Birth As We Know It ™️-Birth Stories and Experiences

48-Kelly Durbin, IBCLC-2 Vaginal Births-Jojo & Ella-Protecting Your Potential for Breastfeeing

January 24, 2024 • Kiona Nessenbaum • Episode 48

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In this episode, Kelly shares how her determination to get the birth she desired led her to choosing a birth location that was 1 hour away from her home, leading to a difficult decision during her labor. She also discusses the importance of being informed on how interventions that happen during the birthing process can have an impact on your breastfeeding experience. 

Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider. 

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Kiona:

Hello, and welcome to Birth As We Know It. I am your podcast host, Kiona Nessenbaum. I have experienced birth as a doula, a student midwife, and as a mother of three amazing children with my husband and high school sweetheart by my side. After attending over 130 births, including my own, I've realized that each birth experience is truly unique. So make sure you subscribe and join me every week as we are guided through many different birth experiences through the lens of the storyteller. Please be aware that some of the stories can be triggering to hear, so feel free to pause, take a breath, and come back and listen whenever you're ready. With that said, let's prep ourselves to dive deep and get detailed about what really happens in the birth space. As a reminder, this podcast is intended for educational purposes only, and has no intention of giving or replacing any medical advice. All advice that is given on the podcast is from the personal experiences of the storytellers. All medical or health related questions should be directed to your licensed provider. Before we dive into the episode today, I want to remind you to please share this episode with a friend or loved one. By sharing, your bringing your community and inviting them to become part of the BAWKI community. We are all here to learn from one another and support one another on this journey that brought us into parenthood. Birthing is a topic that is not talked about enough. So please share this with a friend. And be sure to share your favorite episodes so they can tune into those as well. All right. Let's get into today's episode. Hello, everybody. And welcome back to the Birth As We Know It podcast. Today, I have on Kelly Durbin, who is an IBCLC, as well as a childbirth educator. At this moment, she's not taking any one on one clients because she's in a transitional period, but she will be offering those services later on. So don't hesitate to reach out later on. one thing that she is doing right now is she is An author. So she is writing and right now her book is called Protecting Your Potential for Breastfeeding. So, hello, Kelly. Welcome on.

Kelly:

Hi, thank you so much for having me today. I'm so excited to be here.

Kiona:

Yeah, of course. I'm super excited to have you on. So today we're going to be hearing a little bit of both of your own personal birth stories and then we're also going to be touching on how interventions impact your breastfeeding relationship and lactation.

Kelly:

great.

Kiona:

Perfect. So let's go ahead and start off with you just giving a little bit of an introduction of yourself and telling us a little bit about you.

Kelly:

Okay. Um, well, I will preface all this by saying that at the time that I had my own children, I was not in any way knowledgeable about. very specific information about birth and breastfeeding. So when I came to this work and by work, I mean, my own work as a mother, I didn't have any training in this. So it's only been since the kids were born that I have become. Uh, a birth educator and a lactation consultant. So my first daughter was born 17 years ago and that's when it all started.

Kiona:

Yeah, I think that's great. And I think your path to this work is very similar to many, because a lot of people don't realize what's needed until they realize what's missing in their own experiences, or until they just go through their own experiences and figure out. Some of the challenges and needing to get access to resources and find what those things are. So you're not alone in that journey.

Kelly:

Yes, this is true.

Kiona:

Yeah. So let's go ahead and start talking a little bit about, your experience in your first pregnancy. How was your conception journey and how was your pregnancy overall?

Kelly:

I love that you ask about the conception journey. That's something that most people just overlook because it is a part of the story, isn't it?

Kiona:

Absolutely.

Kelly:

time that, that I was actually pregnant, I was kind of considered sort of the old lady. Like I was 33 or 34, maybe I think I was 34 at the time. I had just gotten married and I wasn't thinking about having a baby right away. I was actually convinced that I had a lot of time. I, I mean, to be honest, I feel 34 is exceptionally young. And for me, I don't know if it was just the fact that I felt like, oh, motherhood seems Like something that I'm still looking forward to in the future. Like I didn't imagine myself as a mother right then. And it, and still it was a, it was a difficult leap for me, even when it happened, but looking back, so the conception journey was nothing that I planned, it just happened like, and to be honest, I think to myself, I'm glad that it did happen that way. So I was, I think I was pregnant like four months after we got married. And again, I did not plan this, but. Looking back, I think, well, I'm really grateful that it worked out this way because what if I had waited another year or two? Would I have felt ready enough or even able to, to squeeze in another pregnancy and birth? Because at the time, I'll get to that later, but I didn't feel that way after my second daughter was born. I thought, oh, there's no way I could do this again. So, In the, in the middle of my thirties, I was suddenly realizing, okay, now the obstetrical world is considering me to be advanced maternal age. I was 35 when my daughter was born. And you know, there, there is an increased risk. I'm not going to be like a risk monger or, you know, say that older people and I'm not, I'm truly not thinking that 35 is old in any way because I did it myself and I didn't feel old, but in terms of the eyes of obstetrical care, they do view that as old. And I just, I wasn't thinking along those lines. I didn't consider myself too old for any of this at the time. So that was a weird part of my conception journey was, you know, kind of thinking that I had more time than I actually did. So that was the very beginning. Then, the pregnancy went fairly well. It was very straightforward. I didn't have any issues that I can recall. I mean, the normal things. I felt tired. I felt overwhelmed. I do recall thinking, Gosh, I don't know enough about this to, to go through with all of it, you know, in, in terms of labor, delivery, birth, becoming a mom. So I enrolled in a very intense 12 week childbirth class and it was fascinating. I literally could not get enough of this information. And so for me, that was like life changing. And I, I felt like by the end of the 12 weeks. I was ready to, completely ready to change my career. I was already a teacher. I was teaching elementary school at the time, and I knew that that was over. I was just going to go forward with planning to become a childbirth educator because I thought, here's this woman doing this job that I didn't even know about, and now I have to, you know, I want to be this lady, this childbirth educator. She was amazing. So I, I ended up, going through the. Labor, delivery, and immediately started learning about, how to become a birth educator myself. Of course, it took me a little while, but I ended up getting there after the, the birth.

