#68 Season 5 Premiere Podcast

Justine:
Hi, I’m Justine.

Sarah:
And I’m Sarah Lavonne.

Justine:
And we are so glad you’re here.

Sarah:
We believe that your life has the potential to make a deep, meaningful impact on the world around you. You as a nurse have the ability to add value to every single person and patient you touch.

Justine:
We want to inspire you with resources, education, and stories to support you to live your absolute best life, both in and outside of work.

Sarah:
But don’t expect perfection over here. We’re just here to have some conversations about anything birth, work, and life, trying to add some happy to your hour as we all grow together.

Justine:
By nurses, for nurses, this is Happy Hour with Bundle Birth Nurses.

Sarah:
This is the most desperate I’ve ever been for a podcast episode in my life.

Justine:
Why is that Sarah?

Sarah:
That we have waited, we have waited so long and we have tried to talk about your pregnancy Justine, and every time, you’ve been more boundary than me where I’m like, “No, but just tell me what do you feel and what’s going on, and blah, blah, blah.” She’s like, “Wait for the podcast.” So you are being let in on our insider scoop conversation about Justine’s pregnancy. If you’re listening to this right now, welcome back to season five and we wanted to give you a little treat. Therefore, we are pre-recording this episode. She will have given birth to her second little baby boy, and we are going to talk about all the things, talk about her birth preferences, talk through her previous birth, and just get into the nitty-gritty. But really you’re just being let in on a conversation between us, and I hope you enjoy it. Because I just want to start asking you normal questions and forget that we’re recording this podcast.

Justine:
Okay. So yeah, I have been keeping it all in and it’s been nice. It’s been nice. I’m someone that is so quick to share and say a thought too, and I’m like, I have foot in mouth. So I’ve been able to dwell and marinate on things.

Sarah:
I haven’t even been a part of your process either, which is sad, but I also understand because you’re like “No, no, no, because it’s going to change and we’ll record this closer to my due date and all the things.” So I need an update.

Justine:
So I don’t know where to start, but I’m 36 and one today, and if you didn’t know, my last pregnancy was four years ago. My son’s four and a half, a little more than that, and I delivered at 34 due to superimposed preeclampsia. I had chronic hypertension, I had a C-section. It was a whole thing, and I have never been this pregnant. It’s a running joke in my house. Every time I’m like, “Oh my God, I’ve never been this pregnant before.” Which is great, I am going to be delivering at 37 and I feel thankful. I have so much empathy for the people waiting till 40 and 41 and 42, and I’m like, I’m literally bracing my belly, turning in my bed right now. So it has been fun to stay pregnant, and it has been really nice to have a controlled blood pressure through this whole pregnancy. It’s been really nice. I worked most of my pregnancy, unlike last time.
Yeah, okay. Here’s the thing. Here’s what I’m debating friends, is do I TOLAC, right? You’re not supposed to say attempt. Do I VBAC? Do I have a VBAC? And I woke up this morning at three o’clock and couldn’t go back to bed because I knew this conversation was going to happen and I just have so much… I think, was it in an episode where we talked about this, Sarah, where it’s like no decision I should make will be out of fear. No, we were talking, this is the whole thing, right?

Sarah:
Oh yeah. This is like bundle birth’s team.

Justine:
Right. Nothing out of fear. So I’ve been like, am I scared of a vaginal birth? Am I scared of a rupture? Sure, sure. We know too much, right, as labor nurses. But I think overall I want a C-section. I know. I think I want it. I know I want it is the words. I want the plan of it all. I want to know I’m at 12 o’clock. I want to know that I knew when I ate, I want to know that my hair can be done. I want to roll in for my appointment. I don’t want to be pushed back for an induction, because it would be an induction. I want to pick my team. I know every single person that I want on my team, and I don’t know if those are just my racing thoughts, just helping me stay in control.
But the TOLAC situation, and I don’t want to, I know that my coworkers listen, some of them, and I love my coworkers, but we work in a place that is understaffed and has too many people and there is a fear of I’m not going to be one-to-one. Our TOLACs are not one-to-one. And mind you, I’ll have me and I’ll have Sarah in the room, because there’s only one anesthesia, what if they’re in the OR? We’ve had times where we can’t get an anesthesia in the back. We’ve had times where the OBs held up, and so it’s just, it’s hard. That’s where it’s hard.
And so it’s not just readily available a lot of times with TOLACs, a facility that does those, it should be. And so I also was telling a friend, Heidi, so she got to hear some of this goop today, I have no interest in tearing. I was like, I have no interest in perineal trauma. And I laughed. I know that she, and I don’t know, she had to do some rehab and a lot of people we know have had to do rehab and I have no interest in that. And there are things that I’m like, I don’t necessarily, I had to be checked today, which I’ll share. I did a GBS swab today and I was like, I just am not excited about someone being in my vagina right now. And a lot of people be in my vagina during a vaginal birth. And I don’t love that that’s a block for me. And maybe there’s too many blocks. But I think ultimately what brought me to this decision is when my OB told me that he was head down, I was sad.
I was bummed. I really liked that he was breech for a while, which he was breech for a while. And I was like, he made my decision easy. So I’d love to hear what you think about that. But I was like, I feel like that’s what my heart is. And then in the beginning of the pregnancy, I always said, “If I’m one, they can try to put a balloon.” And then the last couple of weeks I was like, “Well, my doctor will manually dilate me to one and they can put it in the balloon.” That kind of changed. So they checked me today I am very closed and locked and fortified.

