Sarah's Surrogacy Story

Today we are doing something a little different - bringing in a patient voice. Dr. Alicia Power interviews Sarah who shares her story of becoming a surrogate. Well - surrogate-ish. Her unique path to becoming a surrogate, and her pregnancy and postpartum journeys, spark great conversations around the healthcare system and how providers can hugely impact the patient decision making process in pregnancy and labour.

Resources:

• Water Birth and Immersion during Labour
• Homebirth!! Who, Where and How!
• Patient Resource: The She Found Motherhood Free Birth Preferences Mini-Course & Template

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Transcript

[00:00:00] Dr. Alicia Power: On today's episode, Sarah talks to us about her journey, which is a little bit non-traditional in a surrogate pregnancy and birth. She describes the decision to become a surrogate. How that happened also goes through the birth story and what that looked like in her particular situation. We also have some great conversations around the healthcare system and providers point of views and how that can hugely impact how patients and clients make decisions and labor. So whether you're a birth or to be, or a healthcare provider. This is a must listen to podcast.

[00:00:33] [00:01:00]

[00:01:23] Dr. Alicia Power: Sarah, thank you so much for joining us today. I'm really excited to talk about your story. Cause it's less of a traditional, I'm using my fingers in quotation marks that nobody can see, birth story, but a really unique experience. And from our brief chat before sounds like a really interesting, wonderful, probably a little bit complicated experience that you've been through and are continuing to go through with Sasha. So why don't you get started and just introduce yourself, tell us whatever you want to about yourself and then we'll get into your story.

[00:01:53] Sarah: Sounds great. Thanks so much for having me. So, my name is Sarah. My pronouns are she and her. I'm a cis gender [00:02:00] women. I'm queer and yeah, just had a baby who's now just over seven months, and I'm excited to tell my story. I am also a white settler, sort of in between what's now called Victoria and Vancouver and trying to love and live in the best way that I can in both those places.

[00:02:17] Dr. Alicia Power: Wonderful. Thank you again for joining. So why don't we get started? Tell us how this all began.

[00:02:25] Sarah: Great question. So this story began, one of my, I, so I think maybe to start, I have worked primarily in gay men's house, for over a decade at this point. And so my, that's what my social network looks like. That was what my professional network looks like. And. Yeah. I've had a lot of gay men in my life for a very long time. And there was a stage of life where a bunch of my girlfriends were all rushing to claim who they were going to be surrogates for when we were older, like in our early twenties and I always was sort of like, that seems weird. I think maybe the [00:03:00] men who like were talking about might have to ask us. I don't really know. And so I was I curious about it, but never really got in on that 'claiming surrogacy'. And so fast forward, like over 10 years later, one of my friends who I knew had been interested in this for a long time and I were having lunch with a colleague and kids came up. She has a surrogate-ish situation in her life as well. And she suggested that we do this and I said, I would be open to talking about it. And that's how we got to it. When asked who the idea this was at, the dad says it's it was my idea, which isn't entirely untrue, it does take two or three or four as it turns out. We spent a lot of time sort of, navigating the legal pieces of that, after that initial let's explore conversation ended up with a signed contract and all that good stuff.

[00:03:49] Dr. Alicia Power: And you said before, and I think language challenges us in so many ways, right? It's, there's such a black and white on everything and, as we know, everything is a spectrum. [00:04:00] My ability to focus is a spectrum. People's gender identities, a spectrum. right? There's all these spectrums and we're so, especially in again, I'm using my quotation mark fingers here, like our traditional kind of medical thing, there's boxes that were supposed to fit in. And it's the same thing when we're doing diagnoses, right? Like you should have all of these symptoms to have this diagnosis but we know that's not true. It's just the easiest way for most of us to get our brains around things So. You said the word surrogate ish, can we define a little bit what we're talking about. We're talking-

[00:04:28] Sarah: Yeah.

[00:04:29] Dr. Alicia Power: You.

[00:04:31] Sarah: Yes. Yeah. So carrying and birthing a baby. My egg. One of the dad's sperm. That was one of the things that I think, I was curious about pregnancy and giving birth one of the hardest things for me, actually, when I found out or like understood myself to be queer for the first time was giving up an idea of like having a bunch of babies. That's, I've always loved kids. And part of what was interesting to me and the thing that I advocated for in this [00:05:00] experience was I wanted to have as typical a pregnancy experience, as you can, as a single queer asexual woman, having a kid for your friend, that's a surrogate ish. So um, yeah, so it it was sort of my, my uterus, my egg, as I like to say. And that was also a challenge from a legal perspective, because most of the fertility clinics, most of the providers that we talk to, all of the legal people that we talked to really were cautious about what attachment might look like for someone when it's a) my first time being pregnant, b) my uterus and my egg. And so, I mean, seven months into the experience of having a kiddo, I can't imagine being any less attached if it was somebody else's DNA, but hard to know. Hard to know. From a formal legal perspective. I'm a surrogate. I don't exist as a legal parent. I've never had and never planned to have health decision making power for the baby, which is one of the things that sort of comes in the days before I breastfed a [00:06:00] little but like very much, the dads, Sasha's dads call me mama. That's the language that I use with her. And my little baby. And so I - my parents are grandparents it's a very, it's a very different, like what it looks like legally is very different than what it looks like practically. Sasha slept over with me last night and I see them and their dad's most days. Surrogate-ish is all we've got. Trying to figure it out. From the beginning we said, we'd said we'll teach Sasha that moms looked like lots of different things, that dads looked like lots of different things. And, Sasha's mom looks like someone who doesn't live with her. But also cares deeply about her and, always will to the best of my ability show up in ways that work for all of us.

