were going to be supported in your wishes for an unmedicated birth?

Luciana Arraes:

Right, and that is something that we decided early on, and I think that what led us to meet professionals here that supported that, and those professionals, they are connected to EBB Birth, they shared the information, so I think it was a chain kind of like that. Yeah, cesarean rates are over 50% in Brazil, and I stopped telling people what kind of birth I was going to have, because it’s like, “Oh, you’re very brave. You’re crazy.” No, and here, it’s like a scheduled cesarean, and people go and get their hair done, their needles done that they go have, and the doctors, they just schedule it, and-

Rebecca Dekker:

It’s expected that you’ll schedule a cesarean?

Luciana Arraes:

Yeah. I think at my work, the first time at my boss asked me, “So when did you schedule your baby to come?” I was like, “I’m not scheduling him. He will come.” So, I don’t know, so there was this pressure of wanting to know when he was going to come, and it’s like, “Well, whenever he wants to.” And so, in Brasília, I don’t know, there’s a Netflix documentary, Birth Reborn, and there’s a series of three, and that documentary was film mostly here in Brasília, because there is a big movement to fight against the cesarean mentality, that we call it. So, it’s a movement for home births, for natural births, and so, Brasília’s kind of a hub for the home movement in the country. So, and then based on Netflix, there are three of them, and I noticed that Brasília was this place that really supported natural births. So, we found this group of women, it’s called Livre Maternagem. So, they got together and they have obstetricians, nurses, doulas, acupuncture, osteopathic-

Jonathan Moyer:

Psychologists.

Luciana Arraes:

… psychologists. So, they’re group of women that support women that want to have a natural birth, so they’re pretty incredible. So, we got in touch with them, I got in touch with the doctor and from there, we had a team with our doctor, our obstetrician, Luiza, and we had a nurse obstetrician, so she’s a nurse, Mariana Bahia, who’s also a lactation consultant at IBCLC, and a doula, who is Taciana, and she’s a bilingual doula, so she speaks English perfectly. So, they are all part of that group called Livre Maternagem, and then they were our support from the beginning. So, we started consultations when we were seven weeks pregnant.

Rebecca Dekker:

Wow.

Luciana Arraes:

Yeah. We started really early, as soon as we found out.

Rebecca Dekker:

That sounds incredible that you found that group of people, and we’ll make sure to link to them in the show notes, so people can check out the work that they’re doing. Jonathan, what did you learn from entering this whole world of pregnancy and childbirth, and fighting back against that mentality that Luciana was talking about?

Jonathan Moyer:

Right. Yeah. Well, the first thing that happened to me is that we found that documentary, what is it? Birth Reborn, which is actually a three part series, and we watched it together, and it was just so eye-opening. I had no idea how the structure was set up. It was talking about specifically here in Brazil, but I think the Birth Reborn documentary was really eye-opening for me to learn how society really was set up nowadays to kind of guide women a lot more towards cesareans, and I was shocked, frankly. I was just really, really shocked about that, and appalled. And so, I was so grateful that we found this co-op, a co-op of women professionals who were behind this movement of humanized labor, and against the scheduled cesarean mindset, and through them and through EBB, I learned, I believed that we could really do what we wanted to do. It was in our power, and we found the support here to guide us and help us towards that goal.

Rebecca Dekker:

That’s incredible. So, you had this wonderful team, we call that the “Golden Ticket” in the EBB class, with the amazing providers and very supportive setting, a great team of people surrounding you, and you were educated and you felt informed, and then you hit 35 weeks, and what happened?

Luciana Arraes:

So, we had this whole plan. It’s funny, because we haven’t hit 40 weeks yet. It will be on Sunday. So, August 21st was my due date, and I was getting ready with all our team, and I was doing acupuncture, pelvic floor therapy, and my gym has a special pregnancy class. So, I was taking those classes, getting ready, and I never thought that I was even close to being in labor. So-

Jonathan Moyer:

I wanted to say also, we were doing spinning babies. Our doula taught me what I can do to-

Luciana Arraes:

Help.

Jonathan Moyer:

To help. Yeah.

Luciana Arraes:

To help him set up and being in the right place.

