Episode 56: A Run in with Gestational Diabetes, Among other things: Tabitha’s story
Episode 56 SN: A Run in with Gestational Diabetes, among other things: Tabitha’s Story
In general all the stories women shared on the show reflect on Roe in part because they show how challenging pregnancy can be both physically and mentally even when pregnancy is highly sought after. That’s one of the major take homes from this podcast real women sharing their actual experiences and hopefully contributing to a more realistic narrative around pregnancy and birth. And today’s story is very much in this vein. My guest today walked into pregnancy unsure about whether she wanted to have a child. Ultimately she and her partner decided they did. She ran into gestational diabetes which effected how she felt about the pregnancy and her ability to control her blood sugar, and had a significant impact on the delivery, which happened in late fall of 2019, so she also had to contend with a six month old when the first lockdown happened. She and her partner managed it all and now are enjoying their 2 and a half year old.
To find Tabitha’s writing, click here, here and here…or search for her on the web
Gestational Diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3120181/
https://pubmed.ncbi.nlm.nih.gov/3542067/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4290225/
The Placenta in Pregnancy wrt GD
https://www.ncbi.nlm.nih.gov/books/NBK1668/
https://www.gestationaldiabetes.co.uk/gestational-diabetes-placenta/
https://www.karger.com/Article/Fulltext/455904
GD and preeclampsia
https://www.everydayhealth.com/gestational-diabetes/gestational-diabetes-and-preclampsia.aspx
Induction and Breastfeeding
https://www.sciencedirect.com/science/article/abs/pii/S0378378216302122
https://www.sciencedirect.com/science/article/abs/pii/S0889854517301158
https://www.liebertpub.com/doi/full/10.1089/bfm.2017.0012
Audio Transcript
Paulette: Hi, welcome to war stories from the womb. I’m your host, Paulette kamenecka. I’m an economist and a writer and the mother of two girls. A few things to mention before we get going. First, this episode is late, because COVID essentially grounded me for the better part of two weeks that I’m recovering and episodes will roll out on a regular schedule again, starting now. Second, since the last episode, Roe v Wade was overturned. I still have too much rage about this outcome to talk about it. But in future episodes, we’ll address this specifically. In general all the stories women shared on the show reflect on Roe in part because they show how challenging pregnancy can be both physically and mentally even when pregnancy is highly sought after. That’s one of the major take homes from this podcast real women sharing their actual experiences and hopefully contributing to a more realistic narrative around pregnancy and birth. And today’s story is very much in this vein. My guest today walked into pregnancy unsure about whether she wanted to have a child. Ultimately she and her partner decided they did. She ran into gestational diabetes which effected how she felt about the pregnancy and her ability to control her blood sugar, and had a significant impact on the delivery, which happened in late fall of 2019, so she also had to contend with a six month old when the first lockdown happened. She and her partner managed it all and now are enjoying their 2 and a half year old.
Let’s get to this inpsiring story
Hi, thanks so much for coming on the show. Can you introduce yourself and tell us where you’re from?
Tabitha: My name is Tabitha Blankenbuehler. I’m an essayist I live outside of Portland, Oregon.
P: So nice. Well, let’s go back before children for the very start. You grew up with siblings?
T: I did. Yeah, I’m the oldest obviously she had a brother and a sister. My sister was three years younger than me. And my brother was nine years younger than me. So he was kind of like, you know, I sort of got that mothering experience a little more with him. And still think of him as like a child.
P: Yeah, my sister is eight years older than me and her little nickname in my email is kiddo. So I’m with you. And so we were just talking about before we went to tape, the fact that for a lot of people growing up in a house with siblings makes them think, oh, I want a family. I’m definitely gonna have kids. And it sounds like for you that was not the case. So why don’t you tell us what your experience was?
T: Right? Yeah. I mean, I had, you know, a really great childhood. My parents were loving, supportive people. You know, the kind of people that you would say, okay, they were like born to be parents. I guess. For me. It wasn’t so much that I was that I didn’t have a good childhood that I wanted to recreate or anything like that. It was just sort of that I saw how much time and how all encompassing. Parenting was especially, you know, for my mom and I just didn’t want to do that. Like I wanted to do other things. I wanted to be a writer and you know, I had a bunch of other things I wanted to do be president and all these things. I really wanted to take precedence over having a family and I also kind of thought, you know, well, my family is really great. I don’t need more.
P: Yeah, yeah, yeah
T: I have, I have what I need. So also, when I was growing up, I just didn’t really like you know, I was an oldest child and I was very stereotypically the oldest child. You know, I was like, best friends with my teachers. Oh, all the adults around me and people pleaser and all those sorts of very boilerplate things. So I didn’t like kids. I had a hard time with other kids. I just didn’t relate to people my age. So I think there was that too, but just that I don’t like kids, even though I am one. I don’t want to be I can’t wait to not be one anymore. So
P: Well, I think seeing your mother in that way is wildly insightful. So maybe you were just kind of ahead of the curve there. And I for sure have you know, most people don’t know how they’re going to jack in a child to their existing life. And, and a lot of people, myself included, just kind of threw my hands like up, people figure it out. I assume I’ll be one of them. But it seems to me very smart to look at that and say Holy shit, that’s a lot of time. I can do other things. Right. And now that you’re on the other side, right, you’re right. It is time consuming. Yeah. So how did you move from the I don’t like kids. I don’t want kids to look I’m pregnant.
T: Yeah, it was, you know, really unexpected. Journey, I suppose. So, in 2018, I was on the end of my book tour I was doing I was completely absorbed in that in the writing pursuit and everything. And towards the end of my book tour, I realized I was you know, a few days late on my period, and being very obsessive about everything. I just took a pregnancy test. I figured, oh, well, there’s no way that I’m pregnant. I’m on birth control, blah, blah, blah. And it I took it in my office bathroom, and it was positive. Yeah. And, you know, completely threw me for a loop. It was the last thing I was expecting. And my first instinct was that I didn’t want to have a child and I wasn’t going to keep this pregnancy. So I went in and talked to the doctors at Planned Parenthood. I had caught the pregnancy super early, just because of being so conscientious about my schedule. They wouldn’t have been able to do an effective procedure at that time. And so when I just kind of sat and thought about it for a while, you know, it just sort of gave me the opportunity to react in a way that I didn’t expect because my initial reaction is I don’t want to do this, which is a completely valid response.
P: Totally, especially especially when you’re on birth control, right? Yeah. This was not my intention, right?
T: No, no, and we totally wasn’t and I think we always kind of said, my husband and I, well, maybe when we feel like the time is right, like, you know, whatever the hell that means. means nothing. Yeah. Yeah, the longer I kind of just sat and thought, I realized, maybe this is something that I want to do. I sort of feel a connection to this pregnancy that I didn’t expect to have and you know, I’m just I’m feeling a way. I didn’t know I’d feel. So we had a discussion and we decided that we were going to keep it and was we were really excited. And then a few days later, I had a miscarriage, which is super common in those early pregnancies, but you know, it was devastating as it is in any stage in a pregnancy. So after recovering from that a little bit, we still wanted to try and we still wanted to go down that path that had been presented to us. So we did and fortunately, we were pregnant a few months later.
P: So it sounds like it was easy to get pregnant the second time.
T: It was
P: good.
T: Yeah.
P: So that’s great. That’s one hurdle over. And then this time, you’re excited to check the pregnancy tests, I’m assuming.
T: Oh, yeah. Yeah. Super excited. My big reveal my husband had to go to work trip to Arizona when I was able to take the pregnancy test. So I was flying down to visit him while he was working. And so it took the pregnancy test and my carry on, and I wrapped it up in a little plastic bag. And I picked up In & Out on the way to the airport and I put it in the bag with the double double is like the happy meal price. So yeah, we it was it was all a big party. We were really excited.
P: That’s a cute reveal. So that’s exciting. And then what’s the first trimester like
T: first trimester was pretty good for me. As far as you know, I didn’t get very sick and I didn’t have a lot of problems. The complications for me started to start about I’m sure the second trimester when I had to get the gestational diabetes check. And I ended up getting diagnosed and it was a case where I couldn’t control it no matter how hard I tried with diet, you know, I counted out all my grapes and didn’t do anything that I wasn’t supposed to do, but it just like would not work which was extremely disheartening and induced a lot of guilt. Because it’s like, no matter how hard I try, no matter what I do, I can’t make my body it feels like safe for this child.
P: So there are a lot of different ways to respond to that right to some degree. Your body has already shown that it has a pretty good autopilot in that like you can get pregnant and you’re you’re pregnant and you don’t have any control over that chemistry. Right. It is what it is. But for some reason you’re feeling guilty over the gestational diabetes, which I also assume is like a chemically induced shift in your ability to process blood sugar that you also don’t really have that much control over.
T: No, no, I don’t. Nobody does.
P: Right.
T: But you know, there’s just like any sort of condition. You go and you try to find your answers. And there’s a lot of conjecture about, oh, well, maybe you should have been this weight when you got pregnant or maybe should have thought of that before. Your parents had diabetes are all these all of these things that make you second guess yourself?
P: Is it in your family?
T: Yeah, I have risk factors from both sides of my family, which isn’t necessarily a indication that you will get it but it does of course. Yeah. increase your chances. Yeah.
P: Well, that sounds hard. I flirted with gestational diabetes, which is to say like, I think I had to do like a week long trial where you prick your finger with a needle to measure blood glucose levels at home, which is so wildly unpleasant. I think after day three, I was like who do you say, Well, I don’t eat. There’s no reason to, you know, to scrap the whole system. So that sounds really hard to do. You have to prick yourself every day. You’re nodding yes. On paper. It’s a small thing, but in reality, I thought it was really uncomfortable from the oh my god, the middle of the second trimester.
T: Yeah, right about then yeah, I started to have to do the finger pricks. And then like I said, I couldn’t control it with the diet alone. So I started having to take insulin, and the amount of insulin I had to take just kept going up and up and up. And you know, which was also really distressing. You know, as the vile just kind of keeps like going and going and going and you have to stick it in your stomach, right? Yeah, like, I mean, obviously, I know. Like scientifically or biologically I can’t hit the baby, but it still feels like you’re just jamming it.
