Ep 301: Miscarriage, Prodromal Labor & Healing After a Third-Degree Tear: Melissa’s Birth Story

Dr. Nicole (00:00.182)
In this episode, Melissa shares her experience having a miscarriage, what it was like to go through prodromal labor, and the raw reality of a third degree tear after birth. She's honest, grounded, and super relatable as a first-time mom who really did her homework. Whether you're prepping for birth or just love a good birth story, this one will leave you informed and in spite.

Dr. Nicole (00:31.032)
Welcome to the Birth with Power podcast where knowledge is power and power transforms birth. I'm Dr. Nicole Callaway-Rankins, mom of two and practicing board certified OB-GYN with over 20 years of experience and nearly 2000 births attended. I've seen firsthand how the hospital system can leave women feeling unheard and uncertain, but that doesn't have to be your story.

Here, you'll get the knowledge, support, and strategies to take charge of your birth experience so you can walk into the hospital feeling calm, confident, and empowered. Note, this podcast is for educational purposes only and it's not a substitute for medical advice. See the full disclaimer at drnclemeringhens.com forward slash disclaimer. Now let's get to it.

Hello there, welcome to another episode of the podcast. This is episode number 301. Whether this is your first time listening or you have been here before, I am so glad you're spending some time with me today. In today's episode, I chat with Melissa, a first time mom to her baby boy Gus. Melissa lives in Southern Rhode Island with her husband and their dog, Bo.

She's currently taking some time away from her work as an electrical engineer to focus on motherhood, and she shares a beautifully honest and empowering account of her journey. In this episode, Melissa opens up about her experience with miscarriage, the emotional and physical toll it took, and how she prioritized healing before trying again. We talk about her pregnancy, the discovery of a fibroid, the long stretch of

pro-drama labor that left her exhausted and what it was really like for her to push on her back, no less. There's so much goodness in this episode, real talk, helpful tips and lessons that can truly make a difference in your own birth experience. Can't wait for you to hear it.

Dr. Nicole (02:35.104)
And just a quick update, the Birth with Power pathway is coming, y'all. I know so many of you have been eagerly waiting. You've reached out about when it will be ready. And I so appreciate your patience. I just needed a little more time to make sure it's exactly what you need. And I must say it is shaping up to be fire. So stay tuned. It's going to be worth the wait. All right, let's get into this birth story episode with Melissa.

Dr. Nicole (03:10.318)
Melissa, thank you so much for agreeing to come onto the podcast. I am so excited to have you share your birth story.

Thanks for having me. I'm really excited to share my story.

Yes, why don't you start off by telling us a bit about yourself and your family.

Yeah, so I'm Melissa. I'm a 33 year old first time mom. I live in Westerly, Rhode Island with my husband, our seven month old son and our dog. My husband and I met in college almost 15 years ago. Just kind of crazy. I'm blessed. I know it's crazy. I work as an engineer and I actually just started going back part time a couple of weeks ago. So I was really lucky to have as much time home with my son as I did.

I'm really looking forward to the summer with him and taking him to the beach.

Dr. Nicole (03:54.51)
Nice, nice. That'll be fun. What kind of, I'm always, we're a STEM, like nerdy family. what kind of engineer are you? Okay. All right. Yeah. I actually majored in mechanical in college and then now here I am. righty. So.

electrical

Dr. Nicole (04:11.264)
Well, in order to talk about your birth experience, we have to talk about your pregnancy experience. And in your case, even before that, because you had a miscarriage and that shaped how things happen with your pregnancy. So why don't you tell us about that?

Yeah, so I was actually actually really lucky. I did get pregnant the first time that we tried. I ended up going for my eight week dating scan. And at that scan, the ultrasound tech indicated that there was no heartbeat. She never used the word miscarriage, but I could tell, know, that it wasn't looking good. Right. So she stepped out of the room, called our midwife and said that they were kind of give me a call back later in the day.

And so later that day, they gave me a call and kind of told me what my options were. When she answered the phone, it was kind of shocking because she used the word miscarriage and I hadn't really heard that before. I knew it wasn't good, but it was just very shocking to hear that word associated with it.

Yeah, did you, when you, when you heard like, there's no heartbeat, like we say that, but I don't think it necessarily registers that that means, I know this sounds crazy, but some people even say, well, like, can you keep looking until you find it? Like those kinds of things. So is that kind of where you were? Like it wasn't sort of sinking in that what was happening.

