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Mother’s Day (for us too – baby pics inside!)

May 10, 2020 by Dr. Tiffany Caplan, DC, CFMP, IFMCP & Dr. Brent Caplan, DC, CFMP, IFMCP

As many of you know, we were patiently awaiting the arrival of the newest addition to the Caplan family and just in time for our first Mother’s Day, we are pleased to announce her arrival!

Audrey Ella Caplan happily joined us the morning of April 23, 2020, in the comfort of our home, in Ventura California, measuring in at 6 pounds 12 ounces and 19 inches long. 

Yes, we delivered Audrey at home – and starting her life with her own style, she made her grand debut into the world feet first as a complete breech. We are so blessed she is finally here and healthy – and thank you to everyone in our community who kept us in their hearts! 

Audrey Ella

Audrey’s Birth Story:

After a fairly uneventful pregnancy, other than the obvious worry about the #GlobalPandemic, we found out Audrey was breech in the last month. 

Very often, babies can still turn, to be head down, during the final weeks of pregnancy. When they don’t, however, the only option most providers offer is scheduled cesarean section surgery. 

There are very few providers that are still practicing vaginal breech births, and most schools do not even teach this approach at all anymore. 

Our original plan of giving birth in the local birth center was suddenly not an option if she did not turn head down. Being in California, our midwife was not even legally allowed to deliver a breech baby, and we were obviously faced with a major dilemma. 

Not to mention the obvious risks of being in a hospital right now, we also know how important it is for a baby to be delivered vaginally for proper health and development and wanted to avoid a cesarean section at all costs if possible.

You may not know this, but our gut microbiome plays such an important role in our overall health and the health of our immune system. The bacteria that live in and on us directly contribute to how our bodies respond to our environment. In fact, our own human cells are outnumbered by this beneficial microbiome by 10x! 

Which brings us to the importance of making sure babies develop a healthy and robust microbiome, since babies’ guts are essentially sterile until birth – a blank check, so to speak. 

Research shows that colonization of a baby’s gut happens on their descent through the birth canal. This literally creates the beginning of the baby’s immune system and sets the stage for lifelong healthy immune development. 

Babies born via cesarean section are not inoculated by these beneficial bacteria that are normally acquired by going through the birth canal, and therefore they do not have the same start for the creation of their microbiome – and therefore their immune system. 

We were 100% in agreement: This is NOT the time to risk our baby’s immune system. 

This was why it was so important for us to pursue natural childbirth if possible. Working with autoimmune patients and people with immune system dysfunction every day, we know how vital this early start is for overall health and wanted our daughter to have the best possible start in life with a healthy immune system.

We tried weeks of exercises meant to help the baby turn, basically laying upside down trying to coax her into position, regular chiropractic adjustments and Webster technique, acupressure, yoga and exercise ball. She just didn’t want to turn! 

We were then referred to a local obstetrician that was known for helping breech babies “turn” through a procedure called external cephalic version where they literally try to turn the baby head down externally by force. It was not a pleasant procedure and came with its own risk of emergency cesarean section and was unfortunately unsuccessful after two attempts. The only option we were then given was the last thing we had wanted -a planned cesarean section.

We were devastated. We felt defeated and abandoned – and very, very worried. At every turn, everyone was telling us a C-Section was the only avenue we had, and shortchanging Audrey’s start to her microbiome was the price we would have to pay. But we weren’t going to give up that easily. 

Despite everyone telling us that natural birth could not be done, despite multiple doctors, healthcare providers, family and friends urging us to go the “safe route” and have cesarean, we knew deep down there had to be another way. Our bodies are innately intelligent, and all the ultrasounds pointed to an otherwise perfectly healthy baby. 

Women had been giving birth naturally since the beginning of time. Before prenatal ultrasounds became a standard screen in the 1950’s, women gave birth to breech babies without knowing ahead of time they were going to be breech. It wasn’t until recently, when in the early 2000’s, that doctors stopped being taught how to deliver breech babies vaginally and cesarean section became the norm. (You can learn more about this in the documentary “Heads Up – The Disappearing Art of Vaginal Breech Delivery”.)

We knew deep down there had to be a way to still have a natural birth, regardless of being breech. Audrey’s healthy start was our north star.

We were also faced with having tested positive for being carriers of group B strep (a common bacterium which is known to potentially cause complications in newborns) and were told the standard of care was intravenous antibiotics during labor, to essentially sterilize the birth canal and decrease the risk of infection. 

We wanted to avoid antibiotics for the same reason we wanted to avoid C-Section surgery – the most important part of being born through the birth canal is being inoculated with your microbiome.  We didn’t want to jeopardize Audrey’s microbiome and immune system by sterilizing the birth canal. 

We made the difficult decision to only intervene if necessary, at the time of labor.

And to complicate matters to the worst degree, due to the current global virus, hospitals are not allowing support in the hospital room for the birth, so our midwife and doula would not even be allowed to assist, if we ended up needing a hospital birth. (Thankfully in our region, spouses were still allowed to be present…. But our team would not be there to support Dr. Tiffany.) 

If you’re on the edge of your seat, we are deeply grateful to share that our story has a happy ending!  

Just weeks prior to her arrival, we were blessed to find an amazing team to help us welcome Audrey into the world. 

Dr. Stuart Fischbein is one of the few obstetricians that still practices vaginal breech birth. He welcomed us with open arms, at almost the end of our pregnancy, and with an open heart assuring us that breech is really just a variant of normal. He confidently led us through a conversation that natural breech births are just as safe, if not safer, than the standard cesarean section. 

Us with Dr. Stu.

Dr. Fischbein specializes in assisting “complicated” births (breech, twins, etc.) outside of the hospital setting, at home, and people travel from all over to Los Angeles for the opportunity for natural birth when, like us, they were not given any other option. 

This wonderful doctor allowed us the opportunity to give our little Audrey the best possible start in life, and we are forever grateful.

TEN days past her due date, Audrey Ella decided to join us the morning of April 23rd. Our beautiful birth center plans were abandoned, as labor quickly progressed and plans speedily changed in the last moments to deliver at home. 

We were surrounded by a caring team; Dr. Stuart Fischbein, OB; our midwife Rachel, doula Estelle, and Dr. Stu’s midwifery interns Maria and Alissa, as well as our fur-babies (dogs) Phoebe and Khaleesi.  Quite a welcome committee!

After just 7 hours of labor, Audrey came into the world as nature intended for her, feet first, without interventions and completely healthy and happy. We are so blessed.

Thank you everyone for your warm wishes and thoughts you have sent over the last few weeks, we are overjoyed and so grateful for your love and support!

Love from us all!

Happy Mother’s Day to everyone. 

All our love, 

The Caplan Family

PS: This is not meant to shame anyone who has had a cesarean section. We feel lucky that we were able to find a provider who was willing to allow us the opportunity to have a natural birth. Many people have not had (and will not have) access to a provider like Dr. Fischbein — or even know that there is potential for a safe natural birth with the right team (especially after being told that cesarean is the only option by everyone around them). 

And absolutely, emergencies happen. Having undergone a cesarean section birth is by no means a failure, and is in some cases definitely the better route, depending on the circumstances. Even after cesarean, through childhood development, there are steps that can be taken to mitigate the loss of exposure to the mother’s microbiome during birth and support a healthy immune system.

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