P: Yeah. That’s not a great visual. No, I agree.
T: No, it’s not. It’s great.
P: So we took some questions about gestational diabetes to an OB today and we’re lucky enough to have Dr. Mehta Thiago on the show a fabulous OB from California who’s got a lot of experience with these issues. So Dr. Mathis Yeah, who thanks so much for coming on.
Dr. Matityahu: Thanks so much. Paulette, I love being on your show. Great.
I’m wondering first of all, if you can just define gestational diabetes.
Dr. Matityahu: So gestational diabetes is basically elevated blood sugar in pregnancy. We test for it around 25 to 28 weeks because as the placenta develops, your placenta is basically making the insulin not function as well. And so your blood sugar’s begin to run higher, and for some women, they run high enough that you’re considered diabetic. And so if you’re someone who maybe has a family history, or borderline would become diabetic later or just isn’t following a very good diet, you’re you’re likely to have issues with managing your blood sugar later in the pregnancy because your insulin isn’t working as
well,
P: I neglected to ask them to Dr. Matityahu more about the placenta when we spoke but then I found some articles that suggested that every pregnancy independent whether you have diabetes or not, involves a placenta that churns out more hormones over the course of the pregnancy, some of which block the effects of insulin, which will lead to higher blood sugar levels, the mother’s pancreas will release more insulin but if it’s not enough to compensate for placental changes, and you can end up with gestational diabetes, although there are numerous routes to gestational diabetes. If you have that condition, your needs for insulin will grow as the pregnancy progresses because of an increase in placental hormones.
P: does it feel Like any like not the needles obviously the needles are uncomfortable, but having gestational diabetes doesn’t feel like anything.
T: No, no, you don’t feel different, but only way you’d feel different is just being hungry.
P: Okay, yeah. So once they put you on insulin, does that free up the constraints on your diet or no, then you still have to eat like, grass?
T: Yeah, yeah. They still want you to have really low numbers compared to someone that you might know in your life with diabetes, like type one or type two. The numbers that a gestational diabetic has to get to are so much lower,
P: as I understand that the numbers for gestational diabetes to qualify you as as having that condition are relatively low compared to diabetes outside of pregnancy.
Dr. Matityahu: Yes, we have very strict guidelines of where your blood sugar should be in pregnancy. And so we’re super super tight with sugar control in pregnancy and blood sugar’s that may not at all be considered diabetic for someone who’s not pregnant. We consider that diabetes in pregnancy.
P: Is that because of something that a higher level of blood sugar does to a pregnancy to a fetus?
Dr. Matityahu: Yes. So high levels of blood sugar causes high levels of sugar in the amniotic fluid in the baby’s bloodstream. And so then the baby reacts to that high sugar, high blood sugar by producing more insulin and that puts weight on the baby. So now the baby starts gaining and getting like big and so the body of the baby can get if it’s uncontrolled. So really high blood sugars that are not controlled, would cause the baby to start gaining a lot of weight. So the body of the baby gets much bigger. The baby starts peeing more and so the amniotic fluid is managed by the baby drinking and peeing. And so in a person when they have high blood sugars will drink a lot more fluids and will pee a lot more to kind of dilute the sugar in our bloodstream. The baby will do the same thing will start drinking and peeing more and that also makes the amniotic fluid start to expand because now the baby’s peeing a lot more. And so it causes weight gain on the baby increase in the amniotic fluid and and it can over time they get to like the baby’s lungs don’t develop as quickly as they should. And so it so it can cause a lot of problems with the baby. So one of the problems with the baby getting so big is the baby can get pretty large, the head can come out and now the body is way too big because the baby gained too much weight and so you get what’s called Shoulder Dystocia where the baby can get stuck.
P: So aside from all the difficulty with the needles and the food, like how are you taking this emotionally because it sounds like you’re someone who’s detail oriented. So that seems like
a lot of pressure.
T: Yeah, yeah. You know, it was sort of back to the days when I was in college and on Weight Watchers and writing down obsessively everything I ate and being really obsessive about food and yeah, it was extremely depressing just feeling like no matter how hard I tried, it wasn’t good enough and just being worried that something could go wrong. I think it’s a really common condition but a lot of people don’t really understand it. Like so many things with pregnancy. It’s like unless you’ve actually been with child you don’t know it exists. Like I had to explain it to everybody in my life.
P: Oh, that’s interesting.
I’m wondering if we know why sometimes you can control diet and sometimes you can’t.
Dr. Matityahu: We can’t predict we don’t know. What we know is if you can control your blood sugar’s by diet, or even if you’re controlling them with medication, the baby’s going to do great for women that can control it with diet. We don’t even consider them high risk. That you know you have gestational diabetes, but if it’s diet controlled, you’re a normal risk pregnancy you’re not even a high risk pregnancy. Once we give you medication, we consider it a little bit higher risk pregnancy and so we follow that pregnancy differently. Can we predict who’s going to do well with diet and who’s not? No. And a lot of times even for women like Tabitha who are incredibly meticulous in like cutting out almost all sugar in their diet and doing like the perfect combination of foods doesn’t always work. And, and yeah, and so women also will easily feel like I’ve failed because I have not been able to control how my body responds in all aspects of life. And yes, the reality is we don’t have the ability to control how our body responds in all aspects of life. And we just have to let that go. It’s similar to women who end up with a C section and feel like I’ve failed. I you know, my I wasn’t able to make my pelvis deliver a baby. You know, vaginally we just don’t have control. We just have to accept that all of us type A people have to accept that like we cannot micromanage every aspect of life and how our body responds to things. And I think you know, most of us that have kids quickly learned that you know, we can’t manage how our kids come out and, and grow up either.
P: I mean, one thing that’s interesting about your experience is when things are screwed up, like on the front end, like we could not get pregnant and you do feel like your body is failing you and I you know, why can’t I reproduce and but that’s a totally different feeling than being like waist deep in a pregnancy and having things go a little topsy turvy because now there’s no way but through, right. So that’s a little s and now like you’re very much thinking about the baby that you’re growing and how’s this affecting him or her and like it just seems like it’s a much harder thing to manage.
T: Yeah, yeah. So it just caused a lot of stress. I also had a lot of stress going on in my job. So it was kind of just compounding all of that. And yeah, it was it was a bad final trimester. So for sure,
P: also, like everyone’s telling you not to stress out right, stress is just as bad for the babies. You’re like I’m not freaking out because that’s the one thing I can control kind of not really. So that sounds like a time so take us to the day that you’re it’s your daughter, right?
T: Yeah.
P: Take us through the day your daughter was born. How do we know today’s the day? What does that look like?
T: Yeah, well with the way that my gestational diabetes progressed. I knew fairly early on that it was likely to be an induced pregnancy. Because another thing that happens when you have gestational diabetes is that the baby develops faster, grows bigger. So she already was sort of predisposed to be a larger baby. My husband was 10 pounds.
P: That sounds like a threat.
T: Yeah, it’s not good. When every time you go to the doctor, you get this like ooohh face when they ask about it. So yeah, it just sort of was coming from all sides there. And we kind of had like this tentative date for about a month. or so. So I was sort of working with that. And by that time, I was going into the doctor at least once a week to check on it. And the day before we went into the hospital. It was let’s see. Over a week before this date that we were going to originally induce my doctor, she ran some tests, looked at some things and she said, oh you know you’re kind of borderline for some things and I don’t know I’m sort of thinking we should maybe have the baby sooner and ask okay sooner, like this weekend or what? No, why don’t you come in tomorrow morning. So all of a sudden, I mean, this was a I remember it’s a Wednesday so I had just come off work. hadn’t really obviously prepared to be going yet. But honestly, that was kind of my silver lining of having this condition was sort of the feeling of control and knowing when it was going to happen even if it was like 12 hours.
P: Yeah, yeah.
T: So like nicely packed my bag. We stopped at Starbucks on the way to the hospital. I dressed up and took a selfie by the doors. I mean, it was it was very that so that was sort of a little bit of retribution for all the stress but
P: I like you making the most of it. That’s that’s a good way to do it. Let me ask you before we get to the actual birth, are you imagining giving birth in a tub surrounded by angels strumming harps, or like what what what image did you bring to the delivery?
T: It was so hard for me to imagine because I did all of the classes that the hospital offered and did all of those things and it was all centered around a natural uninduced birth, or they also have a lot of good information for mothers that were getting a C section, which is great, but I kind of raised my hand and asked what happens when you’re induced and they’re just like didn’t really have a very good answer. We toured the hospital before we went so I did see the little jacuzzi and I thought that sounded cool. But yeah, the reality was that with the monitoring for preeclampsia and everything I had to be stuck on an IV the entire time. So all my dreams were very quickly squashed and I just sort of wanted things to be, you know, I want to make use of all the drugs, very happy with modern science love it. So my birth plan was all laid out with those sorts of things. And I remember bringing the printout and pointing at them and everybody just basically was like Oh, cool. we’ll recycle that for you. Yeah,
P: great. That’s a lot of support at the hospital. New Plan.
T: Yeah,
P: so you check in when you’re supposed to and have a blackout I feel like induction is usually thought of as kind of painful because it’s your like ginning your body up in a way that puts it on a schedule that might not naturally be on, which is a hard thing to manage.
