48. Informed Pregnancy Podcast – Hannah Gill

Today, we’re speaking with an operation supervisor for a biotechnology company working in biotherapeutics by day and birth work by night. And we’re going to compare her two birth experiences. Hannah Gill, welcome to the podcast.

Hannah: Hi, Dr. Berlin. How are you doing?

Elliot: I’m doing amazing. What a combination of night and day. By the way, I picture, based on my own introduction, I picture you’re going into a phone booth when somebody’s in labor and putting on a superhero outfit and flying over to save the day. But let’s talk about what you’re doing. Where are you from originally and what’s this biotech business?

Hannah: I was born in Kansas City, Missouri. But I’ve spent the majority of my life in Indiana, with a brief stint in Nebraska, and then back to Indiana.

Elliot: Okay, which part of Nebraska?

Hannah: Tekamah. Very, very —

Elliot: It sounds like not very many people.

Hannah: No. The population was less than my high school.

Elliot: Wow!

Hannah: It’s about an hour north of Omaha, so it’s very small.

Elliot: So, a gas station and a saloon?

Hannah: Basically.

Elliot: And a church?

Hannah: Everyone knows everyone and everyone’s related.

Elliot: Oh, boy. All the people know my business. Alright, and then, where did you go to school?

Hannah: So, undergrad, I went to I.U. Bloomington in Indiana. And then, for grad school, I did I.U.P.U.I., which is Indianapolis University-Purdue University.

Elliot: And you studied?

Hannah: Undergrad, human biology. And then, my master’s is in forensic biology.

Elliot: What does that mean in English? Forensic biology.

Hannah: So, forensic science, what a lot of people see on CSI, but it’s nothing like that.

Elliot: Okay, because?

Hannah: It’s very fabricated on TV.

Elliot: Oh, I see.

Hannah: And the process is taking much longer than that.

Elliot: Oh, doesn’t take 45 minutes to figure it out.

Hannah: No. And most of the time, there’s not an answer.

Elliot: Oh, that’s even worse. And no commercial breaks though, which is nice. Okay. And then, where’d you meet your hubby?

Hannah: We started dating in high school. So, we’ve been together since I was 15 and he was 17.

Elliot: Wow! Did you know?

Hannah: Did we know what?

Elliot: Like in high school? Did that feel like this was going to be a forever?

Hannah: Yeah, probably.

Elliot: Really? Wow, that’s very special. How cool. Alright. And then, kids. Was that like, “Hey, now we should have kids? Since we’ve been dating forever.”

Hannah: Yeah, we always wanted to have kids. We got married in 2016 and decided to not really start trying but not try in 2019 when I got diagnosed with PCOS.

Elliot: Were you having symptoms when you were trying to get pregnant?

Hannah: Yeah. So, I stopped birth control the year prior, and I had been on birth control since I was basically started my period like a lot of women are. And I stopped birth control in 2018 because I was just over it. I was tired of being on it so long, and I was tired of the side effects.

Elliot: THE pill?

Hannah: Yep, the pill. And then, after that, I started having two periods a month instead of one. So, then, I went to my OB-GYN because I said, “This is obviously not normal.” And they did an ultrasound and some blood testing and found like the string of pearls or whatever they call it for PCOS. And then, my testosterone levels were super, super high. So, that’s how I got diagnosed. I don’t have like the traditional PCOS symptoms besides those two things.

Elliot: Oh, so only the diagnostics. You didn’t feel PCOS?

Hannah: Right. So, I don’t have like the insulin resistance or anything like that.

Elliot: Oh, metabolic X syndrome.

Hannah: Right. And the only symptoms I was having was the two periods a month.

Elliot: Wow! With high testosterone, which is like —

Hannah: Yeah, I’ve had acne my whole life, so I just assumed it was just who I was. But it was apparently part of my PCOS. [inaudible 04:24]

Elliot: Symptoms of low testosterone. I feel like, “I’ll take some of yours.” Can we do that? Is that like a thing?

Hannah: Take it away, please.

Elliot: Yeah. Okay. So, then, PCOS, and have you treat that?

Hannah: So, I decided not to treat because they said you can get back on birth control to help. But I was like, “No, I don’t want to do that. I don’t want to be on birth control anymore.” So, my OB-GYN said, “Well, it could take you a while to get pregnant or it could be really fast, it just depends.” And we got pregnant, literally, the first time.

