EBB 279: A Surprise Advanced Maternal Age Pregnancy and Unplanned Home Birth with Dr. Maria Rosselson and Nimrod Gutman, EBB Childbirth Class Graduates

Rebecca Dekker:

Hi everyone. On today’s podcast, we’re going to talk with Dr. Maria Rosselson and Nim Guttman, EBB Childbirth class graduates about their surprise pregnancy, and equally surprising home birth.

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, and welcome to today’s episode of the Evidence Based Birth® podcast. Today I’m so excited to welcome a graduate of our EBB Childbirth class. Before we get started, I want to make you aware of a content notice on discussion of unplanned pregnancy, unplanned home birth, and a 911 call. There is also a mention of witnessing a postpartum maternal death in medical school. 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 guests, Dr. Maria Rosselson, pronouns She/Her, is a physician practicing as a board certified ophthalmologist in the Chicago area. Her husband, Nim Guttman, pronouns He/Him, is an architect. They’ve been married since 2016 and live with their dog, Asher. Their life took a surprising turn when they found themselves unexpectedly expecting their first child, a baby girl, in November, 2022. Their baby’s arrival into the world was just as unexpected, an unanticipated, unplanned, unmedicated home birth. Maria and Nim are both graduates of the Evidence Based Birth® Childbirth class, with EBB instructor, Heather McCullough, who also served as their doula. Today, Maria and Nim are here to share their experience in the EBB Childbirth class with us, as well as their journey through pregnancy, and their very exciting birth story. Welcome, Maria and Nim, to the Evidence Based Birth® podcast.

Dr. Maria Rosselson:

Thank you so much, Dr. Dekker. We’re super excited, and a little nervous to be here, but it’s such a pleasure and an honor.

Nim Guttman:

Hey, there.

Rebecca Dekker:

It’s always fun to have podcast listeners turn into podcast guests to then share their story with other listeners. So when you wrote into us, you told us you were very surprised by an unexpected pregnancy. Can you tell us a little bit about finding out you were pregnant? What was so surprising about it? And what that journey looked like?

Dr. Maria Rosselson:

Of course, a very quick moment of background is that I was 43, almost 44 years old, and my beloved husband was 56, nearly 57 years old, and we’ve been married about six and a half years, and had talked about having children, had never really sort of made a true conclusive decision, yay or nay. We had said, “Well, if it happens, it happens.” And certainly when you’re in love, you say things like, “If I ever thought if it would happen with anyone, it would be with you.” There was no concerted effort of any type to go in this direction. And in the year or two prior to last spring, when we found out we were pregnant, we were managing certain other things of developments of life, Nim’s mom had gotten into some cognitive decline, so we were really managing her end-of-life. We were much more educated about invested in end-of-life and memory care than daycare.

And also, like a lot of other folks, with the pandemic, our work lives, we were re-examining and contemplating, “Gosh, how can we change our lives maybe to manage our stress, make things simpler, take some things off of our plate.” That was the life moment that we were in. We’d gone on a trip, had a really lovely time on the trip, we’re trying to get some inspiration, et cetera, and then came home, and I was like, “Oh, I guess haven’t had my period in a couple of months, and are my boobs a little tender? Am I a little nauseous?” We went out for dinner with my best friend who’s a physician as well, she was incredulous I hadn’t taken a pregnancy test, and I was like, “Why would I take a pregnancy test? I’m so old, and Nim is so old, and no, it’s not happening.”

Nim Guttman:

It took a little bit of convincing to get her to take the pregnancy test.

Dr. Maria Rosselson:

It’s a Friday night in the suburbs, and we went out for Korean food, and we’re hanging out having wine, and I was like, “Fine, go get the pregnancy test. Let’s just go pee on a stick.” So that happens, and the test was so positive, I don’t even think I dipped it in the cup, it just smelled the way vapors of the pee. I could not believe it, I could not believe it.

Nim Guttman:

I was waiting downstairs, talking to her friend, we were just kind of chit-chatting. 20 minutes went by, and I kind of looked at our friend, and was like, “Should I go upstairs and checked?” And she’s like, “Yeah, I think that’s probably a pretty good idea.” So I went upstairs, and the rest is history.

Dr. Maria Rosselson:

So the rest is history. So there was kind of a gut reaction, and then I really said, “Look, we have to give it the best think of our lives, because whatever happens moving forward, we have to feel like we did the best that we could to make a concerted decision.” And we talked to a lot of people that we trusted, read a bunch of things, I listened to a bunch of podcasts, wrote in a journal for the first time ever. I think ultimately, we decided that we would be enough, and that this was a leap of faith that we could handle taking.

Nim Guttman:

And just the circumstances of this were just so, hesitate to say out there, but just so unexpected that we thought, “There’s a reason for it somehow.”

Dr. Maria Rosselson:

I think if there was a quintessential moment, and I was like, “Okay, this is really happening.” I said, “Gosh, it seems so statistically unlikely, and maybe, maybe something magical might occur.” And even though it seemed kind of greedy, and almost too big of an ask, who am I to ask for something magical, that I was like, “I think I want to find out what that might be. We want to find out what kind of people we’re going to become if we go in this direction.”

Rebecca Dekker:

Wow.