Yeah, exactly and she kind of hinted that you know at this point we should see it If we if we waited another couple weeks, we probably still wouldn't see it. Mm-hmm. So I think she just was nervous to show that as sure ultrasound tech. I said she didn't want to give me that information But yeah, I knew it wasn't a positive gotcha result

Dr. Nicole (05:58.648)
Yeah.

Dr. Nicole (06:03.192)
Gotcha, gotcha. And then how did things happen after you had the conversation with your midwife?

So she told me a couple options. I could kind of wait it out and let things pass naturally, or I could take the misoprostol or I could have a D and C. So I chose to have the misoprostol. I had two rounds of that orally, which was very intense, the cramping and the bleeding. And it actually made me, I'm not sure if this is a common experience, but.

Afterwards, I was very fatigued physically. I couldn't walk around for very long without having to sit down. And I just didn't exactly expect that.

I wonder, were you anemic? Because if you had a lot of blood loss in a short period of time, you can certainly feel that.

Yeah, that could have been what was happening. I did bleed for quite a bit after. It was very painful. Yeah, it was just a very emotional experience. I did go to therapy for it, just because I didn't want to carry any trauma associated with that into any subsequent pregnancies. And I wanted to make sure I had kind of fully dealt with it. Right, right.

Melissa (07:15.726)
One of the resources I actually use a lot was the What To Expect app has a forum, community forum posting, and there's a whole forum in there about like loss and miscarriage. And that was really, really comforting for me to use because there were so many people in there that had such similar experiences.

Right. And how do you feel like your midwife helped support you through the experience?

So the midwife I spoke to during the miscarriage was not the one I had normally seen for my routine visits. So I went to go see my normal midwife following that experience and she was great. She answered all of my questions. She kind of told me there's nothing that I probably did or didn't do that caused this and sometimes it kind of just happens. Then my nurse actually, I'll never forget this, she was taking my blood pressure and she was like, has anybody told you that this is not your fault?

And that just like, no one had already said that. know no one specifically blamed me, but it just like really hit home when she said that.

Yeah, well, that's good. That's good. So then how soon after the miscarriage did you you all decide that you wanted to try it again?

Melissa (08:26.84)
So we had decided that we wanted to try again after my next period. I knew I wanted to try. I felt comfortable with that. And my midwife recommended waiting one period, I think just for ease of dating.

Yeah, yeah, gotcha. And then so how soon did you get pregnant after?

the next try. Actually, we're very fortunate. okay. away. Okay, so only just a couple months later.

That's really close for that to happen. Okay. So then how did you feel when like...

Yeah, I felt hesitant. didn't really my guard was definitely up I didn't want to like kind of accept it and get my hopes up right it felt different than my first pregnancy I had a lot of morning sickness before my eight week ultrasound. It's time trying to feel nauseous So it was definitely a different experience, but I still didn't put too much weight into that because I I just wanted to protect myself got

Dr. Nicole (09:24.91)
Gotcha, gotcha. Okay. So then how did the pregnancy and prenatal care?

So it was good. There were four midwives and four OBs at my practice. And I primarily saw the midwives. I had one primary midwife until about 30 weeks, and then I kind of branched out and met all four midwives. And then I met two of the four OBs.

Okay.

And the way that it works at the hospital I delivered at is that the midwives are called first for delivery. So I knew it was a good chance that I would have a midwife. So I felt good about that, not meeting the other two OBs.

Gotcha.

Dr. Nicole (10:04.046)
Okay, okay, okay. So the midwives do all the births essentially and the physicians really only do the C-section?

I think if there's like two births going on, the OB would be there as well. Because there was an OB at my delivery as well.

Got it. So you saw the midwives when I guess I want to back up and say, when did you know like, okay, you could breathe or when did you feel like you could breathe a bit during this pregnancy?

So I'd say probably not until the beginning of my second trimester, I was like, okay, this is really going to happen. I started to feel good. All of our tests came back positive. Like they were good, good results. I will say also my midwife, when I went for the follow-up appointment after the miscarriage, she indicated that sometimes what they do is they offer to test your HDG levels before knowing that that can't really

change anything but it can give you kind of a peace of mind until you have some of those early ultrasounds. So we did do that and that kind of gave me some reassurance. I had a couple early ultrasounds and that was positive experience.