T: Right? Yeah, it wasn’t. It wasn’t painful, especially at the beginning, basically, the first 24 hours when I started taking the initial medication. Were just boring, you know, just sitting in the hospital and since I did have to be hooked up and monitored and poked. They took my numbers for my diabetes every couple hours or whatever. I couldn’t go up and move around, but couldn’t go sit in the tub and couldn’t do a roll around on the ball. You just had to sit in the room. And I remember binging probably 20 episodes of restaurant impossible with Robert Irvine. So I always, you know, kind of think of him when I think yeah, the hospital and so yeah, it was just kind of sitting and just trying to figure out if something was happening, like just sitting and trying to listen to my body, you know, is anything happening? How will I know what’s happening? And I think that was another issue I had was that I didn’t know what labor pains were going to feel like. And I don’t know how someone has to describe that to you. I don’t know how you prepare for that. But what I was thinking was not at all accurate. I am going to go ahead and blame Hollywood and producers and directors because every TV show and movie it made it seem like someone was stabbing you in the gut kind of pain. When it’s actually that feeling that you have to take the world’s worst shit. It’s like the most terrible constipated sort of feeling. So since I felt like that I kept getting up and going to the bathroom thinking I had to poop when I was really starting to have contractions. So oh my gosh, I was really far along by the time I finally asked for my epidural. I think I was I can’t remember like which centimeters or which at this point, but it was like they were kind of saying I’m glad you told us now because you weren’t getting really far along before kind of raising your hand and saying I might be having the baby. So that’s when things started to get painful was when it finally kicked in 24 hours or so later. And that wasn’t so much I don’t think that I was induced it was just sort of the way Well, no, I guess it was sort of that I was induced because some of the things they had to do. They might not have had to do if it was my body’s natural response, like they had to go in and break my water. And that was the most uncomfortable and painful thing in the entire process.
P:Wow.
T: Yeah,that really was awful.
P: Because the cause the getting the thing in your cervix is painful or because the actual breaking of that amnion is painful.
T: Kind of I’m not sure which was which but the whole thing and they had to use the needles so they poked my daughter in the head. You know what she did? I was fine, but it wasn’t fun for anybody. And
P: also when they bring it in, I’m sure you’re like get that crochet needle away from it. Right Like what are we doing here?
T: It’s really terrifying. Yeah. And it was the middle of the night. It was must have been like 3am or something. So everything is very surreal. Yeah, very bad. And then after that, because it was about 5am that I got my epidural. And they missed my spine with the needle. So they had to do it twice.
P: Oh that’s bad
T: Oh my God…But then again, it’s, I think when you’re at that point, it’s just like whatever. I don’t care.
P: I remember being terrified of delivery and I got some comfort from the fact that I knew that at some point, things on the outside would be so bad that I would say, Do whatever you have to to, you know, the threat of an epidural needle seems small compared to having my body crunched from the inside, right. So
T: exactly. Yeah, yeah, you can just whatever, whatever makes it go faster, whatever makes it over. I don’t care. Take my fingers. Take my toes.
P: Yeah. So you get the epidural and then does that calm everything down because now you can’t feel it or where are you?
T: It did a bit but then Yeah, it did for a while. I remember a few hours where I kind of fluttered in and out of sleep. But then slowly those contraction pains started, you know, making their way through the medication I could. I really felt that that was coming. I remember telling my husband you need to go get the nurse now. It is time. It’s amazing how much you know it is time. I had no idea when to know but I did. And unfortunately, I thought that I thought my worst case scenario was like okay, well, once I get to this point, it’s going to be 45 minutes or so. I had to push for three hours. Three hours.
P: yeah that’s a long time. That’s an amazingly long time.
T: It was so long, and I don’t know how. I don’t know how I did it. You know, it’s it’s exhausting. It is the most exhausting thing I’ve ever done or will ever do. And, you know, it’s really easy to say from here. And from before and from any other angle that well you always find a way to do it. Your body knows what to do. It’s natural. Okay, yeah. But when it’s happening, you really feel like you’re going to die. There feels like there’s no other alternative than this is just going to destroy you. And I guess it kind of does in a way. I mean, by the time you’re done, you really are a different person.
P: Yeah.
T: You’ve been through something that I don’t think is necessary. I don’t think anybody has to go through childbirth to you know, live a full life or experience things, but that very specific feeling is just so I don’t know how it could be recreated in any other capacity.
P: Yeah, I mean this to some degree, which is ironic in a conversation between two writers but is something that kind of defies language, which is why no one can tell you what it’s going to feel like when you’re having contractions There are no analogies that are fitting, right. So usually you can sidle up to something similar, but there’s not really anything that’s like it.
T: Yeah, no and yeah, the funny story was my doctor or the doctor who was delivering the baby just kept telling me with each push, one more push, and then you’re a mom. One more push. Gonna be and this went on like five or six. times and I just like screamed “where’s my baby?”.
P: Yes, this is very much like it’s just around the next bend right there. Yeah, that sounds frustrating. So but once the head crowns and all that then it was quick.
T: Yeah, yeah, I had to have an episiotomy which was in my birth plan is don’t do that. But when they brought up the options, like yes, anything now, yeah. So there was you know, that kind of final complication, which also I was surprised how long that took honestly to recover from postpartum you know, I had a lot of issues with sort of pain and things with it and sort of feeling it being there for probably six to nine months after giving birth. So I think, you know, I think it’s a good thing that it was done, but you know, it’s also I think it gets brushed off a lot like, oh, it’s not that big of a deal. But it’s, it’s kind of a big deal. It kind of really sticks with you for a while.
P: Yeah, I wouldn’t I wouldn’t even say kind of, I would say and actually a big deal and it’s a little bit like it falls into the postpartum black hole. And you are everything falls where you just we don’t talk about it anymore. And I find in the discussions of pregnancy, there’s a constant kind of conflating of common and easy
T: hmm,
P: episiotomies maybe common, but it has these real repercussions as you have experienced for a long time, you know, postpartum as some people think it lasts a year after birth, right, which kind of makes sense because at six weeks, your uterus shrinks down to its normal size, but there’s so many other things that don’t either never go back to the way they were or take much longer to heal or so six weeks is kind of I think the date we all have in our head, but right it’s a little bit false. Yeah, I’m jumping ahead a little bit. Your baby is born. They put her on your chest.
T: For a second, and then they had I think she had some of that fluid. So they had to really quick like grab her and start doing some things that really alarmed My poor husband, who could actually see them. But no, she was she was great. She was fine. Of course, the most beautiful thing I’d ever seen and all the all the good things all the good, happy feelings for sure.
P: That’s awesome. That feels fitting after three hours. And then what happens to gestational diabetes does that how does that resolve?
T: Fortunately I the first thing that I made my husband do after I had given birth and kind of got the all clear like okay, you can take a drink of water you can have some food and a little bit. I sent him down the road to Five Guys. He had to bring me a double burger fries and a milkshake. He didn’t think I could finish them which was hilarious. Yeah. after that. But uh, yeah, so they have to test you they keep testing you on when you’re in the hospital to make sure nothing weird happens. And then for the rest of my life, I’m going to need to be screened for diabetes, I believe on a yearly basis, especially with my family’s history and everything but so far I’ve I haven’t had any signs that it’s back or it’s coming back. And neither is Sophie. They have to check her a little more to because that does raise her risk. But no, it’s it’s gone.
P: If you have gestational diabetes doesn’t resolve with the birth.
Dr. Matityahu: Yes, once the placenta comes down, then you go back to having normal blood sugars in the future. About 50% of women can develop diabetes. We usually have women we remind them like every year or so check your blood sugar to make sure that you’re still doing okay.
P: And we think that’s because the pregnancy exerted this extra stress on their body and that has changed the trajectory or we think they were going to get it anyway or there’s no way to know.
Dr. Matityahu: It’s more that they were they were at risk of getting it anyway and with the placenta causing an issue with their insulin. It pushes them just over the edge while they’re pregnant. But if they continue to have a high carb high sugar diet for the next five or 10 years, then they’re going to continue to push their body into becoming diabetic. A lot of diabetes is diet related and not for everyone. So it’s not to say that everyone that has diabetes is has a poor diet because that is that’s not it at all, but but for a lot of diabetics is that we’re giving our body too much sugar and our body’s insulin can’t handle it. And so our blood sugar ends up being high and for some diabetics that’s the issue for others. It doesn’t matter. You can have the most strict, you know, low carb diet and you’re still going to have issues with your sugars because for some people, they just have issues with their insulin production and it has nothing. It has nothing to do with how well controlled or strict they are with their diet.
P: Other than physically healing. How did you find the fourth trimester?
T: I wasn’t I wasn’t prepared for it. I’m sure that might have been said before once or twice Yeah. I was not prepared at all for the hormonal issues and changes. I didn’t sleep for about the first week after having her and it was it was literally making me insane. I felt like I was losing my mind. And I got misdiagnosed. When I called the doctor as having postpartum depression, which wasn’t my issue. It was just it was more I have anxiety. So it was the anxiety manifesting itself. And so the combination of not being able to sleep and the anxiety of just, you know, when I lay down to sleep, and she’s right next to me, I’m like, listening for to breathe, afraid that something’s going to happen. Or on the reverse side. I didn’t have this is like tripping me up. I didn’t want to miss anything. I didn’t want to be asleep while she did something. And I would miss it. I don’t know what I was looking for. You know her to sit up and start talking to me or something. But I felt like the time that I was there was so important. And so precious that if I slept it would it would be gone or something.
P: I mean there’s there’s something real there right like they are one day old once that’s it ever again. So so and they develop so quickly in that period that there’s a lot there’s a lot going on. There’s a lot to watch. There’s a lot going on
T: I also had a lot of trouble because of being induced. my milk would come in. Yep. So I had physical problems feeding my daughter I was going to try and breastfeed. It wasn’t the end all be all to me. I just wanted to make sure that she had food. So when I started having troubles, I wasn’t opposed to using formula or any of those things. But the frustrating and heartbreaking part was you know, she’s telling me she’s crying and she’s telling me that she needs to eat, she’s hungry, and I physically can’t help her I have to wait for my husband to go in the kitchen and mix up a bottle. And so that was really heartbreaking. Not so much that we had to make a change but just that in those moments where she needed me, I couldn’t immediately help her. The way I wanted to
P: and did that wane as she got older because you got more in a rhythm or didn’t have that the whole time?