Nim Guttman:

And we thought about the pregnancy for quite some time, and delayed all these life decisions. And then in the back of my mind, I was like, “Once we make one, it’s sort of like a domino effect, everything else will just follow through.”

Rebecca Dekker:

I mean, I’m just thinking about the surprise you must have felt, and your friends and family, and like you said, you’d been together for a while, you’re thinking this is not even really a possibility anymore, and now you’re becoming parents. So what were those things you were-

Nim Guttman:

You mentioned friends and family, so on her mom’s birthday, we presented her mom with the picture of the ultrasound, and her mom just looked at it in disbelief, and kind of looked at Maria, and looked back at us, and there wasn’t really much of a reaction, more of a disbelief.

Dr. Maria Rosselson:

I mean, I have the most wonderful mom who we had discussed and discussed it for a few years, and then, God bless her, she never gave me any pressure, she never… Insinuating anything, so that was really a marvelous moment. And actually, I’ll say, the notion that I would come to understand my mom in a different way, and that I would share more with her, was actually one of the compelling factors about deciding that this was something that we could handle. It’s banal, and kind of amazing, but it’s this universal human experience, and before, I never felt like I was missing out on anything, we had a great life that was rich and full. The idea that I would have more to share with my mom was surprisingly powerful.

Rebecca Dekker:

You mentioned you dove into finding information, and figuring things out, and taking next steps. So how did you find out about Evidence Based Birth®? How did that come into your life?

Nim Guttman:

Interesting story, so through a mutual friend. We had a pretty broad-based friend group, and as we started releasing this information, I found out that a person in my group happened to also be pregnant, who was an age peer, and she was going to be a first time mom in about a month ahead of us. We wanted to talk to her about what this has done for her, and even though circumstances were different, we wanted to get some information. It turns out that this person happened to be a midwife as well.

Dr. Maria Rosselson:

Right. She had become a birth worker in the time that we had not seen each other in a little bit, but she’s the one that kind of told me about EBB, ’cause I asked, “How are you doing your birth education other than that it’s your job?” And she said, “Oh, you would love this resource.” And I looked at it right away, and I was completely obsessed. Was I obsessed? I don’t know.

Nim Guttman:

A little bit.

Dr. Maria Rosselson:

Okay, I was extremely impressed, and then I was obsessed.

Nim Guttman:

[inaudible 00:09:18]

Rebecca Dekker:

You dove right in, we can say it that way.

Dr. Maria Rosselson:

Yeah, I dove right in. I think what you do is so tremendous, and it’s so hard. Having gone through medical education, reading all that kind of data is so hard, and synthesizing it into these very digestible and very useful elements that you do is so challenging. So thank you so much for doing what you do, and I just started listening to the podcast, and went to the beginning, and kept going, and going, and going. I was not going to spend hours traipsing around the wilds of the internet. Everything I needed was right there with EBB.

Nim Guttman:

I think going through the learning process helped us immensely.

Rebecca Dekker:

I’m thinking back to, you wrote in to us, and you said you had an evolution of thought through taking the EBB Childbirth class, and digesting all of this content about evidence-based care and childbirth, and you took a class, an EBB childbirth class with Heather McCullough, who’s one of our most experienced instructors at EBB. I mean, we’re shipping workbooks to her practically every day, it feels like, because she tracks so many students to her class, and with the other doulas and instructors she works with. What did you mean by this evolution of thought? What happened to your thinking?

Dr. Maria Rosselson:

In the beginning, I think my perspective was very much shaped by my personal experience in medical training, and the experience of my peers who all had children at appropriate ages, who are now graduating from high school. They had their kids in the early aughts. So as a medical student, and as an intern, I rotated through OB-GYN, and it was a very challenging experience. I delivered a few babies, I saw some neat things, but really, I was like, “Man, this is high risk, intense, high liability, scary stuff, and bad things happen, and all the residents are all so stressed out.” And, “Oh, I can’t wait to, God willing, become an ophthalmologist.” That notion that it was a stressful, risky, medical, legally-riddled thing, was how I entered the situation. What it’s worth, one of the most traumatic things I ever saw in my medical training happened in a postpartum individual who was a few days out, and basically had a PE in front of me and actually passed away. I mean, I’ll never forget her.

So my friends were like, “You are going to be with the MFM group, because you are high risk, ’cause you are old, and you will have your baby at so-and-so hospital, and that is how it was going to be.” And I said, “Okay, fine. Great, that sounds good to me.” The more I learned from you, the more I had to make room for this other view, which is not necessarily opposite or conflicting, that, yes, it’s a serious medical situation, but my body is designed for this, my baby is designed for this. Those two things do not necessarily exclude one another. I wanted to be with providers who were experienced, who were good surgeons if that came to pass, ’cause I thought that was very important, and whom I really trusted, because I know that the therapeutic relationship as a provider myself, it only works if you trust each other, and the patient isn’t micromanaging the doctor, because that can raise a lot of different feelings in the doctor.

