Dr. Rebecca Dekker – 00:00:00:
Hi everyone. On today’s podcast, we’re going to talk with Camilla Costa Goetz about how to advocate for yourself if your OB says, they don’t know how to support upright birth. Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. Hi everyone, and welcome to today’s episode of the Evidence Based Birth® Podcast. Before we get started with today’s guest I wanted to let you know we’ve got something big coming your way later this month at EBB. So, you’ve seen the claims, the so-called facts from influencers on social media but what if things aren’t always what you’ve been led to believe. We’re going to be diving deep and un-boxing a topic that’s been touted by misinformation. There are myths, stories, and the research evidence. It’s almost time for us to untangle it all. So stay tuned because we’ll be revealing more on this topic next week, and trust me you don’t want to miss this. Just make sure you’re subscribed to our free newsletter, so you don’t miss a thing. Go to ebbirth.com, our homepage at Evidence-Based Birth®, and sign up for the free EBB newsletter so you don’t miss out on the upcoming detangling that we’ll be undergoing with this fascinating topic.
Now for today, I am so excited to welcome a graduate of our EBB Childbirth Class, Camilla Costa Goetz. Camilla studied fashion in college and is now a full-time stay-at-home mom. She and her husband, who serves in the Army, are based in Washington State, although they do move frequently. Camilla spends most of her days baking and doing craft projects with her toddler. She is a graduate of the Evidence Based Birth® Childbirth Class, and she is here to share her birth story, and more specifically how she advocated her way through several challenging situations, including her husband being off the grid in ranger school towards the end of her pregnancy, dealing with POTs also known as Postural Orthostatic Tachycardia syndrome, and a desire to give birth in an upright position when her Obstetrician was not experienced or comfortable in supporting upright birth. So, we’re going to find out how she handled all of these situations. Camilla, we’re so happy to have you, welcome to the Evidence Based Birth® podcast.
Camilla Costa Goetz – 00:01:11:
Hi, thank you for having me.
Dr. Rebecca Dekker – 00:01:14:
So can you start off by just telling us a little bit about how you found Evidence Based Birth® to begin with?
Camilla Costa Goetz – 00:01:20:
Yeah, I think it was either social media, Instagram, or I think I might have just searched pregnancy podcast. I know that I was looking for information on some of the pregnancy stuff, nausea. I was having a really hard beginning of my pregnancy. And part of what I was looking for was stuff about pregnancy. But then I was also, I had a lot of time on my hands. And since I was so nauseous and miserable, I was really kind of almost obsessive about finding information on how to make labor and delivery go perfectly since I was having a tough pregnancy.
Dr. Rebecca Dekker – 00:02:01:
Mm. Yeah, I’m sure some of our listeners who are joining in right now can identify with that, just kind of like obsessively looking for information to make your experience better. And was there anything else that was going on with your pregnancy or your family situation at the time?
Camilla Costa Goetz – 00:02:17:
So there were a couple of things. My husband and I had just gotten married and we had just moved to Georgia. So it was the first time. That we were both here from Washington and now we’re back in Washington, which is amazing to be back here now that we have a baby. We had just moved to Georgia and we were both kind of the furthest away from our families that we’d been. And I immediately found out that I was pregnant and I was having a really hard time with my health. I was actually kind of very surprised that I got pregnant because. I was pretty underweight and we were trying really hard to get my weight up. Enough that I would start having periods and ovulating again. So we were shocked when I found out that I was pregnant. I was kind of terrified. I had been having a lot of health issues because I have POTS, which for people who don’t know, it’s postural orthostatic tachycardia. The main thing it affects is heart rate. So when I stand up, it can give me a head rush. But my main symptoms were constant fatigue. And then I have trouble eating and digesting. I get full really fast. And so finding out that I was pregnant and going to have to go through a pregnancy was really scary. And I was just terrified of the idea of having to take care of a baby while just being constantly sick. I had spent about a month, just bedridden. I had headaches. It was really bad. And then I found out that I was pregnant and the morning sickness kicked in. So it got worse. So that was kind of all really overwhelming at the beginning.
Dr. Rebecca Dekker – 00:04:11:
Yeah, I can only imagine. I have a friend with POTS and I remember when she was going through just the whole diagnosis process, like the symptoms are kind of vague and can be overlooked or dismissed by a physician. It can be hard to even find out what’s causing you to have these distressing symptoms.
Camilla Costa Goetz – 00:04:30:
Yeah, they’re very varied and different people have different symptoms that affect them in different ways. And when you go to a doctor and talk about your symptoms, they don’t think POTS because the only thing that points to the POTS is the getting head rush or fainting. So it’s always very hard to reach a diagnosis with POTS. I was very lucky that I had doctors who actually listened to me. And I had doctors that instead of telling me that, oh, no, your symptoms are normal. I actually had doctors tell me, oh, no, that’s very not normal when I thought that the things that I was experiencing, other people experienced. I just kind of offhandedly mentioned that I black out every time I stand up. And my doctor said, well, you’re not anemic. That’s not normal for you to be blacking out. For your vision to go completely, that’s not normal. Some people have head rushes, but that’s abnormal.
Dr. Rebecca Dekker – 00:05:28:
And when you say head rush, what do you mean by that?