T: Yeah, I think I continued for about two months to try and feed her breastfeed her and and I supplemented with formula. And by that point, it had become so unpleasant for me. And obviously unpleasant for her because if it’s not pleasant for me, it’s not going to be pleasant for her. And also she was just very not interested. You know, she learned like, oh, this bottle is already to go and I don’t have to do anything. So why am I messing around up here? Yeah. So you know, she was more into that and the process of trying to pump and everything was making me miserable. So one day I had to do a long drive to visit family and during the drive you know my I got those painful over just painful feelings and I just got to home I’m like I’m done. You know, I feel like my body has sort of stopped gotten angry. We’ve done some things during this drive. So we’re just gonna donate the equipment and move on. So
P: yeah, that seems smart. I mean, if you think of all the things your body is doing to get pregnant to stay pregnant, to grow a baby to deliver, and then also to breastfeed, you know, you’ve done like 87 of them. So, all of which are amazing, right?
T: And it’s very weird to see one of my sister’s best friends. She had her baby right around the same time we all kind of clustered together and she was posting on Facebook saying I have so much extra milk and is taking up all my freezer. How is that possible? If I I was taking cell phone pictures of a vial like this big that I’m able to fill like I am having an amazing day and other people are filling up their freezer. It’s very inequitable, it feels like
P: Yeah, yeah, it is like randomly distributed. Yeah,
T: right. Exactly.
P: So how old is your daughter now?
T: She’s just shy of two and a half. Yeah, she was born in September 2018. So Wow.
P: So just before the pandemic,
T: she turned six months old when the lockdown started. So we were just you know, at that point where the newborn infant days was ending, and we were going to go into the world. And then everything stopped. So
P: wow, you’ve been one of the people who’s been shut in with a runaround baby. How’s that going?
T: Yeah, I it’s been very difficult. But at the same time, I am infinitely grateful that she was here. Yeah, it definitely shifted sort of certain priorities. And it shifted different priorities and timelines for our family. So you know, we’re going into six months old and I’m thinking, Oh, we have to start planning your first trip to Disneyland. Oh, we’re going to go to the zoo all the time. You know, all these sorts of social, fun, interactive things. And then all of a sudden, we’re right back into the space we were in, which was a small house that had been purchased. When my husband and I were envisioning a life where it was just the two of us. And it was small. It wasn’t very kid friendly. All these things which wasn’t going to be a huge problem if we were out doing things and having a life out in the world. But then all of a sudden, we were spending all of our time in this small house. So instead of the life I think we were looking at with her for when she was a toddler of doing traveling and doing this class and that group and all these things. We concentrated instead on moving so we’re in a new house or in a bigger house. So that’s been a huge positive change, because there’s so much more room for all of us to move around. Plus, yeah. And we weren’t also not planning for my husband to be working from home for most of two years.
And that’s another silver lining because he’s been able to bond with her in a way that he never would have been able to before the pandemic. She’s really close to her dad and it’s really beautiful, to see that relationship, and also just have that support. I mean, even now when he’s home, it’s nice to just be able to run outside and get the mail or drive out and pick up some curbside groceries without having to necessarily take her with me. It’s just an extra pair of hands and eyes that is super helpful but you know also sometimes you just want to do things yourself and have your time so just the same as anybody. There’s a lot of that give and take with balancing everybody in the same space.
And when I was growing up, my mom was a stay at home mom too. And so, I wasn’t initially planning that for myself or for us. I had a situation with my work where I was going to take an extended maternity leave unpaid so I saved up for all my pregnancy so we’d be able to survive a few extra months, but it was really important to me to be able to be with her for those first six months. Because, I mean, I was very privileged to be able to do that. I think everybody should have that option.
P: Yeah,
T: well, weeks is nothing.
P: Agreed. It doesn’t make sense. Yeah. Yeah.
T: Unfortunately, a few weeks before I gave birth, my company rescinded our agreement. Until me I’d have to be back within 12 weeks. And by that time, I had already made my child’s childcare arrangements with the original timeline in line. And as you know, as any mom or dad knows, finding a daycare and setting up that timeline is not a simple task. Does not magically shift on a dime. You know, I was on waitlists for daycares that I didn’t hear back from until she was talking. So
P: yeah, yeah.
T: So it really kind of forced me to say okay, well, I am going to have to quit this job and stay home with her and that wasn’t my plan, but faced with either I mean, you know, no childcare or
so, once I made that decision once our family made that decision, I thought a lot about my childhood growing up and what my mom was able to do with me. And my favorite memories and those are all really simple things. Those are going to the park and splashing around in the pool, the public pool and doing picnics and all of these things that she was able to do when we were able to do together. And that was super important to me to give to my daughter and experience with her. And so not being able to in so many ways. In so much time you know there’s been those patches here. And there where okay, we’ve gone to the zoo, and then we can’t again this not going back and forth. That’s been really for sure painful and just makes me feel like I’m not not giving her what I wanted to Yeah,
P: although I totally hear what you’re saying. For every parents of every kid at a different age. There’s something that’s being sacrificed in the pandemic. But yeah, but for all of us who are lucky enough not to get sick or get over the sickness quickly. There’s also something gained for like every single age I have friends whose kids are in college and they say like, oh, the kids had to come home and now we get to spend time with them in a way we never would have gotten before and it sounds like your husband has gotten this amazing gift of it and you have the gift of your husband getting that gift right so there are all these things that kind of no way to manage this easily or beautifully. And this is sort of how it falls so I can see how it’d be a bummer if you had plans for music school or all that stuff to be gone but I’m imagining now your two and a half year old has an amazing vocabulary. I haven’t been around to adults. for them.
T: It’s insane. I can’t believe the things she can say and do and you know that’s of course me saying and I haven’t been around enough kids to know but it certainly seems impressive. She knows she has a state puzzle. And she knows almost every single state by sight and can assemble America. I still that’s
P: that’s amazing. That’s amazing. My high school seniors like where’s Illinois?
T: Exactly.
P: Kudos to you. Well done. So does she have any tricks that you want to talk about at two and a half?
T: She keeps asking Alexa for her favorite songs. So right now it’s always Alexa, talk about Bruno.
P: So funny. Talk about digital natives. Good Lord.
T: I know it’s awesome.
P: Very fun. So here’s a question for you even though she’s pretty young still. If you could go back and give younger Tabitha advice about this process. What do you think you would tell her?
T: I think I would say just to keep trusting your gut and not what not even what other people think. But what you told yourself you were going to be and what you were going to do. You need to stop holding yourself to what you were thinking when you were 10 or 20 or even 30 Because yeah, I needed. I trusted my gut when I had my first pregnancy and changed my mind. I trusted my gut when I thought that I’d have to quit my job. And you know, all these all these times that I made decisions that I never would have thought I would have made and probably wouldn’t have supported. Somebody else making To be honest, but they all turned out to be the right thing. Or the thing that has brought us to the here and now which fortunately, is a really beautiful, wonderful place to be we’re really lucky. So yeah, if I would have kept trying to be the person that I thought it was going to be. It would be a miserable mess for nobody but me.
P: What can you say but that a lot of life is experiential…10 or 20 or 30 year old you couldn’t have imagined a lot of the events that happened–getting pregnant despite using birth control correctly? The flip flopping of your work agreement? That sounds like good advice to follow. I wish we had more time to talk about your writing.
I’ve read some of your work. You’re beautiful writer. Where can people find your stuff?
T: My website is Tabitha blankenbuehler.com. And I’m the only type of the blank and biller so if you find it, you’re there. That’s good.
P: That’s good to know. Excellent. Well, thanks so much for coming on and sharing your story. I certainly appreciate it.
T: Of course. Thanks for having me.
P: Thanks again to Dr. matityahu for sharing important information about gestational diabetes, and thanks also to Tabitha for sharing her story. I regret that we didn’t talk about her writer, she is a beautiful writer; I will leave links to her website in the show notes, where you can also find links to some of the medical issues that came up. You can find those show notes at war stories from the womb dot com. Thanks for listening. We’ll be back soon with another inspiring story.
Episode 55: An Unintended Teenage Pregnancy: Sunni’s other story
Episode 55 SN: An Unintended Teenage Pregnancy: Sunni’s other story
Today’s episode features a difficult but important story. It’s the kind of story we avoid in part because it involves difficult emotional topics—sexual assault and unintended teenage pregnancy—topics that society does not handle gracefully. My guest today was sexually assaulted by her partner as a teenager, and carried this unintended pregnancy to term, at which point she put the baby up for adoption. More than two decades have passed since these events transpired, but we talk about how every element of this challenging situation has impacted my guest’s life, and continues to affect her deeply, and likely always will. Now that Roe v Wade is under such direct threat, and there are calls for women to “just carry out the pregnancy and put the baby up for adoption”, what all this does to the woman forced to undergo this experience is more often buried than shared. I am grateful to my guest today for sharing her story.
Episode 54 SN: The Complicated Emotions that can Accompany an Unintended Pregnancy: Jennie’s story
These days the word mother can mean a lot of different things. As today’s guest shares, she sought out the birth of her first child, but the second pregnancy was unintended. Her preference for family size clashed with her partners, Although she may have been open to terminating the pregnancy, her partner was not; she was living in a state whose majority is not particularly supportive of a woman’s right to choose, and she was brought up in a religion in which abortion is not considered a reasonable choice. and so began a very emotionally taxing pregnancy and birth. She shares how she managed these challenging circumstances which I think is an important story to share, especially right now when such black and white ideas about pregnancy and birth are in abundant circulation.
You can find Jennie’s writing here
Average Time for Labor
https://www.verywellfamily.com/length-of-labor-how-long-will-it-be-2759011
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4982443/
Audio Transcript
Paulette: Hi, welcome to war stories from the womb
I’m your host Paulette Kamenecka. I’m an economist and a writer, and the mother of two girls.
These days the word mother can mean a lot of different things. As today’s guest shares, she sought out the birth of her first child, but the second pregnancy was unintended. Her preference for family size clashed with her partners, Although she may have been open to terminating the pregnancy, her partner was not; she was living in a state whose majority is not particularly supportive of a woman’s right to choose, and she was brought up in a religion in which abortion is not considered a reasonable choice. and so began a very emotionally taxing pregnancy and birth. She shares how she managed these challenging circumstances which I think is an important story to share, especially right now when such black and white ideas about pregnancy and birth are in abundant circulation.
after we spoke I talked with a fantastic OB who has much more exposure to ambivalence about pregnancy than most of us and she shares her insights
and one other note to add: Everyone in this conversation has dogs at home, and it seems all dogs were desperate to be a part of this episode..so you’ll hear everyone’s dogs at some point.