[00:06:46] Dr. Alicia Power: Perfect, which is all we can all hope for, frankly.

[00:06:48] Sarah: Totally.

[00:06:49] Dr. Alicia Power: Awesome. Why don't we start with the story? Tell us what you're interested in letting us know around the story. Cause I'm, and we chatted about this before, this is a provider focused podcast because as providers [00:07:00] this even, quote unquote, typical surrogate pregnancy versus your surrogate-ish pregnancy experience is not one that we are a part of frequently. And so for us as care providers, it's often trying to navigate all of this as well. So that's one of the reasons I'm so, I love birth stories, period. End of story and then all of this, but obviously, but I also am really excited to hear your perspective. And hopefully you can bring in the perspectives of Sasha's dads as well in terms of what, what you experienced and how that went. And we're going to chat a little bit later about as a care provider, what can we do? What should we be thinking about to, to help make that journey more, positive more inclusive, more joyful, more, all of that involving the people who want to be involved in the ways that they want to be involved. Yeah, so let's get going. I'll stop talking.

[00:07:51] Sarah: Sounds good. Yeah. I mean, probably some brief pieces. So this was a DIY pregnancy. So we made this happen at home. It took us, [00:08:00] six months, about six months to get pregnant. And I actually had a molar pregnancy in july, 2020. So that was like our first pregnancy, which was very short lived. Then, so that happened. And we had really great midwife care during that time that was mostly focused on me, like it was six or seven weeks so that, that was our first piece. And then we had, we had to wait for six months after that pregnancy from a medical perspective and so reassessed. And I was like, I'm a very stubborn and determined person. And so I was like, we are so far into this in some ways I'm very, I took time and, I really wanted to continue. And so when we got pregnant the second time, we were on a wait list for some fertility clinic stuff. We made it happen just before that, which was really nice. We actually had to cancel our, our appointment with the fertility clinic and we are still like in that first 12 weeks. And so we were really like, we're giving up our appointment, but we don't want to, but we have to like, so navigating that. And then because I had midwives care because I had really liked that. That's sort of what we [00:09:00] looked, I looked for and that dad's really let me drive what kind of care I wanted. And we worked The Midwives Collective in Victoria, which was fantastic. And I also, at the time, like I. Yeah. We've when I first started this journey, I lived in vancouver. By the time I got pregnant, I lived in Victoria. I currently live in Vancouver again. So we also, we're trying to navigate getting prenatal care without having to move back and forth, especially given COVID at that time.

[00:09:27] And also I didn't know who was going to be with me when I gave birth. It was a bit complicated figuring out exactly how that worked, but the midwives that we worked with in Victoria were fantastic. And we had Sasha 's dad zoom in to all the appointments and it was fun. Cause he actually got to record her heartbeat when we were listening to it on zoom and I don't know that we would've been able to think about that the same way. So we did all of, a lot of my care, he attended by zoom, which was really great. And then moved over to midwives here in Vancouver to birth. And a lot of that was like interesting of, I was trying to make decisions about who [00:10:00] would be there at birth, care providers were also like trying not to make assumptions, and walk with me through that journey. Yeah, and it was actually, I did a breath class with some doulas based in Vancouver. And they talked about like the early stages of labor as needing to hotbox oxytocin. Like I'll always remember that as their advice. That's what you need to do in the beginning of labor. And I was like, oh my gosh, who am I going to do that with? I think it really helps me get a sense of what that might be and what, who might help with that. So I'm like, so lucky my best friend who lives in Victoria, was able to take time off work and come to Vancouver while we were waiting for Sasha to be born. Him and his partner navigated that so they could be a part during that time. I'll forever be grateful for that so we sort of made that would happen. But I, being worst case scenario Sarah, was very like, COVID can happen. Like labor could be really fast, planes can stop running, ferries could stop running. Like I [00:11:00] was very hesitant to believe that was going to happen until it actually happened. If that makes sense. So really grateful for all of the different people and world factors that made that, that possible.