Camilla Costa Goetz – 00:05:30:
So it’s just when I stand up, it can be different for different people. For me, I feel it as my head goes kind of fuzzy almost, like static in my head. I feel kind of a rushing in my ears. I can kind of hear it. And then for me, my vision often goes black and I feel off balance and weak. I can always feel it coming on. I’ve never actually fainted. I think that if I weren’t to get to the ground quickly, some of those times I would have fainted. But as long as I just get to the ground or hold on to something, the feeling passes. And that’s honestly the easiest to deal with of the symptoms of POTS. A lot of doctors like to really focus on that because that’s the main.
Dr. Rebecca Dekker – 00:06:21:
You worry about fall risk and passing out and hitting your head.
Camilla Costa Goetz – 00:06:25:
Yeah. And it’s the main thing that diagnoses POTS. For me, it’s the least of my worries with POTS. Definitely the digestive, the nausea, the fatigue, all of those things are much worse. With throughout my pregnancy, the worst thing was that I would feel out of breath and just so weak anytime I was standing up or even sometimes sitting up. I spent a lot of the first 20 weeks of my pregnancy only being able to move from the bed to the couch and then maybe get up to have a meal if I could tolerate eating. But as my pregnancy progressed, my blood volume increased. And that was actually the best thing that has ever happened for my POTS was the third trimester of pregnancy, I felt amazing.
Dr. Rebecca Dekker – 00:07:17:
Wow. Because you finally had like kind of enough blood pressure and to maintain your cardiovascular system without everything kind of collapsing down to your feet.
Camilla Costa Goetz – 00:07:26:
Exactly. Yeah. The blood no longer was pooling in my legs as much. And so I. Felt so much better. I was shocked. It was kind of overnight that I started to feel better in the pregnancy. It happened gradually, but then I got COVID. And then after I recovered from COVID, I just felt amazing. I was up and out of bed every day. By that point, my husband actually, of course, Army, he was at a point in his schooling where he had the option to go to Ranger School. In the Army, it’s one of those things that having a Ranger Tab is very important. It really sets you apart. So he really wanted that. And when we found out that I was pregnant, we knew that he would be gone my entire third trimester. And that our only communication for the entire third trimester would be one three-minute phone call every three weeks, which would equal three phone calls overall. If he managed to make it through in that amount of time, and then letters that would take a week to two weeks for him to receive and for me to receive. So it wasn’t like you get a letter every other day. Like we were writing letters every day and sending them and I would get letters that he had written two weeks ago. So we knew that that would be a really hard thing. And we were really hoping that he would make it back for the birth. He didn’t. But while he was gone, I was so glad that my POTS symptoms went away and that I felt great. I was a little bit worried, you know, fall risk, all of that late in pregnancy. But I felt amazing. I had a friend actually fly out to Georgia to spend some time with me. And we spent that whole time hiking and like actually getting out of the house. And that was really huge for me to go from being bedridden to going on five mile hikes. That really kind of shocked me.
Dr. Rebecca Dekker – 00:09:27:
That sounds like it was a huge turning point for you in your pregnancy journey. Yeah, you’re right. And it being fortunate in that that was the time when you couldn’t get support from your husband. He was in this super intensive training off the grid. Do any of you want to do a Google search on Ranger School and read about how intense it is? That’s incredible that, you know, he was going through that while you were growing this baby and knowing he might not make it back in time for the birth.
Camilla Costa Goetz – 00:09:57:
Yeah, it was pretty crazy. And then if he had made it through each phase, once you can recycle and have to redo a phase, which he ended up doing. If he hadn’t had to redo mountains phase, they call it, then he would have been back three weeks before the due date. He had to recycle mountains phase, which was very hard for both of us to find out. And then he had to make the decision. Does he want to stay in after he’s gotten to that point? Does he want to stay in and redo that phase and potentially miss the birth? Or does he want to quit and come home? And I knew that he would not ever get over it if he had to quit. And I knew that I was well prepared, partially because of the Evidence Based Birth® class. I knew that I was well prepared to give birth without him there. And I knew that my mom would be there. She was able to fly out and actually spend a whole month, maybe even six weeks with me. And so I knew that I would be fine. And it was still really hard for us when we found out that he potentially wouldn’t make it back.
Dr. Rebecca Dekker – 00:11:03:
You would have had to go all the way to your due date or past your due date in order for the timing to work?
Camilla Costa Goetz – 00:11:08:
To my due date. For the timing to work, it would have been fine if he had made it, if I had not given birth a week early. He would have made it back, I think, five days before the due date.
Dr. Rebecca Dekker – 00:11:19:
Okay. So you were hoping and… That you would hold out until that point.
Camilla Costa Goetz – 00:11:24:
I read about it. And for most first time moms, you do go over your due date.
Dr. Rebecca Dekker – 00:11:29:
Right.
Camilla Costa Goetz – 00:11:31:
You know, it’s not something that you can never count on. Anything when it comes to when you’re going to have your baby. But I was pretty sure that I would go over the due date or another thing that I was pretty sure would happen because I felt like for us, things happen all at once. You know, we got married and moved in the same two days and then got pregnant immediately a month after that. So we tend to do things all at once. Whether that is planned or just the way that things happen. So I was pretty sure that I would show up to his Ranger School graduation, this big event, and go into labor at that graduation. That’s throughout the entire pregnancy. That was kind of the joke, and I was pretty sure that that was going to happen. So I was very surprised and unprepared when I went into labor a week before the due date.
Dr. Rebecca Dekker – 00:12:20:
So let’s talk about how you set yourself up. With support and education. So you took the Evidence Based Birth® Childbirth Class. Was your husband able to attend remotely with you or was that something you did by yourself or with somebody else?
