September 15, 2025 • 48 mins
Join us as we discuss an intense, yet victorious birth story from our midwifery practice in San Diego, navigating gestational diabetes management, labor challenges, our longest pushing phase we have supported as midwives, and the journey of a firmly committed and focused first-time mom.
01:09 Diving into Birth Stories
02:04 Reflecting on Midwifery Practices
08:59 Client's Journey to Midwifery Care
10:10 Managing Blood Glucose Issues
17:44 The Birth Story Begins
23:05 Navigating Early Labor Challenges
23:22 Rest and Reassurance
23:54 The Importance of Patience
24:13 Encouraging Progress
24:41 The Power of Support
24:56 Midwives' Tools and Techniques
25:35 A Critical Nap
26:00 Reassessing and Adapting
26:41 Pushing Through Obstacles
27:26 Facing Position Challenges
29:01 The Final Push
30:44 A Hard-Earned Victory
32:10 Reflecting on the Birth Experience
40:41 Postpartum Reflections
42:58 Empowering Future Births
46:40 Community and Support
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Be sure to subscribe to the podcast to catch every episode. Follow us on Instagram for extra education and antics between episodes at: @beautifulonemidwifery
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome to at Home with Kellyand Tiffany, where we share
powerful tools, excitingeducation, and relatable views
about holistic health,physiological birth, and
thriving in the female body.
We are home birth midwives insunny San Diego.
Passionate about thealternatives that give women
control and confidence inhealth, in birth and in life.
(00:24):
We've poured a lot of love intocreating very in depth and high
value offerings.
A monthly membership, aphysiological birth course, and
holistic guides for the womenwho really want to dive all the
way in.
But this podcast.
We want to bring zero costinformation about health and
natural birth and make theseimportant topics accessible
(00:46):
always.
Your support of the show is alsozero cost and means everything
to us.
When you leave a review, sharean episode and join our
newsletter.
It really helps us keep thisspace open, ad free and full of
honest, valuable conversations.
Now let's dive into today'sshow.
kelly_1_07-31-2025_0928 (01:09):
Welcome back to the podcast at home with
Kelly and Tiffany, and we have agreat one for you today.
One of our favorite things to doare share birth stories.
So we have a wonderful birthstory to jump back into.
We're just excited to be herewith you.
I'm so happy that we startedincorporating these birth
stories into this space.
We love sharing them onInstagram and always get
(01:29):
feedback of wow, I love seeingbirth from this different
perspective as we are sharingwhat we are seeing and things
like that.
And so this is another just coolway both.
Professionally to share somethings and to educate and to,
you know, just give some ideasto women of oh, that happened in
my pregnancy.
Oh, so interesting.
That's how they handled it.
But also just personally becauseit's a little bit of a
(01:51):
walkthrough memory lane of whatwas going on at the time and our
own lives and things like that.
So, excited to jump into thisone.
tiffany_1_07-31-2025_092846 (01:58):
I know I could do birth stories
every single episode.
It would be my greatest desire.
I recognize that.
Women want well-roundedinformation.
And the I it, I feel responsibleto share information about other
health pieces for women.
But the birth, I mean, even justcompiling the research, quote
(02:21):
unquote, reminding myself whathappened at this birth.
I was like, I love this.
I love this.
And this was one of those birthsthat.
Groom me as a midwifetremendously.
And I love the, I love how birthdoes that.
I just, it's so good foreveryone who's around it.
(02:41):
It is just the ultimate.
The ultimate, like leveler, theultimate, ah, it's just so good.
kelly_1_07-31-2025_092847 (02:48):
Oh yeah, absolutely.
I'm excited to get into some ofthe details, both even
prenatally, but especially thebirth itself.
I remember thinking like, wow,her decision to choose this type
of care, like at the differentpoints along the way, changed so
much of the outcome, right?
And not oh, look how great weare, but just.
Just the fact, like her choicesthat she made months prior to
(03:11):
her birth itself absolutelyimpacted how the birth itself
was supported and seen and allof it.
And so it's it's just cool toconsider.
tiffany_1_07-31-2025_092846 (03:21):
I know I love it.
I can't wait to share witheverybody first.
I'm gonna read a review, okay?
This is from Isabel Beach.
She says, best podcast ever.
Five stars.
Off to a good start.
Then she says, the friendliest,funniest, most educational
podcast on women's health,pregnancy, postpartum, et
cetera.
(03:41):
From a holistic perspective,I've learned so much from Kelly
and Tiffany and laughed a lotalong the way.
They have obviously put so muchwork into making an awesome
resource for the world.
Great job ladies, and thank you.
A must
kelly_1_07-31-2025_092847 (03:55):
The world.
The world.
I love it.
tiffany_1_07-31-2025_092846 (03:59):
The entire world friendly and funny.
I mean,
kelly_1_07-31-2025_092847 (04:03):
you want?
tiffany_1_07-31-2025_0928 (04:04):
thank you everyone obviously have put
a lot of time into thisresource.
Thank, I'm glad that shows, Ican imagine a world in which it
might not show.
kelly_1_07-31-2025_092847 (04:15):
Yeah.
It feels good to be seen andencouraged in this as we work
diligently behind the scenes.
tiffany_1_07-31-2025_0928 (04:21):
Okay.
Getting into this birth story,the last one we shared, we were
like, honestly, the birth wasuneventful and here's a couple
of interesting things that likehappened along the way, but
birth can just be really simpleand straightforward and I don't
know, un noteworthy.
But this birth,
kelly_1_07-31-2025_092847 (04:42):
Vy.
tiffany_1_07-31-2025_0928 (04:43):
birth is noteworthy.
This birth was.
It was crazy.
This birth to me was crazy.
And I recognized while I wasgoing through this chart there's
things I remember about thisbirth that we did not chart.
And I'm wondering why were wevery busy?
Did we not want a permanentrecord of it, did we, am I
(05:09):
remembering it wrong?
About the.
kelly_1_07-31-2025_092847 (05:12):
Yeah, that's an interesting thing too.
There's been a couple of thosetimes where I've gone back and
be like, oh that's how wethought about it.
But in my brain, I thought aboutit differently and.
You know, we've talked aboutlike people getting their
medical records from theirbirths, you know, from like the
hospital and being like, oh, I'mlike underwhelmed.
'cause I remember all this extrastuff that wasn't put in there.
We're usually, look, we're verydiligent in what we add and a
lot of mom said, this mom movesto toilet, you know, whatever.
(05:35):
It is just interesting whatmight have been in there or what
might have been missed.
tiffany_1_07-31-2025_0928 (05:39):
Yeah, so we're always doing our best,
that's for sure.
There's some things that I likehad questions about, so as a
more seasoned midwife now versuslooking back, this was, this
birth was the very beginning ofour second year of practice, I
think.
Oh.
Second, maybe
kelly_1_07-31-2025_092 (05:56):
Probably second.
tiffany_1_07-31-2025_092846 (05:57):
I don't remember.
kelly_1_07-31-2025_092847 (05:58):
I don't remember exactly, but.
tiffany_1_07-31-2025_0928 (06:00):
Maybe second.
so, it was hard to say'cause thefirst year we only had a few,
the second year is when wereally got going.
So I think this might havetechnically been the third.
Third, technically the thirdyear.
Nope, second.
Sorry.
I
kelly_1_07-31-2025_092847 (06:11):
Oh.
tiffany_1_07-31-2025_09284 (06:12):
date on it.
Second year of practice.
Very passionate, very skilled,very highly trained, very ready,
totally competent.
But there was things that nowgrownup midwife Tiffany,'cause I
was responsible for the chartingat this birth that I would look
at now and say.
(06:33):
What is, what are you trying tosay here in the chart?
What do you This no.
Tiffany, what?
What do you mean that's notenough information?
How, in what way?
So that's good because I alsonoticed that there's things that
we chart, which is a funny thingabout using these charts in
order to create these episodeoutlines.
There's things that we wouldchart better now, and then
(06:56):
there's things that we just havereally let go.
don't know if we're throwingourselves under the bus here as
providers, but as you start toget more comfortable, and we're
not doing 36 births a yearanymore.
So what was funny is we have aentire call log of information
of when we talk to this clienton the phone in pregnancy or an
(07:21):
important email or somethinglike, we documented all of that.
And it's just inter, that wasinteresting to me where I'm
like, wow, that is reallythorough.
Really thorough to have all ofthat documented and responsible
and good, right?
Yeah.
But just not something we wouldtake the time to do anymore.
Un you know, unfortunately, wejust
kelly_1_07-31-2025_092847 (07:42):
Yeah when you're busy too, you have a
lot of systems and when you be,when you take some of those
pieces off your plate, not thatlike it's all helped or skelter
or whatever, but there's justnot the same.
Systems, I guess, in place.
And the, our ability tocommunicate, because we're
dealing with so few clientsclinically right now, our
ability to communicate togetheris just much simpler and
(08:06):
straightforward, rather thanneeding to go back and do that
over, you know, so many clientsat once.
tiffany_1_07-31-2025_09284 (08:13):
Yes, and especially when there was
three midwives working in thesame practice, there was things
happening that we were not apart of but needed to catch up
on, or there needed to be arecord of it for the benefit of
the other provider.
And so, yes, there's a time andplace for that, but how nice
that I can remember most of theconversations I have with our
clients now.
I can tell you about theminstead of writing a really
(08:34):
detailed note and you can belike, okay, cool.
Thanks for letting me know.
Which is just interesting to seehow things evolve over time and
are constantly, you know, influx and changing.
I hope that.
Younger midwives or midwiferystudents hear that and think,
oh, okay, so there isn't one wayto go.
There isn't just my preceptor'sway and the best way to document
(08:57):
and chart and take care ofpeople that way.
Okay, so the history of thisparticular client, she actually
didn't come to us until she wasover halfway through her
pregnancy.
She was 23 weeks pregnant withher first baby.
She spent her first pregnancygetting care through Kaiser, and
we didn't chart why she wanted ahome birth.
(09:18):
We didn't chart why she decidedto come from exclusively Kaiser
care into midwifery careplanning a home birth.
Do you remember?
kelly_1_07-31-2025_092847 (09:26):
I don't actually remember what her
words are, but I do know thatwas an important aspect at this
point in our practice of askingabout that.
And I recognize that.
I don't necessarily remember herreasons.
They must have been compellingenough that we were like.
Yes.
I have a feeling it has to do abit with how medicalized her
pregnancy had become over time.
(09:49):
You know, just with thedifferent issues that she was
dealing with.
tiffany_1_07-31-2025_0928 (09:51):
Yeah, and so she had been in the
medical system a little bitalready.
She had a history of PCOS.
She was on some medications forblood glucose control.
She had an early pregnancy bloodglucose test that was totally
normal.
She had an A1C that was totallynormal.
But we ended up dealing with alot of blood glucose instability
(10:14):
in her pregnancy and quickly wedo our normal like gestational
diabetes screening with ourclients around 28 weeks.