Dr. Nicole (11:09.086)
Okay, good, good. And did you have any issues or concerns during your pregnancy? I know I believe you had a fibroid, is that right?

Yeah, so I had a pretty large fibroid. It was the type that's in your muscle and it was right at the top of my fundus. And I had no history of fibroids that I knew of, but at the 20 week ultrasound, it was identified and I was kind of concerned because I had never heard anything about me having that before. But my midwife wasn't too concerned. She just said at about 32 and 36 weeks, they were going to do some additional growth scans just to make sure that

because of size of it. It's about six centimeters. it was like, yeah, even towards the end of my pregnancy, you could kind of see it popping out the top and everybody was like, oh, is that his head? I was like, no, that's my five-roy.

is a good size.

Melissa (11:58.36)
So yeah, it didn't cause me any issues until about 38 and a half weeks. Towards the end, I was walking a lot. And so I had gone for a walk at lunch one day and I came back and I was having this pain up at the top of my stomach. And it wasn't coming and going like a contraction would be. It was kind of just consistent and it hurt more when I took a deep breath.

Okay.

And so they thought maybe I was dehydrated. I had gone for a walk. So I tried some electrolytes, tried to rest and it didn't really help after a couple hours. So I ended up going in and getting checked out just to make sure. And they did a non-stress test. Of course my blood pressure was high because I was nervous. But all my tests came back okay. And they kind of determined that it was just, I had somehow irritated the fibroid and it was kind of causing some pain in that region.

Yeah, sometimes they can what's called even degenerate where the blood flow starts getting cut off to them and it can cause pain So that may be what have what have happened? Okay, so but then your blood pressure must have settled down because they didn't ask you to stay. Yeah

Yes, they did. And they even drew blood and urine and everything and everything came back okay.

Dr. Nicole (13:15.63)
Okay, okay. All right. So overall your pregnancy and prenatal care was pretty straightforward and no big issues.

Yeah, I watched being pregnant. did you really? Yeah, I know some people don't agree with that.

Yeah, I was not a fan of being pregnant. The only thing I liked is the kicks and the moving. But and I like that I wasn't I'm usually cold all the time, except when pregnant. I was always warm. I was walking around in November with short sleeves. But you love pregnancy. All right. All right. I love it. Love it. All right. So then how did your labor start? Let's hear it. Let's hear that.

Yeah

Melissa (13:54.606)
So my labor started, was 40. So at my 40 week appointment, was 30, I was three centimeters and 70 % a face. Okay. But he was not firmly applied to my cervix. She could feel him kind of moving around. Gotcha. So I had her perform a membrane sweep to try to get things going. It wasn't as bad as I expected to be honest. I had heard kind of horror stories. I kind of prepped for like a good amount of pain, discomfort, but it wasn't too bad.

What was that experience like for you?

Melissa (14:24.034)
I don't know if that was because he wasn't firmly applied.

I've it differently. For some people, it's not a big deal. For some people, it's really uncomfortable. We don't really have a good way to predict who's going to be who. Yeah. Yeah. Yeah. And let me back up and say, you said you were 40 weeks. Was there any talk about induction before that?

So there was at that appointment we talked we actually scheduled an induction Because of the date that I didn't want him to be born it was in September I didn't want him to be born on September 11th and the days in which different OBs and midwives are gonna be on call I actually scheduled an induction for That following Tuesday, so I would have been 40 weeks in five days. Okay, and I felt comfortable with that just after talking to

my providers.

Gotcha, gotcha. okay. they stripped your membranes and then what happened after that?

Melissa (15:18.392)
So the following day at 7 a.m. I went for a walk and that's when I kind of started to feel some very mild period cramping. And I was like, I think these are the start of contractions. So I was still working, of course. And so I was working from home and I started work that morning and it lasted about two hours. And then at nine o'clock I was like, all right, I think this is definitely happening. I think I'll log off and start just.

preparing mentally. So I timed them just to get a baseline of where we were at that point and they were only about 15 minutes apart and they were not very intense at all. They're very mild. So I kind of just was on the birthing ball trying to get him into the right position. And then about 12 o'clock they started to intensify a little bit. They were anywhere from like two to seven minutes apart. They were not very consistent and they were lasting 30 to 40 seconds.

Okay.

