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In this episode we talk with Evidence Based Birth® Childbirth Class graduate, Leah Bergman about her experiences navigating a recommended 38-week induction due to a diagnosis of Intrauterine Growth Restriction.

Leah Bergman is a new mom and has recently made the decision to leave her full-time job as a church musician to be able to dedicate more time to her family and raising her daughter. She received a bachelor’s degrees in cello performance and music education from The Ohio State University and attended Luther Seminary in St. Paul, Minnesota as a Master’s of Sacred Music student. While living in the Twin Cities, she performed with various ensembles including singing with The National Lutheran Choir. An Iowa native, she moved back in 2016 where she has enjoyed playing her cello with local music and theater groups. When she’s not involved in music or busy with the baby, Leah enjoys cooking, knitting, coloring, sewing, and going on walks with her husband, Gunnar, and dog, Winnie.

In this episode Leah shares how she was inspired by a friend to read Babies are Not Pizzas and then on the recommendation of her midwife found the EBB Childbirth Class. Leah and her husband were planning for birth with as few interventions as possible, until an ultrasound showed signs of intrauterine growth restriction (IUGR). In collaboration with their midwifery team, they pivoted their plans and began to prepare for an induction at 38-weeks. Leah walks us through the difficulties in trying to make informed, evidence-based decisions about pregnancy and how they opted to induce at 38-weeks. Additionally, Leah shares her long two-part induction story and insights into how she was able to use the EBB Childbirth Education to advocate for herself during her induction and after delivery. Despite not having the birth she was originally planning, Leah reminds us that with education and preparation, you can achieve the positive and empowering birth you want, even if it isn’t what you originally expected.

Rebecca shares the evidence on Intrauterine growth restrictions.

Content Warning: intrauterine growth restriction or fetal growth restriction, risk of stillbirth associated with IUGR, medical interventions to induce labor, labor induction, pregnancy complications, high risk pregnancy, frequent ultrasound and NST testing, mention of risk of Cesarean birth, mention of the risk factors for IUGR: placental insufficiently, genetic and congenital problems in pregnancy, anti-phospholipid antibodies, baby born small for gestational age

Resources and References

Find out more about Anna Sutkowski’s doula practice and EBB Childbirth classes here.
Find out more about Rebecca’s book, Babies are Not Pizzas here.

Intrauterine Growth Restrictions:
Listen to Dr. Nicole Rankin’s podcast in IUGR here.

Access a Medscape article on Fetal Growth Restriction (requires a free account) here.

UpToDate article on Fetal Growth Restriction (requires a paid account) here

Inductions:
Listen to the EBB Podcast Episode 153: The Pros and Cons of the Foley and Dilapan-S for Cervical Ripening During an Induction here.

Listen to the EBB Podcast Episode 222: Navigating Induction and Pregnancy at 35+ with EBB Instructor and Birth Fusion Founder, Jennifer Anderson here.

Obtain a copy of EBB Pocket Guide to Labor Inductions here.

 

Transcript

Rebecca Decker:

Hi everyone. On today’s podcast, we’re going to talk with Leah Bergman, Evidence Based Birth® Childbirth Class graduate about her birth story and experience using the EBB childbirth class to prepare for a labor induction due to intrauterine growth restriction.

Welcome to the Evidence Based Birth® podcast. My name is Rebecca Decker 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, and welcome to today’s episode of the Evidence Based Birth® podcast. My name is Rebecca Decker pronouns she, her and I’ll be your host for today’s episode. Today we are so excited to welcome a graduate of our Evidence Based Birth® Childbirth Class to share their birth story. Before we get started, I want to let you know that we will be talking about intrauterine growth restriction or fetal growth restriction, including the risk of stillbirth associated with that condition, and the use of medical interventions to medically induce labor. 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, Leah Bergman. Leah Bergman, pronouns she her, is a new mom who recently made the decision to leave her full-time job as a church musician to dedicate more time to her family and raising her daughter. Leah received bachelor’s degrees in cello performance and music education from the Ohio State University and attended Luther Seminary in St. Paul, Minnesota as a Masters of sacred music student. While living in the Twin Cities, she performed with various ensembles, including singing with the National Lutheran Choir. Originally from Iowa, Leah moved back to Iowa in 2016 where she has enjoyed playing her cello with local music and theater groups. When she’s not involved in music or busy with her baby, Leah enjoys cooking, knitting, coloring, sewing, and going on walks with her husband Gunner and their dog, Winnie. Both Leah and Gunner were graduates of the Evidence Based Birth® Childbirth Class with EBB instructor Anna Zukowski. Leah, welcome to the Evidence Based Birth® Podcast.