Let’s get to this inspiring story.
P: Hi, thanks so much for coming on the show. Could you introduce yourself and tell us where you’re from?
Jennie: I am Jennie Case and I am currently in Conway, Arkansas.
P: Oh, wow. Wow. Cool. Excellent. Jennie. We’re going to talk about the family you and your partner created but sometimes the family you came from influences some of those choices. So I’m just wondering, Do you have siblings?
J: I do. I’m the middle child of three. So an older brother and a younger sister,
P: Are the three of you close in age?
J: my brother is 14 months older than me
P: Oh wow
J: and my sister is four years younger. So he and I are very close in age. Oh, yeah.
P: So did that influence your thinking at all about how many kids you want or how close you want them
J: it did when I was growing up? I was close with my brother. Until we both became teenagers, which I think is pretty typical, especially male female siblings. And I wasn’t very close with my sister. She was four years younger, right? And so my brother and I, kind of excluded sometimes from our childhood games. So when we were contemplating having a second child or thinking about having more than one, I worried about the age difference and my kids I have two are four years apart, and I worried that they wouldn’t be close as a result and four years might just be too too large of a gap.
P: Well, I’m interested to see how that turned out. So when you walked into pregnancy, what ideas did you have about what pregnancy to be like?
J: I was just curious about pregnancy I wanted with my first child in particular, I just wanted to have that bodily experience that seemed significant, something that it seemed like experiencing life meant, or the fullness of life for me meant also trying to experience the fullness of a pregnancy so I was really curious. What that would be like, and I wanted to hopefully, feel grounded and whole in my body and have it be really a kind of embodied experience for me.
P: That’s super interesting. And did you get pregnant easily.
J: I did. Yeah, I was one of those lucky people, I guess.
P: So you found out with a home kit.
J: uh huh
P: And what was the pregnancy like?
J: The pregnancy it was pretty smooth. With my oldest who’s my daughter. I didn’t have many complications except for the high blood pressure. At the end. I had my blood pressure. I think during the third trimester just kept going up. And so I worked with a midwife and she started to get concerned, which made me start to get concerned. So otherwise, you know, I was interested in an unmedicated birth and I was fairly active you know, kind of a green crunchy vegetarian, so I thought I was doing everything right and was really interested in being as healthy as possible and doing prenatal yoga and then to have my body seemed to rebel by just having a high blood pressure was a strange adjustment.
P: So it sounds like you hadn’t had that experience before. There’s no high blood pressure. No,
J: I usually have pretty low blood pressure.
P: So so let’s get to the birth then. How do you know today’s the day?
J: That’s with with both my pregnancies that’s a really interesting question, right? Because how I approached pregnancy I wanted to feel my body I wanted just to be really present in that experience. And I was really frustrated near the end of my first pregnancy because I kept having Braxton Hicks contractions every night from like 2am to 5am
P: Oh, wow.
J: To where I couldn’t sleep. I thought maybe this is it. Maybe this is it, but then it wasn’t they would go away. You know, as the sun started to come up, and I was so frustrated because I was exhausted from being up for three hours every night. And you know, thinking is this is is this it? So in the end with her I had to I was induced for high blood pressure. So they did Pitocin and everything and so that experience was…
P: wait, so slow down there. So where do you get to the point where they say, Okay, we’re gonna have to induce you and how does that unfold?
J: Yeah, I had, I think I had a, you know, at that point, I was meeting with midwife once a week. And so I had an appointment on Thursday.
P: And you’re like, like 37 weeks? Are you closer?
J: 38 about 38 Yeah. And it was high. Right. So they made me go to the hospital and their kind of triage area for pregnant women and lay there for a while to see if my blood pressure would go down on its own. And then they sent me home and said I need to be on bedrest that weekend in order to get my blood pressure down, and then go back on Monday and they were hoping the two midwives who I was working with at that point, were hoping that my body would just go into labor on its own or my blood pressure would be down and they could, you know, wait it out a little longer, but instead it was still high. On Monday, of course, right? Because I was nervous.
P: Did it feel like anything to you?
J: No, no. it didn’t
P: that feels like a particular cheat for someone who wants to be embodied.
J: Right.
P: that you can’t control and don’t feel
J: Yeah, exactly generating this birth.
P: So you come in on Monday, and they say, we’re just we’re gonna have to induce you.
J: Yep. I said, Well, we have to do this. It’s not safe. And then, you know, I was rushed off. I think I was crying because that’s not how I wanted my birth to be. It’s hard to have an unmedicated birth if they immediately start you on Pitocin right. So it seemed like what I had wanted was sabotage from the start before anything could even happen.
P: I assume they’ll do an unmedicated birth with Pitocin if you have high blood pressure, or no that’s not
J: Yeah, cuz they’re worried it’s preeclampsia, or it’s going to develop into preeclampsia. So I think their thinking is if your blood pressure is consistently high like that, it’s not safe and you need to get the baby out.
P: Okay, so does that mean that they’re you’re definitely having an epidural or what does that mean?
J: They did Pitocin it was up to me and whether or not I’d have the epidural. So what was interesting about my first birth is I was on Pitocin it was fast, right? So I was actually only in labor for about five hours, which I’ve been told is extremely quick for a first time, mother, especially an induction so my body probably was about ready, even if it didn’t start the way I wanted it to so they started me on Pitocin I tried. You know, I kept refusing other pain meds not because I’m against them, but just because my goal was not to have an unmedicated birth. So I kept refusing them.
P: And what’s the pain like how do you how do you feel?
J: It was intense? Yeah, it was intense like I lost. I don’t know if most women feel like this. But I just all the sensations went inward, right? I lost sight of what was what else was happening in the room. Someone could be looking at me their head, two feet away, and I wasn’t entirely aware of them. I was just internal at that point. But so I probably would have asked for an epidural if that part lasted a lot longer but but it didn’t then suddenly. You know, they said it was time to push them.
P: Wow, that is really fast for a first one.
J: Yeah. And I mean, the midwife had come in to check me in the hospital and thought she had more time. So she left to go get lunch or dinner. And then the nurses suddenly had to call her and say no, you need to come back here. She’s about there. So it was unexpectedly quick.
P: It sounds like you’re doing unmedicated, right?
J: Yeah. I had Pitocin. But I didn’t have an epidural. So it was okay in the long run.
P: And was the birth what you expected it to be?
J: It was That’s a good question. I think I was kind of in awe of how physical it was, and how much you don’t control at some point, right. Felt very much probably around the time I was transitioning that your body just takes over.
P: Yeah.
J: What I wanted, didn’t matter. It was my body. I wasn’t telling my body to do things. My body was going to do it and he was going to work to get this baby out whether I was ready or not. And that was a really, you know, for someone who wanted that embodied experience that was a really powerful realization for me to just feel my body do what it needed to do.
P: It feels like the high blood pressure is a bit of a teaser. Yeah, like look, you already have no control.
J: Yeah,
P: but it’s not painful yet? Yeah. And then after the birth was that look kind of the way you had envisioned that you were hoping for?
J: it was so physical, right? I wasn’t prepared to be bleeding that long and to have to do so much postpartum care every time you have to go to the bathroom and the smells and everything that was just very surprising to me. And I had stitches because she came so fast. I had a second third degree tear, I forget which one so I have stitches and just all that care surprising. I don’t think I was adequately prepped for that part of it. But so the physicality stood out to me there as well.
And then I breastfed both of my kids and it surprised me how long it took to become comfortable with that. Like it was those first two weeks are hard and I can definitely understand why. Many women just can’t make it past those. First two weeks if they want to breastfeed, especially if they don’t have supports. I mean, I remember one night my nipple was burning and I couldn’t get my daughter to latch and I was crying and I was frustrated and my husband was calling the clinic to see what to do because he didn’t know what to do. And you know, his crying wife here who can’t breastfeed at 11pm and so that surprised me.
P: You thought it would be more quote natural and
J: I thought natural easy, right? But natural does not mean easy.
P: Yeah, yeah. I mean, it’s particularly interesting. I just saw some article today about the infant formula shortage. Yeah. And my youngest is 18. And I like it set me in a panic. Yeah, you know, it’s a terrifying thing to imagine.
J: Yeah.
P: And people suggesting you should just breastfeed. Yeah. It seems like that is a suggestion that comes from someone who’s never breastfed.
J: Yes, yes. and who isn’t? I mean, even if you do breastfeed, there are so many challenges you face like, you know, I worked. So pumping has its own issue. balancing all of that, and yeah, it’s complicated.
P: So, how was as the baby in the fourth trimester? She’s fine. She’s,
J: yep. Yep, she she was.
P: And now it sounds like for the second child, it was unplanned. Is that what you’re saying?
J: Yeah, this was unplanned. So he was an unplanned pregnancy.
P: So is that you caught that because you missed your period or how that happened?
J: Yep, I’m missed my period. So we had I had actually told my husband I was done having kids. I didn’t want to have any more and then a month and a half after I hadn’t gotten my period. And then I took a test and it was positive. So psychologically, it was a lot to adjust to.
P: I can imagine what were there. What was your husband? Looking forward to having more kids or were you guys on the same page?
J: We weren’t so that was part of part of what made it so difficult. He wanted more than one kid a lot more than I did. So we weren’t in agreement there.
P: And that child is how old now?
J: He’s now five,
P: five, so obviously, we kept the child Yep. Can you remember that road? How did you how did you sort of get over the initial resistance? The idea?
J: Oh, that took a long time for me. And, you know, I was caught up a lot and questions of choice and questions of bodily autonomy and what do you do in this situation? And you know, that can be a big rift between partners and it certainly was for us and then but what do you do when you’re caught in the middle of it right, and how much do you want to put a relationship that risk?