But in my mind, I'm like, okay, this is happening. I'm gonna be having my baby. Maybe tonight I'll go to the hospital. But eight o'clock rolled around and they slowed down to about 20 minutes apart. But they would come back if I would go for a walk or if I would like curb walk or up and down the steps, that type of stuff, they would come back. So I wasn't exactly sure what was happening. And being on the ball was the only comfortable position at that point. Laying down, sitting down, even on the toilet, I was...

looking forward to that because I, you know, the dilation station, but that was not happening. I was not comfortable at all. So they were never closer than five or six minutes apart. And then all through the night, you know, they were closer to like 10 minutes and my husband went to sleep. I couldn't lay down. So I sat on the birthing ball and just kind of leaned over the bed in hopes that I could close my eyes every couple of minutes. Right. But about one in the morning I called triage.

Melissa (17:15.48)
just to kind of tell them what was happening and if they had any ideas of what kind of I should do. And they kind of indicated, lay down, rest, take a hot shower. If your contractions stop, then you're not really in labor. And I thought, my goodness, I am so tired.

I was getting ready to say you must have been exhausted.

I was exhausted and I would take a shower every couple hours and they would stop. But as soon as I got back out, they would start again. I was more just getting tired. I was using the combs in my hand to kind of work through some of the tougher contractions. But then at about four in the morning, I called Triage again and asked them,

If I came in, would I be admitted? And they told me that only if I had cervical change since the last time I was checked, which was at my last appointment, I was three centimeters.

Gotcha. So this is going on almost 24 hours now. Yeah. OK. OK. OK. And I should back up and I should let me ask you first, what did you do to prepare for your birth?

Melissa (18:21.614)
So I did lots of stuff before the miscarriage, before I pregnant the first time I started listening to your podcast. I started listening to the mommy labor nurse. I took some classes at the hospital. They offered some free classes, a breastfeeding class and a birth class. And that class was actually good just to know the policies of the hospital and the way that they do things at the hospital.

Yeah.

Dr. Nicole (18:51.278)
Gotcha. Gotcha.

They gave you a tour so you could visualize the room that you were going to be in and that was really really helpful for me and I did take your birth plan class which was super helpful and your childbirth education course as well.

Nice. Okay. All right. Good. Good. Good. Good. So what are some things that you wanted for your birthday?

So I did want to try to labor at home as long as possible. I thought maybe I'd want to labor in the tub that they had at the hospital. I didn't end up doing that, but I didn't really, I wasn't excited about an epidural. I was open to it. I was just more nervous about the needle going into my back. I felt educated on it as far as the medication and the risks and everything. I just was not crazy about that needle.

And if you see it, it's not a small needle either. So, but yeah, especially going like around your spine and all that. So I totally get that.

Melissa (19:48.748)
Yeah, it just made me nervous. I know it's low risk, but I was just afraid.

Gotcha. So were you planning that you were you going to try to do unmedicated or what were your thoughts?

I was going to try to use the nitrous. I thought that that would be a good option for me, especially wanting to be able to move around, be in different positions. I thought I also wanted to not push on my back. That ended up not being the case, but I thought that I'd want the freedom and mobility to move around.

Sure, gotcha, gotcha, gotcha. Was there anything else that you wanted for your birth?

I definitely wanted skin to skin, delayed cord clamping, all that good stuff. And I really wanted to go into labor spontaneously. I really desired that. I was kind of nervous to have a C-section if that was the way things went. And I would really prefer not to be induced.

Dr. Nicole (20:42.702)
And then I'm sure with the med-blast, all of those things were pretty standard.

Yeah, yeah, yeah. Not the hospital that a lot of that stuff was standard. They waited a minimum of five minutes for delayed cord clamping. Okay. They put the baby right onto my chest.

Nice, nice. And did they discuss all that during the prenatal or during the tour, I guess, maybe the birth class even?

Yeah, so some of it was during the birth class, some of it was during the tour, and then some of the questions I had already asked my midwife so I knew what their standards were for delayed cord clamping and skin to skin.

Yeah, those are lot of the questions that I tell folks to ask. It provides a lot of reassurance ahead of time. Yeah. So yeah. And then was there anything other than the needle that you were afraid about?

Melissa (21:24.302)
was afraid of hemorrhaging. just, not that I have any specific risks really, I just, that was just a fear of mine. didn't want to have uncontrolled bleeding.

Got it. Got it. Got it. Okay. Okay. Okay. So then now back to your birth. So with all those things in the background, this is you're going on now almost 24 hours and they say, if you haven't changed, then we're not going to admit you. like, how did you feel? What happened next?