But I also knew that I knew enough to have certain hopes, and soft preferences, all the while, very much in the context that anything can happen, it’s totally unpredictable, don’t plan too hard, don’t commit to too many things, know stuff, know what would be nice, and then trust your providers to have the best intentions. And I think that’s kind of how things had changed. So whereas, for example, initially, I probably would never have advocated to want to eat and drink as a result of the class, I think I was like, “Why wouldn’t I eat and drink.” Every birth that I ever saw, the person was on their back, in a hospital bed, and I was like, “This makes zero physiological sense. I am going to hopefully advocate for having freedom of movement.” Things like that-

Nim Guttman:

Hands and knees [inaudible 00:13:53] whatever.

Dr. Maria Rosselson:

Oh yeah, like the birth stool, sounds like the best thing ever, and that’s kind of what happened for us. We didn’t have a birth plan or anything like that.

Nim Guttman:

We had two key items, right?

Dr. Maria Rosselson:

Right. We had hopes.

Nim Guttman:

Yes.

Dr. Maria Rosselson:

We had birth hopes.

Nim Guttman:

I wanted to catch the baby, and we were interested in delayed cord clamping.

Rebecca Dekker:

No, catching the baby is a big deal. What was the childbirth class like for you? What did you learn that led you to that point where you were like, “Yeah, I want to be involved in catching the baby.”

Nim Guttman:

I can’t carry a baby through labor, I am not the one in labor, I am not the one that is pregnant, but in some fashion, I wanted to be able to be an active participant in the event. There’s some quality to having “hands-on experience” in childbirth, and the closest thing to having hands-on experience is the physical experience of being able to catch the baby, and also be in charge of how the birth sequence can happen. So I kind of thought that those two small things, catching the baby, A, having a physical connection, and asking for a delayed cord clamping, so in some sense affecting the birth sequence.

Rebecca Dekker:

And protecting your baby, so that they can get all their blood right at the start.

Nim Guttman:

Yep.

Dr. Maria Rosselson:

Before I started listening to EBB, this whole concept of self-advocacy, having the partner be your active partner, the number of roles that are so important for them to fully, physically, practically, literally support you, that wasn’t in my radar at all, and it was such a huge thing that we learned, and I think it made me feel like we were so much more in this together, having an active role for you that was so important was such a big deal. And I kept hammering at you about that, “How do I know you’re going to support me? How do I know you’re going to do this? You didn’t read the book, look book coffee table.” I got the Birth Companion, and was opened just a few times, and then one day, he was like, “Why don’t you just believe that I will be there?”

“Okay, I’m just going to believe.” That’s a good framework, I just decided to believe that it was going to be okay.

Rebecca Dekker:

Yeah, and I love the literal meaning of the word hands-on, and how you want to have hands on the baby, but I’m assuming you also had hands on Maria during the labor process, and we can talk more about that later, using your hands therapeutically. Before we get into the birth story, really quickly, you’ve talked about your mindset, and your birth hopes, who had you chosen to be your provider? Where were you planning to have your baby? And how was that all ready to go?

Dr. Maria Rosselson:

The number one feature was that we wanted to utilize doulas, which again, nobody that I know had done 15, 20 years ago, it wasn’t a thing, but the evidence seemed so strong that I think why would not?

Nim Guttman:

The friend that we had consulted before that was a midwife, she was also a doula, and our neighbors, they suggested 312 Doulas, and we felt like, “Okay, in an LDR, in a labor and delivery room, we can advocate for ourselves, but really, we probably want a partner in that.” The partner can do all sorts of things for you, provide food, provide comfort, talk to the medical providers, and just advocate for you when you are in a situation that may not facilitate clear thinking on your part, right?

Dr. Maria Rosselson:

That’s right. Again, because I did learn of all the various things that can happen, I was most comfortable with an MD, and with this maternal fetal medicine group that is in our area, that has a great reputation, that my best friend has worked a lot with in concert on various pretty sick patients. So she was like, “Look, all the doctors in this group are great, and they really know what they’re doing, and they take care of the sickest of the sick. So you are going to be their most annoyingly well patient, and they will roll their eyes at you, and your requests, and things, but you’re in really great hands.” And I was comfortable with that.

Nim Guttman:

They actually did roll their eyes at us once or twice. They did have a midwife on staff, and I think at one point we were talking to her, and she kind of looked at us, and she’s like, “You’re like candy to us. I mean, you’ll be fine, don’t worry about it. We deal with people with diabetes and just people that are super high risk.”

Dr. Maria Rosselson:

It was definitely going to be a hospital birth, but the hospital did have one room with a tub, and from the very beginning, every visit, I was like, “I want that tub, I want that tub, I want that tub room if possible.” I mean, it’s a little bit of a random chance whether you get it or not.

Nim Guttman:

The funny thing that did happen, we’ll get into this later, but we didn’t get a chance to negotiate this, but at one of our last doctor visits, I think we were like, “Look, these are some of the things that we want to have happen. We want a delayed cord clamping, and my husband wants to catch the baby.” And the doctor looked at us, and said, “Yeah, no, we don’t do that-“

Nim Guttman:

“We don’t know about this baby-catching.”

Dr. Maria Rosselson:

And I was like, “If I caught four babies as a completely bewildered third year medical student, my husband can catch this baby with you behind him.” And then they just kind of changed the subject. So anyway, hospital birth, and I fully anticipated that I would want pain relief-

Nim Guttman:

Epidural, yep.