Jonathan Moyer:

Right, right.

Luciana Arraes:

And so, we were doing all of that, thinking that we still had a month, “Oh, we still have a month,” and I was working in the symphony, and that was my last week of work. I decided, 35 weeks is enough. We recorded Beethoven 5th on Friday on Saturday, I went to the gym, squatted and all that, and on Sunday, I woke up really feeling-

Jonathan Moyer:

And you played a wedding.

Luciana Arraes:

And I played a wedding on Saturday night. I’m glad I didn’t go out into labor in the middle of the wedding, and I was stealing the show. But someone looked at my belly and said, “Oh, that baby’s coming, right?” I was like, “No, I have a month,” and the next day, and then on Sunday I started feeling little cramps. I was like, “This is strange,” sent a message to my nurse, and she said, “Let’s make sure that we rule out a UTI, because it’s too early.” Okay, then the owner of our apartment decided to change all the electrical wiring, we don’t know why.

And then, okay, we decided to rent out an Airbnb, my dad came to help us with that. And we were at the Airbnb, because my house was going to be turned upside down. And I said, “It’s okay, you do it now because I still have a month for the baby to come.” We are at the Airbnb, and I start feeling a back pain, incredible. Jonathan starts massaging, and then I swear, I felt that he kicked or did something, and immediately I felt a contraction, and I jump off the bed, and I kept telling Jonathan, “Jonathan, don’t worry. When the water breaks, it’s not like in the soap operas and the novelas, that we’re going to be like, ‘Ah.'” It was exactly like a novela, and just like, plop, and I was like, “Oh my God.”

Rebecca Dekker:

It burst?

Luciana Arraes:

I was like, “What is this?” And then I call, our nurse said, “Take a photo.” I take a photo of the water, and she’s like, “Yeah, your water broke.” I was like, “But it’s 35 weeks,” and then I start calling everyone and I was like, “Jonathan, take the amniotic fluid out of the floor of the Airbnb. Let’s grab-“

Jonathan Moyer:

Grab some towels.

Luciana Arraes:

“… some towels,” and then the nurse and the doctor’s like, “Okay, we’re going to go to the hospital.” So we had a birth plan. We did a birth plan, and here in Brasília, we have three hospitals that have rooms for natural birth, for what they call a humanized birth is just… but for vaginal birth. So, some of them have a tub, they have things that you can grab on, a ball, different things just for that. So, we had option A, B, and C. We also left the options open within that, because a lot of women get frustrated if they don’t get the room that they were imagining, so we wanted to just make sure that I didn’t have expectations.

We kind of didn’t have expectations of how it was going to be, we didn’t plan, but we had a plan of where we were going. So, that hospital also have a very good neonatal ICU, the NICU, and so, I thought, “Well, he’s preterm.” We decided as a team, let’s go there in case he needs any of that. He ended up not needing it, which was really good. So then, well, we knew all about the stages of labor. It’s like, oh, you can’t eat between contractions. The contractions started five minutes apart already, from the start. I was like, I thought I was going to have time to talk. I cannot even read.

Jonathan Moyer:

Yeah. We thought we’d spend time laboring at home. The nurse was going to come be with us, then say, “Okay, now it’s a good time to go to the hospital.”

Rebecca Dekker:

So Jonathan, what were your thoughts when her water broke like that?

Jonathan Moyer:

Oh my goodness. It was so surprising and we felt very nervous, because that’s a little early, but immediately I just thought, let’s just trust, trust our team. I’m going to trust Luciana, and let’s trust Oliver. He’s ready. Let’s go.

Luciana Arraes:

Yeah.

Rebecca Dekker:

So, did you drive to the hospital or how did you get-

Jonathan Moyer:

I did drive. It was after midnight. I think we got going about 1:00 AM. The roads were clear. That was nice, and we-

Luciana Arraes:

But we came home from the Airbnb, it was very close to our house, and then first I talked to my doctor, and I was shaking and I said, “35 weeks,” and she was like, “It’s okay. His lungs are ready. He’s like a late preterm baby. I’ve seen many babies being born at 35,” and that really gave us peace from the doctor on the phone. And I said, okay, “So, let’s do this, but let’s go home,” because we had gone to the US in February, so I got a laboring gown, I got a bunch of Frida Mom things, and I was like, I want my thanks for the labor, at least that.