Kiona:

I think that that's awesome. and the fact that you were so inspired by your childbirth educator that you were like, whoa, all of this information is super important to me. So I definitely want other people to do this. And I also love that the course that you chose was a 12 week course because so many childbirth education courses are like weekend ones, like just jammed into one weekend, or sometimes spread out, but I feel like the 12 week ones are very far and in between. It's more of people trying to get the most out of the time that they have of, like, squeezing all this information into a small amount of time and trying to get all of the information at the same time. Like, there are courses out there that are as small as, like, six hours, you know? You signing up for that 12 week course just showed your commitment to really wanting to be educated on what was going to happen.

Kelly:

This is really true. And I, I do, people often look at me like, what? You took a 12 week course? Like, that sounds nuts. Of course, it was only one night a week for 12 weeks. But, most people, I think, options right now typically include, you know, a four hour course, maybe. If you're lucky, you could do a Saturday Sunday where you come three hours each day. But there aren't very many, at least not in my area, that offer weeks long and I think the benefit of this is you continue every week to kind of grow and expand your knowledge and you can come back to the birth educator and ask more questions and you can go down the rabbit hole with this information or that information in a three hour class. There's no time for that. You literally have no time. And as a birth educator, I can tell you it's difficult to fit all that information into a really short period of time.

Kiona:

It really is, and I think, like, I agree with you in saying having it just at one night a week and giving you a full week to, like, process the information that you obtained in your course. makes such a huge difference because you do come back with questions and you do have time to do your own research and you also have time to look up something that your childbirth educator likely had never heard of before and it gives them something to dig into to then potentially implement into their future courses, you know, so it's beneficial for both the attendees of the course as well as the educator. And when it comes to needing to try to fit it all into a small amount of time, I 100 percent agree with you. I feel like there's never enough time to actually, like, even if someone was to sit down every single day of their pregnancy and do something about education, there's so much information out there. That it feels like it's never enough.

Kelly:

This is exactly right. And I felt like I wanted to do my best to be prepared. And part of that, for me, was avoiding interventions. I had a really intense fear of needles and medical interventions at the time. I have since overcome a lot of these fears, but I was really, pretty scared of, like, just, having things happen that I didn't really want to engage with. And so part of that was driving my need to be as educated as I possibly could. Cause I felt like if the more than I know about this, the more I can make good informed decisions, if I need to even make decisions on the fly, like during the labor. Not just leading up to it. So it was, it was a little bit fear based, which I mean, I don't recommend, grabbing onto your fears. I, I would suggest, like, if I could tell myself years ago, I think I would just say, you know, maybe you ought to work through this a little bit, which I think I have, but the education piece really helped me.

Kiona:

Yeah, I was actually just gonna ask, how would you feel that you attending that 12 week course impacted the way that your labor played out? I

Kelly:

I'll tell you what, I, I feel like it may have been a little bit naive of me, but at the end of the 12 weeks, I was so convinced that I could do any part of this labor, I thought, you know, I can do this every bit of it. I feel like it definitely erased a whole lot of fears for me, because of course I had never had a baby before, so, you know, people hear all these. Kind of wacky stories about what happens during labor. And for me, I felt like at the end of the 12 weeks, I was in control. I felt powerful. I felt like I could do what it was going to require for me to get this done. And in a weird way, I was kind of looking forward to it, you know, of course everybody wants to meet their baby. I don't know too many people who say they want to go through labor again, but, I did somehow harness this, excitement and, and I, like I said, it may have been a little naive of me, but I, I even felt like throw it at me. I can take it. I'm ready to do whatever, because I felt that confident at the end of the 12 weeks and I don't regret any of that.

Kiona:

I actually think that's amazing, and I would say totally not naive because it's totally fine for you to have this confidence going into labor. You know, like, I am begging and hoping that all birthing people have this level of confidence because then you go into your labor with this energy of saying I can, right? And When things do come up, then you're like, okay, there's a little bit of a thing, but I still got this, you know? So you navigate with that. And I love that confidence. So Did this 12 week course happen to impact the decision of where you birthed your baby?

Kelly:

I had already decided that I wanted to do a birth center birth. And I was living in Ohio at the time and the birth center near me had closed like, maybe two or three years before I got pregnant. And I thought this stinks. I really wanted to do this. I wanted that experience because it felt more in line with my goal to avoid needles, avoiding intervention, avoiding maybe a little bit of pressure from the care team that I didn't want to put up with. But during my pregnancy, my husband and I moved to Indiana. And even though there was no birth center in our town, there was one an hour away and I started going there for prenatal care. Sort of at the end of my pregnancy. And they said, you know, as long as you're healthy, let's do this. Someone, several people cautioned me about, driving so far because it was over a little over an hour away from our house. And I thought, you know, an hour is no big deal. But looking back, it was kind of a big deal and I, I'm not sure that with the same set of variables that I would make that choice again, which is why my second birth was definitely different and I did not drive an hour in the car in labor. That was, that was hard and it could have gone sideways, you know, it didn't, thankfully, I did make it to the birth center and everything was fine, but, it, I can see that it could have gone very sideways.