Camilla Costa Goetz – 00:12:31:
So he was able to, and it was important to me that even if he wasn’t going to be at the birth, that he kind of learn as much as possible.
Dr. Rebecca Dekker – 00:12:40:
Like have all the same information.
Camilla Costa Goetz – 00:12:41:
All the same information. And kind of, if he wasn’t at the birth, I did want him to kind of understand what was happening, both because it was important to me that he know, what I’m going through, and that he not, you know, that I was prepared. I felt like since he wasn’t there, I knew that he would be really kind of scared and anxious about me doing this alone. And I wasn’t alone. I had my mom. And actually when I thought about giving birth, I knew that my mom would be more helpful. You know, I think that he would have been there and supportive and he is an amazing partner. But there’s just something about having your mom there and having someone who has been through it and given birth. Over someone who is going to be worried and not really know how to help or how to understand what you’re going through.
Dr. Rebecca Dekker – 00:13:37:
Yeah. And I’m sure it depends on your mom. Like it sounds like-
Camilla Costa Goetz – 00:13:42:
Exactly.
Dr. Rebecca Dekker – 00:13:42:
Your situation, that was great. I know for both me and my younger sister, we were like, absolutely not. Our mom cannot be there when we give birth because of her, her anxiety, you know, in worrying about us, but everybody’s different, you know, and I’ve talked with a lot of our Childbirth Class graduates who felt really good about their mom being their support person.
Camilla Costa Goetz – 00:14:03:
Yeah.
Dr. Rebecca Dekker – 00:14:03:
It’s amazing for you.
Camilla Costa Goetz – 00:14:04:
It can be very different for everyone. For me, having my mom there was definitely the best person that I could have had as my support person. I have a brother who is 15 and a half years younger than me. And my mom tried to have a home birth with him. So I was there for all of that. And so I saw how she dealt with that and that home birth, it went okay. She labored for very many days and then eventually had to get transferred to the hospital and have a C-section. So that was kind of my experience with birth before getting pregnant. And a lot of people hear that and they’re like, oh, you must be so scared. But my mom was so calm the entire time. And, you know, even after being in labor for three days, she was still so focused. And so I knew that she would be a support person that would stay calm and that would kind of know what I was going through. I had seen that, which I think as a 15 year old, that was a really good experience. And I also saw like, kind of the side of like when things kind of go wrong, how it can be totally okay. I know that for some people, it doesn’t go perfectly okay when things go wrong. It did for my mom. And it was really nice to see how even when things don’t go as planned, they can still be just fine.
Dr. Rebecca Dekker – 00:15:29:
Mm-hmm. How powerful for, you know, a 15 year old to witness that. That’s incredible.
Camilla Costa Goetz – 00:15:34:
Yeah. And I had a friend there too. She, you know, close friend for many years and she really wanted to be there. And my mom was like, yeah, have the teenage girls here at the birth. And we were there for very many days, very many days without sleep, just watching and waiting for my mom to have this baby. It was a very interesting experience for two teenagers. And it was very exciting being there for that. I know that different people have different ideas about whether siblings should be at births. I think that obviously it kind of depends on the age, but I loved being there even though things got intense at points. It was really cool.
Dr. Rebecca Dekker – 00:16:19:
That’s awesome. So taking us towards the end of your pregnancy, you’d had the EBB Childbirth Class. You had support lined up. What kind of birth were you planning?
Camilla Costa Goetz – 00:16:31:
So I knew that I wanted unmedicated vaginal birth and that was really important to me. I both thought that I had looked at the risks and the benefits of epidural and all of that. And I definitely thought that the risks outweighed the benefits. And I know that I have a high pain tolerance. I know that specifically for that kind of thing, I had an IUD in the past and I didn’t feel the insertion. So I knew that like in that way, I don’t feel pain as much as a lot of women do. I tend to not have that bad of period cramps, all of that. So I felt confident that I could do it. I also was really scared of the epidural, to be honest. I really don’t like the feeling of being numb. I really don’t like things on my back. I was very scared of the needle and I was very scared of not being able to be in control of my birth in that I wanted to be able to feel everything that was happening, whether it was pain or just the sensations of contractions, the head moving down, all of that. It was important to me that I could feel that so that I could be the one in control and not have to.
Dr. Rebecca Dekker – 00:17:44:
Kind of like cede that control to somebody else because you didn’t know what your body was doing.
Camilla Costa Goetz – 00:17:49:
Exactly. That was really scary for me. And honestly, I was never scared of childbirth. I was scared of having doctors dictate my experience with it. So that was part of why doing the Evidence Based Birth® class was so important to me. It was because I wanted to be so overprepared. I wanted to be able to tell the doctors that I knew what I wanted and that I knew that it was evidence-based and that it wasn’t just, you know, some crazy idea that I had. So that was all really important to me. So that was kind of my plan was to go in. And honestly, I don’t think this is a good idea. All I really wanted was to give birth alone and not be at the doctor. I would have liked to have a midwife, but at that point, I knew that that wasn’t an option in Georgia with the Army health care. I knew that that wasn’t an option. I was tempted to just stay home and just give birth without any assistance. And I knew that that was not going to be as safe option. I know people do it and I know that it goes well, but…
Dr. Rebecca Dekker – 00:19:00:
So you were that kind of wary of doctors and hospitals, but you were tempted to go unassisted at home.
Camilla Costa Goetz – 00:19:07:
For me, it was not so much that I was that wary of doctors and hospitals. That was definitely part of it, but also that I was that confident in my body and the ability to do that. Kind of that combination of I knew that I could do it and I was scared that that would be taken away from me.