So, we came home really quick, and I remember our doula said when the water breaks, water keeps coming out, but I didn’t know, every contraction would be a… Of water. And so, we were on the elevator, there was another contraction, and water on the elevator, I was like, I’m just leaving a path of my water breaking. And so, we had the peace of mind to put some things in the bag. And so, it really felt like a soap opera because a few weeks before, I had a car accident. I was rear-ended when I was stopped at a red light, and I was alone. That was very scary. We checked on him afterwards, but we didn’t have our car. We had a rental car that was given to us, and of course, I was like, “Get towels, because the rental car is going to be a lot.” And so, we had all those thought, and then we finally got going to the hospital, right?

Jonathan Moyer:

Mm-hmm.

Luciana Arraes:

And I got to the hospital, I was like three minutes apart, the contractions, and the doula was coming and she called me, and she was in another city, 40 minutes away. She was on the way, and she’s like, “Should I go to the hospital?” I was like, “Yes. I don’t think this baby is waiting,” and my doctor sent a message with everything she wanted from the people in the hospital.

So, when I got there, it was interesting because the people on call, they sometimes are more to the cesarean idea, right? And my doctor said to me, “You can deny the cervical check, because your water already broke. That can lead to a chance of infections, and we don’t need to know at this point. We know that you are in labor.” And so, I got there and I refused the cervical check, and they were very offended, but I stood my ground because I knew the evidence on that, I knew and I said, no, and she’s like, “Oh, you and your doctor are going to be responsible, because if something happens, you can sue us,” and I’m like, “I’m having contractions and you’re worried about us suing you?”

Luciana Arraes:

But I stood my ground, didn’t let them check, and I did not have a cervical check. So, I don’t know how much I was dilated. My doctor said, “You don’t need to know, we know that it’s progressing. We know it’s coming, and we don’t really need to know how much it is.” I was like, “Okay, well then let’s not do it,” and we didn’t do it. And for them at the hospital, it was a shock, but for me, because we knew, I remember that the failure to progress said that the active labor is six centimeters, right? But I did not really need to check if I was six, because it felt like it was inactive labor already, based on the contractions and based on everything. So, that was another moment that having the knowledge, just I could stand my ground on it.

So, then we got to the hospital and the whole team arrived, it was awesome, this team of women arriving in the room, and they have their uniforms, it’s just it felt like cue in The Avengers theme, and it’s our team coming to the rescue. And I don’t know if you think that, but I think the most amazing things about that team is they just let me be. They were just looking at me, they were ready to help, but they did not interfere. They let me do things. Every contraction I would move the way I wanted to move, the way I did with my physiotherapist in the class. They were not guiding me, “Do this, do this,” or “Sit.” No, they let me-

Jonathan Moyer:

They just let it happen. Yeah.

Luciana Arraes:

Yeah, they were just there to observe. They always say, there’s a way of saying in Portuguese that a doctor performs the labor, and they always are adamant and say that they assist on the labor, that the labor is the woman’s, the women and the baby. So, we were the ones running the show, and they were the support team. When they came in and I saw all three women there, and Jonathan, I was like, “Okay, I’m ready to just let go. Then I can go now. This is happening.”

Rebecca Dekker:

And Jonathan, what skills were you putting into practice? Because I know in the EBB child birth class, we talk about lots of ways you can help your partners stay comfortable. So, what was your role during all of this?

Jonathan Moyer:

Right. Yes, I was trying to stay sensitive to what I could do to lend support. I wanted to give a lot of emotional support. I was just by her side the whole time. I didn’t realize this until our doctors said afterwards, she was impressed that I never left her side, not even to go to the bathroom, and I was just there, and they were impressed with how calm I was. I didn’t feel exactly calm inside, but I wanted to project calm and confidence to help Luciana. So, I was just there for that. I did some practical things. There was a shower in our room, and she sat in the shower for some time and I ran some warm water over her to see if that helped keep her comfortable.