[00:11:11] It was 41 weeks and one day when Sasha was born. And so we were doing sort of our post states' monitoring and saw an intrauterine growth and our midwives team was sort of like, if you stay, that happened in the hospital. And so then they pitched the midwives and the midwives came and I had, they were sort of like, if you stay if we'd go and talk to the hospital staff, they'll get you to stay. You won't go home. This will be that. We know that's not what you want. I was pretty concerned about like potential homophobia, trying to be in labor and explain these are Sasha's dads. And like they have medical decision-making, this is my best friend who I'm not married to, who like is here. And we're doing our thing. So I really wanting to avoid a hospital birth, just because I knew what we wouldn't have to talk like encounter those factors if we were at home. So I'm forever [00:12:00] grateful to our midwife who was really like, let's do a stretch and sweep. Let's talk about a castor oil plan for 24 hours from now, and let's talk to the dad. And I think that was also one of the challenges too, when that was happening. We were at, I was in the hospital alone because COVID, and trying to make these decisions that, any decision that was like about labor and birth I got to make, any decision that was about Sasha and her health dad's got to. So I was really stressed in that moment trying to be like, I definitely don't want to be in the hospital. We think that's the medical advice we'll get. I think that's what the dads will want to do. And so our midwife really did a great job of navigating that, setting me up to, to make decisions and include the data in that. Yeah, we all agreed on a conference call. I was in the same room where my molar pregnancy was diagnosed, which was also like, I know part of what was going on for me. But yeah, we had decided that we would give it 24 hours, go home, get comfortable, pack for [00:13:00] the hospital, hope that labor would happen. Do a bunch of things to get labor started at home and then come back the next morning, if needed. But we didn't get there, which was great. Yeah, it was great. So I went home. My best friend and I went on a juice buying expedition for our castor oil smoothie. My midwife had been like, my midwife had been like, make sure you eat a meal that you won't mind throwing up later.

[00:13:24] Dr. Alicia Power: Or pooping out.

[00:13:25] Sarah: Yeah, exactly. Very quickly. Totally. We made some decisions around that. We watched a good movie. I had a Tens machine at home because we had doulas who had dropped that off. And so we used a Tens machine for nipple stimulation. I was just doing all the things laughing, walking, yeah, all the things. And so went to bed at 10:00 PM and was hoping labor was starting, but like I had hoped to labor was starting two nights before that. And it obviously hadn't.

[00:13:55] Dr. Alicia Power: So I'm just going to, I'm just going to say right now, because I, from a medical point of view, [00:14:00] I have to say this very, in a responsible way an IUGR means a small baby often means that the blood supply is not getting to the baby and the placenta is not functioning, which is why you were going to be brought in the next day to make sure that baby was still safe. And I'm sure had you not gone into labor, you would have, hopefully in a trauma-informed conversation with a care provider, all of these things that you're saying is wonderful. In your case, you I'm sure had an informed consent discussion with your midwife. You made the decisions that you felt right for, but certainly, these decisions would not necessarily be the medically advised decisions in this situation. So let's just be clear on that. However you, it's your pregnancy, it's your birth? You get to make your decisions. But I just don't want people thinking, oh, I'll go take castor oil with my IUGR baby. Hope for the best. Don't do that people. Yes, unless you've had a very informed discussion with your care provider and the risks and benefits of the decisions you're making. Okay. Thanks. Unpause.

[00:14:58] Sarah: Yes. No. Absolutely great. And I think, it was very that was a very hard decision for me. For us. And yeah, I think looking back seems like such a small part of her story because it worked out really well, but. I was very prepared to go to the hospital. And even though I wanted a home birth for mostly those reasons that I've talked about, I was very much like we will go to the hospital if we need to go to the hospital. So I was grateful for that I think I was like, part of it was, I was like quite stressed and I think. The midwife was like, you're not gonna give birth right now. I think part of it was just like, you need to actually go home. You're not going to give birth right now. Exactly.

[00:15:41] Dr. Alicia Power: And I think, and I. and I. want to be very clear that it sounds like you had excellent informed discussions. And you made this decisions based on that really good information from your midwife. And and I think. Those of us who are more traditional birthers I in my birth, I made a decision that looking back on it, [00:16:00] wasn't necessarily the smartest thing to do. 'Cause, I was like, likelihood of it happening. Well, it did happen, Right. And that's fine. And I think as care providers, this is one of the really important thing that if there's any care providers out there. Part of your decision making was made out of fear of the hospital system. And the fear of how you would be treated and judged and spoken to right.

[00:16:21] From a trauma care provider point of view. Like hits really hard because we all feel like we're doing the best we can, but we all have our biases and we all have our judgments and we all come across in ways that we don't necessarily intend. But that makes the hospital very scary, dangerous place for some people. And it sounds like that's a big part of your journey. And so I really actually appreciate you saying that because from my point of view, that's so important for me to hear and for other care providers to hear. To know how much we in our treatment of people actually impact their decision-making. As opposed to you just making the decision that you feel is right for you. In a like rainbows and unicorns kind of situation.

[00:16:59] Sarah: Yeah.

[00:16:59] Dr. Alicia Power: Right. [00:17:00]

[00:17:00] Sarah: Totally. Yeah. Yeah. And I do, I really did have great care in that. I worked through some of that, like, you know, I really did not want to be in the hospital. And that was obviously what we avoided and that was my choice to avoid that. And I'm so lucky I was supported by care providers and dads to, to do that. But also like, I, I did come a long way, We did have people along the way, like lots of well-meaning people who were like, oh, like your husband must be so excited. Care providers. Whether it's blood work or ultrasound staff, or people in the post-states monitoring, those are the types of comments that, they're not the end of the world. But when I was thinking about a beautiful place of hotboxing oxytocin. Being like rolling my eyes at the next person who asked me about my husband is not gonna lead to like calm, baby vibes of joy. So that was really, I think the pieces, you know, I wasn't worried that it would be horrific, but I just. From thinking from a physiological birth perspective, like those are the [00:18:00] types of things that weren't gonna, weren't going to help a situation in my estimation.