So within this first month of usjust getting to know each other,
maybe we only had one or twoappointments before we had to
tackle some really.
Serious discussions andconversations about keeping her
(10:35):
as low risk as possible in orderto stay in our care.
But with that PCOS, polycysticovarian syndrome, it's really
common for blood glucose issuesto go hand in hand.
It's really common for fertilityissues.
There's just like a whole entiresymptom picture there that.
We can't go into, but one ofthose things was really long
cycles, and so I think she wouldgo like four or five months
(10:58):
without having a period.
And so as she was.
Working on getting pregnant.
We used or she used earlyultrasound as her dating at six
weeks or something, which issuper accurate.
We were able to establish anaccurate due date with that.
We talk with our clients a lotabout having multiple factors of
information when establishing adue date, and sometimes that
(11:20):
early ultrasound is part of it.
Sometimes your own knowledgeabout your cycle and ovulation
and fertility and potentialconception is a part of it.
How long your pregnancies havebeen in the past or pregnancies
in your family history, like allof that can get thrown into
dating stuff.
And so she had this she had theglucose tolerance test with
(11:45):
Kaiser and I had to remindmyself.
kelly_1_07-31-2025_092847 (11:49):
why that?
tiffany_1_07-31-2025_092846 (11:50):
Why that ended up being a part of
it, because very few of ourclients actually choose the
glucose tolerance test, which isstandard in medical care.
But most of our clients do someother type of gestational
diabetes screening just becauseyou can collect more information
with other methods and stuff.
kelly_1_07-31-2025_092847 (12:10):
Yeah, what was interesting is because
her, you know, her care had beenthrough Kaiser and it made sense
lab wise that she was like, I'mjust gonna go make this kind of
as easy and straightforward aspossible.
Or so she thought maybe forherself.
But she did that GTT test andfailed, and I remember her
calling about that.
And being really stressed outabout it and saying, okay,
(12:31):
they're telling me I need totake the three hour test.
And she was like, I'm gonna doit.
That's what I want to do.
And I want to go, you know,continue to follow through what
Kaiser is recommending.
So she did the three hour testas well.
Failed that one as well.
So on, on our minds we have veryspec, like specific parameters
limitations.
And so, you know, it's just inher heads, what exactly is going
on here?
(12:51):
What is she, you know, what kindof feedback is she gonna get?
What is she going to need tohelp potentially stabilize some
of her numbers?
And so she was freaking out aswell.
And Kaiser basically is oh yeah,it's fine.
Here's some information aboutsome nutritional counseling,
which was.
Poor, from what I remember thenutritional counseling she was
given was very different thanwhat we had to eventually like
(13:15):
work, you know, her towards, butthey didn't provide her a
glucose monitor.
They basically said, here yougo.
Here's some nutritionalcounseling.
We'll deal with this later,basically.
And so again, we are like wecare about the outcome of this.
We care about how your body isresponding.
We care that you want this homebirth.
We want to be able to do thistogether as long as it is safe,
as long as we can get some ofthese things stabilized.
Through lifestyle things, right?
(13:36):
That's our parameter here.
And I remember a lot of back andforth on that nutritional
counseling piece, how in depthwe were with providing that for
her, how in depth it was to getthe feedback from her.
But food really was a hard,,it's like a sticking point in
this pregnancy.
It was a hard.
Aspect to nail down.
(13:58):
It was a hard aspect tostabilize.
She would swing quite a bit fromwhat I remember from this, like
hyperglycemic.
Space to this hypoglycemicspace.
And she would come in and justbe like I feel terrible, right?
And so I'm doing these things,but then we would be like, Ooh,
yeah, but that thing that you'redoing isn't within these,
parameters.
Let's try to take that out,really work on this piece.
(14:20):
And so at some point she was upto four, glucometer readings a
day.
And a food diary.
So we know okay, you're takingthis seriously, right?
You're really working hard atthis.
And we just continued to tweak,Hey, we're seeing this.
Let's just take that outcompletely.
Let's swap these things out.
Let's make sure we'reconsidering these things.
Here are all the supplements werecommend.
(14:41):
Here are the lifestyle things werecommend for you to get that
stubborn fasting number,, morein control and eventually.
W again, with a lot of work onher part, it did start to
stabilize.
And I remember being like, oh,thank you.
We could see that it had thepossibility, but we had to work
very hard.
But on both ends, I mean, shehad to work so hard for, food
and lifestyle stuff, but we didtoo in order to partner together
(15:04):
to make this not only justoutcome happen, but just a an
opportunity for her to feelbetter and for her to have.
The healthiest pregnancy thatshe could.
tiffany_1_07-31-2025_0928 (15:14):
Yeah.
And in our call logs, we weretouching base with her every two
days.
She was sharing her food diaryand her blood glucose readings
and we were troubleshooting withher like, okay, that was a
little bit too much of this.
Let's try to back this off alittle bit, add in some more fat
maybe not that first thing inthe morning.
And it was just.
(15:35):
So much tweaking.
And that can be reallyoverwhelming for women.
It becomes a total part-timejob.
Food is really mental for womenand emotional.
And when you're pregnant,there's just an extra
sensitivity to blood glucosescreens and just, or swings.
And wanting to just do the bestthing for your body and your
(15:57):
pregnancy and for your midwivesto have to say, I know that your
Kaiser doctor doesn't care aboutthis because.
To them, you're borderline.
But to us, we have to care aboutit.
We have to put these things inplace.
We have to keep you as stable aspossible.
Our limitations are different.
Our parameters are different.
The way that we're, ourresources are different.
We're gonna have a your baby athome.
(16:19):
It's lower resource.
We need to be sure that thispregnancy is.
As tight as we can be on some ofthese things.
And so that's the beauty ofmidwifery care, but also can
just be tedious and more of moreresponsibility too, and a lot to
a lot to take in stride.
And it's your first baby.
So your first baby, you'realready having some of these
complications.
(16:39):
You're, it already feels like amiracle that you're pregnant at
all.
And just ha just having a lot.
But what it did is itstrengthened our communication.
It gave us a lot of touch pointswith this particular client who
came into care late.
It gave us a lot of opportunityto establish relationship and
communication and expectationsand figure out how to work
(17:00):
together and how to communicate.
So before the birth even starts,we're laying this groundwork,
we're laying this foundation of,are you in?
I'm in.
How In Are You?
Okay, I will match that.
And that piece, that threadreally carried in to her birth.
And so I'll get into it becausedo you see how many notes I
wrote about the bird?
kelly_1_07-31-2025_092847 (17:21):
Oh, and then there was this, but
also this, but don't forgetthis.
And also this thing happened andthis went on for this long.
Yeah.
tiffany_1_07-31-2025_092846 (17:27):
I know because I'm just like, this
was a, it wasn't the longestbirth we've ever been to, but it
was really, it was long.
It was really long.
So it started out actuallycrazily optimistic.
It was like too good to be true.
Because I think on her due dateor the day before, her due date,
(17:47):
the night before her activelabor started, she was starting
to have contractions and theywent into the evening and the
next morning around 5:00 AM Ithink we may have not even known
that she was in labor.
May, maybe we did.
Maybe we had the heads up.
kelly_1_07-31-2025_092847 (18:04):
I remember getting I was the one
who got the call at 5:00 AM andI was like, oh, bless you for
not telling me at 10:00 PM like,Hey, I might be in labor'cause I
would be up all night thinkingabout it.
But yes.
Yeah, continue.
tiffany_1_07-31-2025_0928 (18:18):
Yep..
So it's actually her doula whocalls and her doula was a, is,
was, is still a great friend ofours and someone that was easy
to recommend.
'Cause we like working with themand we know that they'll do
really well with our client.
She calls us herself and shesays, Hey, I've been here for a
while.
This person has been laboringall night.
(18:39):
Her contractions are strong.
This is a very experienceddoula.
Her contractions are reallystrong.
Her water just broke.
And she's saying she has a lotof pressure, so I think you need
to come here right now.
And we're like, whoa.
Maybe this'll be one of thoseprimates, one of those first
time moms that just has a reallystraightforward, quick labor.
(18:59):
And so we're trying, we, we knowthat might not be the case, but
we have lots of signs thateverything is going really
quickly, and so we're like,okay.
Let's be cautiously optimisticand I remember we rushed to her
house.
We got there around 6:00 AM Weobserve with our own eyes.
(19:20):
Oh, she is very active.
Oh, while we're setting up ourequipment, she's starting to
grunt at the peak of everycontraction.
We do our normal intake andassessment.
We always offer a vaginal exam.
But we.
We don't recommend itnecessarily.
It's just this is information.
If you'd like to have it, it'savailable to you.
(19:40):
It usually doesn't help at thispoint.
But she declines it and we'relike, yeah, who needs to know
what's going on in there?
All your external signs areabsolutely beautiful and
amazing.
We are so good.
To just hang out and wait andsee what happens.
Even if you don't have a babyfor a few hours from now,
everything's progressing sosmoothly for you.
(20:01):
She was coping really well whenthe midwife team arrives, it
always makes everyone excitedoh, this is actually happening.
And so there was like a lot ofthat going on too.
Kelly, you mentioned that yougot the call'cause you were the
primary, so that means that youwere like in charge of the
birth.
I'm sure we've explained ourroles before.
(20:22):
To our audience as we'redescribing Bruce, but
kelly_1_07-31-2025_092847 (20:25):
at the time, I forget if it was
like by week or something, but Iwas the one who was like first
call basically.
But from the information I wasgiven, I was like, I'm not going
to just show up by myself'causeit sounds like we're about to
have a baby.
So I called you and we came andI I remember thinking, oh wow.
Like she's.
It seems like she's going tohave a baby soon, but we don't
(20:48):
we don't say that, right?
We say trust your body, listento your body, all of those
things.
And we were there for a couplehours at the time when we were
like, okay, like we're notreally.
We're not really going forward.
We're not necessarily goingbackwards, but we're just in
this same space here, right?
And we're like, okay, all ofthis pressure that you're
feeling like that is, that's anormal thing.
(21:08):
Your baby is, coming down,coming through and here's how we
best can support you in that.
So she was grunting and almostbearing down.
We were like, Hey, you can blowthat out if that feels right
too.
She began doing that for awhile.
And then.
Eventually, again, a couplehours later after that, she's
oh, the pressure is like moreintense when it's there, but
(21:28):
it's not there all the timeeither.
And so I rem I remember at thetime being like, oh, I wonder
what position her baby's in.
I wonder, what we're up to.
And her doula was thinking thesame exact thing.
Her doula is incredibly skilledon positioning stuff, so she's
we're just gonna go ahead andwork on some of these things.
I'm not gonna tell her thatshe's working on pushing her
baby out.
We're just gonna get into thesedifferent positions.
But already around 11 or so,she's already getting tired,
(21:52):
right?
The mom is, she's been up allnight working so hard.
We've been there for right, likesix hours, five hours, whatever.
At this point, she's I really, Ithought I was gonna have my
baby.
I really want to just like, canI just push really hard?
We offer another vaginal exam,which she declines.