Luciana Arraes:

You knew that warm water was a comforting measure.

Jonathan Moyer:

Mm-hmm.

Luciana Arraes:

A nonmedical comforting measure, right?

Jonathan Moyer:

Yep. I did the, I don’t know what you call it, the pelvis?

Rebecca Dekker:

The hip squeeze?

Jonathan Moyer:

Hip squeeze.

Luciana Arraes:

The hip squeeze.

Jonathan Moyer:

Hip squeeze, exactly. We had been doing that throughout the pregnancy, because that really helped Luciana, and there was a moment in labor she asked me to do that with the contractions. So, I got behind her actually, as you were squatting, I think.

Luciana Arraes:

It was almost like we call it in Portuguese, “expulsive,” but I don’t know, the last phase of labor. It was incredible how it helped when you feel like your pelvis is going to shatter, somehow it doesn’t, and then he would squeeze, and he knew exactly what to do, because he knew that. And remember when Ali asked you, “Do you want to stay north or south?” So, he knew where to stay. He was always behind me, holding me. You wouldn’t think that, “Oh, where am I going to be placed?” But we talked about that in the childbirth class, right?

Jonathan Moyer:

Right. Yeah.

Rebecca Dekker:

Wow. And how long did this active labor go on then, Luciana? Because you said when you arrived, you felt like things were already progressing quickly. What happened next?

Luciana Arraes:

So, we went to the hospital room, and they started getting the labor room ready, and then I asked, “Oh, is the labor room with the tub available?” And they said, “No, it’s being used,” and so, I was like, water birth out of the room, so okay. Changed my mindset, we are not going to have a water birth. I know I arrived at the hospital at 1:00 AM, 1:30.

Jonathan Moyer:

1:30, I think. Yeah.

Luciana Arraes:

And he was born at 6:59. So-

Rebecca Dekker:

So, fairly quick?

Luciana Arraes:

It was quick. I remember, I think I stayed in the room less than an hour, and then we went to-

Jonathan Moyer:

The birthing room.

Luciana Arraes:

… the birthing room, yeah, and from there, it was really quick, probably four hours into four and a half hours, he was there. I kind of lost track of everything.

Jonathan Moyer:

Me too. I wasn’t paying attention to the time.

Luciana Arraes:

It was funny, because when I was definitely in active labor, and between contractions, I asked my doctors like, “Okay, since we are at the beginning of things and I’m still fine, what are my options if I have to take a medication or something for pain?” And she’s like, “We are not at the beginning. You are way farther down the road,” I was like, “Oh really? Okay, then let’s keep going.” I thought it was like, “This is just the beginning, I’m in that much pain?” But I think it was way into active labor.

Rebecca Dekker:

Yeah.

Luciana Arraes:

Yeah.

Rebecca Dekker:

And how did the pushing phase go? So, you went to a separate room for the actual birth or delivery, and how did that phase go, the last phase of labor?

Luciana Arraes:

I felt that was the hardest one, the pushing phase. They prepared the room very nicely, just no lights, everything was dim lighting, and they have this starry, it’s like stars on the ceiling, they prepare the rooms very nicely, and there was a sign, I don’t know if you saw that sign, “You are stronger than you think.”

Jonathan Moyer:

I remember that, yeah.

Luciana Arraes:

Every time that I opened my eyes, I would see that sign, “You’re stronger than you think,” I was like, “Oh my God, really?” And they were there, and I felt that the pushing is… Somehow, I had the idea I was going to push, and he’s going to come out. So, the pushing was a little bit at a time. So, having that patience, it felt like I was stuck. So, I remember the nurse always saying, I said, “Am I stuck?” I kept asking her, “Why is it going so slow?” And she was like, “Slow is good. Slow is good for you, it’s good for him. It’s good for you and for him. Just keep breathing.”

And they kept repeating this, I was like, “Why is it going so slow?” It was like, “Slow is good, and it’s not going that slow. You’re feeling that,” and I remember my doctor saying, “I know exactly what you’re feeling. I felt that in my labor too.” And so, it just felt like I pushed, and ugh, he didn’t come yet. Push is like incredible pain, he didn’t come yet, but I would start moving, and they would just see, “Oh, she wants to get into the bed.” So, they would help me into the next position, but they would never say, “Go into that position.”