[00:18:06] Yeah. I mean, that was the beginning and it was a pretty stressful piece. I had been packed for the hospital for so long. Cause I'm worst case scenario Sarah, very committed that we would have a worst case scenario. Went home and did a little bit more and yeah, so went to sleep that night. And pretty soon after I, and one of the things I had decided to that's important to the story is that did not want to know the time. I did not want anyone to tell me the time. Birth was going to take the amount of time it was going to take. So we had turned off all the clocks rotated them all away. I didn't know what time it was. So I went to bed. And woke up and just started going poo so often, I had not taken castor oil at this point. I hadn't taken it, had it prepared. The midwife had said it works better if you take it in the morning. So I went to sleep with literally the castor oil smoothie in a blender plugged in the bathroom. So that I could wake up at 4:00 [00:19:00] AM and turn it on without waking my best friend who was sleeping in the other room because no one wants to sleep with a pregnant lady, especially if you're not married to. I think, so yeah. Gone to sleep with this castor oil smoothie, plugged in, in the bathroom, ready to take, I woke up and was dressed. Going poo. And I think, I wasn't sure if it was labor or nerves or something, I ate. And yeah, so like I kept waking up and doing that. And then eventually I was like, oh, I wonder if this is contractions. On the She Found Motherhood podcast, they said keep everything as normal for as long as possible. And so I went and put on an adult diaper. This is like a hilarious decision that I didn't expect. And just went back to bed, but like still was getting up relatively often with, what in retrospect, were contractions.

[00:19:50] At 4:00 AM, that was like the castor oil smoothie time, I called my doula and was like, I think I'm having contractions. I don't know. Should I take this smoothie? She [00:20:00] was lovely and said go back to sleep. Call me in a few hours and that, I don't remember too much of the phone calls after that, but I turned out I did not take the castor oil, the midwives had called me. I was on their close monitoring so they called a few hours after that and they were sorta like, you don't need a castor oil smoothie. And a little bit after that. So around eight, between seven and eight, I got to the point contractions where I was like, I don't really want to do this alone anymore. And my best friend had just woken up around that time. So it worked out really well. And that's like most of what I remember like that overnight period, I was really like, I'm not in labor. I'm going to sleep. You have to keep things normal. And then there's the decision making about not taking the castor oil smoothie, was that next hurdle. And then it was having my best friend join as my labor person. And that was what that day look like. And I had, like it's made my bed, got my book out with that had like the exercises that I wanted to do, the breathing exercises that I wanted to do. And I had it all [00:21:00] bookmark and basically got him up and was like, great. Here's the book. Your job is, remind me of this one breathing exercise. If that one doesn't work, flip to the next one that's tabbed. And he had done, he was like really great support and had done one of the birth classes with me. So we talked quite a lot about what the plan was overall, but I got up that morning and was like, here's the plan? Just to reminder this at the end of my rational thought for the rest of the day. So, good luck!

[00:21:25] Dr. Alicia Power: Perfect.

[00:21:26] Sarah: I'm going to go do child's pose contraction on the floor right now. Yeah. And then I think pretty quickly after that, I got so cold. I hadn't heard birth story where someone had been dressed, freezing, but I like was wearing a hat and like a wool dress and socks and under blankets. Um, and I'd been a bit concerned about being naked in front of my best friend. And so I eventually decided that I was going to take a hot shower and this felt like such a smart decision at the time. And he was like, do you want privacy? I said yes. Got in the shower, 10 seconds later was like, I'm going to have [00:22:00] to get out of this hot, amazing shower. And I don't know how to do that. And he came back and helped me with a warm towel and some warm clothes and all that good stuff. Yeah, I was very, very cold. That was a big memory for me of the day. He like, they got the dads and my best friend were coordinating. They've dropped off a space heater, which we were running in the bathroom.

[00:22:25] And so around 11, between 11 and 12, I had sorta got to the point with the contractions where I was like, I don't think that I can do this forever. I don't really have a sense of like how, where I'm at like, if this is normal, how far we're into this? And so we got to talk to my doulas, which was really awesome. And, I had two doulas, and so one of them was able to talk to us and then one of them came a little bit later and we continued to do different positions for contractions, like a mix of standing being in the shower. And I think like one of those pieces that I had really thought about so often we have this [00:23:00] conversation about childbirth and pain. And that was really not my experience of it. And again, I think like which fails us in, I'm also really trying to kind a of talking about my experience. It's just mine and it's certainly not everyone else's, but I'd been really conscious of like pain as the concept. And what I really experienced was rectal pressure. My poor best friend was like, I'm a gay man, and you said rectal pressure, 150 times between 8:00 AM, and when Sasha was born and like no one needed to hear it that often, but it was basically like pooing a little bit, part of every single contraction. And my best friend and my doulas changed my diapers lots, which was really not part of the labor experience that not necessarily, necessarily anticipated.

[00:23:45] Dr. Alicia Power: Not really part of the birthing plan, haha

[00:23:48] Sarah: But I just didn't realize that it was like, with every contraction. That was a possibility.