Sarah:
Fortified.

Justine:
There’s no opening there, which is normal, 36 and one. It was a functional prime over here. But when I think C-section, I’m so at ease. When I think VBAC, I’m not. And when I think, but then I’m then I was in my head too and I’m like, I’m Justine and I work for Bundle Birth and physiologic birth, and we care about vaginal births, but we care about making a decision based on what you want, ultimately. Total decisions. And this is an informed decision. I mean, I could rupture tonight and sure, maybe I’ll try. There’s variables, but I think ultimately, C-section is what I want.

Sarah:
Great.

Justine:
I feel good saying it, but I also feel like I’m disappointing you, and I know I’m not disappointing you. I know. But I feel like in general, in life, we make decisions too based on we don’t want to disappoint people. But I’m in Enneagram 9, and if you know anything about the Enneagram, I make people happy, but I’m like, I want a C-section.

Sarah:
Okay.

Justine:
I’m nervous about a C-section though in the sense of I got two weeks last time with my baby in the NICU to recover. I got a lot of sleep.

Sarah:
Yeah, and you didn’t already have one.

Justine:
Yeah. And it’s harder and harder the more you do. I do pretty well with that kind of pain anyways though, surgical pain. But there’s some variables there that are different. But I think that my plan for the C-section is fun, which we can talk about. And I am so excited to just have a different postpartum experience and even just that is healing. Even when he was breech, I was like the fact that he can come with me to recovery and he can come with me to my room and we can have skin-to-skin. And I’d gotten no more than 20 minutes skin-to-skin in the entire two weeks that he was in the NICU, at a time. So I just think that it is going to be so much different and so healing in those ways that my experience is going to be so much better. So I’m excited about it. You have so much to say.

Sarah:
I don’t know that I do. I feel like I’m just listening and taking it in, and my job is to listen and take it in and just scope out what is actually going on. And I think my only question I have is if your unit felt more safe, would that change for you? And it’s not going to feel more safe. But I think just out of curiosity, how much of this is, and those of you managers and educators that have some staffing power, this is the thing, and unfortunately you do have the inside scoop, but every patient that comes to any hospital is expecting to receive safe care.
And what I’m hearing is, I’m drawing a line and I’m the one saying it, not you, but what I’m saying is that there’s concerns for safety on your unit. And that to me is so devastating, but a reflection of the current state of why we have terrible outcomes in this country. And the fact that you are making an informed choice based on the environment, how many patients don’t get that choice? And how many patients, if they really knew what was going on, might make a different choice too?
I mean that’s just heartbreaking to me. But also what am I going to do about it? Nothing at this point other than supporting you.

Justine:
I know, I hear that and I’m like, well then why do I get to choose that and they don’t?

Sarah:
Because you paid your dues, boo.

Justine:
I know, but still. And then it’s also too on the TOLAC Calculator, which how do we feel about the TOLAC Calculator?

Sarah:
Oh my God, I’m so annoyed by the TOLAC Calculator. I think it’s a piece of information, just like every piece of information out there. But more than anything.

Justine:
I scored terribly.

Sarah:
Of course you did. So do I. And I’m not pregnant. But I think, I mean, on a patient side, I hear doctors use that with an agenda, and they’re functioning out of fear. And while your number is this, and so your chance is blah, blah, blah, and I’m the one getting those phone calls of the breakdowns and the freak-outs of my doctor thinks it’s not possible. You never know until you try. And even TOLAC, you’re concerned for rupture. In general, your chance of rupture is less than 1%, and that includes the ones that are not catastrophic. So if you knew you weren’t going to rupture your uterus and you knew that you were safe, would things change?

Justine:
See, I don’t know too, because then I’m like, oh, okay. So the advantage would be I have Sarah, right? I have this huge advantage. When people hear that, when I tell people in my unit, they’re like, “Oh, you have Sarah. You have to TOLAC.” People have said that. And I’m like, “I know, I get that.” But just like my BMI and I’m closed and the longer I’m on the unit and the longer my blood pressures are going, then they’re going to be like, “Maybe we should start mag. And just all of these things that I’m like… And I was telling my husband today, I don’t think I’ll say after, I should have had a vaginal, but I could say I should have just done a C-section.