But visually, I remember beinglike, we were able to see, she
(22:14):
was laying down or something, orI forget if she was feeling it,
but she felt, or we saw somelabial parting, so we were like,
oh.
So maybe this is what we thinkit is, maybe this is what we're
working on here.
Maybe we are having a baby andwe're just, working slowly.
And I remember that specificallybeing like, okay, great.
I guess, a vaginal exam reallywouldn't like what exactly,,
(22:37):
what exact information are wegoing to get when we're seeing
some of these signs, hearingsome of these signs outwardly.
But as you can imagine.
A woman in that position whenshe's just oh my gosh, I'm
exhausted.
I am, I'm ready just to have mybaby.
She's starting to feel reallydiscouraged because she's dude,
my, the intensity that ishappening right now and the
amount of pressure and mybearing down,, this is around,
(23:00):
this is like afternoon already.
And she's just feeling reallydiscouraged.
She's I don't want a vaginalexam.
I don't want your fingers inthere.
My water has already broken.
I'm trying to, decrease thepotential for infection.
Having that be another thingthat's, on my list of things
that I'm considering.
And, she had been working reallyhard.
So eventually, like around 1230or so, we were like, here's what
(23:21):
we're gonna do.
Get into bed, be as comfortableas possible.
Setting her up with as manypillows, and obviously
contractions are waking her up,but she really does start to
fall asleep during that time,which I remember stepping
outside of, the room with youand being like, I'm so thankful
that she is that she's asleep atthis point.
(23:41):
I'm so thankful that hopefullythis is.
Like us not being in there, usnot talking about anything.
Her just being able to rest andfocus on that important part of
the work of labor will behelpful.
tiffany_1_07-31-2025_0928 (23:54):
Yeah, and I, because we had charted so
many times that she declined avaginal exam every couple hours
that was being offered to her.
I'm sure that we were giving hercounseling like.
Everything you're doing iscompletely fine.
We're totally patient.
You're good.
Your baby's good.
You don't need this right now.
But if you want us to try tounderstand what is happening, we
(24:17):
have to get that information.
I mean, we, because we'relooking at, we now, we've been
supporting all the externalsigns of the being it looking
like you're getting towards theend of your labor.
All that looks really positive.
But now we're starting to getinto the zone, especially with
you saying that you're reallytired.
Where we might be, we mightreally be able to utilize that
information.
(24:38):
So I just imagine.
I just imagine how much it takesfor her to say, no, I actually
want to trust my body.
I wanna really feel and leaninto what's happening in my
body.
I'm saying I'm tired because Iam, but I'm frustrated.
It really means I just need moresupport.
It doesn't mean that I wannagive up.
It's like this dance between allof those things and the, and
(24:59):
honestly we can offer thosetools and we can bring those
resources in, but the mostsupportive thing we can do is
wait.
Especially for a first time mom,it's really common for that last
bit of dilation to take sometime just because the cervix is
open.
Just because she's feelingpressure doesn't mean that it's
time to start pushing.
There's so much going on inthere that we're not trying to
(25:20):
define an experience by what thecervix is doing at all, but this
is definitely the point wherewe're starting to wonder if
there's something more we can doto support her to prevent her
from burning out later.
In the labor, right?
So she sleeps for a half anhour, which was probably so
incredible.
I'll just, I'll leave a teaserin here.
(25:42):
This is not the last time wesent her to bed before she had a
baby.
But it was definitely needed.
It's a, it's one of the toolsthat we use as midwives.
Let's not always just be pushingthings forward.
There's your body's saying itwants rest, it needs something
more.
So she wakes up at 1:00 PM fromher nap.
Things are about the same, andshe.
Finally asks for a vaginal exam,and what we discover in the
(26:07):
vaginal exam is actually reallyencouraging it.
She was nine and a halfcentimeters.
She had an internal or a, ananterior lip, which is part of
the cervix in the front was notfinished dilating, but while
your hand was in there for theexam, Kelly, she pushed a little
bit and that cervix moved out ofthe way.
(26:29):
All in that.
All in that one step.
And then the baby moved down.
You felt the baby move.
Once the cervix moved out of theway, you felt the baby move down
into her birth canal while youwere in there.
And so then she starts pushingwith that and.
kelly_1_07-31-2025_092847 (26:46):
Try
tiffany_1_07-31-2025_092846 (26:46):
We try to be really accurate with
our charting because it just, itmatters.
It's a medical record, but wewanna be really careful that we
don't say something is happeningthat actually isn't.
And so, even though she'sfeeling gruy, even though she
was giving some bearing downeffort, we did not chart that
she started pushing until thispoint.
(27:06):
It's one o'clock in theafternoon.
Because now we know that hercervix is fully out of the way.
Now we know that her baby'smoved down a little bit.
And that's when we charted thatshe officially started pushing
at 1:00 PM And so Kelly, whathappens an hour and a half
later?
kelly_1_07-31-2025_092847 (27:27):
It was not a baby.
I will say that she's continuingto push At this point, we're
keeping our fingers out becausethe effort that she was giving,
when my fingers were in, I waslike, you are moving your baby.
You're not necessarily pushingyour baby right out with this
one push, but like I can feelmovement happening, right?
And so about an hour and a halfafter that she's still pushing,
(27:48):
she's resting, we're doing a tonof spinning baby stuff, right?
Just trying to work with whatshe is doing.
But we notice that hercontractions start to space out
a little bit.
And so that like when she'slaying down in particular, she
starts to get a lot of rest.
That is not necessarily a badthing, right?
That can be a very good signthat hey, we're getting closer.
(28:09):
Your body's saying, Hey, I needto rest'cause I'm about to have
a baby.
And so we were like, let's justgo with that.
Let's try to get you asnourished as possible.
Drink some water, eat some food.
And yes, go back and take alittle nap for a little bit
because there's no, we don'tneed to force this.
We don't need, like your baby isdoing well, you are doing well.
(28:30):
Again, a nap together with yourhusband cuddling in bed because
your body's already wanting togive you some space in between
these contractions is a goodoption here.
So we just sort of were like,let's you two go ahead and do
that.
And she was able to do that fora couple hours.
And I think we also probablytook naps at this point, or,
we're chilling, hanging out in aroom right side, right outside
(28:52):
of their room.
But it was a good couple hoursfor her to start to rest and
reset and the hope was that shewould hope, wake up and push a
baby out.
tiffany_1_07-31-2025_092846 (29:02):
I know we're just like looking for
these, we're looking for thisbig switch, right?
We're looking for this big ah,there we go.
Applying time, applyingpatience, applying nourishment.
That really is just gonna fillyour tank up and then you're
gonna just pop into.
It being more obvious andstraightforward, but it's four
30 in the afternoon.
(29:22):
Again, she's getting to thatplace of I don't know how long I
can do this for.
It was, is what I'm doing evenhelpful?
And so she asked for anothervaginal exam.
During your exam, you suspectthat.
There, the baby's head is justin a wonky position that like
the neck is not, that the baby'schin is not flexed all the way
down.
Creating the most likeaerodynamic space.
(29:44):
And then feeling the suturelines on the baby's head.
You.
Think that what you're feelingis that the baby is ROP, which
is facing towards mom's rightside, but also sunny side up,
which is a very difficultposition to push a baby out in,
especially for the first time,but also common.
(30:05):
It's like one of the most.
Common things that can makelabor take a long time.
So at this point in the labor,we've already been
prophylactically supportingpositional things, suspecting
that's the most likely thingthat's holding things up.
But now we have it as likealmost an official diagnosis.
And so you're like, okay, weneed to figure out how to work
(30:27):
with this.
We have already been sort ofworking to turn the baby and we
will continue to do that, but Iremember the doula who can love
her to death, but she can bebossy and she did have this
moment in this labor where shewhispered to us.
This is the way that this babyhas to come out.
We, if we could have turned thisbaby, we would've done it by
(30:49):
now.
She has to push this baby outop.
And I remember thinking, I thinkyou're right actually.
I think you're actually right.
We do.
This is what we're working withand this is just gonna be hard
and we need to be in it with herfor that.
So you actually kept yourfingers in at this point and you
were applying pressure and this,it turned into a whole, it
(31:11):
turned into like a whole, we'regonna do whatever we can to just
try to get some movement on thisnow.
Like we just have to be workingevery single time.
Every single contraction we'rejust in it and the hanging out
and just waiting to see what thebody does on its own.
We're like, we're trading thatout for now.
We just need to try to preserveyou having your baby at home
(31:33):
because that window is narrowingso much because now we have some
things stacked up against thiswhole thing.
So you're applying pressure onwhere she should push like
Totally.
What we, have only learned fromthe medical model, right?
Like somebody's finger stayingin there and saying, here, push
right here.
Do you see I'm putting all thispressure on your rectum.
(31:55):
Push against that.
And she actually found thatreally helpful.
So.
I hope that women who arehearing this story can see how
sometimes it's absolutelynecessary to pivot, change
directions, use a different setof tools.
It's not gonna look like what wethought it was anymore.
We have to almost let that dreamdie and just try to preserve the
(32:18):
overarching goal.
kelly_1_07-31-2025_092847 (32:18):
And I remember having my fingers in
there and saying can you feelthis push against this, try to
move my fingers, kind of thing.
Again, things that I had heardin midwifery school at certain
births that I was at was certainpreceptors and midwifery school,
but thinking, oh, this is reallyfunny that I'm doing this.
But they, the couple was solike.
No, you, I want you guys to doall the things now.
(32:40):
I know I declined everything,but now I'm going to say yes to
anything, everything.
I just wanna move forward inthis.
And I remember her saying yes,this is really helpful.
But there wasn't really muchchange in how baby was coming
down.
And so I was like, well, I don'tneed to keep my fingers in here
for, a long time or anything.
And so basically what we didagain was the doula took control
(33:01):
of some spinning baby stuff andwas still doing that, just given
the information that I hadgotten with.
The vaginal exam.
And she does that for a while,right?
Probably, I mean, at this pointat time, right?
That was around four 30 whereall of that was happening.
And then around six 15.
She asked for a vaginal examagain.
She was like, please, will youjust see if anything that I'm
doing is working?
(33:22):
And it was working in a specificway.
So when I went in to do thevaginal exam, I was mostly
interested because i'm like,your cervix is out of the way.
I'm mostly interested in whatyour baby's, position is, where
they're at, where their, headis.
And this baby was directly op,meaning like directly Sunnyside
up now.
So that pushing and thatmovement had shifted baby a bit
(33:45):
from that more.
Position.
But that was the moment where Iwas like, yes, okay, we are
gonna have an op baby.
We just have to work with whatwe're working with here.
She, was.
She wanted the information.
So we spoke about that.
We talked about that.
And then she was still feelingthis overwhelming kind of urge
to push and all of that.
So around 7:00 PM we're stillworking together, but then we
(34:08):
start hearing a little bit ofdeceleration in babies.
Heart rate comes right back upto baseline, quickly.