Elliot: The first time that you were off birth control? I mean, no.

Hannah: Like the first time not preventing.

Elliot: Okay. So, after the pill, you were doing something else to block.

Hannah: Yes.

Elliot: So, you were ready. You said, “Let’s try and see what happens.”

Hannah: Yeah, I said, “Well, it could take a while, it could be fast. So, let’s just not prevent and let’s just see what happens and –”

Elliot: Boom!

Hannah: Literally, the first time.

Elliot: How was your pregnancy?

Hannah: Awful.

Elliot: Oh, come on.

Hannah: Not awful. Not horrible, but I was sick the entire nine months for my first pregnancy.

Elliot: Sick. Nauseous, or also something –?

Hannah: As in like vomiting all day.

Elliot: So, hyperemesis?

Hannah: It was very borderline. So, it wasn’t officially hyperemesis because it wasn’t like constant all day every day. But the majority of my first trimester was constant all day. And then, the second and third trimester, it was at three to four times a day. But it never ended after the first trimester.

Elliot: That’s something hyperemesis to me. First of all, did it stop as soon as the baby was born?

Hannah: Oh, yeah.

Elliot: Yeah. So, it does sound like its hyperemesis. Because we have a couple episodes about hyperemesis. One with Amy Schumer discussing her experience with pregnancy and hyperemesis, and then one with a few doctors. But the doctor said is that they’re kind of nailing it down to hormones created by the placenta.

Hannah: Okay.

Elliot: So, [tied it to hormone 06:07] that makes you feel full all the time. So, in excess production so that anything you eat makes you feel like overfull. Like you’ve had too much like you have to get rid of it. So, it’s a little bit sounds like that. But there’s a foundation called the Her Foundation, H-E-R, and they have great resources for people who are struggling like that during pregnancy. And one of them is an app where you can kind of input your symptoms and then send it to your doctor to get a better handle on whether that’s hyperemesis or not. So, I was already grateful that you did the podcast, but now, another chance to help people who experience pregnancy like that.

Hannah: Agreed, because I was never diagnosed with it.

Elliot: Was there a plan for birth?

Hannah: Yes. So, I had planned to do an unmedicated hospital birth. And I just took the basic hospital birth class, and then an advanced labor birth class is what they called it to kind of help you get through it without medication.

Elliot: Also at the hospital?

Hannah: Yes, but it wasn’t after looking back at my experience and what I know now was not very helpful. It was a very fast, just like quick and dirty type of class on “here’s some comfort measures,” but it didn’t really help prepare me.

Elliot: Sometimes, the hospital birth class feels like how to be a good patient at our hospital.

Hannah: Oh, yes! I agree. That’s what I know now.

Elliot: I usually recommend if you want to do something that’s a little out-of-the-box for typical hospital birth to do a non-hospital birth class.

Hannah: No one I knew had ever birthed outside of a hospital, and the majority of people I knew did not birth unmedicated. So, I just thought, “Oh, you go to an OB, go to a hospital and that’s how it is.” I didn’t know what a birth center was. I had never even heard of a doula at that time, or I didn’t know anyone had a home birth. So, I just kind of took the route that I do best, and that’s what happened.

Elliot: Alright. Well, let’s take a quick little break and when we come back, we’ll see how that birth went. Don’t go anywhere. We’ll be right back.

[break]

Elliot: Welcome back to the podcast. We’re talking to Hannah Gill. Okay, so first pregnancy, boom! Right out of the gate and horrible motion vomiting all the way through. But then, you took a hospital birth course on childbirth and you did an extra class for unmedicated childbirth. And how did your labor start?

Hannah: So, I didn’t really feel like the gradual build-up a lot of people talked about. It was more of as soon as my contractions started, they were extremely intense and five minutes apart.

Elliot: Wow! Okay, what time of day was that?

Hannah: About 5:30 in the morning.

Elliot: Okay. So, boom! And so, I assume it woke you up.

Hannah: Yes. I had gotten up to go to the restroom and then try to go back to sleep, and that was not happening. So, I decided to get in the shower to see if that would calm anything and it definitely did not.

Elliot: I mean, it just progressed?

Hannah: It just kept getting worse and worse as far as the pain goes. So, my husband is already at work at this time.