[00:23:54] Dr. Alicia Power: Certainly. We use this term pain, but it's, everybody experiences it differently and you really don't [00:24:00] know what it's going to be like until you're in the midst of it, right? Because it is different. I deliver babies for a living. It's what I do. Thousands of babies, and I did not expect what my labor contractions were going to feel like, it was not what I had anticipated. Yeah.

[00:24:17] Sarah: Yeah. And I think it was weird. Cause I had I wasn't one of those people that, like, I was just like, if it's painful, I'm going to tell you if it's painful. If it, I didn't want to use like any of the metaphors around waves or different metaphors that people use, I was like, that didn't feel like me. And I certainly know lots of people that works for, but it was very interesting because in the moment I was like, this is not what I expected. And I really didn't. I think I really didn't go into it with a lot of expectations, but it was just, from I think some of the fear that I had, and I think some of the fear that often comes in these conversations about childbirth. It was really different than that. Yeah. We did a lot of the contractions and I pooed a lot so much. And I had bought the diapers for post-partum per all the [00:25:00] checklists and yeah, my, my best friend's feedback was like, that is not the right size for you. And I was like to clarify, that's not, I didn't intend to wear them while I was pregnant or have other people necessarily take them on an off me so that was like a funny sort of piece of that, that I hadn't really expected.

[00:25:16] So yeah, that was like one of the big memories and then being cooled. So after a bit, like our lovely doula had said, why don't you, I think I had done a bit of convincing them that I was going to take a rest. She also I think was on board with that. And they wanted me to lie on the ground. And I was like, that's a terrible idea. I'm just going to lie on this cozy bed. So I lay in the bed and then we had this conversation about, she was thinking that I was probably getting close to 10 centimeters. Should we call the midwives? I really you know, I was just in this like hot box of oxytocin. You know, where it was pooing myself regularly. Little bit here, a little bit there, but, yeah, it wasn't really ready for other people to come. So she did, she had quite a task to convince me. That it would [00:26:00] be okay for the midwives to come. And we had that conversation we had talked about. I don't want to know what centimeters I'm at like they, the midwives can check me. They can talk with my best friend and the doulas, and then they, like those folks figure out what to tell me based on all the work we had done before. And so the midwives came and that really did like pretty quickly change the vibe, which makes sense. But I got checked. I was at 10 centimeters which was great. Obviously such great news. And then I'll always remember, I really didn't, the midwife really wanted me to roll onto my back so she could check me. And I was like, there could not be a more painful, like for whatever reason, I was really against it. And I looked back at the photos and I was like, I was never actually really on my back. I was still mostly on my side. I would have been a very challenging patient. I think. In that moment. So shout out to Laura for managing me at that particular moment of unreasonableness, but, yeah. And so they were like, okay, so you can get ready to push. And I was like, oh, we have a lot of time for [00:27:00] that. So if you just go and set that up, I'll lie in my bed a bit longer. Um, and you know, like time at that, like my sense of time at that point in labor was obviously quite limited. So they were continuing to do the regular checks that they have to do. I'm not sure how often it would have been Alicia, but listening to the baby and making me roll on my back, which they weren't really doing but I thought it was extremely unreasonable. Unreasonable at the time.

[00:27:25] And then yeah, I went to the birth tub and was able to get in and I had said that I wanted to try to push by myself without a lot of coaching or feedback, just to start. Cause I had done some birth prep and had some strategies that I thought might work, didn't want to have too much going on. And so like at that point there was a lot of people in the room. I had, I had two doulas. One was our birth photographer. One was there in a doula role, my best friend. And two midwives at that point. So there was like, more [00:28:00] people than average, maybe. And there's lots of conversation and I was just so focused on doing my thing. I wasn't really taking in a lot of the external stimulus and so started pushing pretty quickly. And then there's a bit of a conversation about. Should the dads come, what do you think, Sarah? And I'll always remember. I was like, yeah, absolutely. But he can't talk to me and most of the midwives I had met in the room, I hadn't met actually either of the midwives and so I was like in looking back on it, I was like, I wonder what it would have been like to be a midwife, knowing that a baby was like about to be born and the person delivering the baby was like, he can come but you just can't talk.

[00:28:35] Dr. Alicia Power: It's not an abnormal thing that we hear. I'll tell you, it's pretty typical.

[00:28:39] Sarah: Okay. I Okay Oh, great. I was very like conscious of that idea of well, maybe that wasn't the greatest, first impression. But, yeah, the dad got to come and he had been the doulas and my best friend, someone else was talking to him. I didn't talk to him all day. I had other things I had been focusing on, but he said he knew what was going on. The doulas had apparently talked to him like not that long ago. And we're [00:29:00] like, oh, the baby's probably going to be born this evening. And so he made like last dinner out plans. In a way that you can do when you're connection to the birth process is maybe different than average. And, not that long later pushing as going pretty well. And so not that long after they were like "get down here now" you're probably going to miss it. No last dinner happened for the dads, but yeah.

[00:29:22] So she was born, and I think, you know, like pushing, I found I was very just internal and there's lots of conversation. I knew people were talking. Couldn't have told you a single thing. My only real memory from that point was one of the midwives making sure that, reminding me not to stand up because I guess in water births the baby needs to be born in the water. So that was like my only thing I was like, I don't think I can stand. I was so worried about not having the physical strength. At that point. So I was like, I don't think I can stand up, like don't worry.