But we're just noting that andwe're like, Hey, we might listen
more often.
Hey, we're like being aware ofthis.
And then, but we decided becauseshe was so tired, because we
were hearing these things, we'relike, let's just give a little
bit of a break for a little bit.
Let's try to blow through yourcontractions for the next like
(34:31):
half hour, the next hour.
Potentially.
Maybe that's what you need,right?
To just relax your body, blowthrough that.
We're not saying don't.
Do what your body is wanting todo, but basically just blow
through that rather than bringall of that energy down in like
a pushing situation.
And so she does that for half anhour or so, and at eight o'clock
(34:51):
that night, she was like, I notpush.
And we're like, we are not goingto, stop you from that.
If you, if that's theoverwhelming thing.
But then, that's all goingnormal for the next like hour.
Again, I'm just thinking of 5:00AM us.
So, so idealistic and all ofthat, but around 9 45 ish.
So mom's been pushing for thishour and a half.
(35:12):
She's I can't stop.
Around 9:00 PM she's I amputting everything I possibly
have into pushing.
She's doing like the purplepushing that we often talk about
Hey, you don't necessarily needto do that again.
The pivots that we are makingand this mom's willing to make,
and the mom feels like she needsto make, and we're just,,
throwing everything that we haveat it at this point.
But baby's heart rate is stilldoing a little bit of a thing.
(35:34):
She's baby is, decelerating, butthen coming back up to baseline,
having a good recovery.
And so we're like, okay, I thinkbaby's doing okay, but also we
may need to like mix.
This purple pushing that youstarted doing in with a little
bit more breathing, Butthankfully we had a baby who was
returning back, to baselines.
And so we were listening prettyconsistently at this point and
(35:56):
telling her like, Hey, how aboutevery other contraction?
Will you push, breathe throughthe other ones and let's.
Give baby a little bit of amoment because your baby's
struggling too.
They've had a long day as well.
They're working very hard aswell.
But I do remember the momentwhere we discovered as we were
looking at mom, laboring and allof that.
(36:16):
It was around 9 45 that nightthat we could see the top of the
baby's head.
And so this baby was finallydown far enough for us to be
able to see what was going on.
And that just felt soencouraging.
But even seeing it, I rememberlooking at the suture lines and
being like, okay, we're havingan op baby, and we're just doing
(36:36):
that.
Obviously we still had some timeto get to the end point, but
that was around 9 45 and therewas a little bit of a
celebration that happened in theroom, and then we all were like.
And now we actually have, stillhave to get this baby out, so we
gotta get back to work, right?
And so we're listening a bunch,and then finally about a half an
hour later, so this mom hadworked for hours and hours to
get her baby down.
(36:57):
At 10 15, she birthed the baby'shead and then the baby came out
completely at 10 16.
And I remember being like everyounce of things that was in my
body was like, oh my goodness.
I'm so thankful, not just likefor how hard it was, but I'm
just so thankful that this babycame out and this baby came out
at home and this baby is okay.
(37:19):
I do remember though, the babybeing slower to transition and
question, not a questioning thathappens sometimes.
We like to give baby as muchtime as they need to transition,
but I remember being like, thislooks like a baby who's been
working hard all day as well.
tiffany_1_07-31-2025_0928 (37:34):
Yeah, and baby came out with meconium.
It took a few minutes for thisbaby to like really come around.
Clearly the baby was stressed.
Clearly the mom was stressed.
Clearly we were really ridingthe edge here.
We were fully informed.
I don't think that we were, Idon't think we were playing.
Too riskily with the situation.
(37:56):
We were constantly incommunication with each other,
with the parents.
They had full, appraisal andconsent of everything that we
were noticing and seeing.
And we were just barely gettingenough progress, barely keeping
things stable, that it wasappropriate to stay home.
She was still appropriate formidwifery care.
(38:17):
It was just like, we just needto get this baby out and.
If things had changed in adifferent way or something had
destabilized, I remember feelingvery much on the edge of calling
this birth for a transfer.
Not because it was an, notbecause it was potentially
turning into an emergency atall, but just whoa, how long?
How far?
How much can we stretch before?
(38:39):
We're just giving a little here,giving little here, giving a
little here.
I think other midwives.
Absolutely would havetransferred.
I don't think that would've beenthe wrong call either to
transfer at this point.
But that is not what the momwanted, and we were willing to
hang in there with her and see.
And even though the baby wasshowing some signs of distress,
the baby was not showing signsof being.
(39:02):
Dangerously distressed.
It was a normal amount of, Hey,my head's been compressed in the
vagina for a while.
Every time you pushed, I'm notgetting the oxygen I want.
It's taking me time to comearound.
But the baby came out, man.
The baby came out.
That was such a victory foreverybody.
It ended up being reallyimportant to the mom.
So even though we have toreflect on these pieces in our
(39:23):
care and the clinical aspect ofit, and we have to take
responsibility for places wherewe were riding the line on some
things at the end of the day.
The ultimate piece to me.
And I mean, safety is importantand of course that's what we're
there for.
But the ultimate piece for me isthat mom saying.
I would've, if I would'vetransferred, if we wouldn't have
(39:43):
seen that through at home, myexperience, my story would have
been completely different.
Completely changed, completely.
She needed us to be in it therewith her, and I think that was
one of the strengths that youreally brought Kelly to the
team.
Just in reflecting on my own, Iremember feeling I'm not sure if
we should keep doing this athome.
(40:04):
And you believed in her.
You saw enough progress that youfelt like things were moving
forward enough to just keeppushing and keep believing in
her.
And I mean, that was incredible.
Really incredible experience.
I was stretched a lot.
Our skills were stretched andchallenged a lot, and it ended
up making a huge impact on thismom and her family,
kelly_1_07-31-2025_092847 (40:25):
And I think it's probably different
having your fingers in andseeing some of those, you know,
like some of those.
Pieces.
Not to say that there weren'tmoments where I was like I
don't, I will never saynothing's something's
impossible, but you're justlike, how long or how long can
we do this?
How long can both of them likebe okay?
So she had an eight hour activelabor, which is great.
She had a nine hour secondstage, which is a long long long
(40:48):
time.
And that's just something tonote that like Absolutely.
If she was not at home.
There would not be an option forthat to have happened.
And then that third stagethough, like the excitement was
not over because her placentatook a while to detach.
Also not surprising with howlong her labor was and
everything that her body wasgoing through and how exhausted
(41:08):
she was.
But almost an hour and a halfbetween when the baby was born
to when the placenta, came out.
There were no signs of concern,no excessive bleeding or
anything.
But we did give her some herbsto help encourage.
That was around minute 45 afterthe baby was born that we were
like, Hey, let.
Let's just try to encouragesomething.
And she eventually startedmoving some positions.
(41:28):
We got our birth stool out andshe actually delivered her
placenta over that with noconcern.
She had about 400 ccs of bloodloss throughout her entire
immediate postpartum, which is adecent amount, but not
necessarily concerning.
And she was feeling good minusthe fact that she was.
Exhausted from the entireexperience.
We checked her for tears aswell.
(41:49):
She had a first degree tear, butshe, as we were looking at it
and counseling and given herfeedback she declined to repair
it and it actually healedwonderfully.
Her baby was only seven pounds,zero ounces, so, I think that
there was a lot of concern abouther.
Glucose readings and potentialGDM status with gestational
diabetes.
And she produced a very normalsized baby.
(42:12):
So there was a lot that waslike, Ooh, that was abnormal.
And then there was a lot that wewere like, oh, look at how this
storyline ended here which wasan interesting thing to consider
as well.
tiffany_1_07-31-2025_0928 (42:23):
Yeah, there's like a lot for her to
process obviously like that is,was a tremendous, a really cr
crazy thing to have toexperience.
Especially, as your onlyexperience, you're very.
First experience with birth,having it be that hard.
I think that there's a lot ofwomen who can relate to that.
A lot of women who are thinkingright now wow, I pushed for four
(42:46):
hours and then I was offered acesarean.
I wonder what it would've beenlike if somebody would've given
me more time, given me moresupport, taken me, had I been in
an environment that I would'vehad more options.
And I think there's some reallyimportant pieces here in that.
Of course who her team was, thesetting, the care model that she
chose.
(43:06):
She had a lot of support withher partner.
She had a lot of support withher doula.
All of that, she was really wellprepared for a potentially super
hard birth.
And that is, that was the goalin preparing all of those
things.
But she was also reallycommitted and I think.
That just impacted us the mostis her commitment, and I had no
(43:27):
idea that she was prepared towork so hard and for so long,
and to want to give up but notgive up, which like, as we've
already said in another setting,it would have been all too easy
to have that story changed withthe inpatient provider.
Her choices up to that pointafforded her options in labor
afforded her time.
And even though the birth waslike a lot she said that she
(43:50):
wouldn't have changed it becauseshe knows that how the odds were
stacked against her and how thatwould have turned out in another
environment.
And so even going through thatreally hard, long thing was
better for her to have theoutcome that she wanted and the
type of birth experience for herown baby and her own family.
And.
Like we need to hold on to thosepieces too.
(44:12):
That is just as important assome of the other pieces.
We need to, like women need tohave some context for what
things really matter, whatthings don't matter.
Preparing for long or hardlabors totally owning your
experience for the good.
Pieces and the vision and thebeauty, and then the challenge
and the victory that comes withwalking through that challenge.
(44:35):
It is usually an accumulation ofmany informed choices and
really.
We wanna help women prepare forbirth in a way that gives them
the best chance for staying inthe driver's seat.
And so I hope that is what comesthrough in this story for
listeners, that you can applythese concepts.
The Midwifery model template isavailable for your birth plan
(44:56):
too.
And that is just every, that'severy bit of passion that we
share in our childbirtheducation class too.
So visit the link in our shownotes to check out that course
if you haven't already.
We have applied birth prep toevery single stage of pregnancy.
So your vision has a chance tolike build and spiral and layer
(45:17):
in the ways that just make yourbirth yours and keep you in the
driver's seat.
And that is, that's midwiferycare.
That is really good midwiferycare in a nutshell.
And having those strategies andlearning that nuance and being
able to.
To have that as a part of yourstory.
I hope that is an encouragement
kelly_1_07-31-2025_092847 (45:36):
I mean, there's so many pieces
here, right?
If you're somebody who hasstruggled with blood glucose
levels in previous pregnanciesor positions of babies in
previous labors, things likethat, there's so many pieces
here that I think can be gleanedAnd learned from, and just
hopefully again, even if you'resomebody who hasn't given birth
yet, that maybe, yeah, thissounds intense, but there's also
(45:57):
the, there's births that go sostraightforward and smooth and
babies just like.
It flies out on a cloud andeverything is, easy and
wonderful.
There's no moral, good or badright here.
This is a hard earned experiencefor these parents, and that is
good and worthy too, and I thinkimpacted her.
Awareness of herself as a momand built her confidence too as
(46:20):
she entered into motherhood.
Which like would she havepreferred an easier labor of
course.