Kiona:

Yeah, and I, I see both sides of that. I see you really wanting to have this specific kind of birth and this specific kind of energy around you during your labor. So, to Sacrifice that drive of an hour. You're like, I'm willing to do this, right? And then I also see the cautions, why there would be cautions, because an hour away is quite far, and that is, that time can change based off things that are completely out of your control with other people's lives and traffic, car accidents, or running out of, gas, I don't know, you know, something could impact it. So, I see both cautions, but I also want to give you some kudos because you were really determined and that's not a bad trait to have.

Kelly:

Yeah. I was actually really determined. And once I found out that there was a birth center within 60 miles, I was like, Oh, yeah. We can definitely do this. So we lived in Bloomington, Indiana. My daughter was born in Indianapolis and I, like I said, it ended up being okay, but it was a, it was a wild ride.

Kiona:

Yeah. Do you want to touch on a little bit of what your labor was like?

Kelly:

Yes. So unlike most labors, my labor started or at least, The, the whole episode began with a forceful breaking of the water and this is not typical. Most people do not start labor by having their water break. So for me, my water broke about four o'clock in the afternoon and I really thought, okay, this is going to all get started right now and everything's going to be like fast forward. And it wasn't like that at all. I was surprised. To find that by like 5 o'clock, 5. 30, nothing was happening. I literally didn't think anything was going on. Now, things were probably going on, but I wasn't aware of any major contractions. So I called the midwife, and they said to me, Okay, well, thank you for calling. Your labor will probably start overnight or in the morning. Call us back when some, you know, when it really gets going and I thought, well, okay, you know, nothing was happening. So I just let it go, um, about maybe two to three hours later. I was really in distinct and active labor and I think the midwife was a little bit, Skeptical. She thought, you know, well, maybe this is just, you know, Braxton Hicks, or you're just having a little bit of, I don't know what she was thinking, but she put me off again and said, and I wasn't really planning on going to the birth center right then, because things were still, seven, eight minutes apart. And I was just having regular contractions that weren't over the top but, by eight o'clock at night. It was, it had picked up to the point where my husband was panicking. I was thinking like, what do we do? I don't really want to make this drive right now. I was at this point where in that space, when labor is really going actively. And you feel like you have to go to the bathroom almost every contraction. And so I was thinking, there's no way I'm getting in the car. I really need to be near this toilet. So for me, it was not even going to happen right then. So I, I went through this maybe an hour and a half, 90 minutes where I was really in the bathroom the entire time. And my husband kept coming in and he's like, are you okay? I'm like, I'm totally fine. Just let me be for a few minutes. So by like 10 o'clock that night. I had already been really, I would say, two to three hours of really active labor and my husband did not know what to do. He was on the phone with the midwife and they kept saying like, Oh, maybe you should, you know, get in the car and make the drive. And my husband called my sister and she said, You need to leave. You need to go right now. And I just, I was really not, I didn't want to engage with the car. I was afraid to make the drive and I just felt more safe in my bathroom. But finally, I think by 10 o'clock, 10:15 that night, we got in the car. We made the drive. And I will say this, I could not find a comfortable position, so I was really, that was a struggle for me to, to get all the way there, like in really hard labor. Um, we got, we pulled into the birth center about 11:15 that night and I was fully dilated. 100 percent right when we got there and the midwife thought, well, this baby will be born, you know, in 30 or 40 minutes, but things really started to slow down and I got into a hot bath at the birth center and then all of a sudden it seemed like nothing was happening. And there is, there is this, this whole idea of like this little break that many people get after the full transition and your dilation is complete. Things can sometimes slow down and have a little breathing space before you feel the urge to push. And so I never felt the urge to push. So I just kind of sat in the hot bath and I was really in the zone. The midwife was, she was pretty frustrated though, that things weren't moving along really quickly. And because it was after midnight at this point, she was alone. And I think she was the, the assistant had not answered her phone or her page or whatever it was back then. And she was nervous to be there by herself. And she was feeling, I could tell that she was feeling frustrated that this just wasn't happening. Like I had slowed so much. So she ended up calling a nearby hospital and they had a very slow night. And one of the nurses from the labor and delivery unit at Methodist hospital down the road from this birth center came over. And so she finally had a nurse there with her and apparently they were friends. I think they knew each other. So she calmed down a little bit more once this nurse arrived and the nurse was very nice to me. The midwife was, I think she was getting frustrated and she was having Maybe a little bit of a shorter temper than I had ever seen her have in prenatal care. My husband didn't know what to expect, so he was just like flying by the seat of his pants. And it all felt like not exactly how I had intended. I had envisioned it being like this amazing, quiet birth center experience. But in reality, The midwife was frazzled. She was very frustrated that, that the baby just wasn't born right away. And I think until this secondary nurse showed up from the hospital, I feel like she was, she was really at this point where she couldn't decide if I should transfer to the hospital or if they were going to let me continue to linger with no action. Like, it was very strange. So, after probably two hours of being in the bath and then maybe getting out and try, she kept encouraging me to try different positions. She said, you know, I think you need an episiotomy. And I was like, this is the reason why I came to the birth center. I did not want to engage with any interventions. I didn't want to do. anything that would, compromise me. And I felt like at the time, episiotomy did not seem like an appealing option. And I told her, I said, no, I'm not, I'm not doing that unless there is an absolutely urgent need. I just don't want to do it. And she said that I'm, you know, I'm really, you have to deliver this baby right now, or we're going to do the episiotomy and consider going to the hospital. And it was at that point where I was like, okay, I got to figure this out. So it was 2 o'clock or 2. 30 in the morning by the time they were really starting to kind of put the pressure on me. And looking back, I think to myself, if I had been there in the room supporting me during this birth, I would have said, you know what, maybe she needs a snack. Maybe this woman needs a big drink, or maybe she needs to get up and walk around and go to the bathroom. Like, I didn't have the change of scenery that I would have recommended for myself. And I, I really believe, to be honest, I was just hungry. That sounds a little goofy, but I didn't eat anything after about four o'clock in the afternoon. So. I was really way low on like my normal calorie. I was working on a deficit. I was just really hungry. And, and, you know, for people who haven't ever given birth, you may just think like, oh, it just happens or it unfolds, but frankly, it's like an athletic event you have to have. Hydration, you have to have the energy to get to stand there on your own, support your body weight and this baby in whatever position feels comfortable and you have to push the baby out. And my baby just didn't want to come out. So I, I did after they were a little more insistent on the episiotomy. I was like, okay, I can do this. I don't know how I did it, but I, I've summoned the strength to push this baby out. And it happened. She was born at two 42. So long after we got to the birth center and, I wouldn't say too long, frankly, it seems in, in, in the whole scheme of things, it was pretty short, but since I was fully dilated, when I got there, they were, they were thinking, oh, the baby will just, you know, come right out. And it took several hours. So that was the concern. But anyway, that's how that birth went down.