Rebecca Dekker:

Mm-hmm. Okay. So, you got to choose what positions you were in?

Luciana Arraes:

Mm-hmm.

Jonathan Moyer:

[inaudible 00:29:51] fine, yeah, and it was changing.

Luciana Arraes:

Yeah. I felt different needs every time. Then I felt the need to squat, and then my doula held kind of a piece of… What do you call it?

Rebecca Dekker:

A sheet.

Jonathan Moyer:

A sheet. Yeah.

Luciana Arraes:

Sheet. And so, I would hold to this and squat, and I was like, here, my classes at the gym are coming really in handy, because I was squatting. It felt like a workout. The pushing phase was a workout, and that’s what we were talking about, how important is for pregnant women to be active and to exercise, because I think there’s a mindset that exercising is bad for pregnancy. If I wasn’t as active and doing… I was swimming most of my pregnancy, and doing water aerobics for pregnant women, with teachers specialized in pregnant women, and that all came, I was like, I knew exactly what to do, my body knew how to squat, my body knew how to hold all of that. I kept feeling in the pushing phase.

And so, finally, we sat in a, it’s like a little stool, that’s where we found… And Jonathan was holding me. I felt like more supported. So, Jonathan was holding this hand, the doula was holding that hand, and my doctor was on the floor, and the nurse, they were both on the floor with little flashlights. He’s just lying on the floor, and I remember one contraction, then his head popped out. I was like, “Oh my gosh, he’s almost there,” and then they were like, “Do you want to touch his head?” I was like, “No, I don’t.” I don’t know why. I was like, “What is happening?” And finally, one more contraction, he just jumped out, and my doctor caught him, and that was pretty incredible, and the-

Jonathan Moyer:

-put him directly in your arms.

Luciana Arraes:

Oh, I remember, and it’s so funny when you’re in labor and that’s what was nice being unmedicated, I felt everything, and then I knew exactly when was the ring of fire, it started burning, and I yelled in English. I was going between English and Portuguese, like crazy. It was like, I don’t even know. And I just yelled “Ring of fire!” And then they all start laughing, I was like, she really knows all about labor. I was like, “Oh, thank you for letting us know. We know exactly where we are.”

Jonathan Moyer:

She was so prepared knowing every stage, that she told me she was mentally checking off, “Oh, now I’m at this place. There I go. Okay. Now it’s this,” until she got to the point, “Now it’s ring of fire!”

Luciana Arraes:

And then now he’s out, yeah, and I didn’t know if I was going to get the labor that I could feel everything, unmedicated, and it’s pretty incredible, even though I was nervous because it was early, I didn’t know how he was going to be born, but he was born screaming. So, I was like, this is great. He came right to our arms immediately and we had our golden hour, and then while I got transferred so the placenta could come and she could check, so Jonathan did skin to skin with him. So, for the hour, so you stayed with him, right?

Jonathan Moyer:

Yeah, and before that, when the umbilical cord was ready, when it stopped, I got to cut it, and then I did skin to skin with him.

Luciana Arraes:

And then my placenta just came out, they’re like, “Oh, you’re very ready.” They were even looking at the placenta just like one contraction, plop, and they’re like, “Oh, here comes the placenta.” And I had a minimal tear, very minimal tear, just didn’t even need to stitch, but she did stitch one stitch. And then after an hour, then the pediatricians came, checked on him, everything was fine, he was just a little tired, but the Apgar was nine, I think. And then we went to the room and immediately we started breastfeeding, because our nurse was also a lactation consultant, so she was there to help us because for premature babies, it’s harder for them, because the muscle is not there. So, she helped him, and he did nurse in the first moments. So, we did everything. We were very respected the whole way with our team.

Rebecca Dekker:

Wow, that’s wonderful. And what feelings were going through, both of you when Oliver came out and was finally in your arms?