But did that labor teach her andgrow her and build her
confidence in other ways likethat probably were surprising to
her.
Have Absolutely.
And so that is encouraging tome.
As well as just the own personalreflection as a midwife all of
those years ago when when thisbaby was born.
(46:40):
So, this was a great one to comeback and consider and continue
listening.
'cause every so often we willkeep sharing these birth stories
and we love the conversationsthat we're having with you
outside of the episodes aboutthem as well.
So you can hop on over toInstagram and DM us and chat
about this too, if you have anythoughts and feelings about
this.
And we will catch you next week.
(47:01):
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(47:24):
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(47:46):
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Welcome to at Home with Kellyand Tiffany, where we share
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Now let's dive into today'sshow.
kelly_1_07-31-2025_0928 (01:09):
Welcome back to the podcast at home with
Kelly and Tiffany, and we have agreat one for you today.
One of our favorite things to doare share birth stories.
So we have a wonderful birthstory to jump back into.
We're just excited to be herewith you.
I'm so happy that we startedincorporating these birth
stories into this space.
We love sharing them onInstagram and always get
(01:29):
feedback of wow, I love seeingbirth from this different
perspective as we are sharingwhat we are seeing and things
like that.
And so this is another just coolway both.
Professionally to share somethings and to educate and to,
you know, just give some ideasto women of oh, that happened in
my pregnancy.
Oh, so interesting.
That's how they handled it.
But also just personally becauseit's a little bit of a
(01:51):
walkthrough memory lane of whatwas going on at the time and our
own lives and things like that.
So, excited to jump into thisone.
tiffany_1_07-31-2025_092846 (01:58):
I know I could do birth stories
every single episode.
It would be my greatest desire.
I recognize that.
Women want well-roundedinformation.
And the I it, I feel responsibleto share information about other
health pieces for women.
But the birth, I mean, even justcompiling the research, quote
(02:21):
unquote, reminding myself whathappened at this birth.
I was like, I love this.
I love this.
And this was one of those birthsthat.
Groom me as a midwifetremendously.
And I love the, I love how birthdoes that.
I just, it's so good foreveryone who's around it.
(02:41):
It is just the ultimate.
The ultimate, like leveler, theultimate, ah, it's just so good.
kelly_1_07-31-2025_092847 (02:48):
Oh yeah, absolutely.
I'm excited to get into some ofthe details, both even
prenatally, but especially thebirth itself.
I remember thinking like, wow,her decision to choose this type
of care, like at the differentpoints along the way, changed so
much of the outcome, right?
And not oh, look how great weare, but just.
Just the fact, like her choicesthat she made months prior to
(03:11):
her birth itself absolutelyimpacted how the birth itself
was supported and seen and allof it.
And so it's it's just cool toconsider.
tiffany_1_07-31-2025_092846 (03:21):
I know I love it.
I can't wait to share witheverybody first.
I'm gonna read a review, okay?
This is from Isabel Beach.
She says, best podcast ever.
Five stars.
Off to a good start.
Then she says, the friendliest,funniest, most educational
podcast on women's health,pregnancy, postpartum, et
cetera.
(03:41):
From a holistic perspective,I've learned so much from Kelly
and Tiffany and laughed a lotalong the way.
They have obviously put so muchwork into making an awesome
resource for the world.
Great job ladies, and thank you.
A must
kelly_1_07-31-2025_092847 (03:55):
The world.
The world.
I love it.
tiffany_1_07-31-2025_092846 (03:59):
The entire world friendly and funny.
I mean,
kelly_1_07-31-2025_092847 (04:03):
you want?
tiffany_1_07-31-2025_0928 (04:04):
thank you everyone obviously have put
a lot of time into thisresource.
Thank, I'm glad that shows, Ican imagine a world in which it
might not show.
kelly_1_07-31-2025_092847 (04:15):
Yeah.
It feels good to be seen andencouraged in this as we work
diligently behind the scenes.
tiffany_1_07-31-2025_0928 (04:21):
Okay.
Getting into this birth story,the last one we shared, we were
like, honestly, the birth wasuneventful and here's a couple
of interesting things that likehappened along the way, but
birth can just be really simpleand straightforward and I don't
know, un noteworthy.
But this birth,
kelly_1_07-31-2025_092847 (04:42):
Vy.
tiffany_1_07-31-2025_0928 (04:43):
birth is noteworthy.
This birth was.
It was crazy.
This birth to me was crazy.
And I recognized while I wasgoing through this chart there's
things I remember about thisbirth that we did not chart.
And I'm wondering why were wevery busy?
Did we not want a permanentrecord of it, did we, am I
(05:09):
remembering it wrong?
About the.
kelly_1_07-31-2025_092847 (05:12):
Yeah, that's an interesting thing too.
There's been a couple of thosetimes where I've gone back and
be like, oh that's how wethought about it.
But in my brain, I thought aboutit differently and.
You know, we've talked aboutlike people getting their
medical records from theirbirths, you know, from like the
hospital and being like, oh, I'mlike underwhelmed.
'cause I remember all this extrastuff that wasn't put in there.
We're usually, look, we're verydiligent in what we add and a
lot of mom said, this mom movesto toilet, you know, whatever.
(05:35):
It is just interesting whatmight have been in there or what
might have been missed.
tiffany_1_07-31-2025_0928 (05:39):
Yeah, so we're always doing our best,
that's for sure.
There's some things that I likehad questions about, so as a
more seasoned midwife now versuslooking back, this was, this
birth was the very beginning ofour second year of practice, I
think.
Oh.
Second, maybe
kelly_1_07-31-2025_092 (05:56):
Probably second.
tiffany_1_07-31-2025_092846 (05:57):
I don't remember.
kelly_1_07-31-2025_092847 (05:58):
I don't remember exactly, but.
tiffany_1_07-31-2025_0928 (06:00):
Maybe second.
so, it was hard to say'cause thefirst year we only had a few,
the second year is when wereally got going.
So I think this might havetechnically been the third.
Third, technically the thirdyear.
Nope, second.
Sorry.
I
kelly_1_07-31-2025_092847 (06:11):
Oh.
tiffany_1_07-31-2025_09284 (06:12):
date on it.
Second year of practice.
Very passionate, very skilled,very highly trained, very ready,
totally competent.
But there was things that nowgrownup midwife Tiffany,'cause I
was responsible for the chartingat this birth that I would look
at now and say.
(06:33):
What is, what are you trying tosay here in the chart?
What do you This no.
Tiffany, what?
What do you mean that's notenough information?
How, in what way?
So that's good because I alsonoticed that there's things that
we chart, which is a funny thingabout using these charts in
order to create these episodeoutlines.
There's things that we wouldchart better now, and then
(06:56):
there's things that we just havereally let go.
don't know if we're throwingourselves under the bus here as
providers, but as you start toget more comfortable, and we're
not doing 36 births a yearanymore.
So what was funny is we have aentire call log of information
of when we talk to this clienton the phone in pregnancy or an
(07:21):
important email or somethinglike, we documented all of that.
And it's just inter, that wasinteresting to me where I'm
like, wow, that is reallythorough.
Really thorough to have all ofthat documented and responsible
and good, right?
Yeah.
But just not something we wouldtake the time to do anymore.
Un you know, unfortunately, wejust
kelly_1_07-31-2025_092847 (07:42):
Yeah when you're busy too, you have a
lot of systems and when you be,when you take some of those
pieces off your plate, not thatlike it's all helped or skelter
or whatever, but there's justnot the same.
Systems, I guess, in place.
And the, our ability tocommunicate, because we're
dealing with so few clientsclinically right now, our
ability to communicate togetheris just much simpler and
(08:06):
straightforward, rather thanneeding to go back and do that
over, you know, so many clientsat once.
tiffany_1_07-31-2025_09284 (08:13):
Yes, and especially when there was
three midwives working in thesame practice, there was things
happening that we were not apart of but needed to catch up
on, or there needed to be arecord of it for the benefit of
the other provider.
And so, yes, there's a time andplace for that, but how nice
that I can remember most of theconversations I have with our
clients now.
I can tell you about theminstead of writing a really
(08:34):
detailed note and you can belike, okay, cool.
Thanks for letting me know.
Which is just interesting to seehow things evolve over time and
are constantly, you know, influx and changing.
I hope that.
Younger midwives or midwiferystudents hear that and think,
oh, okay, so there isn't one wayto go.
There isn't just my preceptor'sway and the best way to document
(08:57):
and chart and take care ofpeople that way.
Okay, so the history of thisparticular client, she actually
didn't come to us until she wasover halfway through her
pregnancy.
She was 23 weeks pregnant withher first baby.
She spent her first pregnancygetting care through Kaiser, and
we didn't chart why she wanted ahome birth.
(09:18):
We didn't chart why she decidedto come from exclusively Kaiser
care into midwifery careplanning a home birth.
Do you remember?
kelly_1_07-31-2025_092847 (09:26):
I don't actually remember what her
words are, but I do know thatwas an important aspect at this
point in our practice of askingabout that.
And I recognize that.
I don't necessarily remember herreasons.
They must have been compellingenough that we were like.
Yes.
I have a feeling it has to do abit with how medicalized her
pregnancy had become over time.
(09:49):
You know, just with thedifferent issues that she was
dealing with.
tiffany_1_07-31-2025_0928 (09:51):
Yeah, and so she had been in the
medical system a little bitalready.
She had a history of PCOS.
She was on some medications forblood glucose control.
She had an early pregnancy bloodglucose test that was totally
normal.
She had an A1C that was totallynormal.
But we ended up dealing with alot of blood glucose instability
(10:14):
in her pregnancy and quickly wedo our normal like gestational
diabetes screening with ourclients around 28 weeks.
So within this first month of usjust getting to know each other,
maybe we only had one or twoappointments before we had to
tackle some really.
Serious discussions andconversations about keeping her
(10:35):
as low risk as possible in orderto stay in our care.
But with that PCOS, polycysticovarian syndrome, it's really
common for blood glucose issuesto go hand in hand.
It's really common for fertilityissues.
There's just like a whole entiresymptom picture there that.
We can't go into, but one ofthose things was really long
cycles, and so I think she wouldgo like four or five months
(10:58):
without having a period.
And so as she was.
Working on getting pregnant.
We used or she used earlyultrasound as her dating at six
weeks or something, which issuper accurate.
We were able to establish anaccurate due date with that.
We talk with our clients a lotabout having multiple factors of
information when establishing adue date, and sometimes that
(11:20):
early ultrasound is part of it.
Sometimes your own knowledgeabout your cycle and ovulation
and fertility and potentialconception is a part of it.
How long your pregnancies havebeen in the past or pregnancies
in your family history, like allof that can get thrown into
dating stuff.
And so she had this she had theglucose tolerance test with
(11:45):
Kaiser and I had to remindmyself.
kelly_1_07-31-2025_092847 (11:49):
why that?
tiffany_1_07-31-2025_092846 (11:50):
Why that ended up being a part of
it, because very few of ourclients actually choose the
glucose tolerance test, which isstandard in medical care.