Dr. Maria Rosselson:

Because, I mean, I have nothing against it. Again, based on my previous experience when I observed births, and I actually had a job in the anesthesia department as a fourth year medical student on the L&D floor, helping the resident on call set up for epidurals. So I got to see a lot of folks having epidurals and not, and I must admit that the memory of the people that had had the epidurals was more appealing than the memory of the folks that did not have the epidurals, so I thought, “Gosh, I think that’s what I would be comfortable with.” So that was the plan.

Thanks to all the things that we learned about the arrive trial, we actively and repeatedly declined any suggestion of a 39-week induction, and I was like, “Look, I’m very comfortable with the relative risk of stillbirth and whatever else of going to 40 plus. I don’t want to go to 41 weeks, but let’s just see if this baby will come by herself.” But we had a scheduled induction.

Rebecca Dekker:

By the due date is what you were hoping?

Nim Guttman:

Yep.

Dr. Maria Rosselson:

Right.

Rebecca Dekker:

Okay.

Dr. Maria Rosselson:

So we had a scheduled induction at 40 and four, and then I came for my last visit prior to that, and said, “Well, we’ll see what happens.”

Rebecca Dekker:

Yeah, and we’ll make sure to link in the show notes the research on the evidence on different options at age 35 plus, just so if people are curious about inductions and the different time points. So Nim, what were you about to say?

Nim Guttman:

Oh, you mentioned 35 plus. So what is that considered geriatric?

Dr. Maria Rosselson:

No, it’s advanced maternity advancement.

Nim Guttman:

No, but they did-

Dr. Maria Rosselson:

They try not to use geriatric anymore.

Nim Guttman:

Anymore. Correct. But-

Rebecca Dekker:

It’s still on the diagnosis schedule though, I believe.

Nim Guttman:

It is, it is.

Dr. Maria Rosselson:

But I’d be ancient, they would just be like…

Rebecca Dekker:

Yeah.

Dr. Maria Rosselson:

Museum specimen pregnancy.

Rebecca Dekker:

But clearly your body was capable of doing this, so-

Dr. Maria Rosselson:

Thank you, body.

Rebecca Dekker:

Yes. And I wanted to point out, you mentioned 312 Doulas, for those of you who don’t know, that’s Victoria and Heather McCullough, who both of whom are experienced EBB instructors as well as having a doula practice. So take us to when you went into labor, how far along were you at that point, and what happened?

Dr. Maria Rosselson:

I was so blessed and so fortunate. It was the most uneventful pregnancy of all time. I felt great. I had zero issues, and was able to work my butt off, and more than up until 38 weeks. Then the last two weeks I was off, and I’m so glad that I had that opportunity, because it gave me a second to catch my breath, wrap up all the small things, and really have a moment of communion with my husband.

I hadn’t seen him work from home, and realized just how hard he works, and it raised my empathy capacity for him, which I think was a good frame of mind to be in. And so I just kind of spent those last couple weeks seeing friends, and taking lots of walks, and just trying to think about what was going to happen. And because of what we had learned from 312 and from EBB, I decided that we try our darnedest to do natural labor induction things. So I walked as much as I possibly could, I mean, I did at least 20,000 steps in those last couple weeks and before then, and I actually tried-

Nim Guttman:

20,000 steps a day.

Dr. Maria Rosselson:

Right. I tried to run, we’ve run some marathons, I tried to run throughout my pregnancy, and then it got uncomfortable about 35 weeks, so I was just going uphill in the treadmill with my arms like this a lot, and frightening the people who peeked into the gym. In the last week, I actually ran three times, and I was like, “Man, this baby is never coming. I’m going to have to throw her up, because she’s not coming the normal way if I am suddenly more comfortable running.” But I was being as physically active as I could be. We started the dates at 36 weeks, so many dates, good thing I like dates, nipple stimulation at 39 weeks, and I was doing the EPO at 38 weeks. So those were the things that made sense, they were not-

Rebecca Dekker:

Not super invasive or anything.

Dr. Maria Rosselson:

Exactly.

Rebecca Dekker:

Yeah.

Dr. Maria Rosselson:

Decent evidence, inexpensive. Good thing I like dates, let’s do it. My due date was a Saturday. I was just going about my day. It was really important that I get a pedicure, I was like, “I can’t miss this, ’cause then I’ll never get another pedicure ever again.” And just running some errands, et cetera, and nothing happened on Saturday. The next day, Sunday, 40 and one, same thing, just kind of running around doing things, we went for that COVID test for the pre-induction.

Nim Guttman:

You did say something changed though, on Saturday-

Dr. Maria Rosselson:

So long, long walk. I think I walked 30,000 steps.

Nim Guttman:

Yeah, Sunday was the 30,000 steps day.

Dr. Maria Rosselson:

And then literally at about three o’clock, we were hanging out with a friend, and I was like, “Oh, my Braxton Hicks.” That had been happening for weeks, and, weeks and weeks. I was like, “Oh, that seems different. That seems to be in a different location. Are they coming every 10 minutes or so? okay, whatever, they don’t feel that bad.” And we communicated with the doulas, and they were like, “Oh, sometimes things happen at 3:00 AM.” But nothing happened at 3:00 AM, I got a decent night’s sleep. So I woke up on the Monday, which was 40 and two, and just kind of went about my day, dog walk, “Oh, I think these contractions are happening every seven, eight minutes, but they’re fine. I’m fine.” Do my breakfast, another walk. Took a work call, bouncing on the bouncy ball, contractions stopped. Didn’t like the work call. I had read the evidence on castor oil, and I did procure some castor oil, but it did not sound especially appealing.