I was exhausted and I knew I needed some sort of relief. I woke up my husband at about four o'clock, five o'clock, I guess. And I said, we got to go to the hospital. I need some relief here. So we pack up our stuff. We get to the hospital about 530. They take us to triage and they check me and they determined I was about a four. But I had a bulging bag as well and he was not firmly applied.

Right.

Melissa (22:22.259)
And so they did decide to admit me. So I was very happy about that. at that point they asked me if I wanted an epidural and I said, yes, please.

gotcha, gotcha. So how, how, how soon once you got in the room and all of those things, how did that, that

It was pretty quick. About 8.30 the anesthesiologist came in since it was the morning time, the morning shift. He, think I was one of the first people he saw. so yeah, about 8.30 he came in. I got the epidural. That was an interesting experience. I didn't realize that they wouldn't let my husband hold my hand or be near me. They kind of made him sit across the room and I kind of had like this mini panic where I just was like, oh my God, this needle is going to go into my back.

But my nurse was amazing. She was incredible. She was like, you're okay. I got you. And she sat there and held my hands. the nurses that I had during my labor and delivery were incredible.

Awesome. Awesome. Good. Good. So the epidural went in okay and there were no issues with that.

Melissa (23:26.318)
Yes, it went in good. I felt it in both legs. I could still move my legs, but yeah, the pain was gone.

That's actually the best type of epidural where you still have some movement in your legs, but you don't feel the contractions as much. That's going to help. It's easier for pushing that way when you have some sensation as opposed to your legs being really dead numb. It's also a really weird, it's kind of weird when your legs are completely numb. It just feels weird.

I think it was like the perfect amount of numbness. They were kind of tingly, but I could definitely still feel them. And I think that was part of the other, one of the other things I was kind of nervous about was them just being completely dead and not feeling like I could move at all.

Yeah, yeah, exactly, exactly. Okay, so then how did your labor progress after you got settled into the hospital and everything?

So after I got the epidural, it progressed pretty quickly. My midwife put me into a couple of different positions with a peanut ball to try to get him firmly applied. She came back at about 10 o'clock and she's like, I'm gonna check you. If you're progressed enough, I'm gonna break your water. And I agreed with that. I thought that was okay at that point. But she ended up going to check me and at the same time broke my water kind of a couple minutes before.

Dr. Nicole (24:46.85)
Gotcha.

And it was a big gush.

you

but he was in a good position. so seven centimeters about 10 o'clock, she came back about maybe an hour and a half later and checked me again and I was nine centimeters. And at this point, I can't exactly remember why, but, and this may be one thing I would, if I had to go back, I would ask more questions, but she ended up giving me a little bit of Pitocin to get me over the finish line there, to get me to 10 centimeters. Yeah, don't exactly remember why.

Okay, I'm curious too because it just sounds like you were progressing along pretty, you know, smoothly.

Melissa (25:27.406)
Yeah. Okay. I know she gave me the lowest dose and then she came back about an hour later. I was fully fully dilated and she said, okay, if you start to feel any rectal pressure, let me know it's time to push. Right. And of course I'm like, okay, I don't really know what that means, but I'll let you know. So 10, 15 minutes later, I was like, I think I feel the pressure. Right.

So she comes back and she's like, all right, we're going to try to push in this way. And I of course had no idea what I was doing. And she's like, no, I don't think you're feeling enough pressure. So I'm going to give it a little bit more time. We're going to come back. You should be, it should be a little bit more intense than what you're feeling it now. And at this point, they also turned down my epidural. Okay. So that I could feel more. I could definitely feel things. Yeah.

Okay, okay.

Dr. Nicole (26:16.942)
And then let me let me ask you because at this point had you gotten any rest at all like had you were you able to take some naps or?

rested a little bit after I got the epidural, but I didn't actually fall asleep. just kind of like closed my eyes for an hour or two. And I did get a little bit to eat. gave me, I was able to have some like chicken broth.

Got it. Okay. Okay. Okay. All right. So then they said, wait a little longer. And then how would happen after that?

So that was just, I didn't have to wait too much longer after that. Maybe like 20, 30 minutes later, I was like, okay, this is definitely what she's talking about. And so she started to get me into position. I pushed on my back a little bit and they teach you pushing in the classes. I guess I didn't really realize how far back my legs had to go and how.

about now.