But most of our clients do someother type of gestational
diabetes screening just becauseyou can collect more information
with other methods and stuff.
kelly_1_07-31-2025_092847 (12:10):
Yeah, what was interesting is because
her, you know, her care had beenthrough Kaiser and it made sense
lab wise that she was like, I'mjust gonna go make this kind of
as easy and straightforward aspossible.
Or so she thought maybe forherself.
But she did that GTT test andfailed, and I remember her
calling about that.
And being really stressed outabout it and saying, okay,
(12:31):
they're telling me I need totake the three hour test.
And she was like, I'm gonna doit.
That's what I want to do.
And I want to go, you know,continue to follow through what
Kaiser is recommending.
So she did the three hour testas well.
Failed that one as well.
So on, on our minds we have veryspec, like specific parameters
limitations.
And so, you know, it's just inher heads, what exactly is going
on here?
(12:51):
What is she, you know, what kindof feedback is she gonna get?
What is she going to need tohelp potentially stabilize some
of her numbers?
And so she was freaking out aswell.
And Kaiser basically is oh yeah,it's fine.
Here's some information aboutsome nutritional counseling,
which was.
Poor, from what I remember thenutritional counseling she was
given was very different thanwhat we had to eventually like
(13:15):
work, you know, her towards, butthey didn't provide her a
glucose monitor.
They basically said, here yougo.
Here's some nutritionalcounseling.
We'll deal with this later,basically.
And so again, we are like wecare about the outcome of this.
We care about how your body isresponding.
We care that you want this homebirth.
We want to be able to do thistogether as long as it is safe,
as long as we can get some ofthese things stabilized.
Through lifestyle things, right?
(13:36):
That's our parameter here.
And I remember a lot of back andforth on that nutritional
counseling piece, how in depthwe were with providing that for
her, how in depth it was to getthe feedback from her.
But food really was a hard,,it's like a sticking point in
this pregnancy.
It was a hard.
Aspect to nail down.
(13:58):
It was a hard aspect tostabilize.
She would swing quite a bit fromwhat I remember from this, like
hyperglycemic.
Space to this hypoglycemicspace.
And she would come in and justbe like I feel terrible, right?
And so I'm doing these things,but then we would be like, Ooh,
yeah, but that thing that you'redoing isn't within these,
parameters.
Let's try to take that out,really work on this piece.
(14:20):
And so at some point she was upto four, glucometer readings a
day.
And a food diary.
So we know okay, you're takingthis seriously, right?
You're really working hard atthis.
And we just continued to tweak,Hey, we're seeing this.
Let's just take that outcompletely.
Let's swap these things out.
Let's make sure we'reconsidering these things.
Here are all the supplements werecommend.
(14:41):
Here are the lifestyle things werecommend for you to get that
stubborn fasting number,, morein control and eventually.
W again, with a lot of work onher part, it did start to
stabilize.
And I remember being like, oh,thank you.
We could see that it had thepossibility, but we had to work
very hard.
But on both ends, I mean, shehad to work so hard for, food
and lifestyle stuff, but we didtoo in order to partner together
(15:04):
to make this not only justoutcome happen, but just a an
opportunity for her to feelbetter and for her to have.
The healthiest pregnancy thatshe could.
tiffany_1_07-31-2025_0928 (15:14):
Yeah.
And in our call logs, we weretouching base with her every two
days.
She was sharing her food diaryand her blood glucose readings
and we were troubleshooting withher like, okay, that was a
little bit too much of this.
Let's try to back this off alittle bit, add in some more fat
maybe not that first thing inthe morning.
And it was just.
(15:35):
So much tweaking.
And that can be reallyoverwhelming for women.
It becomes a total part-timejob.
Food is really mental for womenand emotional.
And when you're pregnant,there's just an extra
sensitivity to blood glucosescreens and just, or swings.
And wanting to just do the bestthing for your body and your
(15:57):
pregnancy and for your midwivesto have to say, I know that your
Kaiser doctor doesn't care aboutthis because.
To them, you're borderline.
But to us, we have to care aboutit.
We have to put these things inplace.
We have to keep you as stable aspossible.
Our limitations are different.
Our parameters are different.
The way that we're, ourresources are different.
We're gonna have a your baby athome.
(16:19):
It's lower resource.
We need to be sure that thispregnancy is.
As tight as we can be on some ofthese things.
And so that's the beauty ofmidwifery care, but also can
just be tedious and more of moreresponsibility too, and a lot to
a lot to take in stride.
And it's your first baby.
So your first baby, you'realready having some of these
complications.
(16:39):
You're, it already feels like amiracle that you're pregnant at
all.
And just ha just having a lot.
But what it did is itstrengthened our communication.
It gave us a lot of touch pointswith this particular client who
came into care late.
It gave us a lot of opportunityto establish relationship and
communication and expectationsand figure out how to work
(17:00):
together and how to communicate.
So before the birth even starts,we're laying this groundwork,
we're laying this foundation of,are you in?
I'm in.
How In Are You?
Okay, I will match that.
And that piece, that threadreally carried in to her birth.
And so I'll get into it becausedo you see how many notes I
wrote about the bird?
kelly_1_07-31-2025_092847 (17:21):
Oh, and then there was this, but
also this, but don't forgetthis.
And also this thing happened andthis went on for this long.
Yeah.
tiffany_1_07-31-2025_092846 (17:27):
I know because I'm just like, this
was a, it wasn't the longestbirth we've ever been to, but it
was really, it was long.
It was really long.
So it started out actuallycrazily optimistic.
It was like too good to be true.
Because I think on her due dateor the day before, her due date,
(17:47):
the night before her activelabor started, she was starting
to have contractions and theywent into the evening and the
next morning around 5:00 AM Ithink we may have not even known
that she was in labor.
May, maybe we did.
Maybe we had the heads up.
kelly_1_07-31-2025_092847 (18:04):
I remember getting I was the one
who got the call at 5:00 AM andI was like, oh, bless you for
not telling me at 10:00 PM like,Hey, I might be in labor'cause I
would be up all night thinkingabout it.
But yes.
Yeah, continue.
tiffany_1_07-31-2025_0928 (18:18):
Yep..
So it's actually her doula whocalls and her doula was a, is,
was, is still a great friend ofours and someone that was easy
to recommend.
'Cause we like working with themand we know that they'll do
really well with our client.
She calls us herself and shesays, Hey, I've been here for a
while.
This person has been laboringall night.
(18:39):
Her contractions are strong.
This is a very experienceddoula.
Her contractions are reallystrong.
Her water just broke.
And she's saying she has a lotof pressure, so I think you need
to come here right now.
And we're like, whoa.
Maybe this'll be one of thoseprimates, one of those first
time moms that just has a reallystraightforward, quick labor.
(18:59):
And so we're trying, we, we knowthat might not be the case, but
we have lots of signs thateverything is going really
quickly, and so we're like,okay.
Let's be cautiously optimisticand I remember we rushed to her
house.
We got there around 6:00 AM Weobserve with our own eyes.
(19:20):
Oh, she is very active.
Oh, while we're setting up ourequipment, she's starting to
grunt at the peak of everycontraction.
We do our normal intake andassessment.
We always offer a vaginal exam.
But we.
We don't recommend itnecessarily.
It's just this is information.
If you'd like to have it, it'savailable to you.
(19:40):
It usually doesn't help at thispoint.
But she declines it and we'relike, yeah, who needs to know
what's going on in there?
All your external signs areabsolutely beautiful and
amazing.
We are so good.
To just hang out and wait andsee what happens.
Even if you don't have a babyfor a few hours from now,
everything's progressing sosmoothly for you.
(20:01):
She was coping really well whenthe midwife team arrives, it
always makes everyone excitedoh, this is actually happening.
And so there was like a lot ofthat going on too.
Kelly, you mentioned that yougot the call'cause you were the
primary, so that means that youwere like in charge of the
birth.
I'm sure we've explained ourroles before.
(20:22):
To our audience as we'redescribing Bruce, but
kelly_1_07-31-2025_092847 (20:25):
at the time, I forget if it was
like by week or something, but Iwas the one who was like first
call basically.
But from the information I wasgiven, I was like, I'm not going
to just show up by myself'causeit sounds like we're about to
have a baby.
So I called you and we came andI I remember thinking, oh wow.
Like she's.
It seems like she's going tohave a baby soon, but we don't
(20:48):
we don't say that, right?
We say trust your body, listento your body, all of those
things.
And we were there for a couplehours at the time when we were
like, okay, like we're notreally.
We're not really going forward.
We're not necessarily goingbackwards, but we're just in
this same space here, right?
And we're like, okay, all ofthis pressure that you're
feeling like that is, that's anormal thing.
(21:08):
Your baby is, coming down,coming through and here's how we
best can support you in that.
So she was grunting and almostbearing down.
We were like, Hey, you can blowthat out if that feels right
too.
She began doing that for awhile.
And then.
Eventually, again, a couplehours later after that, she's
oh, the pressure is like moreintense when it's there, but
(21:28):
it's not there all the timeeither.
And so I rem I remember at thetime being like, oh, I wonder
what position her baby's in.
I wonder, what we're up to.
And her doula was thinking thesame exact thing.
Her doula is incredibly skilledon positioning stuff, so she's
we're just gonna go ahead andwork on some of these things.
I'm not gonna tell her thatshe's working on pushing her
baby out.
We're just gonna get into thesedifferent positions.
But already around 11 or so,she's already getting tired,
(21:52):
right?
The mom is, she's been up allnight working so hard.
We've been there for right, likesix hours, five hours, whatever.
At this point, she's I really, Ithought I was gonna have my
baby.
I really want to just like, canI just push really hard?
We offer another vaginal exam,which she declines.
But visually, I remember beinglike, we were able to see, she
(22:14):
was laying down or something, orI forget if she was feeling it,
but she felt, or we saw somelabial parting, so we were like,
oh.
So maybe this is what we thinkit is, maybe this is what we're
working on here.
Maybe we are having a baby andwe're just, working slowly.
And I remember that specificallybeing like, okay, great.
I guess, a vaginal exam reallywouldn't like what exactly,,
(22:37):
what exact information are wegoing to get when we're seeing
some of these signs, hearingsome of these signs outwardly.
But as you can imagine.
A woman in that position whenshe's just oh my gosh, I'm
exhausted.
I am, I'm ready just to have mybaby.
She's starting to feel reallydiscouraged because she's dude,
my, the intensity that ishappening right now and the
amount of pressure and mybearing down,, this is around,
(23:00):
this is like afternoon already.
And she's just feeling reallydiscouraged.
She's I don't want a vaginalexam.
I don't want your fingers inthere.
My water has already broken.
I'm trying to, decrease thepotential for infection.
Having that be another thingthat's, on my list of things
that I'm considering.
And, she had been working reallyhard.
So eventually, like around 1230or so, we were like, here's what
(23:21):
we're gonna do.
Get into bed, be as comfortableas possible.