Dr. Rebecca Dekker – 00:19:25:
You wanted to be in the driver’s seat.
Camilla Costa Goetz – 00:19:27:
I really did. I might have. A little bit of control issues sometimes. I definitely like to be in control and especially when it comes to my healthcare because I’ve had POTS and you know I’ve kind of gone through so many different doctors. And even though my doctors have been wonderful, some of them, and I got a diagnosis faster than most people do. I have also had a lot of doctors be the opposite and kind of tell me that, oh, no, your symptoms are not what you think they are. You know, I’ve been very dismissed sometimes by doctors. And I’ve also been led in the wrong direction by doctors for some of my health issues and had things get worse because of advice that doctors have given me. So I definitely knew that I needed to had experience having to advocate for myself in that way. And I’ve also had experience knowing that I need to advocate for myself while I’m in a doctor’s office and being so overwhelmed that I couldn’t and kind of confused. And I know that in the birth class, we talked a lot about kind of how doctors can be an authority figure and how that can be hard to go against. And I’ve definitely experienced that in other areas of my health care. So I was really scared that in the moment, I wouldn’t be able to advocate for myself. And then I also had a couple of experiences with the doctors that I was seeing at the Army hospital.
Dr. Rebecca Dekker – 00:21:00:
Okay. So you were planning on giving birth with OBs at a military, at an Army hospital in Georgia.
Camilla Costa Goetz – 00:21:06:
Yes, that was the plan originally.
Dr. Rebecca Dekker – 00:21:08:
Okay.
Camilla Costa Goetz – 00:21:08:
You know, I discussed with my family, with my husband’s family, flying back to Washington and having a home birth. That was what I wanted. But after discussing it with my husband, I knew that there was no way that he would make it to Washington after Ranger School to be at the birth. So I knew that I couldn’t do that. If he didn’t make it back for the birth, it would potentially, he would be delayed in Georgia even after getting out of Ranger School before he would be able to come see me and baby, if I gave birth in Washington. So we knew that I had to give birth in Georgia. I tried to look into doing a home birth in Georgia and it was more complicated than in Washington. They have different laws and I couldn’t really figure it out. It seems to me, at least like in Georgia, the laws make it difficult kind of intentionally to have a home birth. And I knew that my insurance wouldn’t cover it. They’re very specific about.
Dr. Rebecca Dekker – 00:22:06:
Do you have TRICARE?
Camilla Costa Goetz – 00:22:07:
Yes, I have TRICARE. In a lot of ways, TRICARE is wonderful. We have everything covered, but also it’s very specific about where and when and how you do things.
Dr. Rebecca Dekker – 00:22:19:
Mm-hmm.
Camilla Costa Goetz – 00:22:20:
So I knew that one of the first things I did when I started OB care was they made me sign something that I would give birth at that hospital, which that made me uncomfortable because I was not sure that that’s what I wanted. And here they were saying, you have to sign this document.
Dr. Rebecca Dekker – 00:22:38:
You have to commit right now to this hospital.
Camilla Costa Goetz – 00:22:40:
Exactly. And later, after talking to my OBs, they were like, oh, that’s not a legally binding document that is just saying that you’re receiving care here. So that was weird for me. I wasn’t sure what I was signing exactly, but I think that it was just saying that I was receiving care there. I don’t know. But I had a couple of bad experiences with doctors there and that made me even more wary. And then I was also seeing a MFM, a maternal fetal medicine doctor, partially because of the POTS and then partially because I had a ventricular septal defect as a child. So they, you know, I just had additional scans that they had to do on the baby, make sure that her heart was okay. And the maternal fetal medicine doctor asked me, do you want to give birth at the Army hospital? Or do you want to give birth at the civilian hospital? She said that she could mark me as high risk. And that then I would have to give birth at the civilian hospital. So then that would kind of give me a little bit more control over who my OB would be. At Martin Army, I would have had an OB, but obviously it’s whoever’s on call. And I knew that there were a couple of doctors that I would be absolutely okay with giving birth with. So I had intentionally made sure that I had my OB appointments with a different doctor every time I wanted to meet everyone. Because I knew that, yes, I can request an OB, but really it’s going to be whoever’s on call. So I had met all of them and I had a couple of wonderful doctors who were very attentive. And then I had a couple that… I knew I absolutely did not want in the room with me. I had one doctor who looked at my heart rate and asked if we would like to schedule a C-section when I was 20 weeks pregnant because my heart rate was 120. I didn’t feel like 120 was a high heart rate and I didn’t feel like that made any sense. So I asked him, well, why are you recommending that I schedule a C-section now? And he said, well, giving birth is like running a marathon. Do you think that you could run a marathon right now? And I thought that that was the strangest thing to say. Yes, giving birth is like running a marathon. That is an analogy that is often used. But no, that does not mean that you have to be able to run a marathon to give birth.
Dr. Rebecca Dekker – 00:25:13:
Most of us couldn’t have a baby.