Leah Bergman:

I’m so happy to be here. Thanks for having me.

Rebecca Decker:

So tell me, when you were pregnant with your baby, how did you find out about Evidence Based Birth® or the EBB Childbirth Class?

Leah Bergman:

So I actually found out about it before I was even pregnant. When my husband and I started trying to conceive, I happened to see a friend post on Facebook, she’s a maternal health advocate in Iowa, and she posted about your book Babies Are Not Pizzas. And I knew her and I trusted her and I thought the name of the book was so interesting that I went and downloaded it and listened to it while I was driving to and from work in my car. And then I said to my husband, you need to listen to this because it has so much good information for us to talk about when we start planning to have our baby. And then when we did get pregnant, when I asked our midwife about childbirth classes in the area, she said, well, have you heard about Evidence Based Birth®? And I was like, oh, of course I have the book. And so then I went online and looked for classes and that’s how we got into it.

Rebecca Decker:

So you found Anna, and she’s not in the same city as you, but she’s kind of close geographically to where you’re were.

Leah Bergman:

Yeah, as far as I know, there are no current EBB instructors in Iowa. I couldn’t find any, so if there are any folks out there that want to be EBB instructors in Iowa, that’s a need here. So they were just out in St. Louis, which is not too far. We were with two other lovely couples that were in St. Louis, but we were able to join remotely, which was wonderful.

Rebecca Decker:

And what made you decide to hire a midwife then?

Leah Bergman:

So at our hospital, actually the university hospital, they have a really wonderful midwifery program within the hospital. So we were able to give birth in the hospital with midwives. If I had my ideal birth in a little bubble, I really would’ve wanted to do a home birth, but my husband was not really comfortable with that, so we kind of were able to meet halfway and give birth in a hospital with midwives, which was really a wonderful way to do it. And because of, we’ll talk about this later, but because of my need for induction and everything, I probably wouldn’t have been able to give birth at home anyway. So we really loved being with the midwives at the university.

Rebecca Decker:

And then when you got in the class with Anna, what was your experience like taking the class with Anna and the other families who were expecting?

Leah Bergman:

There was really a sense of openness and welcome of all types of people and birth experiences. It turned out that many of us kind of had the same wants for our birth experiences. We were really able to facilitate conversations openly about fears and questions about what was going on and no judgment. And my husband and I really found it helpful, the format, especially being on Zoom, but also having the homework beforehand. We were able to really have some good quality conversations between the two of us before getting into the Zoom classes too.

Rebecca Decker:

So you would work on the material, watch the videos, discuss what you learned, and then get on the Zoom call and talk about it in more depth with Anna and the other families?

Leah Bergman:

And she was able to bring up other things that based on getting to know us as people too, what we may need to know extra that wasn’t addressed in the videos and homework.

Rebecca Decker:

So she supplemented the class with her knowledge and experience. And so tell us then, you said we’re all kind of planning a similar kind of birth. What was your dream birth going to look like?

Leah Bergman:

Yeah, so my dream birth was going to be very no to low intervention birth. I was hoping to have no continuous fetal monitoring and be as mobile as possible, have little distraction and all that kind of stuff go into birth spontaneously. And that didn’t end up happening, but we’ll get into it more. I did end up having a lot of the things that I wanted even with getting induced, but my ideal was kind of as close to a home birth experience in a hospital as possible.

Rebecca Decker:

Okay. Yeah. And your husband was on board with that? He was also interested in that?