So I actually called our friend who’s the midwife, was like, “Should I do the castor oil? The induction is Wednesday and it’s Monday.” And she was like, “Well, you could have an orgasm instead.” And I was like, “Oh, that sounds more appealing.” So did not do the castor oil. Nim is furiously working, and at about four o’clock…So I’m having contractions the whole day, but really just two to three max out of 10 intensity. They’re becoming closer together, but perfectly disruptive, so we go for a walk at 4:30-

Nim Guttman:

At about 4:30, it was pencils down for me, and we decide-

Dr. Maria Rosselson:

Right.

Nim Guttman:

To go for a walk, and Maria’s like, “Having some contractions.” And we had spoken to-

Dr. Maria Rosselson:

Let’s use the contraction app timer.

Nim Guttman:

Yeah, that 312 Doulas had told us. We timed the contractions, we walked for about 40 some odd minutes, thereabout, and in that span, she had 13 contractions.

Dr. Maria Rosselson:

17.

Nim Guttman:

17-

Dr. Maria Rosselson:

17 in 35 minutes or something like that.

Nim Guttman:

That lasted anywhere… There were 20, 10 to 30 seconds long.

Dr. Maria Rosselson:

Correct.

Nim Guttman:

And were about an inconsistent amount apart.

Nim Guttman:

We’re walking, she’s like, “Oh, here comes another one. Okay.” And we’re walking with the dog. I’m timing these things, and the app is saving it. And then the app is like, “You need to go to the hospital.”

Dr. Maria Rosselson:

To the hospital, to the hospital.

Nim Guttman:

And I’m like, “Yeah, this is not-“

Rebecca Dekker:

But you’re just talking through it, they’re-

Nim Guttman:

Yeah, this is not what 312 has-

Dr. Maria Rosselson:

This is not what 312 has told us-

Nim Guttman:

Has told us.

Dr. Maria Rosselson:

Is the time to go to the hospital.

Nim Guttman:

Yeah. So then I took a screenshot of everything, and I sent it off to 312 Doulas. After we finished our walk, we came back home, and they’re like, “Yeah, that’s all pre-labor stuff. No need to worry. You should go home, relax, take a hot bath, have a glass of wine-“

Dr. Maria Rosselson:

Eat something.

Nim Guttman:

“Eat a great meal, just take a chill.”

Dr. Maria Rosselson:

Right.

Rebecca Dekker:

Which makes sense, because they were happening frequently, but they were very short and very tolerable.

Dr. Maria Rosselson:

Yeah, right. So we have some negotiations about when the dog is going to go to the dog care person.

Dr. Maria Rosselson:

We get some pizza-

Nim Guttman:

We get some awesome garlicy pizza, because we know that kind of savory, sort of spicy-

Rebecca Dekker:

This is Monday still?

Dr. Maria Rosselson:

Correct.

Nim Guttman:

This is still Monday, same day. We get this pizza, we have this wine, Maria’s like, “Oh, I’ve got some more contractions.” I’m like, “Should we time them?” She’s like, “There’s not much going on, and they’re still pretty inconsistent.” And me being there kind of like, “Okay, no, let’s not time them, whatever. You’re going to tell me when we need to begin to time these things, and we’re still negotiating about the dog.

Dr. Maria Rosselson:

Things do get a little bit more… The sensations change to being more lower back, like, “Well, let’s try this rice sock with the warm rice.” And-

Nim Guttman:

But we did the rice sock a bunch of times.

Dr. Maria Rosselson:

That’s somewhat pleasant.

Nim Guttman:

Yeah.

Dr. Maria Rosselson:

Let’s try the TENS unit, that is unpleasant. This TENS unit is just giving me a different kind of discomfort. Box ticking, I’m like, “Well, let’s turn some TV on. Let’s distract ourselves.” Antiques Roadshow is on-

Nim Guttman:

Watch Antiques Roadshow for a little bit.

Dr. Maria Rosselson:

And there’s still this video of me at this moment-

Dr. Maria Rosselson:

I’m hands and knees-

Nim Guttman:

The TENS unit.

Dr. Maria Rosselson:

With the TENS unit. I specifically had put on this shirt that I got when I graduated from residency. It’s a Kentucky unbridled spirit shirt, and it has a good vibe for me. So I’m in my shirt, I’m hands and knees over the couch. And now that I see this video, I’m like, “That is a person in labor. This is a lady in labor-“

Rebecca Dekker:

And you’re doing it.

Nim Guttman:

In the video, I’m like, “Are you okay? Is it painful?” She’s like, “It’s really nothing, but the TENS unit is really annoying. The TENS is bugging me.” And you just-

Dr. Maria Rosselson:

Just take that thing off.

Nim Guttman:

“Just take that thing off things.”