Sarah:
Interesting.

Justine:
You know what I mean?

Sarah:
Yeah.

Justine:
Mind you, on the flip side, the idea of having a vaginal birth to me isn’t something that I’m like I desperately want or need. I think Nathaniel, my first son, I wasn’t super disappointed in that part. It’s more the connection that we didn’t get right away. Versus I would like Eric to see what I do for a job. That’s not a reason to go through all of that. It’s just not, I could put on a documentary, not a very good one.

Sarah:
You do.

Justine:
So no, all those girls are lying according to my coworkers. Do you remember that? I think I shared that where one of our new grads was like, “I watched so many L and D vlogs. None of them were honest. This job is so hard. They all made it look so roses and rainbows. So funny.

Sarah:
This is not the job.

Justine:
Anyways.

Sarah:
I think that was my next question for you, especially in just thinking about and making sure, I feel responsible for making sure that you’ve thought through things in a way. Because again, I don’t want you walking away having any regrets. I’m hearing very positive things and it’s all very encouraging to me. But I think the question I had was especially with, given that you are a labor and delivery nurse, and especially given our history and how much we did physiologic birth from the jump and stuff, that there’s no desire in you to experience that side of it for yourself?

Justine:
Yeah. I mean there’s no, pull, no. No. And I’m wondering why, and I wonder, I mean, I kind of like that I have the C-section side of our job.

Sarah:
For sure.

Justine:
I have the anti[inaudible 00:14:01] side of our job, the sense experience-wise, right? But even though I have that side, I still really want people to have their vaginal births. I see sometimes nurses will be like, “I got a C-section, whatever. You can get one too.” I don’t have that. I don’t want that ever to have that. But yeah, your brain goes out the window though when you’re pregnant. I was looking at preeclampsia signs the other night. I’m like, I know these signs. And so I don’t know if when I’m not pregnant, I would say that. And I was really worried about that when we did our leading change class with Mikkel and I was crying during the class and she was recording it and I was like, “I have trauma around my birth?” But the trauma, when I started crying was the skin-to-skin in the OR story.
And what I got taken away from me because him leaving to the NICU, and that’s where I feel like the healing’s going to come for me in my experience. Not that I need that. And I also, I’m scared that I’m banking on that. I don’t think I have anything left from that. Because yeah, I just, I’m really excited that he’s term and healthy that we know of and just going to be there with me. To think about, I was already home with Nathaniel at this point of his gestation. He came home four pounds, 10 ounces. Noah’s still inside me, his name is Noah by the way. And that he’s a full-

Sarah:
A full human.

Justine:
Living thing, not just a pink alien. You think of them as pink little aliens inside. But there’s cute hair and normal skin. It’s so weird. I think about it all the time. Every delivery still.

Sarah:
Same.

Justine:
We’ll be doing skin-to-skin. I’m like, you were right inside.

Sarah:
He was just inside of you. You just made that.

Justine:
Yeah, yeah.

Sarah:
Same. I think about it every single birth. It’s wild.

Justine:
Yeah, wild. It’s hard to visualize it when there is the alien inside you kicking.

Sarah:
So first of all, it sounds like we’re having a C-section, which is exciting. And then let’s land and let’s be done and stop stressing about it, and just move on and you know exactly what’s going to happen. And you hold onto that 5:30 time slot.

Justine:
Okay, so that got changed today.

Sarah:
Oh, oh just kidding.

Justine:
No, but I think it might be better for everybody. She asked me, she was like, “How tightly are you holding on 5:30? And I was kind of to tied to it.” But I was like, “It’s fine. What do you need?” The reason I was tight was for my son’s life, I wanted him to not have to worry, but she wants noon, she really needs noon. And so I was like, “All right, noon it is, whatever.”

Sarah:
Okay, great.

Justine:
Sounds great.

Sarah:
Sounds good. Yeah.

Justine:
Anyway, so yeah, we’re holding to the noon spot.

Sarah:
Well, and then you, in theory, as far as being hungry, 5:30, you’re going to be starving by 5:30. So noon’s better for food.

Justine:
No I’ve thought about that, yeah. It’s true. It’s true’s.

Sarah:
That’s great. And then you have the whole afternoon and then you have, right, exactly. You sleep all night, you check in, you have your baby, and then you have all afternoon before you have a normal night’s sleep to get your rhythms and have a couple feeds in and all that.

Justine:
That’s true. That’s perfect. Yeah, so it could be great. Okay, so noon.

Sarah:
Noon for your scheduled cesarean birth and then this whole assisted thing. So you’ve been all over the map. This we have sort of talked about where you’re like, I think I want to do the full whammy where I scrub in and throw on the arm gloves or whatever they use. I don’t know if they’re long. It’s probably a gown.