[00:29:55] Dr. Alicia Power: And if anyone is interested in learning more about home birth or water birth, we actually have a podcast on [00:30:00] each that we did one with one of our local midwives. And we talk about, there's like certain protocols that need to be in place. And one of them is a baby needs to be born in the water and then out, because they take that the diving reflex and all of these things. And so if people are interested in learning more. I'll link those in the show notes and they can go have a look for sure.

[00:30:16] Sarah: Yeah. I didn't really notice that like dad came in. I had no way- I had no idea. I was very in my own sort of pushing world and uh, Sasha was born. Just like with about 30 minutes of pushing, which, yeah. Was obviously, part she was little, part it was a water birth. Part, I don't know part, it was just the that particular birth happened and, yeah. And I think from the moment that she was born, turns out, so I didn't know this at the time, but the cord was wrapped around her neck and we have like a very cool photo that shows like she's barely out of me and the cord is there and you can see it. But at the time, I didn't know that. I think like looking back, [00:31:00] that was definitely one of the things that we had never met either of the midwives that were actually at our home birth, because the way that COVID was at that point in time, all the teams had changed. Our permitted midwives were walking into the situation of like knew I was a surrogate ish. Knew it was my best friend clearly found out that the dads were not there. They didn't have a lot of context for what was going on, but from the moment Sasha was in my arms and the tub I'll always remember I had my arms straight out and just looking into her. But we had had this conversation right before she was born of okay, we'll need you to help grab her. And then as that was happening, I went to grab her and they were no don't. And so I like was pretty hands-off and then they put her in my arms and the cord was fine at that point in time. But things from there got really rushed. And our plan had been sort of like to like chill out in the tub before cord cutting or clamping and just like slow things down a bit, and things went really fast at that point in time. And [00:32:00] I really internalized that something was wrong with the baby. And I think partly that was our conversation about the IUGR, and being at home and not being in the hospital. And so I had really thought something was bad and they were like, who's going to cut the who's going to cut the cord. And there was like all this rush and the midwives ended up cutting it. They asked my best friend and he was like, no. Like wrong person, it was a bit. Everyone was just like a bit chaos and it was supposed to be a little bit slower or that's what we talked about and planned for.

[00:32:34] And yeah, so baby left me like pretty right away and I, I then got separated. So they've moved me to go and deliver the placenta. Of course, I got super stressed because I wasn't with the baby. And they had her like somewhere else. The dad started holding her and I was in a different room, so I couldn't really see. And I just kept being like, all I want is the baby. But they were like, you have to deliver the [00:33:00] placenta. So there was, I think like we had intended that time to be a little bit more all of us together. But it got really separated. So I had a bit of problems delivering the placenta, ended up getting a shot, ended up having the placenta, like they tucked it out. And I was just like so focused on seeing the baby. And so I think, it was a bit like I didn't really care about what was happening. Because I was really trying to get to Sasha, but I apparently didn't articulate that at all. So like in my head, something was bad happening to the baby, and in my head I needed to see her, but I wasn't communicating that. And our doulas thought something was wrong. I think there's just the cord being wrapped around the neck, that was a thing that the providers were obviously trying to manage in a good way. But I think like it didn't get really clearly communicated. So from their perspective, it seems like everything was fine after the cord was set, but everyone else was a little like still on edge.

[00:33:54] And then yeah, we a pretty traditional, like we started breastfeeding right away after [00:34:00] that. And then at that point in time, then they had weighed Sasha and they were five 14, so pretty little. And so were, talking to us about the hospital and blood sugar monitoring. And we were trying to figure out, what we wanted to do. And that was really not my decision. So I was dealing with the placenta and focused on, on, that type of stuff. And then one of the dads came in was just like, what do you think? And so we made the decision to stay at home. With like lots and lots of monitoring. And we're able to say at home and breastfeeding went really well from the beginning. I had frozen, I had expressed colostrum for the bunch of weeks before that. So we were able to give that and we had formula, really worked on supplementing and building Sasha's weight back up.

[00:34:40] So that was that was it and I think, I have. I was extremely high. I did not anticipate at least two weeks, maybe three, that I think the power of those birth hormones, I had thought a lot about post-partum and like postpartum depression and anxiety. And I think, I had prepared for [00:35:00] that, but I was like, not prepared to just be so on top of the world about, what that experience was like. But I think like a big reflection that I have is knowing how like intensely happy and over joyous I was, like to know that the flip side of those hormones would have been devastating. I, think like the high was so wonderful, but very aware that the flip side of that, if that's how powerful it was then the good side of the emotions, like experiencing on the depression or anxiety side would have been really challenging too. So yeah, so Sasha's then dad's ordered my best friend and I dinner. We ate dinner together while Sasha hung out with her dads and a few of their close friends, and then she came back. So we were living in an apartment building just a few floors apart at that time. The Sasha came back downstairs and did overnight with me for all of the skin to skin and breastfeeding. And that was that journey of early days of, spending lots of time with me and lots of times with dad's. [00:36:00] That's what I've got to say.