Dr. Maria Rosselson:

So things-

Nim Guttman:

So then she’s like, “Why don’t you go get…” Well, yeah, things are getting a little…

Dr. Maria Rosselson:

Yeah, it’s getting more, it’s about a six, seven out of 10 pain at this point I would say. But still I can manage. Finally, the decision’s been made to take the dog to the dog care, and I’m trying to-

Nim Guttman:

To get the car ready to take the dog to dog care.

Dr. Maria Rosselson:

Trying to do some positions at this point, so I’m trying the Miles Circuit, I’m trying to be a little more upside down. That is really not working at all.

Nim Guttman:

I’m downstairs, I get the car ready for the dog. I come up-

Dr. Maria Rosselson:

So it’s about 8:30 PM at this point.

Nim Guttman:

I come back upstairs-

Dr. Maria Rosselson:

On the same day, for the 40 and two day, the Monday. And I was like, “Man, it’s really getting lower, it’s a little rectal, and I am most comfortable sitting on the toilet. That geometry feels very okay.” I kind of sit on the toilet, get off to be laying down, moving around, sit on the toilet, get off to be moving around. And then I was like, “Oh, this is feeling kind of vagy and different, maybe my water’s going to break.” I’m like, “Okay, on the toilet, it’s feeling kind of vagy guess my water’s going to break.” And he’s in the bathroom with me. And I was like, “Oh, I should look at this, apparently-

Nim Guttman:

Hold on, hold on.

Dr. Maria Rosselson:

“Breaking water.” And I should make sure that there isn’t a cord or an arm. My husband wishes to chime in important detail.

Nim Guttman:

Yes.

Rebecca Dekker:

Okay. Nim, so you’re witnessing it from a different perspective, so tell us what you were saying.

Nim Guttman:

Correct. So at this point, I am actively chatting with-

Dr. Maria Rosselson:

The doulas.

Nim Guttman:

With Heather. I’m actively chatting with her, and I’m like, “Hey, it’s starting to get a little vagy. What do we do?” And Heather’s like, “Draw a bath, go sit in the bath, just relax.”

Dr. Maria Rosselson:

Maybe the water’s going to break.

Nim Guttman:

“Maybe the water’s going to break.”

Dr. Maria Rosselson:

Maybe the baby did something to a nerve, and that’s why it felt a little vagy.

Nim Guttman:

Yep. Maybe we should just go back and forth, so hop back to Maria, and she’s like…

Dr. Maria Rosselson:

I’m like, “Okay, I think the water’s going to break.” And I’m looking at what’s between my legs, and there is just this stack of things that is emerging, wiggling its way out of my vagina.

Nim Guttman:

And my was like, “Oh, I think the water broke.” And so I text Heather, and she’s like, “Hooray.” And I’m like, “I think Maria wants to talk. Are you available?”

Dr. Maria Rosselson:

Meanwhile, I’m like, “Oh, this bag is not breaking.” And then I literally said, “What is that bulging feeling in my perineum?”

Nim Guttman:

And she’s still sitting on the toilet.

Dr. Maria Rosselson:

“What could it be?” And then I said, “Oh, that’s the head.” And the baby flops out into the toilet.

Nim Guttman:

She says, “Oh, what’s that bulge? Oh, S-H-I-T, that’s the head.” And I’m like, “Huh?” And she stands up, and all I see is the portion of torso and then legs.” And in my brain I’m like, “What do I do? What do I grab? Just grab anything.” And I don’t know if I caught the baby before she hit the toilet, or if I fished her out of the toilet. I, all of a sudden, have a baby in my arms. It’s not making much noise, and she wasn’t moving around-

Dr. Maria Rosselson:

Right, so she wasn’t like a bad color, she wasn’t a limp, but there was not a lot of noise.

Nim Guttman:

And so I’m looking at her, and I start to rock my arms. Again, in my brain, I’m like, “Well, we didn’t come this far to deliver a baby that is notviable.

Rebecca Dekker:

Going to make it, yeah.

Nim Guttman:

And so I’m like, “Do I need to do some baby CPR?” But these thoughts are very quick. I mean, the whole thing may have been only 10 seconds long. And I’m like, “Well, maybe I’ll just bend down and blow.” And so I kind of came short of blowing into her mouth, but I blew on her, and then she kind of shook around.

Dr. Maria Rosselson:

You just blew in her face a little bit.

Nim Guttman:

Yes, and then I blew on her again-

Dr. Maria Rosselson:

And I was like-

Nim Guttman:

And then she started to cry, and I’m like, “Okay.”

Dr. Maria Rosselson:

And I was like, “Give her to me.”

Nim Guttman:

And I’m like, “Maria, here. Put her on the boob.”

Dr. Maria Rosselson:

And that’s what I did. I took the baby, and I just-

Rebecca Dekker:

Are you standing over the toilet right now? What did you do?

Dr. Maria Rosselson:

I’m back to sitting on the toilet.

Nim Guttman:

She’s sitting, she’s back to sitting, and I just put the baby on her. And then I’m like, “What do we do? Let’s call our doula friend.” Oh, whoa, wait, wait, wait, wait. And in the middle of all this, I’m still-

Dr. Maria Rosselson:

She’s still texting with Heather.

Nim Guttman:

I’m texting with Heather, and I’m like… She’s like, “Hey, what’s going on?” And I’m like, “We just delivered.” And she’s like, “What? A pizza?”