Elliot: What?

Hannah: Yes. And I just called it. Yes, he leaves for work around 5:00 am.

Elliot: Holy moly. Okay.

Hannah: So, I called him —

Elliot: Before he left, nothing.

Hannah: No, it was not until he left, of course.

Elliot: And then, half an hour later, raging.

Hannah: Yeah.

Elliot: Okay. And then, he came back.

Hannah: Yeah. So, I gave him a call at work, or I actually texted him first. And I said, “Hey, I’m starting to have contractions. They’re really intense. I’m going to try to get in the shower, but I’ll let you know how things go.” And I started using that contraction timer and it said, “Go to the hospital.”

Elliot: Oh, wow.

Hannah: So, I called him on like the work line because he wasn’t answering his cell. And I told them, I said, “Get him home now, please.” And he got home and I was on the birth ball and he was like, “What am I supposed to do?” I said, “Just grab the bags. Let’s just get going.” And of course, it by this time, it was getting close to rush hour around where we are. And I was not looking forward for about 30 minutes from the hospital. I was [unintelligible 10:10].

Elliot: Oh, my.

Hannah: So, it was interestingly —

Elliot: If only you were in a small town with 200 people.

Hannah: Oh, yes. Like before.

Elliot: Yes, rush hour would be like rush minute.

Hannah: Yes. So, the drive to the hospital was pretty rough with having to wait in traffic.

Elliot: With that kind of intensity especially.

Hannah: Yeah.

Elliot: We’re you in the front seat?

Hannah: Front seat.

Elliot: Like buckled in like or on your hands and knees?

Hannah: At first, I was buckled in and then I got off buckled, took my coat off because I was sweating. Rolled the window down and mind you, this was December and it was freezing, but my husband was cold. I was like, sweating. So, no, I was buckled in at first. And then, it was just like bracing myself and holding on to the door, trying to breathe through my contractions.

Elliot: I mean, it sounds like a caged animal.

Hannah: Yes. That’s exactly how it felt.

Elliot: I’ll probably get in trouble for saying that, but that’s what it just sounds like. You need to have space and get out of there and move.

Hannah: And I was vomiting my entire labor, too.

Elliot: Oh, in the car?

Hannah: Yeah.

Elliot: What happened when you got to the hospital?

Hannah: So, they had me sign all those fun forms as I’m reading through my contractions and then got me into triage and I was only three centimeters.

Elliot: Ouch. Okay.

Hannah: Yeah.

Elliot: Have you been checked before?

Hannah: Yeah. So, my first pregnancy, I did get checked the day before I went into labor. I was 2 centimeters and I had my OB membrane sweep.

Elliot: Oh, okay. Do you think that contributed to the morning events?

Hannah: Probably, yes.

Elliot: Okay.

Hannah: I think so because it was much more intense than I had expected. So, maybe the sweep kind of escalated that.

Elliot: Was there like any blood after the sweep?

Hannah: No.

Elliot: Okay. So, 3 centimeters only. In your words, 3 centimeters?

Hannah: Yes, because [I had been to 11:59] the day before and with how intense my contractions were, I was expecting to be way further along. So, that was kind of —

Elliot: Six or something?

Hannah: Yeah. And they did check my platelets. I did not mention I had gestational thrombocytopenia, where your platelets are low.

Elliot: Oh, wow. We do have a whole episode on gestational thrombocytopenia with Dr. Nate Fox, that was triggered by Mandy Moore who had it with at least her first pregnancy. Wow. So, does that mean you were borderline epidural?

Hannah: I was borderline. So, I wasn’t as low as where you absolutely know for sure you can’t have it. It was always really borderline. And for my hospital when they checked it, it was like right at the level. So, that’s why I decided, “Okay, I’m just going to get it.” Because who knows, in a couple hours, I may not be able to anymore.” So, I just went ahead and got it because my contractions were so intense and I was right on that level. So, I got them right away.

Elliot: I mean, it also sounds like with the intensity and the progress, like your mind might have been easily persuaded anyway.

Hannah: Oh, yes, it was all mine game. Yeah, for sure.

Elliot: Okay. So, did it work?

Hannah: The epidural? Yes, it worked wonderfully. And I took a nap.

Elliot: Okay, great. And how did the rest of that labor progress?