Justine:
What do they call them? Booties, arm booties?

Sarah:
yeah, they’re like long arm. The ones you put on that you go up the vag for the heads, when you’re pushing up the head. Or even I would throw that on for rectal cytotech.

Justine:
What? Yeah.

Sarah:
Because you’re under there and your whole arm’s in the juices.

Justine:
I mean, that makes sense, but I never thought of that.

Sarah:
You just get it all over you?

Justine:
I mean, you’re a different nurse than me. You are so much more put together. I’ve never thought of that. I never would’ve had the brain power to even think about that. That’s great. Very good.

Sarah:
Now I’d be like give me the sleeve. It’s like a part of the thing that and the glove and you’re all up in there. Anyway, so you wanted the whole scrub in. Where are you at with all of that? The full…

Justine:
So I would say about-

Sarah:
I don’t call it family-centered, I don’t call a family center C-section that, but that’s what some call it.

Justine:
Yeah, yeah. So I went off at 34-ish weeks now, 35 I think. And right before I left, I had everyone on board. I showed everyone in the video and everyone was really excited about it. My tech was like, “I need dinner, you got to buy me dinner. I’m stressed.” I was like, “Great, I’ll buy you dinner. No problem.” She’s the only one. But she’s like a tech through and through, right? Everyone else is like, “Cool.” Now that I’m moving up in the time slot, there would be an anesthesiologist instead of a CRNA. And if it’s the anesthesiologist that’s the one that is our main one. She is, I imagine would be so into it. She’s very wants to do skin-to-skin, loves that stuff.

Sarah:
Cute.

Justine:
Hopefully send the video to a friend to show her since I’m not there, and then we’ll see. But ultimately, I just want that baby on me as soon as possible. Now I just don’t care.
A few weeks ago it was very much important to me and now I’m just, I don’t want to, I’m so concerned, which I shouldn’t be of being too much. Who do you think you are? Not that I think anyone’s thinking that, because even my friend who-

Sarah:
No. And it’s you. Who is ever going to think that of you?

Justine:
I don’t know. And so even my friend was like, “You’re going to change the way we do it for everybody if you do it this way. If they see that being possible, then maybe we can at least do skin-to-skin.” Because we don’t even do skin-to-skin in the OR right now. And so I handpicked everyone, everyone’s down, in theory, the doctor’s down. She’s like, “You just want to hug your baby sooner. I get it.” And that’s just really sweet.

Sarah:
Do you have a clear drape option?

Justine:
No, no, they will put the drape down to see, if I want, there’s no clear drape, our director’s trying to get them. But there’s just such a disconnect on our unit of, so I’m a supervisor at night, and when I go to meetings during the day, there’s two things I’m thinking about. Our director is like, “Well, we have clear drapes, right?” No. “We’re doing skin-to skin in the OR, right?” No. We’re not even transferring baby skin-to-skin to postpartum. They go in there and she’s like, “I thought they all should be on the skin transferring in the bed to postpartum.” I’m like, “Whatever, put the rails up.” So she had no idea. There’s such a disconnect. Our policies are that, we literally have a family center birth policy in the OR, but we don’t use it because resistant to change. So I’m hoping to be the catapult of that.

Sarah:
Catapult that.

Justine:
Catalyst in that.

Sarah:
Catapult everyone forward.

Justine:
Catapulting the catalyst.

Sarah:
The catalyst.

Justine:
Forward. And if I could do that, that could be really cool. And that’s another fun little results of this beautiful birth we’re going to have in the OR.

Sarah:
Yeah, great. I am not going to be allowed, likely.

Justine:
So flexible on that.

Sarah:
We’ll flex and flow on that. I just am going be to the nicest, most easygoing, it’s she’s a nurse. I’m not going to break a sterile field. What are you afraid of? And I will be so helpful. And then Eric can just be present. I’ll take photos of you guys.

Justine:
No, I know. So one of my fears is, so we do want to record it. And so by the time this happens, by the time this airs, it doesn’t matter. But we want to record it. And there’s no recording on my unit as we know, but I’m the kind of nurse that I’m like, “They’re going to say no recordings, so just pretend you’re taking photos. I don’t care if you record.”

Sarah:
That’s what I do every birth.

Justine:
And so yeah, you just pretend you’re snapping. I have one nurse that’s a daytime supervisor that wanted to come in just to be the bulldog for me on making sure everything happens. And one of the last things I talked to her about and was like, I do really would Sarah in there? And she’s like, oh yeah, whatever. We’re going to do whatever you want. So I’m just hoping I haven’t talked to her in a week or two. That can still happen and she can come in.

Sarah:
I hope I can hold it together.

Justine:
Yeah.

Sarah:
I’m going to cry right now.