Dr. Maria Rosselson:

‘Cause we’ve been talking about having pizza for dinner.

Nim Guttman:

“A baby. What”” And I’m like, “Yes, we just delivered the baby.” I’m bloody, she’s crying, we have a baby right here. And then I look at Maria, and I’m like, “What the F just happened?”

Dr. Maria Rosselson:

That got said a few times. Who do we call?

Nim Guttman:

“Who do we call?” And then I’m like, “Let’s call the other doula friend.”

Nim Guttman:

So I tried to call her, and she’s not available. And then I’m like, “Maybe we should call the doctors.”

Dr. Maria Rosselson:

Maybe let’s just call the doctors.

Nim Guttman:

So then we call her physicians at the hospital, and they’re like-

Dr. Maria Rosselson:

She was very nice.

Nim Guttman:

we go to the hospital.

Dr. Maria Rosselson:

You should get checked the baby checked out.

Nim Guttman:

And then I’m like, “All right, let’s call 911.”

Dr. Maria Rosselson:

Let’s call 911. And we called 911, and they came promptly. And meanwhile-

Nim Guttman:

It was 911 and a bunch of firefighters.

Rebecca Dekker:

The usual, you have a bunch of firefighters coming in and-

Nim Guttman:

When I go downstairs to let them in-

Dr. Maria Rosselson:

The placenta slithers itself out with a sweet little plopping noise into the water. And then they march up here, and we have a little discussion about what hospital to go to-

Dr. Maria Rosselson:

And we end up going to the local hospital that is just a mile away, and I was like, “Oh, I really want to go there.”

Nim Guttman:

The paramedics wanted to clamp the cord, we told them no.

Dr. Maria Rosselson:

Well, they said, “Where is the placenta?” And I said, “I’m sitting on it.” And then they just kind of looked at me, and then when we were leaving the apartment to go to the hospital, they were like, “What should we do with the placenta?” And I said, well-

Nim Guttman:

Get a plastic container.

Dr. Maria Rosselson:

Let’s get a plastic bag. And I just reach into the toilet with my hand like a scoop, and just pop it into this plastic bag, and I said, “Give it to me.” And then I have my arm around the baby, and my other hand with a sack of placenta, and off to the hospital we go. And that was that.

Nim Guttman:

Yeah.

Dr. Maria Rosselson:

And that’s how she came. I just need to say a million times over how outrageously lucky we were, how the stars were aligned. We were so fortunate, and how good our child was to us in her arrival.

Nim Guttman:

One of the last providers we saw at the local hospital was like, “You guys are pretty fortunate. I mean, the last toilet baby that I saw did not do so well.”

Dr. Maria Rosselson:

Right. So we were very, very lucky. And we went to the hospital in the ambulance, and they were like, “Did you have prenatal care?”

“Yes, I am an old lady.”

Rebecca Dekker:

Yeah. You start getting all the stigma of an unplanned…

Dr. Maria Rosselson:

Right, I had lots of prenatal care.

Rebecca Dekker:

Yeah, you’re like, “I had plenty of prenatal care.”

Dr. Maria Rosselson:

NST every week for forever. We came to the hospital, and actually, our experience… Really, again, we are so lucky, and this experience has been so much kind of a miracle in every way. I am a pessimistic realist, and I was bracing myself for every possible challenge, difficulty, badness, et cetera, and really, it’s been fortunately so much the opposite. All the providers, the nurses, all the docs were terrific, and our baby did very well. Of course, the toilet bowl arrival bought her a blood culture, and I had ultrasound, and a chest x-ray, and whatever, but I thought they were sort of low concerned interventions. Everything was very nice in the hospital. I did have elevated blood pressure when I arrived, and ultimately, that just ended up being taking medication for about six weeks. But in retrospect, I wonder if we had been in the hospital for our set hospital birth and I’d arrived and my BP was high, who knows what would’ve happened? Who knows how things would’ve played out differently?

Rebecca Dekker:

So this all happened on the same day?

Dr. Maria Rosselson:

Correct.

Nim Guttman:

Yeah, Monday.

Dr. Maria Rosselson:

So I think I was technically in labor for about 30 hours or so.

Rebecca Dekker:

But they were such mild contractions that you weren’t even really thinking of it as-

Dr. Maria Rosselson:

Correct, correct. And people were like, “Oh, your pain tolerance must be great.” And I said, “No, I don’t think of myself that way at all.” But I just think I was lucky. I mean, I do have to say, my mother had an unmedicated birth because at the time and the place, that was the only option, and she swore to me it really was manageable, and I didn’t believe her. And my sister had an unmedicated birth twice in the United States in the aughts and she said it was manageable, and I didn’t believe her. And that happened to be my experience, but I think I was just lucky. I really think that there’s nothing special.

Rebecca Dekker:

Everybody has a different unique experience, and I think it’s important to hear a spectrum of stories, because there’s a lot of factors that can play into how much discomfort you feel or don’t feel. And for whatever reason, her positioning, your mental state, your environment, you coped really well, and it didn’t really seem like you were in active labor until the baby was there.