Hannah: So, I progressed very quickly. I got my epidural around 8:00 or 9:00 o’clock, started pushing around 1:00 o’clock.

Elliot: So, four hours? And this is 1:00 pm.

Hannah: Yes.

Elliot: So, really not that long after your entire labor started.

Hannah: Right.

Elliot: Okay. So, how was pushing?

Hannah: I pushed for four hours.

Elliot: Did the epidural start to wear off? Did they turn it down?

Hannah: No. The epidural was so strong. I could not even tell I was pushing.

Elliot: Oh, wow.

Hannah: Which is part of the problem.

Elliot: Oh, four hours of that.

Hannah: Yes. So, four hours of that.

Elliot: What position?

Hannah: Just like the semi-reclined position. So, I couldn’t —

Elliot: You couldn’t get into like hands and knees or stuff like that?

Hannah: I didn’t know that was an option at the time. So, yeah.

Elliot: Well, if you could go back in time, listen to this episode.

Alright. So, pushing on your back with your pelvis closed and numb from the chest down.

Hannah: Right. And then, the whole holding your breath counting for 10 seconds. Push, push, push, push, push, that type of thing. So, the “coach pushing” that everyone hears about.

Elliot: Yeah. Okay. And in the four hours, was the baby handling it well? I assume [inaudible 14:25].

Hannah: There was one [unintelligible 14:27], but they didn’t make a big deal about it. They just had me put some oxygen on and rest for a minute.

Elliot: Okay. And then, what happened?

Hannah: So, we figured out that baby was most likely asynclitic, the way he was coming down. And we didn’t know if it was a boy or girl at this time, just a side note. So, the way the baby was coming down, just kept coming down, going back up, coming down, going back up. So, after this four hours, I opted for a cesarean.

Elliot: Okay. Asynclitic essentially means not lined up with the runway very well. So, all that pushing is not really coming down, it’s just flexing the head sideways. And then, as soon as you stop pushing, the head flexes back up. Always recommend seeing a baby chiropractor after a labor like that, by the way. Okay. So, how is the cesarean for you?

Hannah: It was not great. Like, I actually felt a lot more than I expected to. So, they gave me —

Elliot: Oh, great. You didn’t feel you’re pushing, but you felt your abdominal surgery.

Hannah: Right. So, I was like basically screaming and telling my husband like, “I need something else. This hurts really bad. I can feel a lot.” So, they gave me some additional medication through the epidural, whatever they give you that’s extra. And I kind of dozed off for a few minutes, I think. I don’t know if I fell asleep or what they gave me just kind of knocked me out a little bit, but I don’t remember my baby being born, basically.

Elliot: I was afraid you’re going to say that.

Hannah: Yeah. I don’t remember hearing him cry. The first thing I remember is my husband saying, “Babe, it’s a boy,” because we didn’t know. And I was just so out of it and so loopy that I don’t really remember much of it all.

Elliot: I’m so sorry.

Hannah: Thank you. I mean, I appreciate the sentiment there. And I know it’s hard for a lot of women who have that experience. I know a lot of people go through it, especially if they’re having to be put under general anesthesia, too. Thankfully, I didn’t have to do that.

Elliot: But it sounds like you’re pretty close.

Hannah: It was pretty close, yeah. I mean, I just had the epidural, so I didn’t need general. But they did give me, I don’t know what they gave me additional to help with the pain, but I kind of dozed off for a little bit.

Elliot: For a key moment.

Hannah: Yes.

Elliot: So, how was your recovery?

Hannah: So, in actual recovery room, I went hypotensive and I hemorrhaged really bad. So, I was like on the verge of completely passing out because my blood pressure was so low and I had a lot of blood loss. So, during that process, I was kind of out of it. But my husband was trying to help my son nurse at the same time, but I was like shaking and I couldn’t really hold him. So, he was helping him do that.

Elliot: Oh, this begs the question, did he get any pictures or video of the baby coming?

Hannah: Not of him actually coming out, but like in the operating room. We got some photos of him on, like the warmer thing.

Elliot: I was saying anything to fill in the blanks of when you were out.

Hannah: Not really. They got a picture of us all three together in the OR. But I don’t really remember that being taken. I just see the picture.

Elliot: Okay, so something.

Hannah: Yeah, something.