Melissa (27:14.59)
Intense I had to push it was just way more than I thought So I did start to push I pushed for two and a half hours or so

Which is not bad at all for a first time baby. We don't even, we get concerned at four hours. So you were, you were fine.

Yeah, I did. So I knew that they had a mirror that you could use and she's like, you want to try to use a mirror? I was like, no, absolutely not. I have no interest in this. So about halfway through, she's like, are you sure you don't use the mirror? I really think it's going to help you with your progress. And I was like, okay, I'll try it. And I'm going be honest, I'm glad that I did. Really? Yeah. Okay. It was really, really helpful for me to see my progress. And I actually progressed like way more during that.

period of time I was using the mirror. I did stop using it once he was starting to crown and I started to tear a little bit because that was a little bit too much for me. it definitely helped me up until then.

Okay. And then while you were pushing, were you mostly on your back or did you try different positions while pushing?

Melissa (28:19.608)
So in the beginning, I definitely tried different positions. I got on hands and knees on the bed. The bed bottom kind of came out. So I was able to be in a squat position with a squat bar. just didn't love those positions because of in between my contractions, I just felt like I still had to hold myself up or still had to brace myself too much that I was just too tired for.

Okay, okay, okay.

So I primarily push on my back.

Okay, okay. All right. All right. Yeah. And that's the thing. You want to be able to like have the opportunity to try and figure out what works. You just don't want to have to be forced to do any one thing. So that's great. So then you're pushing, push for two and a half hours. How was your energy? Like, how are you feeling? Or were you just running off adrenaline?

I was so tired. I got to a point and I was telling my husband, I can't do this. I was screaming. said, I cannot do this anymore. I just, I can't do it. And he was a rock star. He was like holding my leg, telling me, you can do this. I know you can do it. And he was just so, so, so, so supportive. I could not have done it as effectively as that.

Dr. Nicole (29:22.926)
that's really good. Was he did? Well, what did he do? Did he do anything to help you ready to prepare you or you just naturally just sort of like he stepped in and he was like, I'm going to help you get through this.

He just kind of helped me get through it. He did attend all the classes with me at the hospital, so he at least was aware of just the process and the way that things would happen. And he knew it could take a long time too, which I think was important.

Okay. So then what, I guess what, what time did you start pushing and then what time was your baby?

So I started pushing probably about like 11 15 11 30 and he was born at 145

Still trying to understand why she gave you pitocin. Like, I don't know why I can't. Like, because you were, I mean, you got there that morning and you were already like, I mean, but anyway, okay, I just.

Melissa (30:17.294)
I wasn't sure. back on it, was like the one thing I didn't fully... I don't, at least I don't remember if there was some justification.

Okay, okay. All right. All right. So then tell me about the actual birth part. and who was the midwife? Was it a midwife that you knew? Like, were you?

So.

Melissa (30:36.462)
It was a midwife that I knew. Yeah, I had met her a couple times and yeah, she was great. She was there the whole time I was pushing. She was giving me a perineal massage the entire time. She was coaching me. She was also a rock star. She was like, mama, you can do this. You got this. She was incredible. It was awesome.

Okay, okay, good, And you felt like those things were helpful.

Absolutely, yeah, I if I had a different midwife, I don't know if it would have been the same experience

Okay. Yeah. and I guess I should ask, they do, do you remember if they did like counting or were they just kind of letting you push and sort of just, or was it all the things to try to figure out?

out what worked. Yeah, they they counted for me for when I was having a contraction. So I could feel when I was having a contraction, I because they turn epidural off and it was the most and everybody's like, you'll just feel some pressure when you have the epidural. And let me tell you, was way more than just some pressure, at least from what I I know. Yeah. And it was it was very, very intense. Pushing was the hardest thing I have ever, ever done.

Dr. Nicole (31:45.23)
Yeah, it sounds like you were feeling I mean did they turn the epidural off or was it?

I think they turned it off more than I know if they intended or than I thought because I kept pushing the button. She's like, it's maxed out and I was like, okay, don't

short.

Dr. Nicole (32:00.387)
What happening?

Dr. Nicole (32:07.124)
Okay, okay. So then tell us about when your son was born.