Justine:
I know. So that is the goal for that. And I need to text her. I’m going to put that on my…

Sarah:
I’m crying for y’all. I’m very professional though, in person. Let’s be clear, because when I’m there, it’s very business first. But when I think about it now, I’m like, I’m so happy for you.

Justine:
I’m excited.

Sarah:
What other preferences do you have? So what I’m hearing is, scheduled cesarean birth, potentially.

Justine:
Yeah. It’s going be a little surprise.

Sarah:
Family, what’s the surprise?

Justine:
So another little surprise for my friend who she won’t know because she won’t listen to this yet. We’ve known each other for a decade. She’s in nursing school and she’s going to be there that day on my unit. And so the clinical instructor is going to have her be the one that preps me and take me, which is fun.

Sarah:
Cute.

Justine:
So that’ll be fun. So she’ll be able to see my birth too. So that’s cute.

Sarah:
That’s adorable.

Justine:
I know. So one of my preferences is that I have her as my student, and then I have for prepping, I am very much like, you can put the Foley in before, I don’t really care, whatever. Because I did that with Nathaniel. I had mag and putting the Foley in did not hurt at all. The taking it out hurts so much worse. So much worse.

Sarah:
Do you think because it’s just irritated?

Justine:
That’s a good question. I don’t know if that was why, but now I’m big. I’m like, take a big deep breath and then I’m going to pull it out. Well usually, we pull it out before birth, so it doesn’t really matter. But if I’m ever in that like a TRP or antepartum role, they don’t have a block, but yikes. Okay, I’m going to have the same meal that I had with Nathaniel as my last meal. So something I do is, that’s one fun part about having cesarean births is you know exactly what you eat. So every year since Nathaniel’s been born, we have the same thing every year, but for the night before his birthday. So it’s a stuffed crust cheese pizza, and apple juice.

Sarah:
I was ready for filet mignon or a lobster tail or something. No, that’s great.

Justine:
I love stuffed crust cheese pizza.

Sarah:
Yum.

Justine:
From pizza places. But we’re going to have that so noon actually makes more sense for that. I was like, how am I going to do that at 10 o’clock in the morning?

Sarah:
Oh yeah, exactly.

Justine:
For my 17:30. And now Nathaniel gets to eat it with me, which is fun.

Sarah:
Cute.

Justine:
And then the goal is, yeah, every year they’ll crave that for the rest of their lives before the night before their birthday. And yeah, my preference is that you’re there, that Eric is there, and I have my OR nurse picked out. She’s our circulator, known her for years and preferences afterwards. So I would like to, I’m going to breastfeed just to say it like that, right? So I’m going to breastfeed and it’s going to all be different this time. I have high preferences to be discharged quickly, so I’m going to be trying to get walking… I don’t even know the rule because our nurses won’t take the Foley out for 12 hours, and let them walk until the Foley’s out. And the guideline is let them walk I think at six or eight, leave the Foley in. And Eric would always say, “We have cabbage patients walking before then.”

Sarah:
Right.

Justine:
[inaudible 00:25:30] So the goal is to walk, to manage my pain and walk to get home. Because man, I got to tell you, you always become slightly different in your care no matter what. If you’re going to get your [inaudible 00:25:45] appointment or having a baby, having surgery, whatever, visiting the ER Urgent Care, I have way more empathy for people that have kids at home. Planning sucks, when people just go into labor in the middle of the night, where are your kids? And the people that have to bring them. And then the people that can’t come. I’m like, it’s two o’clock in the morning, what are they supposed to do? You didn’t plan this.

Sarah:
Right. Baby’s coming.

Justine:
And so that, a lot of empathy for that right now, but planning and Sarah gets to film Nathaniel meeting Noah, and that’ll be super fun. Very excited. I hope he’s not super shy. I’m prepping him for being filmed. He’s much better at being on camera these days.

Sarah:
That’s great. Oh, I have the whole camera situation all packed up. And the extra SD cards came so that we have plenty of room and I got an extra battery because I’m worried about the battery dying. This footage that we’ll get is so beautiful.

Justine:
I know, I’m like, did you bring your makeup? Can you bring your makeup bag?

Sarah:
Sure. We can do lashes and everything. Can you imagine? We could do a little glam sitch if you want. Would that make you feel better?

Justine:
Yeah, that’d be nice.

Sarah:
Before, so you go in looking and feeling great.

Justine:
Yeah, that’s true.

Sarah:
You’re not going to sweat it off.

Justine:
I mean, yeah, if I’m not going to sweat it off.

Sarah:
That’s the thing about scheduled cases, they look fabulous.

Justine:
People look great. I would like to be fabulous. Okay. Yeah.

Sarah:
Okay, let’s do it. I’ll bring your foundation from filming. I found it the other day and I was like, oh. I’m probably the exact same color.

Justine:
Yeah, that’s funny. My coworkers are going to be like, “Who is she?” Because I literally never wear makeup at work. That’s fun.