Elliot: That you can look at. Okay. And then, recovery at home. Wait, so did your blood transfusions?

Hannah: I did not have to get transfusions. They just said it was more than they would like to see from the cesarean, but not enough to get a transfusion.

Elliot: Related to the thrombocytopenia?

Hannah: I don’t know. I guess it could be. That would make sense. I don’t know if it was that or I know that if you, I guess pushing for a long time cause that.

Elliot: The uterus doesn’t, yeah. Okay. How was your home recovery?

Hannah: It was pretty rough. I was on quite a bit of pain postpartum at the hospital and at home, and I didn’t really feel comfortable doing much of anything for several weeks. And I think it was a lot of emotional pain as well as physical.

Elliot: So, on the physical side at the incision?

Hannah: Yeah. And in my abdomen in general.

Elliot: Are you athletically?

Hannah: I was before I got pregnant. Yeah. Not as much during my pregnancy or postpartum.

Elliot: My observation, it seems to affect people more than people who are less, you know, in tune with the body.

Hannah: Right. And I’ve heard that the like tension, if your muscles are tighter, can cause a lot of issues too. So, if you are athletic and you have really tense muscles and they’re not relaxed, they can cause some issues.

Elliot: Well, again, in my observation, clinically in the office, one of the things that we see is if you’re strong and also tight, combination of strong, tight creates a rigid environment. And if the baby’s not lined up well with the runway, then it’s a bit harder to maneuver in that static environment. And that’s where you end up spinning your wheels a lot in labor.

But the cool thing about that is if you can do something, get rid of that tension, the excess tightness, the dysfunctional shortness, and all you have is the strength, then it goes the other way. Those are like the most powerful births that I’ve ever seen.

And then, emotionally, how were you feeling? You said that was also uncomfortable.

Hannah: Yeah, it was really just kind of thrown off and shocked by my birth experience. And I ended up with postpartum depression and anxiety and had to go to therapy to help talk through that, which was extremely helpful. I recommend it to anyone that needs it. So, it was a rough postpartum, physically and mentally, for sure.

Elliot: Did lactation go well for you?

Hannah: Yeah, yeah. He actually nursed great. Breastfeeding was wonderful and we breastfed for a year.

Elliot: Oh, okay. At least, there’s some things that did go well.

Hannah: Positivity?

Elliot: Yeah. In your way that you wanted them to go. I guess looking back, would you have done anything specific differently?

Hannah: I probably would have waited on the epidural. Or if I would have known at the time, gotten a doula for that birth, but I didn’t know what a doula was. I didn’t know that was the thing. So, that’s probably what it done differently. And then, I also would have, I didn’t mention this, but they did break my water at 9 centimeters. I asked them to break it because I didn’t know any different. And I feel like he could have gotten a better position if my water wasn’t broken.

Elliot: Yeah. It’s hard to know, but one wonders for sure. And just getting ready for the hyperemesis before we move on to your next baby, was it like literally that same day that it stopped?

Hannah: Yeah. I wasn’t sick at all. I was sick all through labor, and that I wasn’t sick at all afterwards.

Elliot: Were you hungry?

Hannah: I was hungry. I think the only other thing that made me sick with my pain meds postpartum. That made me sick until they got the right one.

Elliot: This is when you start going to phone booths and helping other people in labor. Tell me about that.

Hannah: So, I started out with childbirth education first.

Elliot: Okay. Becoming a childbirth educator?

Hannah: Yes, yes.

Elliot: A specific method?

Hannah: Not a specific method. I just wanted to become an out-of-hospital specifically. Because of how my experience with my birth class and how I did not enjoy it. And I thought, “Well, there needs to be a better option for people because that wasn’t great.” So, I just started to do that first. And then, I did not get into doula work until after the birth of my second.

Elliot: Oh, wow. Okay, wow. That sounds like an excellent place to take a quick break. And let’s find out about the second pregnancy, birth, and the doula work. We’ll be right back.

[break]

Elliot: Welcome back. We’re talking to Hannah Gill. And let’s talk about baby number two. So, was that planned?

Hannah: Yes, the second was planned for sure.

Elliot: Super fast again?

Hannah: It took two cycles, but still relatively fast, yeah.

Elliot: Pretty darn fast. Especially, people get very nervous with PCOS. So, that it’s always going to take a while. How was your second pregnancy?