Camilla Costa Goetz – 00:25:15:
Yes. And then I said, well, a lot of women give birth. And I would say that vast majority could not run a marathon, especially at 20 weeks pregnant. You’re asking me this. And he said, well, if you run up a flight of stairs, do you feel out of breath? And again, I was like 20 weeks pregnant. Yes, yes, I get out of breath when I run up a flight of stairs. And he said, you just want to think about a C-section because giving birth is really hard on your body, so you should really just think about it. And so I knew that that was not the kind of person that I wanted in the room with me. And then there were a couple other things about him. He kept putting things in my chart that were completely incorrect. And so I knew that if I was in a situation where I had to give birth with him in the room, that I would not feel comfortable and that I would likely not have the birth that I wanted. And later, I have since become friends with another woman who gave birth in the same month that hospital. And that doctor took her into a C-section when she was nine centimeters dilated, that she feels like she didn’t need. The baby was doing fine. So hearing that and hearing her stories about having had him as her OB, I feel like I definitely made the right choice in making sure that he was not the one there. And I wish that she and I had met before so that I had been able to kind of share with her, my experiences and recommend that she meet him ahead of time. Because I think that things could have gone differently for her. But because of that experience with that doctor and then just a couple other experiences and kind of knowing my experiences at the Army hospital in general, I felt like the civilian hospital was a better choice. And then I was able to find an OB that was actually a block away from my house. It was a small private clinic that did births at the hospital that they wanted me at. So I was able to walk to the rest of my OB appointments at that point, which was wonderful. And I selected an OB. I specifically wanted a female, and I wanted someone who had had experience with POTS and would support me in an unmedicated birth. So I selected this doctor. I talked to her. It was a good fit. They never mentioned to me that she had a planned vacation the two weeks surrounding my due date.
Dr. Rebecca Dekker – 00:27:53:
Oh no.
Camilla Costa Goetz – 00:27:54:
So I didn’t actually end up having her my last two prenatal appointments or the birth, which was kind of disappointing since I had gone through the trouble of intentionally selecting this OB, but it all turned out fine. I ended up with a male doctor, which is not what I had wanted just because I felt like I wanted somebody who could more understand my body in that they would have had similar experiences, even if you haven’t given birth, feel like, knowing what it’s like to be in a woman’s body, I felt like that would be helpful, but I did like this doctor. He was pretty good.
Dr. Rebecca Dekker – 00:28:31:
Camilla, take us to the day your labor story began.
Camilla Costa Goetz – 00:28:36:
So I’ll actually start the day before I really went into labor. I remember walking through Walmart. My mom and I were doing the kind of last minute things. We had just, you know, taken my car to get the brakes checked, oil change. We did a bunch of things that day. And then we were walking through Walmart, you know, we were buying diapers. We were planning on packing the hospital bag the next day. And I remember saying to my mom, my Braxton Hicks feel really strange today. And, you know, my mom was like, well, your due date is in a week. Do you think you’re in labor? And I said, no, of course not. My due date’s not for a week. I think that it’s just the way that I’m standing. When I walk around, the contractions stop. It’s definitely Braxton Hicks. And then the next day I woke up and there was kind of a gush of what I assumed was discharge. Looking back, it’s very obvious that it wasn’t. But, you know, I showered. I got ready for the day. We had big plans for that day. We were going to stock the refrigerator, make sure that everything was there. We had a couple of meals that we were planning on making to put in the freezer that day. We were going to pack the hospital bag and install the car seat.
Dr. Rebecca Dekker – 00:29:50:
And your husband still wasn’t due to come home for a little while yet.
Camilla Costa Goetz – 00:29:53:
Yeah, he was a week out.
Dr. Rebecca Dekker – 00:29:55:
Okay, so it was a week.
Camilla Costa Goetz – 00:29:56:
He was five days out. And I knew that I had no way to contact him other than I could send an emergency call to Red Cross. And they kind of really stress that calling Red Cross is life or death situations. And we kind of discussed, well, birth is a life.
Dr. Rebecca Dekker – 00:30:13:
A life?
Camilla Costa Goetz – 00:30:14:
So we discussed, like, well, do I call him when I go into labor? And he had said, yes, call me when you go into labor. And I had decided that I was not going to do that. I knew that there was no, like, they didn’t have the option to leave. He was in a different state. He was in Florida at that point. And he would just worry then if he knew that I was in labor. I decided that I would only call if there was some sort of actual emergency situation, or I would call and tell him that we had a baby. And so at that point, I was still very sure that I would not give birth before he came back. I kind of thought that I could just, like, will it to be. I could just hold the baby in. I know that that’s not a rational thought. I know that babies come when they come. And I knew that at the time, but I still really thought that I could control something that is very much out of my control. So at that point, I was getting ready for the day and I was still having kind of discharge is what I thought was kind of dripping. So I put a pad in and I decided that let’s just go run our errands. You know, I had the thought, like, hmm, maybe. Maybe this is my water breaking. But no, it can’t be. I was sure that it couldn’t be. So we got in the car and I drove to downtown Columbus, Georgia. And I stood up out of the car and I said, mom, how wet are my pants? And she looked at me and she cracked up because they were wet down to my ankles. And I knew that, but I was just so determined not to have a baby that day that I was kind of just like, no, they’re not that wet. It’s fine. And then. Once my mom was like, no, Camilla, your water is definitely broken. You’re in labor. Do you feel contractions? I started, like, actually paying attention to my body. Usually I am a person that is very much in my body. I pay close attention to every sensation in my body. Having POTS. I’m often paying close attention to what’s happening, making sure that, you know, kind of watching out for different symptoms, just paying very close attention to sensations in my body. Clearly in that moment, I was in denial enough that I was kind of stepped out of my body and not paying attention to what was happening. Because as soon as I started paying close attention, I noticed that yes, I was having contractions. And that really surprised me because throughout all of the research that I had done, even talking in the podcast, talking to my OBs, everyone made it seem like it would be very clear the difference between Braxton Hicks and labor contractions. I could not feel my labor contractions. I could only see them and I could feel them to the touch, but I couldn’t like everybody described a sensation that I would feel pain. I didn’t feel that I could see them and I would.