[00:36:02] Dr. Alicia Power: Awesome. That's awesome. That sounds yeah. It's a, it sounds like a great. Experience. Full of some complexities.

[00:36:10] Sarah: Yeah.

[00:36:11] Dr. Alicia Power: And also that whole communication piece is so important, right? And it's one of the things that we are all the worst at. Yeah. But it's one of the most important. Just talking about And talking about what we're doing and what we're thinking from care providers and, I know when I'm in an emergency situation, I am, which is where for me, quiet and focused. So if I stopped talking generally, that means something's going on, yeah, just doing right. But it's important us, somebody on the team anyways, to be verbalizing that to the parents, intended parents, birther partner. Yeah. All of those people. So they know what's going on or at least to do a debrief right after right.

[00:36:52] Sarah: Yeah. And it wasn't until like, I think our like four week or five week appointment, like it was really towards the end of our care [00:37:00] that I had been like, cause the first appointments were just so focused on like is Sasha gaining weight, how's breastfeeding going, those really important things. And towards the end of that six week period where the midwives that I had like that was on our team cause they have like different teams in this midwife practice. And so like the midwife from the team that I had, like originally registered with, had took the time to go through the notes with me. And I was like, oh, it was really helpful to know that wasn't actually the best care that could have been provided. The midwife said that like she apologized for that situation because we weren't, Sasha and I weren't supposed to be separated, and I was quite upset about that for, you know, the first 24 hours, I was just completely high and smitten and next 24 hours, I was sort of like, oh, like that felt like it didn't feel good. And I was feeling upset about what happened, but it was midwives who had never met us before, which happened routinely in hospital birth, but not as commonly in the midwife home birth practice. And so they didn't really know what our deal was. And it's hard to walk into a [00:38:00] situation of like knowing that language failed us, right? Like language isn't, there's not enough words to really describe what we had planned, which was I'm a surrogate and legally I'm not related, but in, in practice, we operate two dads and a mom, and we do things with Sasha. They were, I think a bit, trying to protect me from like emotionally bonding with a kid that they didn't know that I was supposed to emotionally bond with, right? So there's lots of different things, but it was really powerful for the midwife to say, I looked at the notes. There's nothing wrong with Sasha. You should've been with her. And I also ended up having endometriosis?.

[00:38:41] Dr. Alicia Power: Endometriosis, it's a bit of an infection in your uterus after, which has happened-

[00:38:45] Sarah: Which happened five weeks after. And like some of that, it seems like some of that was like related to how the placenta situation got resolved. And like the placenta situation probably got resolved that way because I was stressed and anxious and, [00:39:00] honestly, it's hard to know exactly what would have happened, but certainly the like, not really working as a team in that moment. And in that first hour or so was absolutely one of the factors that. That was really challenging. Yeah, the midwife vibe really changed what we had going on and I didn't want to give birth by myself. I wanted, I wanted medical professionals. I didn't want homophobic medical professionals, or medical professionals from the hospital necessarily, but I did really want medical professionals. And that was just a really challenging time for midwife practice because of COVID and everyone was short-staffed and just all those things that we know that we're dealing with. So it's, looking back, like no one was really at fault and also it could have been better. And I think trying to hold space in our story for both of those, has been really important for me I think, to think about that. But I will like the next day when, when the midwife came to visit, she said something about like, [00:40:00] oh, and then there was this other man holding the baby and I hadn't held the baby at that point. I was, had just given birth. But I did say to her, I was like, so you let a stranger that you didn't know hold the baby before me. And I obviously, that wasn't a very kind thing for me to say, and she like I knew the person was connected to somebody. I was like, fair, but also...

[00:40:24] Dr. Alicia Power: Some random guy off the street walked. Yeah. I mean, again, you bring up an excellent point at a couple of things like, in our practice. And a lot of the midwifery practices now are in group practices. Most position practices there, we have three providers in our community who still do their best to attend their own birth. Which is an incredible model, but it's incredibly taxing as a, especially like I've got two young kids, right, can't be on call 24/7. So it's this model that works and doesn't work in so many different ways, but yeah, but it's really important to, you know, the whole traditional birth plan. I must have blah, blah, blah, blah. Sarah and I put together this, not you Sarah, Dr. Sarah [00:41:00] put together that birth preferences. So we've got like a birth preferences course, and we've got like a worksheet, which I'm actually after this conversation going to go look back at it and make sure that we have space for all the exciting combinations of teams that come in. But about that is cause when you're in labour, a lot of the time, you're like, eh, yeah. Don't tell, don't talk to me. I have, I've talked to other people they're gonna tell you what I need, what I kind of discussed right.

[00:41:24] So really important to have that conversation with your support team who are going be with you, but also write it down. So it's something that can actually look at and be like, oh, okay. So this is, who's going to be here. These are their roles. This is what like, especially in. In situations that are not quote as traditional, right?

[00:41:38] Sarah: Totally.

[00:41:39] Dr. Alicia Power: So that we don't have to bug you, but we also get the information that you want us to have.