Kiona:

Wow. There is a lot there. And. I am a little surprised and would love to kind of like pick the midwife's brain as to why they thought the episiotomy was the way to go there. that's just so interesting to me. It's an interesting choice. And, uh, yeah, because as a student midwife, based off of what you told me, obviously, like, we don't have all the nitty gritty details, but I would be like, my first assumption would be get something to eat, get some water, move around. And, and I feel like maybe. Or there was probably a really strong impact from the car ride in your flow of labor, because when you're in the car, you're in the car ride for about an hour, maybe a little bit more, and you're trying to not really have the You, you, you know that you can't relax completely because you're going, you're in this transition period, literally transition in labor, but also transitioning from point A to point B, of your location. So that could definitely impact how your labor flow is. So, I feel like maybe, you really wanted to stay in your bathroom because it was safe and you felt like your bathroom was like a birth cave, I would say, like your birth cave, you know, and then transitioning from your comfy birth cave to a completely different setting with a long period in between is probably what just made labor slowdown.

Kelly:

Yeah. It was a mind shift, like it was something completely different. You know, I agree. I've seen, I've been to a couple of births where the changing of the environment shifted everything. And I do believe that that probably happened for me.

Kiona:

Mmm.....yeah. Uh, with that story that definitely I can see that as being a possibility. Yeah. So let's go ahead and dive a little bit into your second pregnancy and birth. How far in between are they? Like how, how big is the age gap? And then also what decisions did you make that were different this time around?

Kelly:

So my girls are 27 months apart. So just over two years. and. Like I said at the beginning of the hour, I felt like, I had a lot of intense breastfeeding that led to a long period of lactation amenorrhea. So I had no period for a long, long time. I think it was, oh, months. I think I might've had a period 18 months after she was born, which is really unusual for most people. It doesn't. Typically last that long. so I had, I've noticed ovulation. I had one period and I said to my husband, you know, if we were going to think about having another baby, we might want to try this. You know, it could be time and it actually worked. That was it. And, I mean, it seems sort of, almost like a fairy tale, like, does it really happen that easily? Well, it can. And for me, it actually did. And like I had said the first time, looking back, I'm glad that it did because when I had this baby, I was 37 years old and I didn't want to put it off any longer. I was like, okay, now maybe, you know, this will be, this will be it for me. I, I just want to throw in there though that if I was younger, if I had been, you know, in my early thirties when I had my second baby, I would have even considered having a third. But, and it wasn't just me being like 37 or 38 or 39 when I considered it. It was. Like I wasn't really mentally ready because after my second was born, I think my mental health deteriorated a little bit and I wasn't quite there, but that's a whole different story. So, anyway, I did get pregnant pretty quickly. It was, Easy for me. I did. I don't think I noticed any, anything unusual during the pregnancy, except this time I was even more tired. You know, I have a two year old or 18 months old. I was exhausted. I felt just, you know, the usual stuff. Everybody who has a toddler and gets pregnant is probably thinking the same thing. Like, wow, this is much more tiring than I remember it being the first time. So. It's a different ballgame. You have a different lifestyle. You've got a baby. You're already a mother. You know, there's, the demands are completely different. But all in all, I felt very healthy. I felt good about being pregnant at the time. And as you mentioned, I did use my first experience going through the whole labor and delivery to change my approach to the second time. So I knew I didn't want to make that drive. We were still living in the same place. The birth center was still 60 miles away. And I thought there has to be a better way. But again, I wasn't very interested in going to the hospital. And because I had already had an unmedicated birth at a birth center, Sort of, in a way, it felt like the Wild West, but in a way, it felt like I was really calling the shots, and I, I did feel mostly in control of what The things that I could control at the time. So I felt good about that. so this time I talked to some people that I knew in the community there and several of the women that I had already known from lactation support, they were people who had had their children at home. And I was like, okay, I'm a little bit intrigued about this, but I have to do some homework, maybe talk to people about how do you do home birth? Is this a really legit thing to people? is this a good community where I can find supportive caregivers, you know? So I went through all of this and I did make the decision to have my second daughter at home. And the actual thing that kind of tipped me over was, you know, if it doesn't work, even if it's a middle of labor, the hospital was like a mile away from my house. So I thought, you know, there isn't the risks for this. We're probably less than driving 60 minutes in labor up the highway where there was only one hospital in between. My house and Indianapolis. So I felt like all in all, it was a safe decision. I didn't feel like I was putting myself in any kind of risk. You know, a lot of people say, isn't that risky? Well, in terms of human history, most births that ever happened were home births. Right. So it's not when you weigh out the fact that like. You start with a healthy person and a healthy pregnancy. It wasn't risky for me and I, I felt like I was making a good choice for me. So I went forward with it. I found, a home birth midwife who was wonderful. And this time there was no moving locations. I did the entire labor starting at, you know, 5 AM. Working all the way into the evening with a lot of downtime, but I did it all in my house. I was, I don't even think I left the house that day and it was a fantastic experience to not have the pressure of, okay, now we have to shift gears. We have to pack the bags, get in the car, you know, do this transition to another phase. So none of that happened. And my. My mental shift, like the first birth, it never had to happen. I was, I just felt like, um, a, a steady in control version of myself and I knew what was coming because I had had a baby before. But at the same time, it all felt sort of new, you know, different baby, different birth. But I also felt like, I was making the choice that was right for me, and that made me feel much more empowered than if I had, you know, Suddenly been like, well, I'm kind of scared. I don't want to do this I think I'll opt for a hospital birth because that wasn't that wasn't what I wanted and I know looking back if I had done It that way I would have felt like maybe I didn't explore all the possibilities or I let myself down in some way But I'm not recommending home birth for everyone. But for me, it was a great choice