Dr. Rebecca Dekker – 00:33:25:
You could palpate them with your fingers.
Camilla Costa Goetz – 00:33:26:
Yeah, I could feel, oh, everything’s hard now. Things are happening. So I got in the car and I drove home. And halfway through driving home, I had the thought, I’m in labor. Should I be driving right now? Should I have switched spots with my mom? But, you know, we were only seven minutes away from the house. It was fine. And so I got home and we started preparing. I called my OB and they were definitely like, oh, your water broke. You need to get to the hospital right now. I, on the other hand, I knew that I wanted time to prepare. I needed it. I hadn’t packed my hospital bags. The car seat wasn’t installed. I wanted to eat a meal. I knew that they would not allow me to eat at the hospital. That was one of the things that I tried to convince my doctors that I should be allowed to eat. And they were very clear that that was not an option. And I don’t know what they would have done to stop me, but I felt like the best thing to do was probably to eat something. And then I also had the thought that, while I’m still in early labor, I can’t feel my contractions. I should take a nap. I’m going to need this energy. Of course, I couldn’t fall asleep. I was too anxious. Isn’t quite the right word. More excitement. But, you know, definitely a lot of thoughts.
Dr. Rebecca Dekker – 00:34:49:
It’s hard to slow your brain down.
Camilla Costa Goetz – 00:34:51:
I could not slow my brain down enough to take a nap. But I ate a big meal and we started preparing. I got a call from our next door neighbor, who was actually a very good friend of my husband. And by that point, he was a good friend of mine, too. And he called asking if he could use our washer and dryer. And we were very lucky that he happened to move in next door. So I said, actually, Ian, come over, please do your laundry. But also, I’m in labor. Will you take care of the pets for the next day or couple of days? And come over and we’ll talk about how this is going to go. So he came over. He did his laundry. He was wonderful and went and did Target pickup for us. Got the last minute things, you know, stock up on a couple of things before the baby came. And then as I was in labor, I was starting to feel painful contractions. I had a TENS unit attached to my back. We got a knock on the door, and it was actually a couple of friends of my husband’s from the Army that were in the class that he was supposed to graduate in for Ranger School. And they didn’t have my phone number or anything. They just had a feeling that they should come check on me that day. And they actually spent a long time just sitting with me while I was in labor. It was very sweet. You know, these guys that I had met once maybe. So that was funny. And now we actually, one of those guys is, stationed here in Washington with us. So that was kind of a nice and very funny thing for us to have happen, which was that as my mom is running around, I’m sitting there, you know, getting all of the questions-
Dr. Rebecca Dekker – 00:36:39:
Chatting with your friends?
Camilla Costa Goetz – 00:36:40:
Yeah, talking with my husband’s friends, getting all of my questions about what happens after Ranger School answered. So like, I was able to find out exactly what the next couple of weeks would look like for me and my husband. So that was really an interesting thing that we were not expecting. I think that they were very shocked to come in to me in labor. And we could tell that they were very hesitant to leave until me and my mom were in the car to go to the hospital. They were, I think, a little bit worried that I was planning on just giving birth right there, living. But then we headed to the hospital. And at that point, my labor was very much progressing. Then, you know, I kind of labored at the hospital. And that was… not as nice as laboring at home. The getting poked and prodded moved from room to room. There was one point where I was left in a room for about 25 minutes and my mom wasn’t there and they, kind of left me in a room and I was cold and… it was… you know, I was at a point in my labor where I was puking a lot. And so I was just kind of confused. And there were no nurses. And I couldn’t see anyone even outside the room. And so at that point in my labor, I was like, wow, I made the wrong choice coming to the hospital. What is going on? But then they moved me to my room. I met my nurse. And she was wonderful. At that hospital, they have a nurse for the mom and a nurse for the baby. So I met both of them. And then the nurse for the baby obviously left. She wasn’t there until I actually gave birth. And my nurse at the hospital was wonderful in that very clear that she was there to advocate for me when I couldn’t. And so she asked me my birth preferences and wrote them on a whiteboard there in the room. And she knew that I didn’t want eye ointment and she knew that I didn’t want an epidural. So she wrote down like. On little bassinet that they would put the baby in. She actually put a sticky note in it that said, no eye ointment. She wrote it on the board. And then… I had nurses come in every half hour or so with all the equipment to place an epidural. And the moment they would walk in and say the epidural, she would kick them out and say, no, she doesn’t want an epidural. It was interesting. Everybody seemed shocked. It seemed like I’m sure that this can’t be, but it felt like I was the first person at that hospital to ever give birth without an epidural. And that was interesting, having them just assume that that’s what would happen. At that point, I was still very certain of my decision. But if I had been wavering, it was very nice that she was there to make sure that I got what I wanted. Obviously, if I had changed my mind, she would have called them right in. She was there to make sure that I didn’t get pressured into anything that I didn’t want. And, you know, my labor progressed normally. And then as I got to eight centimeters dilated, all of a sudden my body was pushing. And I let them know I want to push. And she checked me and said, you’re only at eight centimeters. I really don’t want you to push yet. Hold it in. And I was confused, but they started throwing things out like, oh, cervical tearing, that’s an issue. I’ve since learned that cervical tearing happens and it’s not as big of a deal as they seemed to make it out to be. But that was the hardest part of my labor was trying not to push when my body very clearly wanted to push. Then finally, we were able to get me to 10 centimeters and my doctor came in. And I had already talked to him about the fact that I wanted to labor, in whatever position I wanted to, I wanted to give birth in whatever position I wanted to. He said. Oh yeah, of course, I want you to be comfortable. Labor in whatever position you want to, and then just get on your back when you’re going to push. And I… like, no, you’re not understanding me. I want to give birth in whatever position I want to. And he was very surprised and said, but how am I going to protect your perineum if I can’t have a good view? And I was kind of confused because I figured that protecting my perineum was kind of up to me and how I breathe and how I push. That’s what I’ve kind of seen from the evidence. I know that active management is an option, but I was hoping to just kind of do that myself, even if I felt like holding the perineum was important. But he really thought that he was going to be the one to prevent tearing. And I just told him I want to give birth in whatever position feels comfortable for me. And he… said, well, I can’t stop you from that. I’m not going to hold you down, but I feel uncomfortable with that. And I told him, you’re going to have to get over that because I, it’s more, it’s more important-
Dr. Rebecca Dekker – 00:41:50:
You’re going to have to manage your feelings of discomfort.