Leah Bergman:

Yes. Yeah, he was really good about saying, I was the one that was going to be primarily doing this, so whatever I needed. But the Evidence Based Birth® Class was really great for us in that way because he does tend to come from a much more kind of science medicine oriented mindset. And I am a little bit freer about things. And so the Evidence Based Birth® Class was really good for us to be able to find where we overlap and meet in our ideas of things and how the birth would go.

Rebecca Decker:

And that way you could approach it as a team and any changes in plan you could approach as a team. So when did you find out that things might not go as expected? When was your first realization?

Leah Bergman:

So actually at our 20 week ultrasound they found a couple of anomalies and one was that the baby’s kidneys weren’t showing normally. And so I ended up having to have regular ultrasounds and NSTs because they were worried about amniotic fluid because it was her kidneys. And so because of that, then they ended up finding other things. So it was at our 36 week appointment that they diagnosed us with IUGR intrauterine growth restriction. It can be symmetrical or asymmetrical. We were diagnosed with asymmetrical IUGR and which meant that her head was still growing pretty normally, but the rest of her body was a little behind. And so at that 36 week appointment they said, okay, this is what’s going on. And they said you’re going to have to induce it 38 weeks.

So that kind of started us spinning about whenever people say you have to do this, I thought, okay, do we really have to do it at 38 weeks? What’s the story? And we had a lot of meetings with our midwives, we had more tests at the hospital and through some really caring conversations with one of the really wonderful midwives that we worked with, we decided okay, it really is going to be best and healthiest for baby and for me, to induce it 38 weeks. We ended up pushing it to the end of 38 weeks, so to 38 weeks and six days so that we could try and do everything that we could to try and get labor going on our own. And that didn’t happen. So we did end up going in for an induction at the end of 38 weeks.

Rebecca Decker:

And for our listeners who are not familiar with intrauterine growth restriction, IUGR, which is also called fetal growth restriction, and if you’re Googling it or looking it up online, that fetal growth restriction, you’re going to find more and better results, because it’s the newer term for it. But what was your understanding, how did your doctors and midwives explain this to you? Was this dangerous for your baby? Was it risky? What led to the rationale for the induction?

Leah Bergman:

Yeah, so my understanding was that most likely my placenta had stopped functioning at a hundred percent. And so because of that, all of the nutrients for the baby were really going to growing the baby’s brain and not as much to growing the rest of the baby. And because of that too, as your placenta deteriorates, then it just could create many more problems the longer you wait to give birth. So they kind of explained it as a kind of slippery slope. You can wait and baby will get bigger and stronger, but the placenta might continue to deteriorate, in which case that could make birth even riskier. And so it’s trying to find the sweet spot of baby being… It was really about trying to find the sweet spot of where we could still have as much of the type of birth as we wanted.

They were saying most likely if we waited too long and the placenta was not functioning, then there was a good chance of probably needing to have a Cesarean birth, which is not what I wanted to do. So baby was showing that she was healthy and strong at that point, at that 38 weeks. And so it made sense to give birth when she was at her strongest.

Rebecca Decker:

And for our listeners who really are not familiar, I wanted to use this chance, if it’s okay with you, Leah, to share some info about fetal growth restriction. So there’s some good info both on Medscape, which has a good article with free registration, or Up To Date, which requires a paid subscription. But the diagnosis of fetal growth restriction is based on a difference between actual and expected measurements of an ultrasound for your gestational age. And traditionally it was defined as being less than the 10th percentile weight for gestational age when you’re estimating their weight with an ultrasound with a single baby. Or it can be defined as an abdominal circumference below the 10th percentile for gestational age. But some researchers have proposed using the fifth percentile because that captures the fetuses that are at highest risk for bad outcomes. Although people who are pregnant with babies between the fifth and 10th percentile still need close monitoring.

And it’s really interesting because one of the hardest parts about diagnosing intrauterine growth restriction, is that of all of the fetuses that are at or below the 10th percentile for growth, only 40% are going to be at higher risk for dying before birth or shortly after birth, because the other 40% are constitutionally small. They just maybe inherited a small stature and so that they’re just healthy small babies. And so it’s really difficult to know exactly what’s going on with the baby. It sounds like Leah, in your situation, because the discrepancy between the abdominal circumference and the limbs and the head, the measurements of the blood flow from the placenta, problems with placental blood flow can put a baby at higher risk for fetal growth restriction.