Kiona:

Yeah, I think that what you just said there at the end is actually very important, not necessarily recommending home birth for everyone because, even as an out of hospital supporting birth worker, like I was a student midwife, birth doula, birth assistant, primarily out of hospital, out of hospital birth is meant for people that are low risk, healthy, and you know, pretty, I don't want to say basic, but pretty smooth. Pregnancies, right? Low risk. so that's important for saying, so thank you for saying that. And I also wanted to say how awesome for you to just be able to make that decision and to go with it, you know, and to know yourself with having had the experience you had at the birth center to then just turn it into having a home birth and not needing to go anywhere, not needing to have that mental load of making a Transition of location. I feel like that has a really big impact on how labor can turn out.

Kelly:

Yes. One other thing that I wanted to mention though, was that in the community, in the town where I lived at the time, which was Bloomington, Indiana, there was a strong culture of a lot of people who had done this. I wasn't the only person that was thinking like, Oh, I'm going to have my baby at home. I knew people who had done it. I knew people who were just regular folks and they, they were part of this home birth movement that was happening. And in the way that it was a part of the community, it was, it was well supported there. It probably still is. And I felt like, well, this isn't odd. I'm not doing anything that's completely out of the ordinary because people here do this. So in that way, it legitimized it for me. And so looking back now, I realized that that one key, the community support, the fact that I didn't feel like a total wacko doing something like, no one ever does this, Kelly, why would you do that? You know, that wasn't how I felt at all. So when we engage with stuff that is well supported in our communities, and I'm thinking now about how lactation care really thrives when we have a good supportive community behind, that's when people Can make these decisions that some people might consider, you know, off the wall, but in this instance, it was well supported. It was part of the community. There were resources for it. And no one thought that I was making like some completely wacko decision. Do you know what I mean?

Kiona:

I know exactly what you mean. And I am a strong believer in what you said as well in having that supportive community behind you and any decision really that you're making, whether that be home birth or breastfeeding, having that strong community really Makes you not feel like a wacko and it really gives you the motivation and legitimacy of, Oh, this decision I'm making is actually, it's okay. You know, so I, I think that's really awesome. And so both of those birth experiences sound really amazing. And it sounds like there's a little bit of ups and downs with your first one with having a little bit of a battle with your provider. but I'm interested in intrigued, especially now as you are an IBCLC. how were your breastfeeding experiences with your little ones?

Kelly:

That is a great question. So totally and completely different. They were totally different experiences. And of course it has to be that way because during the first experience, I knew almost nothing about breastfeeding, right? During my second experience, I had already had two years of lactation experience under my belt. So of course it would be totally different. But even from the infant perspective, my daughters were so different as babies and it wasn't just the personality. My first daughter had, she was born with torticollis, she was also born with a severe tongue tie, but she was so robust. She came out of the womb just ready to take on the world. She had high muscle tone, which in itself sometimes isn't all that great, but she was really robust as an infant. And so. She compensated so much for having these issues that anyone who saw us, all the care providers that I did seek, nobody recognized the fact that she was kind of struggling, which was leading to her overcompensation. And she was a really strong baby. I mean, so strong. She has a ton of muscle. So for looking back, it's not surprising to me because now she's, you know, almost 18. She does seem like she's robust in every way. Super healthy and lots of muscle. So as an infant, she was the same way. So she was meeting all of her milestones. She was a very good nurser, except she wasn't doing it right. So she was using different muscles to compensate for the fact that she had a tongue tie, she had some oral restrictions, and she had torticollis. So at the time, I did ask my pediatrician like, Isn't it a little weird that, you know, these things are going on? And she said, you know, keep at it. I think you're doing okay. She was gaining weight. We had all the, the regular markers of healthiness. They were all happening. So it didn't look like we had a ton of problems, except for me. I was having Dramatic nipple and breast pain. And I could not, no matter what I was doing, I couldn't get it to resolve. This went on for months. So now hindsight, of course, is 2020. I would never ever counsel someone to continue breastfeeding if they were having as much pain as I had, but I didn't know what else to do. I kept going to, volunteer support meetings. So I was very big into. Seeking support at the time. I was going to La Leche league meetings. I again, like I said, I talked to my pediatrician, although I will put this out there. Pediatricians generally don't have any training in lactation. So at the time, I wasn't really aware of that. I was thinking, Hey, this woman who was absolutely lovely as a pediatrician and she was very very knowledgeable. she was a great care carer of infants. I thought that she would know what I needed, but she didn't. And I only know looking back that she had, no training in lactation because, of course, that's how it it ends up being for most lactation consultants. So at the time I thought I was seeking all of the lactation care that was available to me, but I didn't go see a lactation consultant and I'm not sure if I just was blind to the fact that like I needed extra, a higher level of care, or if I just thought, well, this is probably normal and she'll grow out of it. She did compensate, as I said, she compensated very well for all the issues and eventually the pain did stop. And I'll tell you what my professional opinion is now. I think it's just that as a baby, she grew. Her entire anatomy. Her face grew. Her mouth got bigger. It's not that she ever learned to feed exactly right. It was just that together we arrived at a place that was, easy for her to nurse and it was far less painful for me. And I'll tell you that when she was about 10 years old, 10 years, I took her to a new dentist and the dentist said to me, your daughter has a severe tongue tie. How did you not know this? And I thought, I guess I, I just worked through it. So, um, she did have a tongue tie release at age 10 and it does impact her. Even still. She never had a speech impediment, which can be a problem for some infants and children, but. She does struggle with body posture, her back, her neck. It seems very restricted. Even now she's had the release, but again, she was 10 years old. So it wasn't like, shifting things for an infant. Uh, when, you know, we see the infant outcomes, a lot of times people notice right away, as soon as the tongue tie. is released. If it's working well that breastfeeding starts to improve dramatically. Well, like I said, we didn't have that opportunity when she was still nursing. So we just worked through it. My second experience with breastfeeding was much, much different. My daughter had no oral restrictions, or at least they were so minimal. I never. realized it and she didn't have any issues. She was excellent at transferring milk. by this time, I was heavily into learning about lactation and I felt like, you know, this is something that again, I was fascinated by it, just like the birth experience. And, she was a much better nurser. Which gave her, I don't know, of course, pain free nursing for me, but it was, it felt like, again, it was a, an intense, relationship because she wanted to nurse a lot, just like my other daughter. But it was, I felt like, at the time I, I was thinking, there's no way that breastfeeding can be pain free. But then I realized, yes, it can be when your baby has the tongue movement and the mobility that is inherent in the natural way that your tongue and your teeth and your lips are supposed to go. So with that, I was completely blown away again by my own experience as a nursing mother. Like, okay, this can be pain free and it can be a system that works the way nature has designed it to work. So for me, it was another. Complete eyeopening experience that I really felt like I'm so glad I had the second one because it changed my perspective on how lactation really works. And that was, that was good.

Kiona:

Yeah, I think that you having those two very different Breastfeeding experiences is amazing, especially as someone who provides support to people who like through their lactation journey. And the reason I say that is because you just said it yourself. You're happy that you had your second experience because it was so different from the first. You realize. Breastfeeding doesn't have to be painful. And the first time you were just like pushing through, pushing through saying, Ah, it's okay, it's only going to be painful for a temporary amount of time. And for you to bring those two experiences into your profession as a lactation consultant makes a big difference on how you advise and guide your clients through their journey's. So with that said, I would love to talk about how the interventions during birth can impact your lactation.

Kelly:

Yes, and this is something that I find that is missing a lot of times from lactation education. So let's say a person is pregnant and they're thinking, Oh, I need to take a breastfeeding class. It's likely that you will learn about breastfeeding, but it is not very likely that you will learn that birth interventions can negatively impact breastfeeding. That is something that. People just don't talk about and very few people will be able to incorporate that into their hospital experience when they are making decisions about what to do during a birth experience because we don't know what we don't know. So in many ways, it's a blind spot and it's not uncommon to have this lack of knowledge. But when I started figuring this out, and I'm not the only person who's ever figured this out. Of course, it's out there, but you got to dig a little bit to find this information. When I started to realize all of the things that can come together to impact lactation that happened during the birth experiences, I was absolutely floored. And so for me, this has been a main driver in part of the way that I talk to people about lactation. When I'm teaching breastfeeding class, this is a main focus. Like, we all need this information in order to be better informed and to make good decisions during labor and delivery. And, you know, it isn't, I'm, I want to say right off the bat, it's not okay to just think, well, I don't need to have any interventions because sometimes interventions can be necessary and they can be life saving for infants, for moms. It's not okay to just think, well, I'll just not interface with any interventions. Sometimes it just doesn't work like that. But when we have the information and we know, okay, I did have this one intervention. I know that it can negatively impact breastfeeding. Now that I have that information, I can make good choices going forward. And maybe I'll need a little extra lactation support. Maybe it's going to take an extra day or two for my transition to mature milk. But if you already know these things, you can, then again, adjust your experience and bring in the support that you need. So I'm not saying like, Hey, let's all avoid interventions because that's not realistic at this stage, but with the information, we can also make better choices in the aftermath of some of these interventions. So I'll just tell you a couple of them and you can decide if you want to discuss any of these in greater detail. So here are some things that impact lactation and, and the, the way that they do is in multiple different ways. And we'll get to that if you want to dive a little deeper. So first thing is the location of your birth. This can impact your breastfeeding outcomes. The person who attends your birth, and by that, I mean, is it an OB? Is it a midwife? Is it a family doctor? this attendant, the birth attendant does seem to have some impact on how lactation goes for people. Also, in terms of labor interventions, induction of labor can impact breastfeeding, In multiple negative ways, epidural, pitocin, IV fluids, vacuum, forceps, and of course, cesarean delivery has a major impact on lactation in multiple ways. So like I said, these don't all have the same outcome. Many of them have different outcomes for lactation, but there are multiple things that can go sideways here. And, you know, we can discuss any and all of these in whatever depth you want to.