Luciana Arraes:

Well, I couldn’t believe… I remember the doula saying, “Do you want to hold your baby?” I was like, “I have a baby, and he came out of me? How did that happen?” And it’s like this person on your arm, and he was crying. He immediately settled once I hugged him, it was incredible. I couldn’t believe he came out of me.

Jonathan Moyer:

Yeah. Well, I cried. It was indescribable.

Luciana Arraes:

Yeah.

Jonathan Moyer:

Don’t know what to say, but it was pretty special.

Luciana Arraes:

It’s a miracle.

Jonathan Moyer:

Yeah.

Luciana Arraes:

I still, when I look at him, I’m like, “How did you come out of me? How did you fit in there?” We just say he decided that he was just very anxious to meet us, so he just cut his journey inside short, and came out.

Rebecca Dekker:

And how did it go? Like you said, he came straight to you and wasn’t taken away, so did you get to stay with him the whole time, he didn’t have to go to the NICU?

Luciana Arraes:

No.

Rebecca Dekker:

Or ICU? No? Okay.

Luciana Arraes:

No, the pediatricians were there. I saw them. I was very out of it, but the pediatricians were coming in and out to check if he was born, and when he was born, I remember the pediatrician looking at him to see he was fine, he was crying, he was breathing, and the team was also kind of protective of that moment of us, not letting anyone rush into it.

Rebecca Dekker:

And rush in and take him away, or take over?

Luciana Arraes:

Exactly.

Jonathan Moyer:

Exactly. Mm-hmm.

Rebecca Dekker:

Yeah.

Luciana Arraes:

So-

Jonathan Moyer:

But after we each had our time with him, the golden hour, then the pediatrician examined him, but there with us, they didn’t take him away, just did a physical exam.

Luciana Arraes:

Oh yeah, the room has a little heated crib right next to the bed, so he was able to be checked in the room, so they didn’t have to take him. So, he was weighed, and there was a scale in the room, so the room was ready for him to not leave the room. So, and Jonathan was with the pediatrician while he was doing that, so he was always with us, even after he was not on us.

Jonathan Moyer:

Right. Mm-hmm.

Rebecca Dekker:

And what was your postpartum experience like then, after you went home from the hospital with Oliver?

Luciana Arraes:

So, the postpartum was a little bit more hectic, because we found out that we had different blood types. He’s an A positive, and I’m a O positive, and that triggered a jaundice that was pretty high. So, we had to be in the hospital for five days, treating that with therapy, with the light therapy. So, that was a little hard, and that’s when our team is still checking in on us, but then we were with the hospital team and that was a little harder, because they didn’t really think of the mother. I’m still recovering, and my recovery was really fast. I was already walking and moving, took a shower and all that after the labor, but they kind of scared us, and didn’t quite explain what we were dealing with with the jaundice.

Luciana Arraes:

So, we started getting very nervous, and I was still healing. So, and that was hard for me as the postpartum, because I had to make sure that his glucose levels were high, otherwise, he would have to go to formula. So, I was really working on that and trying to eat well, trying to do all this, and then the jaundice came, and then he has to be only in diapers, and this light thing, and he would cry a lot. And so, that was hard for us all at night, we would just be holding him in the light. So, it kind of flipped to a thing that we didn’t know, and that part, we felt like the hospital wasn’t very understanding of how parents feel. They just… and then they came and two days into this and they go like, “Oh, he lost more than 10% of his weight.” He was born with a very good weight for a 35 week, in pounds. Do you remember, five?

Jonathan Moyer:

Five pounds, something. Yeah.

Luciana Arraes:

Yeah. It’s like two kilos, 650 grams, so that was good. But he lost it because the light therapy dehydrates, so he started losing weight, and they came like, “Oh, you’re going to have to do translactation,” and this sounds like, wait a second. Let’s all take a moment here. And so, then that’s when Jonathan was taught how to feed him with the literal-

Jonathan Moyer:

The cup.

Luciana Arraes:

The cup.

Rebecca Dekker:

Okay.