Sarah:
Yeah, you’ll look great.

Justine:
Fab. That’s so fun. Okay. Yeah. And then breastfeeding, yeah, I just want to have I want to not be nervous about it. And for some reason I’m so concerned about lack of sleep, but when I know that I operate well in lack of sleep.

Sarah:
You basically are, you have a newborn of your life the way that you sleep, but you have systems and routines and you’ll just find your system and routine with him.

Justine:
For sure.

Sarah:
So when I think about your birth, because there’s different stages and of course the birth piece is so important. It’s what we do. It’s the moment and it’s really special. But even talking to you over the last four and a half years, it’s the postpartum and the breastfeeding and the rough start you had the first time around is sort of a crucial time. And I think about other times… That first 24 hours is so important to get it right from the jump and not set, I am gone for 12 hours and then your nipples get raw because he has a poor latch. You know what I mean? I get nervous in that way. So I think we can play it by ear and see how you’re feeling. I don’t want you being concerned about me, but I’m good dear. And also I want to go back to your comment about pleasing me.
All I want for you is for you to feel good about your choice, and for you to have the best experience possible. And if that means it’s a C-section, then that’s exactly what I want for you. I have no agenda, I have no tie.

Justine:
Do you feel like it feels honest?

Sarah:
Yeah, I do. I don’t really have anything else to say about it. I’m like, let’s talk postpartum, let’s move on. You’re good. You know what you want and I’m so proud of you for processing and figuring that out and even being honest about the other little concerns. But if you’re being truthful with me and not just blowing smoke up my ass, and this really is how you feel, then that’s exactly, I think it sounds great. And I think that that is shared decision-making, I don’t doubt that you’re not making an informed choice.
You are making an informed one. There’s nothing, I don’t need to talk through the risks of a C-section versus a vaginal birth. You know. And so if that feels better for you, and it’s not just a, like a I want this because it’s something I can control and I really do want the other outcome. I think I’ve also heard, and I was there for Leading Change when we were filming that and we’ve processed over the years, various times talked about your birth and I’ve heard things about you feeling like you missed out on the vaginal birth. But I’m curious if that’s just like, and you don’t necessarily have to answer this, but is that just what you think you should say?

Justine:
I don’t think what I’m saying now is dishonest. Maybe I said that, but now being pregnant, I think that was the point of once you’re pregnant…

Sarah:
Yes. And it’s your reality because everything’s a theory until it’s truly a reality. And then you actually have to make a choice. I can say right now I want to go without an epidural someday. And in the moment I might be like, screw that. Absolutely not. That is not at all what I want and I’m going to make that choice for myself.

Justine:
Totally. Yeah. Well, my friend, my coworker, she drove me home the other night and she was pregnant for a little bit and she said even in the short period of time she was pregnant, she was like, do I want to C-section? And she’s so physiologic birth unmedicated, just the thought. Because when you’re pregnant, when you start being pregnant, you just don’t, thoughts are different.

Sarah:
Well that’s good. I’m glad. And being a labor nurse, I think you’re prone to more fear. And I think about what happened with your first pregnancy and how much anxiety and how much fear you’ve had. And I think about all our other nurses that we know and all your coworkers, those of you listening, that it is an absolute thing to be extra anxious, extra fearful on all sides. It’s like you can’t win. It’s like you’re trapped because on every side there’s risk. And so I think based on the fear that happened last time, I just want you to feel good about it and not be so anxious about anything. There’s risks involved, but if you feel confident about your decisions, that’s the ultimate of physiologic birth. And that’s where even in the disclaimer in the beginning, I’m like, “Ultimately, we can want it, but if they don’t want it and if it doesn’t align with their preferences, that vetoes every tool, every trick, every desire I have for what a perfect birth looks like.” And good news for you, I don’t actually have one. I just want what you want.
And so that’s why we had to have this conversation because I think I have been concerned that it is a fear-based decision and that it is A, you’ve mentioned things about staffing or your concerns about other little variables that are completely outside of your control or let’s remove all outside factors and see what’s really going on inside of you and not a people-pleasing thing and not a, I’m embarrassed to ask for blah blah, blah. Or I’m embarrassed to want whatever I want. It’s sort of like what is the core and what is the actual desire and let’s go after that.

Justine:
Yeah. And I think my core desire is to have him on top of me as soon as possible. That’s the ultimate goal. And so sure, if my water broke on Sunday and I’m in labor, maybe.

Sarah:
Flex and flow.

Justine:
Right. You never know. But I don’t think that’s going to happen. But my TBS swab was done today just in case.