Dr. Maria Rosselson:

Correct. I mean-

Nim Guttman:

Yeah, I mean, she was small. She was-

Dr. Maria Rosselson:

Yeah, she wasn’t very large.

Nim Guttman:

Six pounds, six ounces.

Dr. Maria Rosselson:

And she always had good positioning. So that’s what I mean, she was so good to us, we’re so fortunate. She was very considerate in her development and arrival. When I was thinking about what the birth would be like, I kept thinking, “Well, this is pain with a purpose. It has an endpoint. I’m choosing to manage it in a variety of ways, and so I’m not… I thought it would be manageable in that sense, that’s what my sister had said was on her mind when she had her unmedicated birth, and this just kind of turned out differently. Lucky for me.

Rebecca Dekker:

Yeah, and I think back to your birth hopes, you said you wanted Nim to catch the baby, you wanted delayed cord clamping and-

Nim Guttman:

There you go.

Rebecca Dekker:

You had a very short list of preferences, and were both met.

Nim Guttman:

There you go.

Rebecca Dekker:

Plus the added benefit of being able to share a really amazing story.

Dr. Maria Rosselson:

It really was. Credit should be given where credit is due, the facility we were going to be at… I think we didn’t have to specify a lot of things, because they are pretty standard at this hospital. So I think they would’ve honored our wishes. But she did get those two special things.

Rebecca Dekker:

Yeah, very special. Nim and Maria, before we go, is there any words of wisdom or advice you want to pass on to expecting parents, people who are entering birth or parenthood soon?

Dr. Maria Rosselson:

I mean, I feel like we’re still totally collecting advice and words of wisdom from everyone, and I’m sort of no one to have any authority, but there’s a few philosophical things and a few practical things. In terms of being in a partnered relationship, assume good intent, you’re in it together.

Rebecca Dekker:

With your partner.

Dr. Maria Rosselson:

Correct.

Nim Guttman:

Yeah.

Dr. Maria Rosselson:

The postpartum and pre-birth, such a trying time, it’s such a big change. It’s difficult not to be reactionary to the things that are happening from each other that are kind of hard to understand in the moment, but I think-

Nim Guttman:

[inaudible 00:41:27]

Dr. Maria Rosselson:

Assuming good intent is a good frame of mind. We sought out communion from every person we could think of. We had our friend who was the midwife, who had had a child just prior to us. We had a couple of wonderful long conversations with a college-

Nim Guttman:

Oh, that’s right.

Dr. Maria Rosselson:

Grad school friend of Nim’s, who was also an older first-time parent, and that was really an amazing reconnection that’s still going on. That’s been really a boon for us, is to just connect with people. That friend of Nim’s has a great way of looking at having his daughter. He said, “Everything I do now, I just think, ‘What can I teach my daughter as a result of this experience?'” And I think that that framework really elevates our thoughts and actions, and makes you be a little more purposeful, and maybe a little less reactive. So we’re trying our best to do that. You really need so much less than you think. People kept telling me that, and I think I have believed it, but it’s really true. I’ve really been very lucky to connect with a bunch of neighbors through our neighborhood Buy Nothing group, and I love using that as a resource for all things baby, and even pre-delivery.

Nim Guttman:

And that’s just a really nice community-based… You take and you give back, I mean, who needs to buy something that’s good for three months-

Rebecca Dekker:

[inaudible 00:42:51] our consumption, and-

Nim Guttman:

Correct.

Rebecca Dekker:

Thinking, especially for first-time parents, that using those resources, that’s a great idea.

Dr. Maria Rosselson:

It was wonderful.

Nim Guttman:

It’s a very sustainable way to-

Dr. Maria Rosselson:

You meet nice people, and get things with the story.

Nim Guttman:

Yep.

Rebecca Dekker:

We used to use Craigslist a lot to… As our third child outgrew things, she was our last, we would list them on Craigslist for a low fee, and someone came and bought a stroller, and she was an EBB listener. It was a really fun experience to just meet other parents as we were passing on our equipment to new parents.

Dr. Maria Rosselson:

And I think the other really big philosophical thing that’s been great for me is practicing active little gratitude moments as much as possible. The postpartum, again, I was embracing myself for just an avalanche of emotions, and hormones, and the possibility of depression, and difficulties with feeding, difficulties with sleeping, difficulties getting along with each other. And I just tried from the very beginning to thank our daughter for just being her. Every time that something pleasant happened that had an unpleasant alternative, I literally would thank her. And every time I had a chance to take a shower when we were home with her figuring her out, I would actively list all the things that I was thankful for at that moment.

And I think that that really went a long way to helping my mental health, and I’m trying to continue that now. ‘Cause it’s tough out there, but if you can, take a second, and realize that it could always be worse, and that means that it’s really not that bad right there, right now, and you have no idea or no control over what’ll happen in five seconds, five minutes, or five days. It makes it all kind of more manageable.

Rebecca Dekker:

Well, Maria and Nim, we have to wrap up this interview, but thank you so much for both of you coming on and sharing your story. So nice getting to meet you, and see your faces and hear your story. So we really appreciate you.

Dr. Maria Rosselson:

We really, really appreciate you, 312 Doulas for guiding us on our journey. We appreciate all the other parents out there who are in these moments.

Dr. Maria Rosselson:

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 in 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.