Camilla Costa Goetz – 00:41:53:
I was like, well, it’s really more important how I feel. So sorry, but you’re going to have to get over that. And he kind of took a moment and he said, okay, I think I can figure it out. Which I thought was funny because I was like, you have to. And then once I was actually pushing, I was kind of on hands and knees and I was going between being upright using the squat bar up on my knees and then pushing kind of on hands and knees. And, you know, I was very focused on what I was doing. But he at one point said to my mom in a very excited manner, wow, I’ve never had this view and it’s actually working really well. I can see everything and it’s fine. I can do this. And then he kind of did some calculations in his head, not actual calculations, but like kind of trying to rearrange in his mind, like, okay, as the baby comes out, I have to turn the baby this way instead of the other way, because I was on my hands and knees. And I remember thinking at the time, like, wow, this is very different for him. And I’m really like, changing his whole way that he thinks about birth right now by doing this, which is funny because, you know, he’s been practicing for 20 years or something. And this is the first time that someone has not given birth on their back for him. And that was kind of like. Well, maybe now he’ll be able to assist other women in…
Dr. Rebecca Dekker – 00:43:23:
Yeah, maybe this will have a ripple effect in the future.
Camilla Costa Goetz – 00:43:26:
That was my hope. But then, you know, I had my baby. The only thing that I didn’t get exactly with the birth was I wanted delayed cord clamping until cord was white. Since I was giving birth on hands and knees, when I turned onto my back, I was on top of the umbilical cord. And in the position that I was in, they were trying to hand me my baby and I couldn’t reach her. So they ended up clamping and cutting the cord. But my nurse later told me, actually, it had pretty much stopped pulsing. It happened really fast, but it seems like your baby got most of the blood. So I don’t know how true that was, but it seemed to be fine, she is obviously very healthy. But it was very interesting giving birth in this setting where clearly most people have epidurals. Most people go along with exactly what the doctors tell them to do. And it seemed like I was very much an anomaly there.
Dr. Rebecca Dekker – 00:44:23:
Way to go, Camilla, to stand up for yourself. And it reminds me of, I don’t know if any of our listeners have heard of discussions about setting boundaries and how when you set boundaries with someone, like this is what I’m willing. And not willing to tolerate with my body. You know, you’re not responsible for managing their feelings. And your doctor is feeling confused, nervous, worried, because it’s something he’s never done before. But like, like you told him, like, you have to figure this out. That’s not my job to manage your feelings while I’m literally birthing a baby out, you know?
Camilla Costa Goetz – 00:44:57:
Yeah, very interesting, because I felt like he kind of made it about him in that moment. And I was kind of laughing at him like, no, you’re confused. It’s not about you. It’s about me right now. But I was very glad that… he didn’t really fight me on it. He just was like-
Dr. Rebecca Dekker – 00:45:18:
Yeah, but you also stood firm and it would be really, really easy for anybody to kind of fold in that moment and give in because that’s very intense pressure. You know, there’s a, like almost like a power differential, the authority figure and you, and you’re in a hospital gown and vulnerable and they’re, you know, dressed in whatever clothes they have standing over you. And it’s, it’s not always easy. So Camilla, that’s like, you know, huge applause to you and, and figuring that out in that moment.
Camilla Costa Goetz – 00:45:50:
Yeah. Made me feel much more confident in general to go against doctors because in that moment, I just felt so- confident.
Dr. Rebecca Dekker – 00:45:59:
It sounded like you were like the grown-up in that moment.
Camilla Costa Goetz – 00:46:02:
Yeah, I definitely was like, wow, I am feeling like a mom right now. Like I am kind of mothering my doctor right now. And that I’m like, I’m gentle parenting you.
Dr. Rebecca Dekker – 00:46:17:
But you did it in like a respectful way too, you know, that didn’t lead to conflict or, you know, kind of a power struggle. It was more like you just stood your ground and said, you know, you’re just going to have to figure this out, but you weren’t mean about it.
Camilla Costa Goetz – 00:46:33:
No, me and the doctor were both kind of laughing at the situation where he was like, no, but how do I do this? And I was like-
Dr. Rebecca Dekker – 00:46:40:
To be fair, like, yes, he was probably educated in a system that trained him to do it that way and no other way. And so, especially with a high risk liability profession like obstetrics, it probably would feel like you’re out of control when you’re doing something that way. Yeah.