Hannah: So, the first trimester was extremely rough for about 17 weeks. Again, borderline. Probably, this time was actually hyperemesis again. I wasn’t diagnosed. But I did end up in the hospital with fluids because I couldn’t keep anything down, and how to take time off work. So, the first trimester was rough, but then it got better after that this time.

Elliot: Good thing about taking time off at work is usually don’t get the answer anyway.

Hannah: I know.

Elliot: So, nobody will even know you’re not there. Okay. So, wow, you said 17 weeks. Does that mean that got better?

Hannah: Yes. After 17 weeks, it got better. I was still nauseous here and there, and had random bouts of vomiting, but nothing nearly like my first.

Elliot: Right. So, it sounds like the first part of your second pregnancy was worse than the first pregnancy.

Hannah: Oh, yes.

Elliot: But then it got a lot better than the first pregnancy. So, interesting how it works. Who knows? And then, what was your plan for this one?

Hannah: So, this time, I originally wanted to do birth center, but it is illegal to VBAC in Indiana in a birth center.

Elliot: Really?

Hannah: Yes.

Elliot: It’s how they made VBAC outside the scope of practice of a birth center.

Hannah: Yes. It’s not allowed.

Elliot: That’s weird.

Hannah: I know. I didn’t know it was a thing until I looked into it.

Elliot: I could see insurance not wanting to cover it but to [outlaw 23:46] it seems strange.

Hannah: Yeah, it’s a little drastic.

Elliot: I feels like restrictive in a free country.

Hannah: Yeah.

Elliot: Okay.

Hannah: So, after figuring that out, I thought, “Well, let’s go the route of home birth.” But the closest midwife to me would not take the first VBAC after cesarean. She would only take the second VBAC after cesarean. So, the closest midwife to me that would take me on was about two hours away, and I didn’t feel comfortable driving that far for appointments. So, everywhere else was out of my service area, unfortunately. So, I decided to stay with my OB that did my cesarean because she was great as far as supporting me through that. And she was completely on board with me having a VBAC.

Elliot: That’s cool.

Hannah: And then, I hired a doula as well.

Elliot: Okay. And did you have the thrombocytopenia again?

Hannah: I did, yes.

Elliot: Okay. So, that was still a question mark in terms of how that might affect you.

Hannah: Yeah. So, I just completely plan to not have an epidural and didn’t even think of it as an option in my mind, just in case.

Elliot: I think the thrombocytopenia kind of risks you out of the out-of-hospital birth anyway.

Hannah: Yeah, it does. Depending on the level, I believe.

Elliot: Right. Yeah.

Hannah: Mine were never that low, I don’t think.

Elliot: In the second?

Hannah: Yeah. They were low in the second, but it was more of just risking you out of an epidural versus out-of-hospital.

Elliot: If you’re low enough to risk out of an epidural, you’re probably too low for a home birth.

Hannah: Yeah, potentially, I think so.

Elliot: It’s my guess. It’s not my area of expertise. But anyway, anything else that popped up during that second pregnancy?

Hannah: I had a marginal cord insertion with my placenta.

Elliot: Okay.

Hannah: And that was the only other weird thing. So, they just did a couple extra ultrasounds just to make sure baby was growing okay. But baby was always fine.

Elliot: Cool. How did that labor start?

Hannah: So, again, it was fast and furious. But when I went into the hospital, I didn’t know I was in labor. I just had some excessive bleeding. That was concerning.

Elliot: Interesting. So, where is this in relation to your due date?

Hannah: I was two days past my due date.

Elliot: Okay.

Hannah: I was a week early with my son, the first.

Elliot: Was there a sweep on the second?

Hannah: No, I did not have any cervical checks and no sweeps.

Elliot: Oh, wow. Okay. So, then, you just start bleeding a bunch, you go to the hospital.

Hannah: Yeah.

Elliot: No contractions though?

Hannah: No contractions.

Elliot: Okay.

Hannah: So, I get to the hospital and they put me on the monitor. They want to check and make sure it’s not placental abruption or anything like that. And I was 3 centimeters at that time. And they said, “Well, how about we –” Actually, probably closer to four. So, they wanted to sit me on the monitor because I wanted to labor at home as long as possible. So, I plan to go home if we could because I wasn’t having contractions. And they wanted to monitor me for about an hour just to see if I made any progress. And in that hour, I dilated another centimeter. So, we just decided to stay at the hospital at that time.