But there’s a lot of causes of fetal growth restriction, it can be genetic problems with the baby or congenital problems with the organs. It can be a maternal infection anywhere from toxoplasmosis to chickenpox and malaria. There’s something called anti phospholipid antibody syndrome that can lead to fetal growth restriction and preeclampsia with severe features can lead to it. Also, just any condition in general that results in low oxygen in the pregnant person or placental dysfunction. So there’s a lot of different causes and sometimes it can be hard to identify exactly what’s going on during pregnancy.

But the question is if you’re going to induce, is it safer for the baby to be born sooner rather than later? And there’s very little consensus on the optimum time. There’s been, I think, five key randomized trials on this and they’ve all found conflicting results. But in general, it seems that the researchers are saying that there’s a benefit of delivering at 38 weeks. So waiting until 38 weeks and not going earlier because if you induce earlier, then you increase the risk of newborn death. So unless there’s some other indication to delivering before 38 weeks, another urgent medical reason, they recommend waiting until 38 weeks. But they also recommend basing the timing of delivery on a combination of factors. What are the medical measurements of the umbilical arteries? How is the baby doing on fetal tests and other doppler tests and signs of the placenta not working properly? And so it’s just a really tricky situation to find yourself in, because it’s not like there’s any hard and fast answers. Is that what you felt like when you were in it?

Leah Bergman:

Yeah, it was completely disorienting and frustrating. I mean, my husband and I had a lot of conversations and tears, because like you’re saying, there didn’t seem to be a lot of just hard evidence to do one way or another. On all of our non-stress tests and doppler and everything, she was showing perfectly. She was passing all of the tests, but they were still saying we need to induce at 38 weeks. So it was really hard to come to the conclusion to go ahead with the induction, because there was so much amorphous information out there.

Rebecca Decker:

There was a lot of uncertainty.

Leah Bergman:

Yeah.

Rebecca Decker:

Yeah. And it sounds like you wrestled a lot, but you came to the decision that you were going to stretch it out, do it the very end of the 38th week. Give your baby as much time as possible, give your body as much time as possible to be ready, because it’s not easy to induce early. When I’m talking with childbirth ed students in our childbirth class or at schools that I teach at, it can be very difficult to induce at 37, 38 weeks because we have the uterus. And in order for the Pitocin or oxytocin to cause contractions, it has to bind to the little receptors that pop out at the end of pregnancy. So, if you induce too early, there’s no receptors, there’s nothing for the Pitocin to latch onto and you can’t get contractions going. So it can be very difficult, especially with your first baby, to induce early. And it sounds like you were trying to weigh all the options. You picked 38 weeks and six days and you went in for an induction, and what was that like?

Leah Bergman:

So we went in for an induction on a Thursday night and they gave me CERVIDIL, which goes in the vagina and stays there for 12 hours. So my understanding is that for first time birthing people, they tend to do that overnight so they can just put it in and you sleep and it does its work and then you wake up and they can hopefully start all of the other stuff to get labor going. It didn’t work that way for me. They put the CERVIDIL in, when they checked me in the morning, there was no change in my cervix. I ended up then having five, they can give six doses of Cytotec or Misoprostol, and I had five of the six doses over the next kind of 24 hours. So I was at the hospital for 36 hours and still had zero change in my cervix.

Luckily at that point, the most advanced midwife came, most experienced midwife came in and she said, we could send you home if you want to do that. It was a little bit taboo, we found out later, for them to send us home. I mean, they gave us the option. They didn’t just send us back, but we said, yeah, I think it would be great to go home, rest, come back and try it again.

Rebecca Decker:

So Leah, they let you go home. You found out later, that’s not typical, but it’s actually a good option for somebody who’s baby is doing fine, your waters have not yet broken, you’re not in labor, and you can just cancel the induction and go back home. Were you relieved to have that option after your midwife suggested that? Was it pretty easy to sign out? How did you actually leave? Because I have almost never hear of somebody actually leaving an induction. It’s something we teach in our childbirth class is like, this is an option. You can always stop it, as long as there’s no risk for infection, you can just stop the induction and go home if it seems like it’s not going to work out and baby’s doing fine and everything.