[00:41:43] Sarah: Yeah. And that was a big takeaway from me is like we had done birth preferences from your podcast, Alicia, like that's, that was the frame that I used. It was like birth plans seem like we're setting ourselves up to fail. So it really framed it as birth preferences. And then I didn't have it printed [00:42:00] out and partly it was like we have two doulas, two dads, and a best friend, like someone has to be able to figure this out. But I do, what I would say if I was doing it again, or if someone else was asking me like, I think I will like one page of here are the people. Here's like the Cole's notes of what's happening. Like baby decisions, dads, mom decisions, best friends, after birth everybody's together.

[00:42:23] That would have, I think really helped orient people. And, they both come from a birth. They had both of the midwives, there cause you had one for the birthing person and when for baby, both had come from other births. Both of them left me to go to other births. There's those factors too that, it doesn't matter how pretty my birth preference document would have been. There was a lot of stuff going on, outside my space that as the laboring person, didn't really know about, or wasn't attuned to, yeah do think that was definitely something that I would do better in the future. Make that a little bit clear for people. And I am for the record. Glad that Nick got to a fold Sasha. Just for Sasha and Nick who may [00:43:00] one day, listen to this podcast. I didn't, I had been very frustrated with that particular midwife on a few pieces and so, you know, it's leaves you have just given birth, all the things. It wasn't the nicest thing I could have said, but also a fair question, perhaps.

[00:43:15] Dr. Alicia Power: Awesome. Sarah. Thank you so much for telling us your story and, you really bring to point a few very important pieces that both from the birthers perspective, partner's perspective, support people's perspective, intended parents have perspective, care providers perspective, that we can all kind of work on and really improve that communication

[00:43:35] Like we said, I think that's really the most important thing. And it's also the hardest thing, oftentimes. And so some great tips and tricks I think in there. And then the other thing is if you have a birth that you have questions around, you don't understand why something happened. Talk to your care provider after.

[00:43:50] Sarah: Yeah.

[00:43:50] Dr. Alicia Power: Maybe it's two weeks later. Maybe you have questions four weeks later. But most of us should, if we weren't there we'll have had a note from that. [00:44:00] So there should be a clear note as to what happened and certainly in my practice, if one of my colleagues delivered your baby, and you have questions that aren't clear to me, I'll call them up and ask, or, you're welcome to go see them and do a debrief because I think that whole processing, if we don't process it, then that's what, like leads can lead to trauma. If we don't understand why something happened and we're confused around it, or the next time you have a birth, you're going to be like, oh my God, is that going to happen again?

[00:44:26] But if you've actually talked through it, you're going to have a better understanding and you're gonna understand why things are done. Or you can have some feedback and say, Hey, I understand why you did that, but this is how I felt in that situation. So maybe in the future, try this, or something like that. Cause we also, from both I speak for myself, I can't speak for anybody else. I appreciate that constructive feedback. ' Cause, I don't know what you're, what you're thinking, unless you tell me, right?

[00:44:47] Sarah: Yeah. Yeah. And I mean, it was very, very powerful to, a) was able to talk about it with my doula who was there and like processing that, like we spent at least an hour talking just about like between Sasha coming [00:45:00] into my arms and the tub for all of a minute or less. To midwives leaving, which like then became my goal. I was like, what do you need me to do to have you, leave? Because that will be bad. But, I did really overall, really love our care. So it was. It was a, quite a radical change in that short amount of time and having the midwife, who wasn't there, but who was able to look at the notes and say, we didn't get that and, they made a commitment really working out. She was like, you did a good job of explaining to me what you wanted. I think that was written down in your chart, but what it turns out is like different midwives in our practice feel differently about what some of these words mean and that wasn't, ended up being unfair to me. And they're going to do something different that felt very cool to just be like, yeah, like things aren't perfect. Everybody has their own staff and makes mistakes and miscommunication happens. And so it was really powerful to just get to a point of yeah, that's what we would have had if it was the midwives who we had talked to you directly. They're going to do something different to [00:46:00] try to make sure that other parents have the words that we all agree on - a broader agreement on what all those words mean. So that was really powerful. And I really appreciate Cora taking the time to have that debrief with me and, and to like really own it and just apologize was very powerful and not something that's happened in other care experiences I've had.

[00:46:20] Dr. Alicia Power: I'm also thinking. Okay, the midwives got there, you were 10 centimeters and you pushed for half an hour and they had filled up a birth tub. There's not a lot of time there to open up a chart and read through. And there's so many pieces of the puzzle, which I think, again, we don't understand necessarily where each other is coming from, right?

[00:46:36] Sarah: Totally. Yeah. Yeah. And I do have a lot more space, I think. They have lots going on now than I did on day one.

[00:46:43] Dr. Alicia Power: But it's still, it's your experience, right? And it's, this is your opportunity to have your experience. And so it's one of those things, like sometimes we feel robbed from our experience because of things that are outside of our control and outside of other people's control as well. But, and so then we have to take the opportunity to kind of grieve that loss of experience. [00:47:00] Whatever that is right. Yeah. totally. Thank you, Sarah. Really appreciate it.

[00:47:04] Sarah: Yeah, my pleasure.

[00:47:05] Dr. Alicia Power: And we'll make sure that we in the show notes, do the home birth podcast, the birth tub laboring. And birth podcast and we'll put our birth preferences three mini course that we have in there as well. So if people are interested in any of that, they can access that pretty easily.

[00:47:19] Sarah: Awesome.