Luciana Arraes:

So, we’re still in the process of him gaining back the weight, so now we found a pediatrician that is, let’s say more sensitive to the parents. He said to me, “He will be fine. I want to know if you are fine, because you need to be fine for him to be fine,” and I feel like the postpartum, the hospital didn’t realize that if I wasn’t fine, he wouldn’t be fine. And even with the food that they were sending, I said, “I’m not getting enough food, I need to eat more,” and they wouldn’t allow food from outside. We couldn’t order something, for example. So, my mom snuck in some food for me so I could eat more, so I could have more milk, so he could gain the weight back. So, I feel like there’s this disconnection between understanding that for the baby to get better, you need to treat the mom and dad.

Rebecca Dekker:

To see it as a whole family unit, because in order for you to care for Oliver, you had to also be supported as well.

Luciana Arraes:

Exactly.

Rebecca Dekker:

Yeah.

Luciana Arraes:

Yeah, and then along the way, so then one pediatrician on the fifth day, she said, “You guys are not thriving here. I’m sending you home. He’s better. His levels are better, so I’m sending you home. So, in the comfort of your home, I think you can take better care.” So, that pediatrician in the hospital realized, and so that was good, and bilirubin went back up, and he spent one day on the NICU to take care of that. So, that was a hard moment, but also in the NICU, they did have to give him formula, and they either do through a-

Rebecca Dekker:

Little tube?

Luciana Arraes:

A little tube or the cup. Since we had trained him with the cup, he took the cup fine, and everyone was impressed, and I said, “Well, we just gave our child the first tool to survive without us us,” so that was very interesting. He was so little, but he already had a tool that he gave us, and he didn’t need the tube, he did the little cup. And so, it was a lot of learning in the postpartum.

And I did with Livre Maternagem, with the team, I did what they called the prenatal psych therapy. So, I had a psychologist that prepared me, and now I’m going to the postpartum, and having sessions with her to kind of understand more of this afterwards, the hospital and how we were treated. And I felt very guilty because he came early, if he didn’t come early, he wouldn’t have jaundice, but our blood types would be different anyway, so kind of working that out in my mind. I don’t know how you felt like. He was very strong to hold everything together until the day that he started crying, and that I saw that, yeah, we are a family unit. Whatever one is feeling, the other is feeling too.

Rebecca Dekker:

Mm-hmm. And how is Oliver doing now?

Luciana Arraes:

He is well, he is gaining his weight back. He’s now nursing full power, which is changing. So, before, he would just nurse a few seconds and fall asleep, because he gets very tired. So, we have to give him a-

Jonathan Moyer:

Supplement with the-

Luciana Arraes:

… supplement, but with my own milk, and sometimes with formula, just a little bit, because he needs gain weight. We found a very good pediatrician, so he sees him twice a week to see how he’s doing. So, we go back tomorrow, but we are feeling that he’s heavier.

Jonathan Moyer:

Yeah.

Rebecca Dekker:

Yeah. And if you are listening, anyone, a little bit of some baby oxytocin, you can go to our YouTube channel and see the video of baby Oliver in the wrap, but you can just see his little ear poking out, a little bit of hair and a cheek.

Jonathan Moyer:

There he is.

Rebecca Dekker:

Oh, there he is. He’s been sleeping this whole time, so yeah.

Luciana Arraes:

Yeah, he is very calm.

Rebecca Dekker:

So, Luciana and Jonathan, do you have any words of wisdom you want to share with people who are listening, perhaps who are entering birth or parenthood for the first time?

Jonathan Moyer:

Yeah, we thought since we had this experience of having a preterm baby that caught us by surprise, we thought it would’ve been a good idea if we could’ve educated ourselves on being prepared to care for a preterm baby. The needs are different. That was the only thing we felt that was missing in our preparations.

Luciana Arraes:

Yeah, I feel it’s hard to even picture yourself having a preterm. I think that’s why it’s not talked so much, and I’m seeing all the information about babies, for example, I see, “Oh, if your baby is one month, he’s going to do this,” and that’s not true with a preterm. So, things like, “Oh no, he doesn’t have a problem. He just needs more time.”

Rebecca Dekker:

He’s younger.

Luciana Arraes:

Yeah. He’s younger.

Jonathan Moyer:

Right.

Rebecca Dekker:

Yeah.