Elliot: Okay. So, now, you’re like 5-ish. No idea where that blood was coming from?

Hannah: No. They said that it just kind of trickled off. It didn’t happen a lot. They said it could have been a partial abruption. It could just have been part of like, a bloody show that was more intense.

Elliot: Yeah. Okay.

Hannah: They didn’t give me an answer on that.

Elliot: And how the labor progress?

Hannah: So, it was a whirlwind, but we got to the hospital around 8:00. I progressed extremely quickly. And my entire labor was five hours.

Elliot: Oh, wow. And how was the intensity?

Hannah: So, it was still pretty intense. But I had done a hypnobabies course. So, I was pretty good at staying relaxed. And then, my husband was very helpful as well. But they were really intense when they picked up. The first ones were very gradual. But then, right around transition, obviously they got super intense.

Elliot: Were you planning to stay unmedicated?

Hannah: Yes. Yeah. So, I was planning no epidural whatsoever. Unless, it was absolutely needed.

Elliot: And was the team around you, the hospital staff, supportive?

Hannah: Yes. So, the nurse we had was super supportive. I was up and moving. I was on the toilet and the shower. She was great about letting me do my thing. And I had wireless monitors. They tried to keep him on as best as possible, but I was moving so much it didn’t really work.

Elliot: Okay. And then, how does that birth end?

Hannah: So, my doula almost didn’t make it because it was so fast. I was texting her throughout the process on like how I was doing. And I text her around right when my water broke, which was a little after five centimeters. I was GBS-positive. So, I did have to get a round of antibiotics.

Elliot: But we should explain that. Group B Strep is a type of bacteria that can sometimes colonize in the birth canal. Generally, In the United States, everyone gets swabbed for it somewhere around 37 weeks. And if you’re positive, then the general recommended treatment is IV antibiotics during labor. Usually, every few hours.

So, you have the GBS. There’s also an episode on Group B Strep Positive with Rebecca Dekker from Evidence Based Birth. And she goes into a lot more detail about what it is, and if there is anything that you can do to prevent it and other potential treatments. Check them out.

Okay, so you have GBS. You’re getting your IV antibiotics.

Hannah: Mm-hmm. And I was up and moving after that, but my water did break around 5-ish centimeters. And right after my water broke is when things really, really picked up.

Elliot: Where were you when it broke?

Hannah: I was still in the bed because I had just got down to my antibiotics. And then, after that, I basically got up and went to the toilet and sat there for an hour.

Elliot: Was it a big old gush?

Hannah: It wasn’t a huge gush, but it was quite like it. Isn’t like obviously a gush, but it was a ton of fluid that came out. Yeah.

Elliot: Okay. It wasn’t like, “Oh, did I just pee a drop?”

Hannah: No, it was like, “This happened.”

Elliot: Okay. Alright. Sitting on the toilet with people around you or did you –?

Hannah: My husband was with me in the bathroom while I was on the toilet, getting me washcloths for my face, rubbing my shoulders, that type of thing. And so, I was on the toilet for at least an hour and that’s when I started transitioning. At the dilation station.

Elliot: What did that feel like?

Hannah: So, my contractions were on top of each other at that point. Like one, back-to-back-to-back. And that’s when my doula walked in, and I told her — her name’s Julie. I said, “Julie, I need an epidural.” She said, “Well, let’s maybe try to switch positions, get off the toilet.” So, we moved to the shower at that point, which was extremely helpful.

Elliot: Warm. Warm water?

Hannah: It was warm. At first, it was way too hot and it was really sensitive on my back, and I had to wait till it cooled down. So, I was leaning over the sink counter until I could get in.

Elliot: Was the intensity in your back? Was it like more period –?

Hannah: No. It was in my pelvis. Like I felt like I was pushing, basically. My husband got in the shower with me and I was hanging on him around his neck. And then, my doula was behind me putting the water on my back.

Elliot: Sounds streamy.

Hannah: Yeah. And I started basically bearing down and pushing in the shower.

Elliot: Grunting?

Hannah: Yeah. And the nurse was like, “Well, maybe we should move to the bed.”

Elliot: Yeah. Did you?