Camilla Costa Goetz – 00:46:59:
Yeah, I mean, I was very surprised. How in that hospital, like… every time they came in, they were like, they would practically like fall to their knees and in shock and awe that I was giving birth without an epidural. And they were like, I had nurses go tell other nurses. And after I gave birth and the nurses would come in and they’d be like, are you the one that just gave birth without an epidural?
Dr. Rebecca Dekker – 00:47:25:
Yeah.
Camilla Costa Goetz – 00:47:26:
I don’t know that they even do statistics on epidurals like they do for like episiotomies and stuff. But I would be curious to know how many people give birth there without epidurals, because it definitely seemed like something that had like-
Dr. Rebecca Dekker – 00:47:43:
Been very rare. Yeah. So Camilla, one more thing I want to hear before we have to go. And that is what was your husband’s reaction when you called?
Camilla Costa Goetz – 00:47:52:
So that was a funny thing, which is that I didn’t call him. He called me. So I give birth at about midnight. So then I knew that at 8 p.m. the next day, I would get a phone call from him saying either I’m coming home because I graduated or I’m coming home because I quit. And I-
Dr. Rebecca Dekker – 00:48:11:
I didn’t complete it.
Camilla Costa Goetz – 00:48:13:
I’m not going to complete the course. So he called and said, I graduated and I’m coming home. I’m so excited. And I was able to top that and say, well, actually, I just gave birth to your daughter. You get to meet her in four days. And then it was pretty exciting, you know, that moment where… We went to pick him up. He got one day to come home. Spend the day with us. And then he had to go back and sleep in the barracks. And then the next day was graduation. And that moment where we went and picked him up that day. Me and my mom and baby went out and, you know, Georgia in the summer. It was the middle of July, you know, in the 90s every day. And we’re there in a parking lot. And he came out and he got to meet this tiny little baby. And everyone there was like, how old is this baby? And I got to say, oh, she’s three days old. And then we went to his graduation, too. And, of course, I had had all the doctors tell me, you know, she has no immune system. Don’t take her anywhere. And here I am at this graduation with hundreds and hundreds of people. Of course, my husband grabs her and immediately starts passing her around. He’s all excited to show all of his Ranger School buddies. Oh, look! Here’s my daughter. So that was kind of anxiety-inducing. And the other thing that happened right in those couple of days is that it was really important to him that his family come to his graduation. So I got to host the in-laws when I was three days postpartum.
Dr. Rebecca Dekker – 00:50:06:
So Camilla, it sounds like it was triumphant, but it was also a lot.
Camilla Costa Goetz – 00:50:11:
It was a lot. Yeah. Again, me and my husband, we do things all at once.
Dr. Rebecca Dekker – 00:50:16:
Yeah.
Camilla Costa Goetz – 00:50:17:
So there was that whole week. And then we were very lucky, and he got to choose when he took his paternity leave. And we knew that we were going to be moving, so we decided for him not to take his paternity leave right away, especially since my mom was still there. We ended up being really lucky, and he had some downtime in between Ranger School and his next thing, where all he had to do was go in for formation once a day. So we had two weeks that weren’t technically his paternity leave, so that didn’t take away from that time.
Dr. Rebecca Dekker – 00:50:50:
Didn’t count towards that, yeah.
Camilla Costa Goetz – 00:50:51:
But that he got to just spend, you know. Recovering from major school, which was also a whole thing. And, just spending time with me and the baby. Yeah, so that was my birth experience, and it was so wonderful and both very much according to plan and very much not according to plan in the most… wonderful way that immediately after giving birth. What I said to my mom was, I want to do that again, which throughout my entire pregnancy, I’d said never again. I can’t do this. I can’t do this again. I can’t do pregnancy again. But immediately after giving birth, I knew that I wanted to do that part again.
Dr. Rebecca Dekker – 00:51:37:
Aww. Well, Camilla, thank you so much for sharing your story and your, you know, your lovely family and hopefully educating others about ways to stand firm and trust your body.
Camilla Costa Goetz – 00:51:50:
Yeah, yeah. I hope that people can do that for themselves because not only was giving birth that felt so triumphant, but also knowing that I did it in the way that I wanted to. That felt really amazing and it made me feel more confident in other areas of my life that I can stand firm and do. Yeah.
Baby – 00:52:17:
Try it!
Dr. Rebecca Dekker – 00:52:19:
All right, can you say bye-bye?
Camilla Costa Goetz – 00:52:23:
Okay.
Dr. Rebecca Dekker – 00:52:23:
Can you say bye-bye?
Camilla Costa Goetz – 00:52:24:
Can you say bye-bye.
Baby – 00:52:25:
Bye.
Camilla Costa Goetz – 00:52:26:
Yeah.
Dr. Rebecca Dekker – 00:52:27:
Bye. Thanks, everyone, for listening. Bye. This podcast episode was brought to you by the Evidence Based Birth® Childbirth Class. This is Rebecca speaking. When I walked into the hospital to have my first baby, I had no idea what I was getting myself into. Since then, I’ve met countless parents who felt that they too were unprepared for the birth process and navigating the healthcare system. The next time I had a baby, I learned that in order to have the most empowering birth possible, I needed to learn the evidence on childbirth practices. We are now offering the Evidence Based Birth® childbirth class totally online. In your class, you will work with an instructor who will skillfully mentor you and your partner in evidence-based care, comfort measures, and advocacy so that you can both embrace your birth and parenting experiences with courage and confidence. Get empowered with an interactive online childbirth class you and your partner will love. Visit evidencebasedbirth.com/childbirthclass to find your class now.