Luciana Arraes:

And I did some exam that said that my chance for a preterm labor was 2%, so I was like, “Oh yeah, it’s not going to happen.” There was no reason to think about it, but not in a scary way, but just reading a little bit about what is a preterm, what does it mean? Even I got in touch with moms in the NICU who had preterms way younger than him, 20 something weeks, and they had C-sections, and the psychological toll, that is really, really heavy. And I think there’s no way to be completely prepared for it, but it was something that I didn’t even want to think about it, because I didn’t want to even entertain the idea.

So, it’s like, how could we talk a little bit about… And also, talk with moms that it works out? They are incredibly strong, and nowadays, the hospitals have a structure in medicine and everything to take care of little babies. It will be okay if it happens. It’s very scary. It’s very, very scary to have a preterm baby, but I think it started with the labor, because we had a labor that respected him so much, he respected us. I could not have imagined gone through the postpartum that we did, if I had had a labor full of interventions.

Rebecca Dekker:

Or a traumatic birth experience on top of all that?

Luciana Arraes:

Exactly, yeah. That would have been very hard.

Rebecca Dekker:

And I know marchofdimes.org has a lot of information about preterm birth, and about caring for a preterm baby, and signs of preterm labor. Were there any other resources you found that were helpful to you that you want to share with others?

Luciana Arraes:

About preterm babies?

Rebecca Dekker:

Mm-hmm.

Luciana Arraes:

I actually didn’t find that much about preterm babies. I would just Google everything, and Google is just like a dark hole, and then I stopped Googling and kind asking more, and I think that would be interesting even for me now, I think. I didn’t know about that resource, so I will check that out, because I checked everything. He was actually, it was funny, because the EBB information on big babies, we read all of that because he was in the 91 percentile.

Rebecca Dekker:

Oh, okay.

Luciana Arraes:

And he was like, “Oh, you’re going to have a big baby.” What does that mean? And so, EBB was very important. And it’s funny, because also, Ali told us in the class that ultrasounds can be 50% wrong in giving you the weight, and there’s a margin of error in there. And so, he was born with the weight of his last ultrasound, which had been two weeks before. So, that means that he was being put in a heavier-

Rebecca Dekker:

Heavier category than he actually was?

Jonathan Moyer:

Yeah. Mm-hmm.

Luciana Arraes:

Yes.

Rebecca Dekker:

Yeah.

Luciana Arraes:

So, the evidence on big babies helped us to really calm down, like, it’s going to be okay if he’s heavy. And then my doctor was like, “Well, he has to be way over four kilos to not have a vaginal birth, and that is rare,” very rare. Yeah.

Rebecca Dekker:

Well, Luciana and Jonathan, thank you so much for sharing your birth story with us. Any final words?

Luciana Arraes:

Well, thank you so much for the work you do.

Rebecca Dekker:

Oh, you’re welcome.

Luciana Arraes:

It reached us all over here. It was fundamental, and it was a key for us having a good birth, and especially in the situation, and Ali was so supportive, and I even have to tell her, because it was funny, we shared in the class that I had eaten something and threw up, and wasn’t feeling well during the pregnancy, and she’s like, “You’re going to throw up in your labor,” and I sure did a lot. Through the labor, I was like, “Ali knew what she was talking about.”

Rebecca Dekker:

Well, I’m so glad you got connected with Ali and with Evidence Based Birth®, and thank you for sharing your story and telling us about all the wonderful people that are working in Brasília to humanize birth, like you said, and it’s very inspiring to hear your story. So, thank you, and thanks to Oliver for being patient through the whole interview.

Luciana Arraes:

Yeah, thank you so much.

Jonathan Moyer:

Yeah. Thank you, Rebecca.

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.

 

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EBB 245 – Evidence on Pitocin Augmentation, Epidurals, Cesarean

EBB 245 – Evidence on Pitocin Augmentation, Epidurals, Cesarean

Don't miss an episode! Subscribe to our podcast:  iTunes  |  Stitcher  |  SpotifyTo celebrate the upcoming release of our Intervention Pocket Guide, we are going to share with you some of the new research on interventions! Last week I had so much fun on Episode 244...

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