Leah Bergman:

It was a huge relief that earlier that morning before the midwife came and gave me that option, I was really in a pretty emotional state, just frustrated that they kept checking, they kept trying things and there was just no change. I was tired. I had tried to sleep for two nights in a hospital bed, which are not comfortable. And so one of the things she said was, you can keep trying, but as we keep trying, there’s more risk to both you and the baby. You’ll become more exhausted, and the likelihood of then ending up again with a C-section birth is, the longer you keep trying, the more likely you are to just be so exhausted that you might end up with a C-section birth.

My husband and I both were so tired that when she gave us the option of going home, it was like, oh, we can do that? That sounds great. So it was a beautiful sunny day and the idea of just getting to go home, get some fresh air sleep in our own bed for a couple of nights and come back and try again, just was the best thing and ended up being really good for us. We came back for the second induction with a much better mindset, I think.

Rebecca Decker:

Yeah. And so one of the reasons I feel like it’s unusual, is because most people when they check in for an induction, they kind of have these expectations that it’s going to go quickly and they will have a baby in the next 24 hours. Today’s the day my baby’s going to be born, or tomorrow morning or something. Did you have those expectations or were you prepared for it to be a long experience?

Leah Bergman:

I was prepared for it to be a long experience. I wasn’t prepared for it to be 36 hours of basically nothing,

Rebecca Decker:

No change. Yeah.

Leah Bergman:

And it seemed like as the midwives kept checking me and there was no change, they were not really anticipating that there would be no change either. So I think that’s part of what ended up getting me pretty emotional at the end there of that first induction. But it turned out that leaving once the midwife and the OB on the floor gave us the okay to do that, it was really easy. They just discharged us and we were able to walk out. So it ended up being really easy and really good for us.

Rebecca Decker:

So when did you come back to the hospital then?

Leah Bergman:

Yeah, so we left on a Saturday. We came back on Tuesday morning. We were really only gone for a couple of nights and we went back on a Tuesday. And they end up, they clearly had been thinking about me in the meantime and how to get labor going get my cervix dilated, they ended up using something called dilators to dilate my cervix. What they explained them to us as is, they’re about the size of pencil lead and they insert them into the cervix, and then they use reverse osmosis to interact with the fluid in your body to expand, and as they expand, they help expand your cervix. So they ended up putting three or four of them in and then after those had done their work, they were able to get a Cook catheter in, and that ultimately is kind of what got labor going.

Rebecca Decker:

So the medications were not successful, so they used something called DILAPAN-S, which we have covered on the EBB podcast. If you go to episode 153, we talk about the pros and cons of both the DILAPAN-S and you mentioned a catheter. We talk about catheters for using mechanical pressure to dilate the cervix. So it’s fascinating that they did something that worked better for your body. And then what happened?

Leah Bergman:

Once they did those dilators, like I said, they were able to get the Cook catheter in. And if I remember right, that catheter was in overnight, and about three in the morning I started feeling contractions. So it’s the first time birth, I was like, is it just cramping from the catheter? Didn’t really know what was going on. Eventually it became clear that they were contractions and then after they took that Cook catheter out, then they started Pitocin, and that really got labor going. The whole time I was on continuous fetal monitoring, which was not my favorite thing in the world. Baby was very active and kept wiggling away from the monitors. I would say if there was a bad part of my labor experience, it was the monitors, but they needed to happen because of the concerns for, the IUGR concerns.

But they did have, at certain points were able to use something called a Monica, which is a wireless fetal monitor, which attaches on the belly. And that was better when they could use that because it didn’t have the straps and the nurse trying to hold on the thing onto my belly. But the downside to that monitor was that you can’t labor in the water, but I was able to be mobile in other ways with that monitor.

Rebecca Decker:

They didn’t have a waterproof continuous monitor option.