So when he was when his head and shoulders were out my midwife Told me reach down and pull him out the rest of the way So I was able to pull him out and put him right onto my chest, which was so awesome So glad that they had me do it that way. Yeah It was it was incredible. So he was on my chest for a good amount of time After he was born. I did have a lot more fluid come out. I think it was combination of and beyond it fluid and

and blood and I did have a third degree tear that they thought might be a fourth degree. But yeah, so the midwife actually brought in the OB that was on call just to consult with her about if it was a third or a fourth and she determined that it was a third degree. And so the OB was the one that actually stitched me up just because she was,

Okay. Okay.

Dr. Nicole (32:56.566)
Okay.

Dr. Nicole (33:00.226)
Yeah. Yeah. Yeah. And did did you I guess how long did that take into that? How did that affect your experience?

So it took, I think it only took about 30 minutes or so. I don't think it was very long. But during that time, I did have them take my son and bring him to the warmer to do everything. Just because I just felt like I couldn't enjoy that when all of that stuff was happening. I like too much. I think because I was afraid I was going to be bleeding a lot that I just felt like I needed to concentrate on that. So he did stay on my chest for a good amount of like.

decent amount time and then once they were stitching me up they took them over there and my husband went over with him. Okay. Yeah and they did delayed cord clamping and everything like that and I delivered my placenta no problem.

Okay.

Dr. Nicole (33:48.92)
Good, good. How much did he weigh?

He was 8 pounds 5.2 ounces. Yeah. Yeah, he was a decent size.

he's a little solid.

All right. And then did you have to get more numbing medicine? Was it painful to get the repair?

or so they actually turn my epidural back on. They actually brought the nitrous over because I thought that I was going to need that, but they ended up turning the epidural back on in that that did that was fine. I used that for it and I didn't have any pain, which I was surprised about. OK. And the other thing, actually, I forgot to mention, so for my fibroid, when that was first identified, she told me that during delivery they would give me

Dr. Nicole (34:22.797)
Okay, good. Yeah, yeah, yeah.

Melissa (34:36.31)
TXA to prevent any bleeding due to that. So they did give me that along with Pitocin following delivery.

Okay. Yeah. It's a class of medicine and like a fibrinolytic or anti-fibrinolytic, a fancy class of medicine that helps with bleeding. Yeah. Yeah. Okay. So then what was your postpartum period like in the hospital? And then once you got home?

So at the hospital, it was great. I loved being in our little baby bubble at the hospital. I did breastfeed, so I kind of got that figured out or started to get that figured out at the hospital. I didn't have any excessive bleeding. It was within the normal range. And then overall, once we got home, again, the hardest thing ever done was trying to figure out this new little baby and all the...

and cues and everything. But overall it's been great. All the normal type stuff.

Good, good. And then when did you, how did you, how do feel like you healed from the third degree tear? And did they recommend anything like pelvic physical therapy or anything like

Melissa (35:53.23)
So I was nervous about the way I was going to be healing and if I would have pain. So I tried to be very regimented about taking like the Tylenol and Ibuprofen around the clock because I was nervous that once it started to settle that I was going to have a lot of discomfort, which ended up not being the case really. It was actually not too bad. Okay. And so it healed very well when I went back for my six week appointment.

She said that everything healed up very nicely. And I did, I am still going to pelvic floor PT.

Okay, okay, so when did you start doing that?

I started doing that about three months postpartum. Okay. And so I've been doing it for about three or four months now. Okay. And she, my physical therapist determined that I do have a prolapse. we're working on fixing that.

Gotcha. Yeah. And then what did you, did you decide on your own to go to a pelvic PT or did your midwife or the OB recommend that you go?

Melissa (37:00.686)
I decided on my own to go. I had asked about it during my prenatal care and she said that, you know, we can recommend one for you if you want, but a lot of times people don't go until, you know, postpartum. Gotcha. And at my six week appointment, they never said anything. I just asked for a referral at that point. They were supportive of it.

Okay, okay, okay, okay, okay, good, good. Yeah, I think you can make a big difference. Our bodies are just changed after you get pregnant and then after you have a baby. Actually, whether you have a vaginal birth or a cesarean. So it's interesting that in in France, for instance, everybody automatically goes to a pelvic PT, I believe. So everything is a little bit different. So that's good that you're going and you feel like it's been helpful.

Yeah, definitely. And I didn't really know much about a prolapse, but my physical therapist has been really educational on that and had pair.