Kiona:

I actually love all of the interventions that you mentioned because I think it's really important that all of the interventions you mentioned are not the first thing that comes to mind for people as something that would impact their breastfeeding experience. And I say that because one of the first things that you mentioned was where you choose to birth. Let's dive into a little bit about that.

Kelly:

The main options, as most people know, in the United States are hospital, a birth center that's connected to a hospital, a freestanding birth center, Or a home birth and all of these locations, of course, there are people that have a baby in the car or while they're, you know, out at the grocery store or whatever. But I'm not talking about unplanned. I'm really talking about your planned birth experience. All of these locations have different impacts on. Breastfeeding specifically, because all of them have different opportunities or rates of intervention and those interventions impact breastfeeding. So I'll just give you a quick example. If someone chooses to give birth at a hospital with a 60 percent cesarean rate, it is likely that whoever goes in there to give birth will have a really high risk of delivering by cesarean and cesarean is known to have multiple lactation outcomes that are negative. So in that way the birth location will sometimes dictate these outcomes. Now, it's not like a equals B It might be like A to B to C, you know it can be one of these domino effect type of things because if you have your baby at a hospital you have every chance of breastfeeding as someone who gives birth at home. However, the risks of these other interventions becomes a lot higher. And that is where we see the problems for downstream consequences for lactation.

Kiona:

Yeah, I think all of that makes so much sense. And I think even to potentially go a little bit deeper, and you can tell me if I'm wrong here, I feel like where you choose to give birth obviously impacts the kind of provider that will be with you at your birth. And then that then leads to the kind of training or opportunities that they have to guide you through your initial breastfeeding experience.

Kelly:

Absolutely. So the birth attendant is another variable. So people who choose to be attended by midwives are twice as likely to be breastfeeding at six months postpartum. than people who give birth with an OB, twice as likely. That is an incredible increase. I wonder about the research because even though this is, this is shown in the research, it may also be a combination of factors. So, you know, being a person who chooses a midwife, you might also be a person who's more inclined to breastfeed. So maybe it wasn't just the fact that you were attended by a midwife. It could be that the environment was more supportive of lactation. Your care provider had a little bit more training or an inclination to support breastfeeding. It may be a host of factors and not to discount the idea that people who choose midwifery care may also be More likely to choose breastfeeding.

Kiona:

yeah, I think that's important to mention too, because They, they kind of have a specific mindset of things, right? Like, there are people out there and there's no wrong or right. It's really just there are people out there that don't want to breastfeed because they don't want to deal with the impact that it has on their body. They don't want to deal with the commitment of time. They don't want to feel anything on their nipples. Some of them are, sexual assault abuse survivors and just don't want to deal with that. So That's a whole, a whole other layer of, some of the things that can impact and guide someone in making a decision to breastfeed.

Kelly:

Yes, absolutely.

Kiona:

Yeah. So in your book, protecting your potential for breastfeeding, do you go into detail about all of these interventions?

Kelly:

In fact, I dedicated an entire chapter to birth interventions and how the negative consequences of some of these interventions can impact breastfeeding in multiple ways. So yes, I did write quite a bit about this because I felt like. If there was one thing that generally we lack knowledge on in terms of the entire scope of preparing for childbirth and breastfeeding, it's this and a lot of times people are unaware. Just take breastfeeding out of the equation completely. People are, are unaware of the negative impacts of birth interventions on maternal health, infant health. Sometimes because a lot of these interventions are overused, we start to see this, kind of negative consequence where things that. That we don't want to happen are coming up more and more frequently, you know, I'll just use a cesarean as a, an example. It is a life saving measure. Otherwise we would not employ this for birth in any way. Right? So we want to assume that, if it's deemed necessary. It's because it's going to be a better outcome for either the infant or the mother or both of them, but because it's an overused intervention, negative consequences are also coming out more and more frequently. And the same thing happens for breastfeeding. But it's also apparent for just for maternal health and infant health as well. So I would say learning about interventions and how they can negatively impact your health is also important. But yes, in my book, I did include a lot of information about how this specific thing, the birth intervention and all the things that go along with it, how does that negatively impact breastfeeding?

Kiona:

Yeah, I think that's great. And I also kind of just want to touch on or say out loud to all of the listeners, that there's so much information out there about lactation, about birth, about interventions. And so it's so easy to get overwhelmed, to figure out what is a good source of information? So listen to your gut and, you know, take the opportunity to check things out. For example, earlier in the podcast we talked about how you, Kelly, decided to take a 12 week childbirth education course. Maybe Don't hesitate to sign up for that 12 week child birth education course because there's so much information that can be shared and then you have that much more time to create a community that you could potentially lean on postpartum, making connections with people in this space and people that are on the same page as you that are in the same area of their journey with you, so I think that's super awesome So Kelly, I think that now is actually a good time to round off this interview with a couple of closing questions and one of my first Questions here would be what advice do you give to those that are wanting to work as a lactation consultant?

Kelly:

That is a great question. So there's a lot of ways that you can work in lactation. There are several different types of certifications and people often jump from, like, an initial certification to other things as they progress throughout their career. So you, you don't have to start off by, you know. Go trying to go for the top, you know, certification. You can start with anything that you find is out there. A lot of people actually start by becoming volunteers. This is the way I got started. However, not everybody is available to be a volunteer. And a lot of people want to do this as a real job. And it is a real job, which is so nice. So, yes, if you want to work in lactation, I would suggest looking at Training, finding out what's available to you. A lot of times the trainings are available online. There may be an in person component, or you may just have to show that you provided support to so many people or for so many hours as a part of your training. There are multitudes of ways to work. You can work on your own. You can be private practice where you see clients. Maybe you see them at their house. Maybe you see them in your own home. You can work in a clinic. you could work at a birth center. You could work at a hospital. A lot of times hospitals are particular, especially in the U. S. And they do specify that they want board certified lactation consultants. Not always, though. I think there are some instances where, you know, People, they may not have any board certified lactation consultants in their area. So they hire whoever they can get, you know, so opportunities are very locally specific. So you'll have to look around and see what is needed in your area and determine for yourself. What kind of work would you like to do? And one thing I wanna stress to people is find the niche, the community that you wanna serve, and then dive into that group or that community. A lot of people who have had experience, like let's say breastfeeding twins, maybe that's their focus. They wanna help that community, the people who are, who are having multiples. And so they will build a, a lactation practice that supports the breastfeeding of. Twins or even higher order multiples. Let's say that someone is part of the LGBTQ community and found like, you know what, when I was breastfeeding, I did not get the care that I needed. It wasn't culturally appropriate. It wasn't sensitive to my identity and my needs, but I am that person that I want to support this community. Make that the focus of your work. There are so many ways to work in lactation and. It doesn't have to be that we're supporting people all in the same way. So if my neighbor was also a lactation consultant, she may be supporting clients in a completely different way than I do. my main focus at this moment is teaching lactation classes and supporting people through volunteer breastfeeding. However, I do plan to change a little bit and shift that focus with more teaching and in person consultation. So, you know, it doesn't have to be One thing all the time. It's a very, changeable practice and, and you can work in a multitude of different ways. So I would say if you're interested, find out what your options are and start taking steps to get your training.

Kiona:

I love that you said to hone in on your niche or your niche. That's so important because there are so many people out there. And I think it's really important for you to mention also that if your neighbor was a lactation consultant, you may support someone in a different way. Because it's not a competition, right? Like it should not be an area of competition. It shouldn't be, I am competing against my neighbor because she's also a consultant. It's like, Oh, Hey, I may not be the consultant for you. So let me go ahead and point you in the direction of my neighbor or my colleague, because they do better at supporting people through X, Y, and Z. You know, I think that's super awesome and really, really important to mention. So my next question is, What is one word that you would use to describe your overall profession?

Kelly:

Oh, wow. I think I would say that it is necessary. It's really important. looking back at the time when I was born and even through like the eighties, people didn't even know what lactation consultants were, you know, the, the whole profession was only born in like 1986, which for some people, that seems like a long time ago, but really it wasn't. So the fact is we need lactation care. We need people who can support this. And you know how we were talking earlier about when the community is there, when you have this really nice. community of support. Things don't seem odd. So if you're breastfeeding and you don't know anyone else that's breastfeeding and you don't have anybody to turn to in your family or your friends or your network of support, it can feel like I'm isolated. I'm doing this all by myself. I'm the only one who does this or makes these kinds of choices. But the truth is, we can tap into these communities of support and this is where lactation consultants are so necessary. And it's really imperative that people, if, if you need that support that you tap into it, and there are so many ways to find good support right now. And most of it is, online because local support, especially during the COVID years, kind of like, just went underground. I, I'm not saying that about lactation consultants per se, but a lot of, volunteer support had to go online. So online is a great place to start.

Kiona:

Yeah, I would agree. I think tapping into those resources that are both local and online is 100 percent a great piece of advice. And your word being necessary. I 100 percent agree with, just because I personally had three very different breastfeeding experiences because my second had a tongue tie that I wasn't aware of until he was older. And then my third, I had her tongue tie revised one week postpartum and it made such a big difference on my breastfeeding journey with her. We just officially stopped breastfeeding because she's two and some months, you know, but I was like, I need my body back, so we can go ahead and pause this, or just stop this altogether. You're good. You're a strong, independent toddler now. But, yeah, so I agree with all of that. My last question for you is, what is one resource we can share with our listeners on your behalf?

Kelly:

So I'll share today that I recently published a book called Protecting Your Potential for Breastfeeding and it's a thorough guide to starting from zero. If you know nothing, this will get you off on the right foot. If you already have a little bit of lactation knowledge or experience, there's still so much in there that's beneficial. It's definitely a good resource.

Kiona:

Awesome. Where can people find this book?

Kelly:

Well, it's available at Amazon at the moment. You can find it probably on any online bookseller. also the publisher has it available on their website. They are called Preclaris Press. you can find me on my webpage for more information if you would like, and that is protectingyourpotential. com.

Kiona:

Perfect. That's beautiful. Well, Kelly, thank you so much for coming on and sharing your birth stories with us, as well as sharing how those stories and experiences that you had led you to your profession and all of the paths in which you take in supporting individuals.

Kelly:

Thank you. Thanks for having me today. This was such a great conversation.

Kiona:

Yeah, of course. I learned so much during this interview with Kelly Durbin. She brought forth a wealth of knowledge from her own lived experiences, as well as from her research. If you want to learn more about Kelly or her book, don't hesitate to check her out at protectingyourpotential.com. Kelly, thank you so much for sharing your stories on the podcast with us. I'm sure many people will pay closer attention to the distance of their birth location from their home. And how interventions that happened during the birthing process and experience could impact their breastfeeding. And for those that are listening now. Don't forget to share this informative episode. And remember if you have a birth story or experience that you want to share on the podcast, head over to kionanessenbaum.com and fill out the guests request form. I would really love to hear from you and hear how your story impacted you. Also, don't forget to join the BAWKI community by following me on Instagram,@birthasweknowitpodcast Next week, stay tuned to hear the episode where I interviewed Carrie Kenner, creator of becoming a birth doula and former owner of big belly birth services. She talks about her three personal birth experiences and how she was bit by the birth bug at a very young age, leading her to where she is today. So stay tuned for all of the juicy details. And I will talk to you all again next week. All right, bye for now.

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