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Published on February 04, 2020

Ashley Jestrab with baby

Giving babies the best start

Ashley and Brian Jestrab, of Protivin, Iowa, welcomed firstborn twins to the world by cesarean delivery, just two weeks shy of their due date. When they conceived a second time, Ashley knew she wanted to try vaginal birth after cesarean (VBAC).

"I didn't get that option with the twins," shares Ashley, a labor and delivery nurse at Winneshiek Medical Center in Decorah, Iowa. "My decision to try VBAC was what brought us to Gundersen in La Crosse."

Gundersen Health System delivers more than 1,600 babies each year and has a VBAC success rate of 94 percent*. That was one factor Ashley considered when choosing Gundersen; another was shared obstetrics care.

Shared obstetrics care means two healthcare providers partner to provide care for a mother during pregnancy and delivery. For Ashley, that meant seeing her primary care provider Kristy Schilling, MD, locally at Gundersen Decorah Clinic for prenatal care, then transferring to an obstetrician in La Crosse for labor and delivery.

"Shared prenatal care was a huge convenience for us," says Ashley, who lives 77 miles from La Crosse and already had her hands full with twins.

But, the commute to La Crosse was well worth it on March 19, 2019, when the Jestrabs welcomed 7-pound, 3-ounce Ava Evelyn to their family.

"I had an uncomplicated VBAC. The experience was wonderful," Ashley says. Within 12 hours of Ava's birth, Ashley noticed something unusual.

"I kept trying to nurse my daughter. I couldn't figure out why she wasn't staying latched. When she was latched, she sounded like a squeaky sneaker," shares Ashley.

A visit from Gundersen Lactation Services revealed Ava had a cleft soft palate.

"It completely caught us off guard. Physically, Ava looked like this perfect baby, but then to hear she had a birth defect was hard to accept," Ashley recalls.

Specialists from Otolaryngology and Speech Pathology met with Ashley and Brian in their postpartum room to answer their questions and explain Ava's future care plan. Certified lactation consultant Jamie Kotsmith, RN, IBCLC, was also by Ashley's side to address her most immediate concern: "How will I feed my baby?"

Jamie Kotsmith

"There are times when direct breastfeeding can be very difficult to achieve. I remind mothers the top priority is to feed their baby, then to protect their milk supply. A happy, healthy, growing baby is best," shares Jamie.

Gundersen's team of lactation consultants visit with all new mothers desiring lactation each day during their postpartum hospital stay. Upon discharge, they see moms and babies in the La Crosse and Onalaska Clinics as often as needed until the family feels confident about feeding.

"I so badly wanted to breastfeed," recalls Ashley. "Jamie spent hours with me determining individualized methods and techniques I could use to try to nurse my little girl."

During Ava's first weeks, Ashley breastfed and supplemented additional breastmilk by bottle. As her nutritional needs grew, she switched to pumping and bottle feeding exclusively—giving Ava all the nutritional benefits she needed.

"I'm so very grateful for all the hard work Jamie put in with us. I couldn't have done it without her," says Ashley.

Gundersen lactation consultants are available, even after you return home. If you're experiencing pain or feeling frustrated, call (608) 775-6876 to speak to a lactation consultant. Appointments can also be scheduled in La Crosse, Onalaska and West Union.

*For women who are medically eligible for VBAC and choose to have one

Experience the 'Baby-Friendly' difference

For the best start in life, surround yourself with the baby experts at Gundersen Health System. A certified Baby-Friendly Hospital since 2008, our staff will help you initiate breastfeeding as soon as possible after birth and encourage feeding on demand. Plus, you'll have the support of our certified lactation consultants when questions arise.

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