Yeah, it's just that things are looser. For most people, it doesn't end up being an issue, but it's great that you're addressing it now. You will appreciate it that you're addressing it now so that years down the line, it will not be a big issue because it can become a big issue. So that's great. Yeah, that's great. So how do you feel about things overall with your birth experience?

think overall I'm very happy with my birth experience. It definitely wasn't exactly the way that I thought it was going to be, but I think in general it was positive. I don't have any real negative thoughts or feelings about it. I think my nurses and midwives and care team were really, really great.

Dr. Nicole (38:38.67)
Awesome, awesome, awesome. That's good. So then if you had to pick one piece of advice, one thing that you would want to tell women as they get ready for birth, what would that be?

I think it would be listen to birth stories, ask other women and mothers their like raw experience, not sugarcoated at all so that you have like a real good understanding of what things are going to be like going into it. I know for me, I kind of wish I had talked about pushing a little bit more just because of how hard I found that. I think that would have been beneficial for me.

Gotcha. Gotcha. And I know, I believe you were also a little bit the length of how that early part of the labor kind of being a prodromal labor also was a long time.

Yeah, I had heard about false labor, but I guess I didn't think that's what that was. I thought it was more like the Braxton Hicks contraction type stuff, and it would just be there for a short period of time and not really last the way that mine did.

Yeah, yeah, yeah. And sometimes it can be long. So it can be. All righty. Well, thank you so much for agreeing to come on and share your birth story. I really, really appreciate it.

Melissa (39:44.184)
Yeah.

Melissa (39:51.95)
Thank you so much for having me. I hope somebody can take something away from this story

Dr. Nicole (40:03.19)
Wasn't that a great conversation? I so appreciate Melissa coming on to share her birth story. Now, after every episode, when I have a guest on, I do something called Dr. Nicole's Notes, which are my top takeaways from the conversation. Here are my Dr. Nicole's Notes from my conversation with Melissa. Number one, prodromal labor is real and it can be exhausting. Melissa went through nearly 24 hours of contractions that would ramp up and die down.

This type of early labor called prodromal labor can be incredibly draining. Sometimes it can last days even. And I don't think we talk about it enough, but it's actually very common and knowing what to expect can help you cope more effectively when it happens. Sometimes we even have people admitted to the hospital for some pain medicine during this time because it truly can be exhausting. I'm just keeping it real for y'all.

Okay, number two, it's okay to push on your back as long as it is your choice. Melissa had actually planned to avoid pushing on her back, but after trying multiple positions, she found that being on her back was what worked best for her. Now, the key here is options. You deserve to be able to try different positions and then do what works best for your body.

Pushing should never, ever, never, ever, never, ever, never be one size fits all. You should have different options for pushing and you decide which one works best for you.

Now, speaking of pushing, pushing can be tougher or easier than you think. Pushing was the hardest part of labor for Melissa, even harder than she imagined. And she wished more people talk about how hard it can be. But I want to be upfront with you. After my 20 plus years of experience, I also know that for some women, pushing is easy. Pushing being very hard and pushing being very easy and everything in between.

Dr. Nicole (42:17.362)
All of that is normal. As I just said, pushing is not one size fits all. Let this be your heads up. Pushing might be hard, pushing might be easy, pushing might be someplace in between. No matter what, it's going to take some energy, some strategy and some determination. And the more prepared you are, the better you'll be able to handle whatever comes. And then finally, healing.

doesn't end at six weeks. After a third degree tear, Melissa was proactive about healing. She started pelvic floor physical therapy around three months postpartum and learned she had a prolapse, something many people don't even know to ask about. We don't talk about this nearly enough, but postpartum healing is really ongoing through the first full year after birth. So,

Give yourself time and grace and tap into those resources to help you. Like pelvic floor physical therapy, actually everybody should probably see a pelvic floor physical therapist after birth. You and your body deserve it. All right, that's it for this episode. If this podcast has helped you feel more calm, more confident, more empowered, the best way to show your love is to subscribe

leave a quick review and share it with a friend. It may not seem like a big deal, but those simple acts make a huge impact and they help more moms to be find a birth with power and get the support they deserve. And if you and I are not connected yet, come follow me, join my community over on Instagram. I'm there at Dr. Nicole Rankins. Over there, I've got great tips, real talk, encouragement.

waiting for you there and my DMs are open. I really do love to hear from you. Now, do me that one last favor and come on back next week. Remember to trust your power and take charge of your birth.