P: I can look online at places like the Guttmacher Institute or the CDC to see that almost half of all pregnancies are defined as unintended. But to give a broader context to Jennie’s particular experience. I took her story to a trusted OB today…today we’re lucky enough to have Dr. Matityahu on the show a fabulous OB from California who’s got a lot of experience with these issues. So Dr. Matityahu, who thanks so much for coming on.
Dr. Matityahu: Thanks so much, Paulette, I love being on your show.
P: Great. Okay, so today we’re gonna talk about Jennie who’s a writer, and I’m gonna read from her writing about her issues. And she’s a piece called the political pregnancy published in the rumpus, and I’m just gonna read little excerpts here. So she writes the spring that Trump wins the Republican primary I discover I’m pregnant with my second child. The pregnancy is unintended. A surprise. A month after I tell my husband that I want to stop at one child. My urine on a stick reveals two pink lines. My reaction isn’t joy. I’m deeply conflicted. But when I mentioned potentially terminating the pregnancy, my husband walks out of the room refusing to discuss it. Earlier that winter when we were still debating a second child. My husband had said his purpose was to be a father. The fact that I no longer wanted a second child snared The Space Between Us, so that it was me holding him back me stopping him from fulfilling his vocation. I’m guessing that this isn’t Jennie’s experience alone. And I’m wondering if women have brought these kinds of issues to you in your practice?
Dr. Matityahu: Yes. And I actually have a couple that I can even think of in particular, because this is a little bit different from someone who’s not in a stable relationship that comes with an unwanted pregnancy. It’s more memorable and sometimes a more emotionally charged conversation when someone who’s in a stable relationship has an unplanned pregnancy maybe has a child already. It’s a really it’s a hard conversation and not I mean, I would say not a hard conversation for me personally, but but definitely I can feel like it’s an emotionally much more challenging conversation and decision for the for the woman
P: and just grappling with all of those and what cultural messages were we bring into the conversations and so that took me I would say, I mean, five years. So work through, I’ve done a lot of writing. I’ve written a lot of essays about motherhood, trying to work through all of the social and cultural and personal issues that came up.
P: talk a little more about the cultural message. What do you mean by that?
J: I think, I guess I don’t think or in my experience, there’s not a lot of supportive cultural messages out there. For women who are experiencing an unintended pregnancy. There aren’t a lot of stories I at least didn’t have access to them. I’m from a Catholic background and there, it’s very clear what you should do if you have an unintended pregnancy, right. There’s no option available. So that’s one cultural message and then I think even within more progressive communities, there’s a sense that you make a choice you want to make and you approach birth or reproduction or pregnancy from as empowered a position as you can. And it was hard to find guidance for kind of that messy middle ground where you know, you just have all these conflicting emotions and you don’t quite know what to do. And it seems like you’re going to disappoint someone no matter what, whether it’s yourself or your husband or your mother, or, you know, whoever voices in your heads and I found that challenging, you know, even especially right now, right, Roe v. Wade is likely going to be overturned or weakened and I’m in Arkansas right, which is I’m now in Arkansas, which is a very conservative area, part of the Bible Belt and most of you know there are a large percentage of the community here is what we’d call pro life. So what happens if someone has an unintended pregnancy surrounded by cultural messages that say abortion or choosing something different is taboo or not something you should even consider? And those can be heavy messages to try and work through especially if you yourself are struggling with what to do
P: outside the doctor’s office, just don’t see the hard conversations that may be happening. I took this issue to Dr. Matityahu And there’s so much cultural baggage around ways to handle unintended pregnancies that you do not want to carry out. So this is very much a struggle for her. So here’s another excerpt. She says, when I say I’m not excited for this child, he says, I’ll be excited for both of us, and something inside of me shrivels and cracks, because what does that mean for him to be excited enough for both of us, for me to become the body carrying your child others want? So when Jennie is living in writing about reflects our larger cultural conversation about bodily autonomy, do patients come to you with questions about abortion and share their conflicted feelings and how do you navigate that?
Dr. Matityahu: So I I have a lot of those conversations. I think those are two two aspects of the of the problem. I often will have the conversation with most women about this decision to keep or not keep the pregnancy will impact you for the rest of your life, no matter which decision you make. This is a life changing decision because for the rest of your life, you will either regret your decision that you kept or didn’t keep the bit you know, like for the rest of your life, you’re gonna say I would have had a one year old at this point, I would have had a two year old I would have had this or for the rest of your life. You’ll say, Oh, I’m so glad I had this baby even though I didn’t want it or you might say I love my child, but I would have completed school I would have kept my job I would have this I would have that. And so it’s an impactful decision no matter which way you go. And I think that most people, it’s about do I keep this life or or do I feel like it’s going to ruin my life either emotionally? Or etc. You know, and then what’s it going to do to my relationship? Like if you’re in a stable relationship, and you’re making this decision, and your partner is against that decision, that has a huge impact on your relationship? Because if you’re keeping the baby because your husband really wants it, but you don’t Okay, now your husband is happy, but you’re feeling resentful and miserable and how what’s that going to do to your relationship is like it’s so charged when you’re in a monogamous relationship. You already have a child together and now, you can’t even have a discussion about a current pregnancy.
P: Oh, I totally agree. And in fact, I’m, I’m working on an episode on abortion. And it’s very hard to get anyone to come and talk about it.
J: Yeah.
P: Because whether you’re from a Catholic background or not, that message is so pervasive. feel shame.
J: Yeah,
P: I keep I keep saying to people, let’s normalize this care choice. Your reproduction has got to be in your control. It’s too dramatic transformation of your entire life for someone else to decide that for you.
J: Yeah.
P: But people are still completely reluctant to talk about it because they feel shame around. Yeah. So what you’re hoping the standard and the ideal is is very much in conflict with Yes, a million other messages
J: And that makes it so difficult in that moment, right when you do have to make a decision. Because I think that decision, many people whether or not to continue or terminate and unintended pregnancy is going to be complicated. Sometimes it’s not right. Sometimes the answer is an easy, yes or no for many women, but I think oftentimes, it’s not an easier yes or no, it’s something people grapple with. And I think it’s hard to grapple with that personally. But it’s especially hard, I think, maybe even impossible sometimes to grapple with that when there’s so many cultural messages and taboos and so much shame associated with with that choice.
P: So unintended pregnancy is very common, as mentioned before, it accounts for almost half of all pregnancies. The lion’s share of those happen when birth control isn’t used properly and the rest happened when birth control is being used properly. In your experience is unintended pregnancy usually a complicated issue or by the time people get to you they’re they’re more settled.
Dr. matityahu: That’s a great question. I would say off the top of my head maybe it’s like half and half and so so I feel like there’s a lot of young women who come in and unintended pregnancy, maybe they’re not in a stable relationship. They’re not sure what to do we talk through what are the pros, what are the cons? What are they thinking what are the consequences? You know, are they in school, or do they have help? You know, and so, so I think that there’s, there’s definitely a number of women that will come in and be really conflicted. And then you know, there’s women who are married and their husband wants another one. They don’t you know, this is unintended, you know, and there’s a lot of conversation around that. And then there’s a number of young women who get pregnant and they are very clear like they call or they send me a message and say, I’m pregnant How soon can we talk about taking care of this and so for a lot of women, they see a positive pregnancy test. They’re like this is not for me, and then they they just proceed without you know, without having much of a conversation about it because they know what they want.
And then there’s there’s women who come in they’re like, this wasn’t planned and they’re, you know, they sort of voice through it, and they say, You know what, unplanned but welcomed and so we have a lot of unplanned but welcomed pregnancies where they’re like, Well, you know, I wasn’t careful. I knew this was a possibility. I was just being stupid, but I think I’m coming to terms with it. it really runs the gamut
P: it reflects that. It’s a complicated issue, right? So there’s a lot of different responses to it.
Dr. Matityahu: Yeah. And I think it’s a hard conversation to have and I and I sort of applaud women who feel comfortable coming to the office and sitting and having that conversation because I think women that come in I think that they anticipate being judged. there’s so many women that come in with an unplanned pregnancy, and think that they’re supposed to act excited. And when they come to my office and I and I say right up front, how are you feeling about this pregnancy, then sometimes they’ll take a step back and say, you know, I’m actually not sure and you can tell they’re embarrassed to even admit that and it allows me to say you know, there’s no judgement here. Why don’t we have a conversation about how you’re feeling about this? You get to decide on what happens with your body and your pregnancy and there’s no judgment. So if you want to have that conversation, we can have that conversation, and it opens up the door for women who are really embarrassed to talk about their ambivalence about the pregnancy. I think that most people feel like, well, I’m supposed to be happy about a pregnancy, especially if they’re in a committed relationship. They feel like well, I’m in a to committed relationship. I was being stupid about birth control. So this is my fault. I just have to suck it up. And I think that there’s a there’s a lot of hesitancy about bringing up whether they feel okay about the pregnancy people. I think women are embarrassed or uncomfortable or guilty if they don’t embrace a pregnancy and I think that there should be room for them to express their desire not to have a pregnancy or maybe to eventually come around to wanting to pregnancy I think there’s there’s a there’s definitely a discomfort with expressing there’s a discomfort with expressing like not wanting a pregnancy. But But mostly, I think the discomfort is if you’re in a relationship. That’s a committed relationship, especially if you’ve had another kid it’s almost like, like, how could you not know and so there’s a lot more judgment for that subset of women.
P: So what was the pregnancy like, given that you were ambivalent?
J: It was hard. I mean, it was really hard. I you know, struggled for someone who wants body pregnancy I felt not very embodied because it was hard for me to feel present in my life at that particular moment. So it was, you know, I struggled a lot with the fact that I wasn’t excited and what that would mean, and if that meant I would be a terrible mother and, you know, if I was ruining his life already, because I wasn’t excited and wasn’t welcoming of the experience. So it was really difficult.