Sarah:
Great. I also, I think publicly, I want to say this because you’re not the only person that I’ve heard say things like, “I really want to make Sarah proud.” Which is so silly to me, but I get it. I do. Sure, I can get there, but also I don’t care what you do. And while I might be physiologic birth person, over half of my clients get induced, many of them, this year, actually that’s not true. I’ve only had one epidural this year. But in general, so many of my patients get an epidural. I don’t care if that’s what you want, great, let’s do it. No problem. And I think that what I would love for the bundle birth community to understand is that it isn’t about our bias. It isn’t about what we love about birth.
And as much as I love physiologic birth and I love when it works, I also… Okay, sometimes it doesn’t. I am not carrying the weight of other people’s experiences. And that for me is very freeing and allows me to step into whatever scenario and be like, great, what do you need here? And how can I be helpful versus sort of pushing an agenda. And I think it’s really hard not to, especially if you’ve had a baby and you have your own preferences or you have strong opinions about things. I can say I definitely have strong opinions about things, but most of my strong opinions come when there’s an injustice happening, that makes me crazy when that’s not right.
That is not right. That is not them making a decision, that is coercion. That stuff gets me crazy and I will have very strong outward opinions about it. But if it’s in the case of the patient’s fully informed and they’ve been advocated for and they are being heard and listened and they have full autonomy over their choices, then hell yeah, let’s get that epi, let’s do a C-section, let’s get there, let’s have a baby. And I can reroute very quickly. So I just want to say that to you and everyone else. Again, the goal is confidence in your decision-making not fear. Whereas now the gift for you is that you get to make a decision based on what you want, regardless what the baby’s doing that you’re advocating for and you’re able to figure out and push into what you want.

Justine:
And there’s some, and they’ll never listen to this of family members that feel like, I feel like they think cesarean is the easy way out, which is frustrating for people that have had cesareans. They’re like, that’s major abdominal surgery. It’s not the easy way out. So then it was their opinion weighing on me to try for vaginal.

Sarah:
I think it’s pretty challenging to entrust your body to somebody you barely know.

Justine:
Yeah.

Sarah:
It’s different hard, but that is its own… And luckily your people, so you’re choosing based on actual knowledge, but most people don’t, and they are at the will and fully surrendered to the medical team hoping it goes okay.

Justine:
Right.

Sarah:
That’s not easy.

Justine:
Mm-mm. I got a Brazilian wax two weeks ago.

Sarah:
Oh yeah, you told me.

Justine:
In preparation of maybe having the TOLAC for the first time ever, holding my sweaty butt cheeks open relaxing.

Sarah:
Did it make you like, I definitely don’t want to labor.

Justine:
Yeah. No, it was something else, dude. And I was like, “I’m only doing this because I know the people.” And plus it’s like, and I know they don’t care. We don’t care. Some people care.

Sarah:
They do and they make comments and your comments, people remember.

Justine:
Right. I’ve heard the comments. So yeah, it matters that we make people feel safe and labor and delivery nurses are so special and we have that skill and that’s why Move was so amazing, right? Because we can get to know each other so quickly and have that rapport so quickly because we are so good at that. I think more than any other unit.

Sarah:
For sure.

Justine:
We are so intimate, so fast. You just have to remember how important that is when making someone comfortable right away. Mind you, I’ve said things like, “You have perfect anatomy.” And I’m like, that came out of my mouth wrong. Just looking at your perfect anatomy.

Sarah:
Your butt hole looks really good. AKA, no hemorrhoids.

Justine:
So, anyways, I won’t be recording more episodes really with you, maybe one or two, but I’m excited for your season overall. Do you want to talk about your plan?

Sarah:
We will miss you. Yeah. This season, let’s talk about season five. We have a lot on the docket. We have Amy, the Good Nurse is going to be on this season. Do you know who that is?

Justine:
No.

Sarah:
So you know The Good Nurse movie?

Justine:
Yeah.

Sarah:
There’s also a documentary. It’s the craziest story of she’s actually an ICU nurse and she helped the FBI or the CIA, it’s probably the FBI, some law enforcement to catch this nurse killer.

Justine:
Oh my God, that’s so crazy.

Sarah:
And went up against the system. And so we’ll be talking about the system and what it means to do the right thing when she got some hospital pushback and tell her story. It’s freaking nuts. So that’s going to be really exciting. I have Heidi, one of our nurse educators, she and Jen Atkinson are teaching the RNC-OB review course. My guess is this won’t be out by then.

Justine:
I plan to be rocking a baby.

Sarah:
Are you really coming to it?

Justine:
No, I really want to, I want to have it on the background even. I just want to be there.

Sarah:
That’s so nice. We’re flying into LA for it. Yeah, we’re going to do a bunch of filming and photos and really document the thing really well so we can give people behind the scenes of what to expect. We’ve been working on that for a year. There will be 2025 dates for those of you getting your RNC in 2025 and beyond. We’d love to have you. The workbook is so stupid beautiful. Of course, I’m so obsessed. And then so the workbook, we give you the slides, they get study halls. They’re actually putting together a custom study questionnaire from the class. So we’re saving all the questions. It’s so much content to get through, but if you ask a question, it’ll go in our question bank. And then Jen and Heidi are going to answer all the questions and send out a custom Q&A study guide from the class. There’s email support, you get the workbook printed, so we ship the workbook to you. It’s going to be a great day. So that’s coming up at the end of October. I don’t know if this will be out by then.