Hannah: We did eventually move to the bed. I was very reluctant to do so, but we moved to the bed and I got on hands and knees to start my pushing process.

Elliot: Was that instinct or was that planned?

Hannah: So, my doula suggested it because I had a partial cervical lip. So, she said with the position of the lip that being on hands and knees would kind of help push that away.

Elliot: Cervical lip, just a piece of the cervix is not quite out of the way yet for the baby to pass through more easily. Okay. And were you starting to push?

Hannah: Yes. So, I was pushing at that point. I pushed on hands and knees for about 10 minutes. And then my doula suggested switching to squat position to kind of help it become down more.

Elliot: Did you have a squat bar?

Hannah: Yes. We had a squat bar. And I was very reluctant to move to that as well because I was just exhausted, and it was great to lean on the back of the bed. And I said, “There’s no way I can hold myself up with a squat.” So, I had this squat bar and then my husband supported me as well.

Elliot: From behind you?

Hannah: Kind of on the side. Like holding my back up so I wouldn’t fall backwards a little bit.

Elliot: How long was pushing?

Hannah: So, it was a total of 15 minutes.

Elliot: Oh, my goodness!

Hannah: Yeah, hands and knees. And then, as soon as I moved to a squat position, it was maybe two contractions and the baby was out. She didn’t have any head mold or anything. She came out so fast.

Elliot: Just came right through. Did that surprise you?

Hannah: It did. Because pushing was like the one feat I wanted to get past because it was so long with my son that I was pushing. And it was intense, and I just felt like she just shot out.

Elliot: Wow! What was going through your mind at that point?

Hannah: First of all, we didn’t know if it was a girl or boy again. So, I wanted to first find out if it was a girl or boy. But it was just so intense and I thought, “Okay, just if I could just get her out, then there’s no chance I’ll have a C-section.” I just wanted to get her out. I just wanted to get past that. But yeah, the ring of fire was brutal.

Elliot: Oh, really? For how long did that last, would you say?

Hannah: Just probably 30 seconds.

Elliot: Okay, 30-second ring of fire.

Hannah: Yeah.

Elliot: How was your recovery?

Hannah: It was great. So, I just had a slight second-degree tear just because she did come out so fast and I didn’t control the pushing to slow it down much at all. But I had a little bit of a retained placenta as well. So, it took a little bit for them to really get all that out and they did an ultrasound to make sure. I actually had to get more of it removed several weeks later.

Elliot: Later? Oh, wow.

Hannah: Because it’s still there. But, overall, recovery from the VBAC was 100 times easier than C-section.

Elliot: Mind and body?

Hannah: Mind and body, yes.

Elliot: Hmm. Well, congratulations.

Hannah: Thank you.

Elliot: I know you worked hard for that. And what an intense journey from beginning to end even just finding out that you had PCOS and the question marks that that brings up. What would you do with a third pregnancy for the birth?

Hannah: One hundred percent home birth, as long as I’m able to.

Elliot: Because now you can — The second VBAC, now that you have a “proven” pelvis.

Hannah: Right. But as long as my platelet levels are fine and everything checks out, I would 100% want to have a home birth.

Elliot: We just have to do another episode in a couple of years. Before we go, tell me about your new nightlife.

Hannah: Yes. So, I am a childbirth educator, birth and postpartum doula. I am owner of Ebb and Flow Birth Co., is what my business is called. So, I do doula support for postpartum and birth, and I’m in Indianapolis in that area. So, I’m really liking it so far. I just started doula work. I’ve only had one birth for my birth support, but I have childbirth education classes lined up as well.

Elliot: Is that what you named your kids, Ebb and Flow?

Hannah: No, no. They’re Hudson and Marley.

Elliot: Oh, Hudson and Marley. I though they’re going to be like Evan and Florence.

Hannah: No.

Elliot: Hey, Hannah, I thank you so much for joining and for sharing your story. And for now, the amazing work that you do supporting others.

Hannah: Thank you.

Elliot: Tell me where we can find you online.

Hannah: So, Instagram is @ebbandflowbirthco. No underscores or anything like that. And then, my website is ebbandflowbirthco.com.

Elliot: Amazing. And we’re over there on the Instagram as well @doctorberlin, D-O-C-T-O-R-B-E-R-L-I-N.