P: As you can imagine, it’s a real struggle for Jennie throughout the pregnancy, and she develops Peri Partum Depression, and she writes, I get counseling and try to think positively about the birth. But a journal entry of mine written in early November is full of fear, fear that I won’t bond and I won’t be happy that something will go very, very wrong. I won’t be a good mother to this child. So I’m imagining, you know, fear of not being a good parent is normal enough. And you know, every first time mom probably has that is a very different situation. And Jennie’s conflict is that she feels so negatively about this baby, that she’s worried about what the consequence of that is. And I’m wondering if you think there is a consequence or is she creating a chemistry that is somehow affecting the baby?
Dr. Matityahu: A couple of different things in that so women that are depressed, anxious having mental health issues during pregnancy? There have been some studies done to try and parse out what kind of impact does that have on the unborn child? I don’t know that we have a great answer for that. But I think in addition to women feeling depressed and anxious, now they’re worried is my depression anxiety impacting my unborn child and so now it just magnifies their depression and anxiety. That’s that’s one thing. Well, I don’t think we have a good answer for that. You know, I wish I could just wave my magic wand and say, Fine, then don’t be depressed and anxious. But that’s not a reality. You can’t just wish that away. You can’t just can’t take that out of the equation. On the other hand, I do have a lot of women who are ambivalent about the pregnancy or just have depression, anxiety and then have concerns about bonding, not feeling excited about the pregnancy, not feeling connected to the pregnancy, worrying that they’re not going to be connected to the baby. And that’s that’s a real concern. That is a part of serious depression and anxiety that needs to be addressed. And so you know, to be able to see a therapist and potentially they need to be on medication during the pregnancy. I mean, that’s one aspect. I have a number of women who after the birth having postpartum depression a huge aspect of that is I don’t feel connected or bonded to my child. I bonded with my first one and I just don’t really feel much for this one. I feel resentment or I just feel disconnected or I just feel tired and aggravated or there’s so many different things that a mom can feel and then they feel guilty. So in addition to not feeling what they think that they should feel, they feel guilty that they’re not feeling what they think they should feel, and then they feel depressed and anxious about what they’re feeling and it just spirals. It’s a form of pretty intense postpartum depression when you’re not bonding with the child not feeling attached to the child not feeling happy about the child. I mean, it’s, that’s pretty serious. And so, again, having mental health support is is incredibly important. And it’s really challenging to get mental health support in this day and age and so there’s that and then feeling maybe ambivalent about taking medication when you’re feeling depressed. Then going back to Jennie, of you know, her peripartum and and postpartum depression has a very strong basis in But the whole lack of communication with their husband and lack of desire for the pregnancy and lack of ability to have that conversation with him in a productive way and come to an agreement where they both feel like they’re heard and and getting their needs met. And so there’s so much baggage behind the postpartum depression that she writes about. That’s not just something that an antidepressant is going to fix, right? And then there’s the religious guilt. So you are adding a whole new dimension of guilt, you know, in addition to society and husband and culture and religious guilt is is pretty intense in real.
P: I’m so sorry to hear it. That sounds really hard to manage. What was it like at your house? Was your daughter excited? At some point when she she was
J: yeah, she wanted a sibling. We ended up my second pregnancy had a boy and she she wasn’t excited about a boy. When we found out the sex of the baby, we told her and she threw herself onto the couch and started sobbing because she really wanted a sister rather than a brother. And then she was playing with her stuffed animals later that day, and she had them go to the hospital and have a baby and then return the baby to the hospital and exchange him for a sister. So she had to work through something.
P: so I’m wondering for and my sister is eight years younger than me. And I completely remember saying to my mother, don’t come home from the hospital with a boy.
J: Yeah.
P: And it was, you know, kind of probably, I wonder if it was probably on the cusp of ultrasound, so maybe they didn’t know the sex.
J: Yeah.
P: So I have all sympathies for your daughter. Yeah. thing to do. Was the pregnancy physically relatively straightforward.
J: Yes, that one was physically fairly straightforward mentally and emotionally. It wasn’t. But physically, it progressed pretty smoothly.
P: Well, I’m grateful for that. Because if you had, you know, high blood pressure in the second trimester, yeah, you’d be like, Are you kidding this? Yeah. And it’s hard and really my body. Yeah. So then let’s go to the birth and how does all that unfold?
J: Yeah. So you know, and here, it echoes my daughter’s birth in interesting ways, because I didn’t know what my body starting labor would feel like I just didn’t know. So as the due date, actually was well, he was born about a week early before due dates, you know, they’re all hypothetical anyway. But as the due date neared, I started to have those Braxton Hicks contractions again for like two to 5am and so I was like, is this it? Is this it again and frustrated with that? Once again, and then one night, you know, I was having these Braxton Hicks contractions. I couldn’t sleep but that had been the case for the past three nights. So I was just walking laps around inside the house and you know, eventually they became stronger but they weren’t consistent yet. So sometimes we’d be two minutes apart, and then there’d be 10 minutes apart and it just, you know, I was like body, what are you doing? But then all of a sudden, it just switched. And, you know, they were consistent and they were strong. So it’s like, Okay, I think we need to do something so I woke up my husband, but we aren’t from Arkansas, so we don’t have family nearby. So we needed to call a friend to come watch our daughter’s so that we could go to the hospital and she lived 30 minutes away so we allow for her to come and in the meantime, it’s like, we don’t have 30 minutes. So you know, he was just coming so he ended up being born and in our bedroom.
P: Wow. What so that sounds like a fairly stressful, a fairly stressful thing to understand in the moment like, Oh, we’re not going to get to the hospital. are you doing all this figuring out or your husband is doing it or
J: it was mostly me. But it Didn’t it feel stressful to me it felt like all right, this isn’t happening, right? Are this is happening? Not going anywhere. And again, there’s no choice right? So it felt once again, like, you know, my body wasn’t giving me the option was saying this is what’s happening right now. So let’s do this. I think it was a lot more stressful for my husband than it was for me. He was very nervous. And I was like,
P: it almost seems like the universe heard you say I didn’t want the intervention I wanted unmedicated and they’re like, no problem.
J: Yeah. Yeah, I did. I had I had hired a doula. Who I was working with for that pregnancy. And she ended up saying afterwards, I think you were just in labor denial, because you didn’t want to go to the hospital, which I don’t know maybe, you know, deep in my subconscious that was the case. But I, you know, I was actually pretty pleased with how that birth occurred. I felt more empowered in that situation than
I had expected to just somewhat the
P: do midwives arrive after the baby’s born or how does that all work?
J: Yeah, the baby was born in July arrived at our house and then eventually we called in the hospital and ambulance transported me to the hospital to have him checked out and everything.
P: But you guys cut the cord and you deliver the placenta and all that stuff by yourself.
J: Yep, yep.
P: Wow, that seems incredible to me. And then you like walk to the ambulance or they carry you out or hearing me out. As the baby was totally fine,
J: and the baby was fine. Yeah, he was a little cold. So they warmed him in a heated incubator for a little bit after we got to the hospital. But otherwise he was fine.
P: And given your entrance into that delivery. Are you feeling in any of the euphoria of having delivered once it’s over?
J: I think I think a great deal of relief. Yeah, I think I felt a great deal of relief, and I was impressed with what my body did and that my body was able, you know, was able to do that on its own really,
P: and are you happy to jump back into breastfeeding or what’s your relationship with that?
J: I was, it’s so strange because you forget a lot once that time period has passed. I feel like I forgot a lot from my daughter after that time period to hip cast. And then when my son was born, it was like, oh, yeah, I remember this part. I remember what it’s like to wake up, you know, every hour and a half throughout the night and have one half of your shirt soaking wet from milk, spraying out of the other breast while you’re trying to breastfeed on the other side and be wet from those nights so that you get those first few weeks afterwards and yeah, familiar in an intense way.
P: Yeah, yeah, I bet. I know. High blood pressure this time. No high blood pressure. Yeah. Well, that’s good. That’s excellent. What was this postpartum like?
J: It was? I mean, it was a challenge. Mentally and emotionally much more than it was with with my daughter. So I definitely struggled with some postpartum depression afterwards, just because of how physical that period is and how much work it is right? You can’t half time being a parent of a newborn. Or, you know, it’s it’s demanding physically, mentally, emotionally. And since this wasn’t an experience, I felt I had signed up to do a second time. That was a challenge for me. So I struggled with that adjustment. But persevered I guess.
P: I’m glad you made it. To the other side, although that sounds like a difficult road to traverse, especially if you’re not if the switch does not flicking you at some point during the pregnancy, right? Because it just gets harder to manage and there’s and you know, you thought your autonomy was being pressed when you were pregnant. Yeah, wait till he’s here.
J: Yeah.
P: So that sounds difficult. Having gone through that, would you have advice for younger Jennie? If she do it again? Or are you too close in time to the birth of a pregnancy? To have a perspective on it?
J: I mean, my advice for younger Jennie would be. I mean, I guess my advice for myself in the moment during those, some of those difficult periods would be that this is normal, right? I think. We don’t always recognize how normal complicated reactions to pregnancy in the postpartum period can be and it is couched or framed as abnormal or pathological when in fact, you know, any, any woman who is pregnant or raising an infant in a situation where she doesn’t have the support she needs, is going to feel strained right? And is going to be anxious or depressed and things like that. So I would tell myself, it’s normal and that you’ll get through it. I would also tell myself that it’s okay. To be more assertive about your choices and your autonomy.
P: It’s such a good point to say that it’s normal because there are no other experiences that you have in your life that are complicated and first of all, in my experience, nothing as physically demanding. As Yes. Yeah. So to imagine that it’s all not even like rosebuds and rainbows, but that you’ll be happy aboutit all the time Yeah. Oh, yeah. It’s such a weird fiction. Yeah, that is present everywhere.
J: Yeah. And, I mean, if you think about childbirth throughout the century, especially, I’d say pre, pre modernization, globalization. Women were never alone, right. If they had a baby they had sisters, mothers, grandmothers, aunts, community members around them all the time helping it was a community you know, it wasn’t like what six what I experienced and what I think a lot of women today experiences. It’s you in the baby in a bedroom at night, right? Or, you know, people come by to see the baby and say hi, but there are long stretches of time where you’re alone in the house with a newborn and that’s not normal, right? So no wonder so many women struggle.