Setting her up with as manypillows, and obviously
contractions are waking her up,but she really does start to
fall asleep during that time,which I remember stepping
outside of, the room with youand being like, I'm so thankful
that she is that she's asleep atthis point.
(23:41):
I'm so thankful that hopefullythis is.
Like us not being in there, usnot talking about anything.
Her just being able to rest andfocus on that important part of
the work of labor will behelpful.
tiffany_1_07-31-2025_0928 (23:54):
Yeah, and I, because we had charted so
many times that she declined avaginal exam every couple hours
that was being offered to her.
I'm sure that we were giving hercounseling like.
Everything you're doing iscompletely fine.
We're totally patient.
You're good.
Your baby's good.
You don't need this right now.
But if you want us to try tounderstand what is happening, we
(24:17):
have to get that information.
I mean, we, because we'relooking at, we now, we've been
supporting all the externalsigns of the being it looking
like you're getting towards theend of your labor.
All that looks really positive.
But now we're starting to getinto the zone, especially with
you saying that you're reallytired.
Where we might be, we mightreally be able to utilize that
information.
(24:38):
So I just imagine.
I just imagine how much it takesfor her to say, no, I actually
want to trust my body.
I wanna really feel and leaninto what's happening in my
body.
I'm saying I'm tired because Iam, but I'm frustrated.
It really means I just need moresupport.
It doesn't mean that I wannagive up.
It's like this dance between allof those things and the, and
(24:59):
honestly we can offer thosetools and we can bring those
resources in, but the mostsupportive thing we can do is
wait.
Especially for a first time mom,it's really common for that last
bit of dilation to take sometime just because the cervix is
open.
Just because she's feelingpressure doesn't mean that it's
time to start pushing.
There's so much going on inthere that we're not trying to
(25:20):
define an experience by what thecervix is doing at all, but this
is definitely the point wherewe're starting to wonder if
there's something more we can doto support her to prevent her
from burning out later.
In the labor, right?
So she sleeps for a half anhour, which was probably so
incredible.
I'll just, I'll leave a teaserin here.
(25:42):
This is not the last time wesent her to bed before she had a
baby.
But it was definitely needed.
It's a, it's one of the toolsthat we use as midwives.
Let's not always just be pushingthings forward.
There's your body's saying itwants rest, it needs something
more.
So she wakes up at 1:00 PM fromher nap.
Things are about the same, andshe.
Finally asks for a vaginal exam,and what we discover in the
(26:07):
vaginal exam is actually reallyencouraging it.
She was nine and a halfcentimeters.
She had an internal or a, ananterior lip, which is part of
the cervix in the front was notfinished dilating, but while
your hand was in there for theexam, Kelly, she pushed a little
bit and that cervix moved out ofthe way.
(26:29):
All in that.
All in that one step.
And then the baby moved down.
You felt the baby move.
Once the cervix moved out of theway, you felt the baby move down
into her birth canal while youwere in there.
And so then she starts pushingwith that and.
kelly_1_07-31-2025_092847 (26:46):
Try
tiffany_1_07-31-2025_092846 (26:46):
We try to be really accurate with
our charting because it just, itmatters.
It's a medical record, but wewanna be really careful that we
don't say something is happeningthat actually isn't.
And so, even though she'sfeeling gruy, even though she
was giving some bearing downeffort, we did not chart that
she started pushing until thispoint.
(27:06):
It's one o'clock in theafternoon.
Because now we know that hercervix is fully out of the way.
Now we know that her baby'smoved down a little bit.
And that's when we charted thatshe officially started pushing
at 1:00 PM And so Kelly, whathappens an hour and a half
later?
kelly_1_07-31-2025_092847 (27:27):
It was not a baby.
I will say that she's continuingto push At this point, we're
keeping our fingers out becausethe effort that she was giving,
when my fingers were in, I waslike, you are moving your baby.
You're not necessarily pushingyour baby right out with this
one push, but like I can feelmovement happening, right?
And so about an hour and a halfafter that she's still pushing,
(27:48):
she's resting, we're doing a tonof spinning baby stuff, right?
Just trying to work with whatshe is doing.
But we notice that hercontractions start to space out
a little bit.
And so that like when she'slaying down in particular, she
starts to get a lot of rest.
That is not necessarily a badthing, right?
That can be a very good signthat hey, we're getting closer.
(28:09):
Your body's saying, Hey, I needto rest'cause I'm about to have
a baby.
And so we were like, let's justgo with that.
Let's try to get you asnourished as possible.
Drink some water, eat some food.
And yes, go back and take alittle nap for a little bit
because there's no, we don'tneed to force this.
We don't need, like your baby isdoing well, you are doing well.
(28:30):
Again, a nap together with yourhusband cuddling in bed because
your body's already wanting togive you some space in between
these contractions is a goodoption here.
So we just sort of were like,let's you two go ahead and do
that.
And she was able to do that fora couple hours.
And I think we also probablytook naps at this point, or,
we're chilling, hanging out in aroom right side, right outside
(28:52):
of their room.
But it was a good couple hoursfor her to start to rest and
reset and the hope was that shewould hope, wake up and push a
baby out.
tiffany_1_07-31-2025_092846 (29:02):
I know we're just like looking for
these, we're looking for thisbig switch, right?
We're looking for this big ah,there we go.
Applying time, applyingpatience, applying nourishment.
That really is just gonna fillyour tank up and then you're
gonna just pop into.
It being more obvious andstraightforward, but it's four
30 in the afternoon.
(29:22):
Again, she's getting to thatplace of I don't know how long I
can do this for.
It was, is what I'm doing evenhelpful?
And so she asked for anothervaginal exam.
During your exam, you suspectthat.
There, the baby's head is justin a wonky position that like
the neck is not, that the baby'schin is not flexed all the way
down.
Creating the most likeaerodynamic space.
(29:44):
And then feeling the suturelines on the baby's head.
You.
Think that what you're feelingis that the baby is ROP, which
is facing towards mom's rightside, but also sunny side up,
which is a very difficultposition to push a baby out in,
especially for the first time,but also common.
(30:05):
It's like one of the most.
Common things that can makelabor take a long time.
So at this point in the labor,we've already been
prophylactically supportingpositional things, suspecting
that's the most likely thingthat's holding things up.
But now we have it as likealmost an official diagnosis.
And so you're like, okay, weneed to figure out how to work
(30:27):
with this.
We have already been sort ofworking to turn the baby and we
will continue to do that, but Iremember the doula who can love
her to death, but she can bebossy and she did have this
moment in this labor where shewhispered to us.
This is the way that this babyhas to come out.
We, if we could have turned thisbaby, we would've done it by
(30:49):
now.
She has to push this baby outop.
And I remember thinking, I thinkyou're right actually.
I think you're actually right.
We do.
This is what we're working withand this is just gonna be hard
and we need to be in it with herfor that.
So you actually kept yourfingers in at this point and you
were applying pressure and this,it turned into a whole, it
(31:11):
turned into like a whole, we'regonna do whatever we can to just
try to get some movement on thisnow.
Like we just have to be workingevery single time.
Every single contraction we'rejust in it and the hanging out
and just waiting to see what thebody does on its own.
We're like, we're trading thatout for now.
We just need to try to preserveyou having your baby at home
(31:33):
because that window is narrowingso much because now we have some
things stacked up against thiswhole thing.
So you're applying pressure onwhere she should push like
Totally.
What we, have only learned fromthe medical model, right?
Like somebody's finger stayingin there and saying, here, push
right here.
Do you see I'm putting all thispressure on your rectum.
(31:55):
Push against that.
And she actually found thatreally helpful.
So.
I hope that women who arehearing this story can see how
sometimes it's absolutelynecessary to pivot, change
directions, use a different setof tools.
It's not gonna look like what wethought it was anymore.
We have to almost let that dreamdie and just try to preserve the
(32:18):
overarching goal.
kelly_1_07-31-2025_092847 (32:18):
And I remember having my fingers in
there and saying can you feelthis push against this, try to
move my fingers, kind of thing.
Again, things that I had heardin midwifery school at certain
births that I was at was certainpreceptors and midwifery school,
but thinking, oh, this is reallyfunny that I'm doing this.
But they, the couple was solike.
No, you, I want you guys to doall the things now.
(32:40):
I know I declined everything,but now I'm going to say yes to
anything, everything.
I just wanna move forward inthis.
And I remember her saying yes,this is really helpful.
But there wasn't really muchchange in how baby was coming
down.
And so I was like, well, I don'tneed to keep my fingers in here
for, a long time or anything.
And so basically what we didagain was the doula took control
(33:01):
of some spinning baby stuff andwas still doing that, just given
the information that I hadgotten with.
The vaginal exam.
And she does that for a while,right?
Probably, I mean, at this pointat time, right?
That was around four 30 whereall of that was happening.
And then around six 15.
She asked for a vaginal examagain.
She was like, please, will youjust see if anything that I'm
doing is working?
(33:22):
And it was working in a specificway.
So when I went in to do thevaginal exam, I was mostly
interested because i'm like,your cervix is out of the way.
I'm mostly interested in whatyour baby's, position is, where
they're at, where their, headis.
And this baby was directly op,meaning like directly Sunnyside
up now.
So that pushing and thatmovement had shifted baby a bit
(33:45):
from that more.
Position.
But that was the moment where Iwas like, yes, okay, we are
gonna have an op baby.
We just have to work with whatwe're working with here.
She, was.
She wanted the information.
So we spoke about that.
We talked about that.
And then she was still feelingthis overwhelming kind of urge
to push and all of that.
So around 7:00 PM we're stillworking together, but then we
(34:08):
start hearing a little bit ofdeceleration in babies.
Heart rate comes right back upto baseline, quickly.
But we're just noting that andwe're like, Hey, we might listen
more often.
Hey, we're like being aware ofthis.
And then, but we decided becauseshe was so tired, because we
were hearing these things, we'relike, let's just give a little
bit of a break for a little bit.
Let's try to blow through yourcontractions for the next like
(34:31):
half hour, the next hour.
Potentially.
Maybe that's what you need,right?
To just relax your body, blowthrough that.
We're not saying don't.
Do what your body is wanting todo, but basically just blow
through that rather than bringall of that energy down in like
a pushing situation.
And so she does that for half anhour or so, and at eight o'clock
(34:51):
that night, she was like, I notpush.
And we're like, we are not goingto, stop you from that.
If you, if that's theoverwhelming thing.
But then, that's all goingnormal for the next like hour.
Again, I'm just thinking of 5:00AM us.
So, so idealistic and all ofthat, but around 9 45 ish.
So mom's been pushing for thishour and a half.
(35:12):
She's I can't stop.
Around 9:00 PM she's I amputting everything I possibly
have into pushing.
She's doing like the purplepushing that we often talk about
Hey, you don't necessarily needto do that again.
The pivots that we are makingand this mom's willing to make,
and the mom feels like she needsto make, and we're just,,
throwing everything that we haveat it at this point.
But baby's heart rate is stilldoing a little bit of a thing.