Justine:
And you get three months to rewatch, right?

Sarah:
Yeah, you get to, normally it’s like two weeks, but because we want you to be able to prep for your class and really hone in and watch it as many times as you want, have it on in the background. And ideally you take your test within the next three months. So sort of time it out that way so you can watch it for three months. And then they have these hour study halls that we’re trying out. We’re monthly. They’ll be on for an hour. And if you have questions or you need support or you just want someone to celebrate the fact that you passed, you can show up and we’ll all be there and hang out and answer your questions. So we’re really excited about that new offering.
And then in November we have our last Shifting the Pitocin Paradigm class. We have our last Physiologic Birth class. We have Black Friday, and then Mentorship opens December 15th for the January cohort. And so those are our big offerings for this year as far as podcast goes. Jen and Heidi will join me. We’ll be talking about RNC and how to get your RNC and what are the benefits and all of that. That’s coming. And then Heidi’s joining me for a couple of episodes, sort of replacing Justine for a little bit. And so we’ll have some conversations about OB things. I know we’re going to talk cord gases. I am like a dodo with cord gases. It’s like I’ve said this before, but it is truly the one thing my brain cannot comprehend. I cannot remember, I cannot get.
And she was like, “Oh, I can teach you.” I’m like, “If you can teach me, then you are the master of the universe.” Because I truly, I’ve sat down with NICU docs, I’ve sat down with OBs. We’ve had, I remember the only reason why I say that, not that they would know cord gases, but they probably should. But I remember having the most extensive OB conversation about cord gases. Didn’t get it. I’ve looked it up, I have to cheat it. I’m like, okay, this means… My brain just doesn’t get it. So we’re going to talk cord gases. We have a couple other special guests coming, which you’re going to have to wait and see on.
We’re going to talk physiologic birth, we’re going to talk home birth. That one’s going to be real spicy, we’re going to talk home birth and the stigma and how he got comfortable with it and why he’s comfortable with it. And I will be very honest about my opinions on that one. So it’s going to be a great season and we’re so excited to be back. We’re so excited for those of you that listen, whether this is your first time or you’ve been following us since season one, our goal is to help you.

Justine:
Five seasons.

Sarah:
I know. And when we started this, remember, I don’t know that we had a long-term plan. It was like, “Oh, let’s do a podcast.” And then we did. And then it’s like, “Oh, I guess we got to keep going.” And now we’re five seasons in.
Well Justine, we are all celebrating this birth, and celebrating a beautiful birth experience, a different birth experience, and looking forward to hearing back. I can’t wait to tell the story and talk through with you about what happens and update everyone on even just the journey of what it’s like for a labor and delivery nurse to give birth. And thank you for letting us into your life and your story and pieces of your feelings and being vulnerable with everyone here about what’s important to you.
And I think it is important for all of us to realize that we, one, our comments are being heard by your coworkers. And that the system, the way the system is set up, has impact on, this sounds dumb, but birth outcomes, but also potentially has impact on those around, you and their birth experiences. And so let’s all just as a reminder for season five as we’re back, as usual, to pause at the door and just remember who you are and what your purpose is and what a difference that you can make in these families lives. And for you, I’m so excited to get to be there this time and get to support you. The little, this is totally a tangent, but the first time around, we didn’t really know each other as well, obviously as we know each other now. And I remember when you gave birth, it was like we’d known each other, and sort of been working together but not really and hadn’t done too much together. And so I didn’t want to meddle.
And so I’m always sort of walking that line of over-offering my support and just letting people have their own experience versus me being like, I can come in and just save the day. And while that is not my intent to save the day, I am excited to be able to potentially help avoid issues and set you up right and be supportive of Eric and help you guys just bond and have a more calm experience than both of you did last time. So thank you for letting us in on that.
And we are so excited to be back. Stay tuned for so many more episodes this season on various things OB-related. Our goal for you is to empower you with the education and support you need to live thriving lives both in and outside of work. And so everything that we do is really modeled around that mission. We are here for you if you need anything, education, support, you’re not sure where to start, you can email us at hello or nurses at bundlebirth.com. And if you want more from us, we have all sorts of classes and mentorship programs, and we have our motion app and all sorts of ways that you can get plugged in with ultimately that goal of giving you everything you need in order to thrive, especially on your jobs.

Justine:
Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you liked what you heard, it helps us both. If you subscribe, rate, leave a raving review and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram.

Sarah:
Now it’s your turn to go and congratulate Justine.