Leah Bergman:

The other monitors I could labor. So I did labor a little bit in the tub early on, but not with that other monitor. Yeah, labor got going. I was able to be up and moving around. They had peanut balls and birth balls that I utilized a lot. I did have a doula that came after labor started going. And so she and my husband were part of my team for labor. I’ll say one of the other things that I was really thankful for in my birth experience was at one point we decided to get up and walk around. We went and walked the halls. My midwife told me to walk with high knees, which I had never heard about before. So I kind of marched around the hallway very slowly lifting up my knees.

And when I got back, the contractions just seemed to be coming really fast, really strong. And I was getting pretty frustrated that I just really needed a little bit of rest between contractions and I felt like I couldn’t get any. And I asked if we could lower the Pitocin a little bit, and the nurse was really reticent to let that happen. She said, if we lower the Pitocin and you’re not going to continue to progress in your labor. But that was one of the times that my doula and my husband were really able to advocate for what I needed. And they talked with the midwife and the midwife said, yeah, if she needs a little bit of rest, that’ll be good for her, because we’ve still got a while to go.

And so they lowered the Pitocin just like two points. I was able to get in bed and rest a little bit between the contractions. And then it felt like before I knew it, I was in transition and ready to move to the next point. So I was really thankful that we were able to advocate for ourselves in that moment and say, I need a little bit of rest. I think that’s going to be the best thing. And I do think that that allowed my body to just relax a little bit, let things work. And before I knew it, we were at 10 centimeters.

Rebecca Decker:

Wow, you mean all the way to 10 centimeters in an induction without any pain medication, or did you have anything for pain? Other than –

Leah Bergman:

I didn’t have anything for pain. I had a little bit of Tylenol overnight with the Cook catheter, but I didn’t have any other pain medicine during the induction.

Rebecca Decker:

And I think your story about advocating to have the Pitocin turned down, is really important because we’ve talked about Pitocin a lot in the past year here at Evidence Based Birth. And the guidelines and the research clearly state that once you’re in active labor and you have a good contraction pattern, that the Pitocin should be turned down or off completely and your body takes over and it doesn’t need it anymore. And it’s actually the AWHONN, which is the Association of Women’s Health and Obstetric and Neonatal Nurses actually has that in their practice guidelines for nurses. So if they’re telling you, no, it’s really bad, we can’t turn down or we can’t turn it off, that actually goes against their organization’s guidelines. So I think it’s important for families and Doula’s and midwives and nurses to know that it’s not only appropriate to turn it down when you reach active labor, it’s evidence based. But way to go to your team for advocating for you, because it sounds like it’s what your body needed anyways.

Leah Bergman:

Yeah, I didn’t know about that, but that was good to know.

Rebecca Decker:

Well, your instincts were spot on.

Leah Bergman:

Definitely.

Rebecca Decker:

So you got to 10, what happened next?

Leah Bergman:

Yeah, so actually I was not quite at 10 then midwife ended up having to, there was just a little bit of a lip of my cervix that she ended up just reaching in, pulling to the side during a contraction. And at that point we were ready to push. There actually was another woman that was getting ready to push at the same time as me. And I was not totally aware of this at the time, but my Doula and my husband filled me in later that the midwife was going to go and help this other birthing person, and my Doula said, Leah’s really ready to push now. I think you better stay, and it’s a good thing that she did. I did end up delivering on my back with the, we were propped up in the bed, but I only pushed for about 28 minutes. I was not expecting as a first time birthing person, I was expecting that pushing phase to go for a really long time.

But the water hadn’t broken yet, and so they did bring a mirror for me to be able to see myself pushing and see the baby come out. And it was interesting because you could see the baby in the sack of water as she was crowning. The sack of water did end up bursting just before she emerged. But I was able to reach down and touch my baby’s head as she was crowning, which was really special. And the mirror was really helpful to be able to see what productive pushing was looking like. I could feel my body and see what was going on at the same time so I could match those up and have really productive contractions and pushing.

Rebecca Decker:

And it probably helps that all that movement you did while you were being induced and sounds like she must have been in a pretty good position to come out.

Leah Bergman:

She was in a good position and she stayed strong the whole time. I think having my Doula and my husband there too and the midwife, they were all really good at helping us navigate that labor so that we would have successful outcome.