(35:34):
She's baby is, decelerating, butthen coming back up to baseline,
having a good recovery.
And so we're like, okay, I thinkbaby's doing okay, but also we
may need to like mix.
This purple pushing that youstarted doing in with a little
bit more breathing, Butthankfully we had a baby who was
returning back, to baselines.
And so we were listening prettyconsistently at this point and
(35:56):
telling her like, Hey, how aboutevery other contraction?
Will you push, breathe throughthe other ones and let's.
Give baby a little bit of amoment because your baby's
struggling too.
They've had a long day as well.
They're working very hard aswell.
But I do remember the momentwhere we discovered as we were
looking at mom, laboring and allof that.
(36:16):
It was around 9 45 that nightthat we could see the top of the
baby's head.
And so this baby was finallydown far enough for us to be
able to see what was going on.
And that just felt soencouraging.
But even seeing it, I rememberlooking at the suture lines and
being like, okay, we're havingan op baby, and we're just doing
(36:36):
that.
Obviously we still had some timeto get to the end point, but
that was around 9 45 and therewas a little bit of a
celebration that happened in theroom, and then we all were like.
And now we actually have, stillhave to get this baby out, so we
gotta get back to work, right?
And so we're listening a bunch,and then finally about a half an
hour later, so this mom hadworked for hours and hours to
get her baby down.
(36:57):
At 10 15, she birthed the baby'shead and then the baby came out
completely at 10 16.
And I remember being like everyounce of things that was in my
body was like, oh my goodness.
I'm so thankful, not just likefor how hard it was, but I'm
just so thankful that this babycame out and this baby came out
at home and this baby is okay.
(37:19):
I do remember though, the babybeing slower to transition and
question, not a questioning thathappens sometimes.
We like to give baby as muchtime as they need to transition,
but I remember being like, thislooks like a baby who's been
working hard all day as well.
tiffany_1_07-31-2025_0928 (37:34):
Yeah, and baby came out with meconium.
It took a few minutes for thisbaby to like really come around.
Clearly the baby was stressed.
Clearly the mom was stressed.
Clearly we were really ridingthe edge here.
We were fully informed.
I don't think that we were, Idon't think we were playing.
Too riskily with the situation.
(37:56):
We were constantly incommunication with each other,
with the parents.
They had full, appraisal andconsent of everything that we
were noticing and seeing.
And we were just barely gettingenough progress, barely keeping
things stable, that it wasappropriate to stay home.
She was still appropriate formidwifery care.
(38:17):
It was just like, we just needto get this baby out and.
If things had changed in adifferent way or something had
destabilized, I remember feelingvery much on the edge of calling
this birth for a transfer.
Not because it was an, notbecause it was potentially
turning into an emergency atall, but just whoa, how long?
How far?
How much can we stretch before?
(38:39):
We're just giving a little here,giving little here, giving a
little here.
I think other midwives.
Absolutely would havetransferred.
I don't think that would've beenthe wrong call either to
transfer at this point.
But that is not what the momwanted, and we were willing to
hang in there with her and see.
And even though the baby wasshowing some signs of distress,
the baby was not showing signsof being.
(39:02):
Dangerously distressed.
It was a normal amount of, Hey,my head's been compressed in the
vagina for a while.
Every time you pushed, I'm notgetting the oxygen I want.
It's taking me time to comearound.
But the baby came out, man.
The baby came out.
That was such a victory foreverybody.
It ended up being reallyimportant to the mom.
So even though we have toreflect on these pieces in our
(39:23):
care and the clinical aspect ofit, and we have to take
responsibility for places wherewe were riding the line on some
things at the end of the day.
The ultimate piece to me.
And I mean, safety is importantand of course that's what we're
there for.
But the ultimate piece for me isthat mom saying.
I would've, if I would'vetransferred, if we wouldn't have
(39:43):
seen that through at home, myexperience, my story would have
been completely different.
Completely changed, completely.
She needed us to be in it therewith her, and I think that was
one of the strengths that youreally brought Kelly to the
team.
Just in reflecting on my own, Iremember feeling I'm not sure if
we should keep doing this athome.
(40:04):
And you believed in her.
You saw enough progress that youfelt like things were moving
forward enough to just keeppushing and keep believing in
her.
And I mean, that was incredible.
Really incredible experience.
I was stretched a lot.
Our skills were stretched andchallenged a lot, and it ended
up making a huge impact on thismom and her family,
kelly_1_07-31-2025_092847 (40:25):
And I think it's probably different
having your fingers in andseeing some of those, you know,
like some of those.
Pieces.
Not to say that there weren'tmoments where I was like I
don't, I will never saynothing's something's
impossible, but you're justlike, how long or how long can
we do this?
How long can both of them likebe okay?
So she had an eight hour activelabor, which is great.
She had a nine hour secondstage, which is a long long long
(40:48):
time.
And that's just something tonote that like Absolutely.
If she was not at home.
There would not be an option forthat to have happened.
And then that third stagethough, like the excitement was
not over because her placentatook a while to detach.
Also not surprising with howlong her labor was and
everything that her body wasgoing through and how exhausted
(41:08):
she was.
But almost an hour and a halfbetween when the baby was born
to when the placenta, came out.
There were no signs of concern,no excessive bleeding or
anything.
But we did give her some herbsto help encourage.
That was around minute 45 afterthe baby was born that we were
like, Hey, let.
Let's just try to encouragesomething.
And she eventually startedmoving some positions.
(41:28):
We got our birth stool out andshe actually delivered her
placenta over that with noconcern.
She had about 400 ccs of bloodloss throughout her entire
immediate postpartum, which is adecent amount, but not
necessarily concerning.
And she was feeling good minusthe fact that she was.
Exhausted from the entireexperience.
We checked her for tears aswell.
(41:49):
She had a first degree tear, butshe, as we were looking at it
and counseling and given herfeedback she declined to repair
it and it actually healedwonderfully.
Her baby was only seven pounds,zero ounces, so, I think that
there was a lot of concern abouther.
Glucose readings and potentialGDM status with gestational
diabetes.
And she produced a very normalsized baby.
(42:12):
So there was a lot that waslike, Ooh, that was abnormal.
And then there was a lot that wewere like, oh, look at how this
storyline ended here which wasan interesting thing to consider
as well.
tiffany_1_07-31-2025_0928 (42:23):
Yeah, there's like a lot for her to
process obviously like that is,was a tremendous, a really cr
crazy thing to have toexperience.
Especially, as your onlyexperience, you're very.
First experience with birth,having it be that hard.
I think that there's a lot ofwomen who can relate to that.
A lot of women who are thinkingright now wow, I pushed for four
(42:46):
hours and then I was offered acesarean.
I wonder what it would've beenlike if somebody would've given
me more time, given me moresupport, taken me, had I been in
an environment that I would'vehad more options.
And I think there's some reallyimportant pieces here in that.
Of course who her team was, thesetting, the care model that she
chose.
(43:06):
She had a lot of support withher partner.
She had a lot of support withher doula.
All of that, she was really wellprepared for a potentially super
hard birth.
And that is, that was the goalin preparing all of those
things.
But she was also reallycommitted and I think.
That just impacted us the mostis her commitment, and I had no
(43:27):
idea that she was prepared towork so hard and for so long,
and to want to give up but notgive up, which like, as we've
already said in another setting,it would have been all too easy
to have that story changed withthe inpatient provider.
Her choices up to that pointafforded her options in labor
afforded her time.
And even though the birth waslike a lot she said that she
(43:50):
wouldn't have changed it becauseshe knows that how the odds were
stacked against her and how thatwould have turned out in another
environment.
And so even going through thatreally hard, long thing was
better for her to have theoutcome that she wanted and the
type of birth experience for herown baby and her own family.
And.
Like we need to hold on to thosepieces too.
(44:12):
That is just as important assome of the other pieces.
We need to, like women need tohave some context for what
things really matter, whatthings don't matter.
Preparing for long or hardlabors totally owning your
experience for the good.
Pieces and the vision and thebeauty, and then the challenge
and the victory that comes withwalking through that challenge.
(44:35):
It is usually an accumulation ofmany informed choices and
really.
We wanna help women prepare forbirth in a way that gives them
the best chance for staying inthe driver's seat.
And so I hope that is what comesthrough in this story for
listeners, that you can applythese concepts.
The Midwifery model template isavailable for your birth plan
(44:56):
too.
And that is just every, that'severy bit of passion that we
share in our childbirtheducation class too.
So visit the link in our shownotes to check out that course
if you haven't already.
We have applied birth prep toevery single stage of pregnancy.
So your vision has a chance tolike build and spiral and layer
(45:17):
in the ways that just make yourbirth yours and keep you in the
driver's seat.
And that is, that's midwiferycare.
That is really good midwiferycare in a nutshell.
And having those strategies andlearning that nuance and being
able to.
To have that as a part of yourstory.
I hope that is an encouragement
kelly_1_07-31-2025_092847 (45:36):
I mean, there's so many pieces
here, right?
If you're somebody who hasstruggled with blood glucose
levels in previous pregnanciesor positions of babies in
previous labors, things likethat, there's so many pieces
here that I think can be gleanedAnd learned from, and just
hopefully again, even if you'resomebody who hasn't given birth
yet, that maybe, yeah, thissounds intense, but there's also
(45:57):
the, there's births that go sostraightforward and smooth and
babies just like.
It flies out on a cloud andeverything is, easy and
wonderful.
There's no moral, good or badright here.
This is a hard earned experiencefor these parents, and that is
good and worthy too, and I thinkimpacted her.
Awareness of herself as a momand built her confidence too as
(46:20):
she entered into motherhood.
Which like would she havepreferred an easier labor of
course.
But did that labor teach her andgrow her and build her
confidence in other ways likethat probably were surprising to
her.
Have Absolutely.
And so that is encouraging tome.
As well as just the own personalreflection as a midwife all of
those years ago when when thisbaby was born.
(46:40):
So, this was a great one to comeback and consider and continue
listening.
'cause every so often we willkeep sharing these birth stories
and we love the conversationsthat we're having with you
outside of the episodes aboutthem as well.
So you can hop on over toInstagram and DM us and chat
about this too, if you have anythoughts and feelings about
this.
And we will catch you next week.
(47:01):
Hey ladies, if you're loving theshow and want to help us keep it
ad free so we can keep talkingabout all things birth and
women's health, without cuttingto an ad about electrolytes or
grass fed beef sticks, here ishow you can support us.
First, leave us a quick reviewor a rating.
It helps more women, new moms,and birth enthusiasts find our
(47:24):
show.
And it honestly means so much tous to be reminded that you love
what we are doing here.
Second, share this episode witha friend, with a doula buddy, or
anyone who is on their ownholistic health or natural birth
journey.
And third hop on our newsletterlist.
This is where we share.
Bonus goodies behind the scenesstuff.
(47:46):
Fun little extras you just won'thear on the show.
You can find that link to joinin our show notes below.
Thanks so much for being a partof this growing empowered
community.
We could not do it without you.
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