Rebecca Decker:

And after pushing for 28 minutes, your baby was born, what happened next?

Leah Bergman:

She was born, she had a really short cord and so they ended up just setting her on my pelvis. She didn’t reach up even to my tummy, but I was still able to pet and cuddle her as she was laying down there. They waited for the cord to stop pulsing. So it was really hard, because she was all the way down on my pelvis. I couldn’t give her kisses yet, but I knew that I wanted to delay that cord clamping. And so we just were able to pet her while she was down there as she was waiting for that cord to stop pulsing. And then as soon as they cut the cord, then she was up on my chest. And one of the really positive things about the midwives that we delivered with, is they’re really protective of those first golden hours after birth.

And so we had almost two hours of just cuddling her skin to skin and they were a little worried at one point about her temperature. They said her temperature’s a little bit low, let’s take her over to the warmer. And that’s another moment that this class was really good at giving me the power to advocate for myself. And I said, let’s just pile out some extra blankets on top of me. I’d like to continue to have her skin to skin. We can get her a little hat if she needs it. Just trying other things to keep her skin to skin before resorting to taking her to the warmer.

So we did manage to have almost two hours of her skin to skin before they did take her to the warmer for just a couple of tests while they got me up to go to the bathroom and get ready to transfer to the mother baby unit. I was just so happy to be able to have those moments of cuddling her skin to skin.

Rebecca Decker:

And was her health okay? After all the concerns about the fetal growth restriction, was there any issues or medical complications you had to worry about?

Leah Bergman:

So she was really small. She was only five pounds, four ounces when she was born. But otherwise, other than the low temperature, which didn’t come up while she was skin to skin, but it wasn’t really low, it did end up coming up that they weren’t concerned about it after she had been in the warmer for a few minutes and then they gave her back. But other than the slightly low temperature and small, she was considered small for gestational age SGA, but other than those things, she was perfectly healthy. We did have some trouble, because of her size, we had some trouble getting breastfeeding going successfully, which was difficult. But we ended up figuring that out with the help of some wonderful lactation consultants. But other than those things, she has been healthy.

Rebecca Decker:

And they didn’t say anything about your placenta or anything like that being the cause of her being small?

Leah Bergman:

Yeah, we don’t really… No, they did some tests on the placenta and, I guess, I don’t know if they found anything conclusive with that or not.

Rebecca Decker:

So she did end up being small like they thought she would?

Leah Bergman:

She did end up being small, yeah.

Rebecca Decker:

But still healthy.

Leah Bergman:

Yeah. Which was so funny because I kept telling my husband, all the babies in my family were huge. We were like 9, 10. My brother was 11 pounds when he was born, and so I kept saying, oh, our baby is going to be huge. So then she came out this tiny little thing, but healthy.

Rebecca Decker:

Did she end up catching up in her growth? She was small for gestational age as she grew in the newborn phase, did she catch up more?

Leah Bergman:

Yeah. So she’s five months now. At our four month appointment, she was up to the 20th percent percentile in weight, which is still small, but considering she started at under one, she’s catching up well.

Rebecca Decker:

Yeah. So Leah, thank you so much for sharing your story. I’m sure this is really helpful for anybody who might be finding this podcast because they have been diagnosed with IUGR or they’re a birth worker who works with parents who have this diagnosis. I think it’d be helpful to hear that you can. I always love hearing positive birth experiences, even when unexpected diagnoses and interventions happen. Are there any words of advice you have for any people who may be approaching birth or parenthood soon?

Leah Bergman:

Yeah, I think just to tag onto that, I think just to know that you can still have a really positive and empowering birth experience, even if it’s not what you expected, or if it doesn’t start the way that you thought it might start. And that if you can still advocate for those things that you want to get it as close to the birth experience that you want, even amid unexpected things that are going on.

Rebecca Decker:

Well, thank you again, Leah, for coming on the podcast and sharing your story, and I hope you’re continuing to enjoy those snuggles with your beautiful baby. And we appreciate you coming on the podcast.

Leah Bergman:

Thank you so much.

Rebecca Decker:

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/childbirth class to find your class now.

 

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

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