P: That is totally true.like you. We lived not close to family. And so family would visit for a week and be super helpful for a week and then leave. Yeah, you’re alone. Again. Yeah. It is a totally different experience when you’re doing it by yourself. Yeah, yeah. That is a very good point. Now I’m excited to read about all your writing. Tell it tell us a little bit about what you’ve written and where we can find it.
J: Sure. I’m gonna let the dog and quickly so he stops barking
P: that’s fine. I’m excited. It’s your dog and not mine.
J: Yeah, well, as a writer, you know, my impulse when feeling conflicted or about something occurring in life is to research it and write about it and try and unpack and understand it that way. So I’ve written a lot about motherhood, and a lot about evolutionary biology in the context of motherhood and feminism. So I written somewhat political essays. About bodily autonomy in the context of the Trump administration when I had my second pregnancy. And then I’ve also written a lot of essays exploring motherhood from that perspective of evolutionary biology and what kind of environment were most humans raising children and during that long hunter gatherer period, and in what ways do we not have those environments in place right now in a manner that causes complexities and makes it especially difficult, or lonely I guess to be a mother today.
P: That’s sounds so interesting, and and so on point and something that gets lost in the discussion of motherhood and what you should be and what the cultural expectation
J: Yeah, yeah, yes.
P: Do you have a website?
J: I do. If Jennifer L case.com. There are some links to essays there. So I’ve published some pieces. And I have one in the rumpus and one on breastfeeding and evolutionary biology. Currently in the North American review, and I have a piece and literary mama and eco tome so and then I have a short piece actually, that just came out in diagram magazine that’s available online.
P: Okay, cool. Well, I will definitely link to that.
J: Yeah,
P: Jennie, thanks so much for coming on. And sharing your story is so interesting. And I look forward to seeing more of your writing. Yeah.
J: Thank you for having me. It was so fun to talk about.
P: Thanks again to Dr Matityahu for giving us a larger context in which to understand the often complicated set of feelings that come with an unintended pregnancy. Thanks also to Jennie for sharing her story–this is not the kind of thing you’ll see on most social media, instagram and facebook, or Meta now I guess, are for bright shiny moments..and seeing those all the time sometimes makes us lose track of the whole picture. I will include links to Jennie’s website on the War Stories from the Womb website in the show notes. Thank you for listening. If you liked the show, feel free to subscribe and share it with friends. We’ll be back soon with another inspiring story.
Episode 54: The Complicated Emotions that Can Accompany an Unintended Pregnancy: Jennie’s Story
Episode 53: Surprised by Preeclampsia: Jess’s Story
Episode 53 SN: Surprised by Preeclampsia: Jess’s Story
Today’s guest did not anticipate that pregnancy would offer a totally smooth ride to parenthood, but the ride she did encounter included a number of experiences that were nowhere near her radar. Managing a lot of challenging conditions like preeclampsia, and post partum anxiety had significant effects on her: first it encouraged her to reimagine what her family would look like and to find contentment in this family even though it wasn’t what she originally pictured; it made her really engage in caring for herself, to focus on both her mental and physical health; and lastly, this experience made her feel grateful for the life she has now.
Find Jess’s podcast, Only You Podcast
Patent Ductus Arteriosus
Audio Transcript:
Paulette: Hi welcome to War Stories from the Womb. I’m your host Paulette Kamenecka. I’m an economist and a writer and the mother of two girls.
Today’s guest did not anticipate that pregnancy would offer a totally smooth ride to parenthood, but the ride she did encounter included a number of experiences that were nowhere near her radar. Managing a lot of challenging conditions like preeclampsia, and post partum anxiety had significant effects on her: first it encouraged her to reimagine what her family would look like and to find contentment in this family even though it wasn’t what she originally pictured; it made her really engage in caring for herself, to focus on both her mental and physical health; and lastly, this experience made her feel grateful for the life she has now
Let’s get to her inspiring story.
P: HI thanks so much for coming on the show. Can you tell us your name and where you’re from?
Jessica: Absolutely. My name is Jessica Meyer. I’m from the Seattle area. And I host only you a one and done podcast with my husband. Cool. Wow.
P: So I’m gonna get to ask it sounds like you have one child.
J: I sure do.
P: So before you had this child, I imagine you had some idea about what pregnancy would be like. What did you think it would be like?
J: I thought I would be anxious during pregnancy. I definitely was aware of that. I’ve struggled with anxiety my whole life, but I also kind of had this sense of confidence. Like, this is what my body’s supposed to do. I’m going to be able to roll with it. You know, whatever comes my way. I had this intuition. I think somewhere that it was not going to be the easiest pregnancy.
P: Okay, that seems much more attuned to how complicated the process really is.than most of us are on the entrance, but I’m interested to hear so did you get pregnant easily?
J: That part was easy. So I am one of five children. And my mom has always told me that it’s like for our family getting pregnant is usually the easy part. And also for my mom, her deliveries were really fast. So I only tried for a week, and I was pregnant.
P: Oh, wow.
J: Yeah, I got off birth control and I was pregnant one week later.
P: Was that exciting or were you like, Oh, my God, I I’m not ready.
J: I was so mad at my mom because she told me it would take a little while she told me it would take after birth control that it would take about six months. That was her advice. She was like, it’s easy to get pregnant. But if you’ve been on birth control, sometimes it takes your body a little bit of time to like, you know, catch up and so give yourself three to six months after birth control and it should happen pretty easily for you. But it happened immediately for me and so I was like, You lied to me. You told me I had three to six months. And now let’s just here just like that.
P: Yeah, that does sound like pregnancy on demand, which makes for wafer thin adjustment period. So you find out with a home kit is that how you found out?
J: Yep. My husband knew before I did. I was particularly moody and emotional, a different part of our lives. We were also closing a business that we used to own. So I was sort of in the process of cleaning up the retail store and saying goodbye to this really important chapter in my life. So I was really emotional anyway. And I remember one morning before one of the last days or no it was the very last day of my business being open. I was crying. And my husband was making me an apology breakfast for for nothing right. But he didn’t have bacon and so he went to the store to get some bacon and he came home with a pregnancy test. He was like, just in case, you know, he knew that we had been trying and he was like, You seem a little different. And I know it’s the last day of your store. But why don’t we take that too and I was just like, flippant, you know, whatever. I’m so sure. I’ll take it fine. And wouldn’t you know it? It was positive. So
P: wow,
J: we found that out on the last day of this other chapter. It was really beautiful.
P: There’s a story book element that timing. As you’re closing the doors on the store, you’re opening them onto this new adventure. So take us through your pregnancy. How was it the beginning? What did you have morning sickness or anything like that?
J: Yeah, I was a waitress at the time. So I had left that business and I started waitressing because we knew that I was probably going to want to stay at home with the baby so I just wanted the job for the in between times. And I was very sick in the first trimester. I remember potatoes would make me really really nauseous and I worked in a restaurant that had a lot of French fries. And just the smell of that would make me so sick. But it was I didn’t actually like throw up that much. It was more just a general feeling of queasiness all the time.
P: Yeah. And did that go away after the first trimester?
J: it sure did
P: Good. Okay, good. And then and then how was the pregnancy after that?
J: Well, it was at the 20 week scan that we found out that my daughter was small. She was you know, in a low percentile, I think about the 20th percentile at that time. And we also found out a couple other things. I had marginal chord insertion, which meant that the umbilical cord was sort of right at the end of the placenta, and that can cause growth restriction as well. And then we found out that her kidneys were not developing quite right. And that’s an issue that my nephew had struggled with as well and he kind of just grew out of it. So that 20 week scan, for me was very confirming for a lot of the anxieties that I had kind of struggled with. I remember at the very beginning of my pregnancy and pretty much throughout the whole thing I was glued to this website that tells you how likely you are to miscarry that day. It’s a percentage, and it goes down every day as you get further along into your pregnancy and I was terrified of losing this baby at that time. I didn’t know I’d be one and done. But I still don’t know it was my first pregnancy and I already an anxious person. So I just felt fear and so when we had that 20 week scan it was like see you were right all alone to be scared.
P: well that sounds regrettably eventful. That’s a lot going on.
J: It was it. It scared me.
P: Let’s go slow for one second here. You’re sitting down but you don’t look giant like somebody
J: I’m very small.
P: So somebody has to be in the 20th percentile like why not? Your baby?
J: Totally. Yes. I’m, I’m five to and like, you know, 120 pounds or something before pregnancy. So the doctors were like, Yeah, you’re small. My whole family is small. We’re all you know, petite women. My husband is like six five or six something I don’t know. So it could go either way with our daughter. But they weren’t so worried about the small aspect, but it was that plus the marginal court insertion that had them a little bit worried because they needed to be able to keep an eye on the blood flow.
P: Yeah.
J: And to make sure that she was actually getting everything she needed and not to spoil the story, but she wasn’t
P: and the kidneys. Is that a genetic issue since you said your cousin have as well or
J: it may be genetic. It’s also just a common issue for babies just in general and it’s almost always something they grow out of. It’s just one of those things we had to keep an eye on as she it was like, I don’t even remember anymore. Whatever her kidneys were connecting to that connection was too thin. I’m sure there are folks out there who know more about it. But luckily that didn’t end up being one of her long term health issues going forward.
P: Good. And so what do they do after this? Can to kind of keep an eye on you?
J: They just did more ultrasound so I think we did an ultrasound after that every month. And I think that was pretty much it. I was with maternal fetal medicine instead of a midwife at that point. They were just watching us really closely watching my weight watching the baby’s growth and she went from the 20th percentile at 20 weeks to like the 10th or maybe the fifth by 30 weeks. So she was definitely growing very slowly and not in line with her own curve. You know, so if she were at the 20th and stayed at the 20th that wouldn’t have been an issue but they could see her kind of getting smaller and smaller.
P: Well, that sounds stressful. How are you between ultrasounds?
J: I was a wreck. Oh my gosh, trying to eat as much as I could. And I remember feeling really guilty. Because I am such a small frame. I wasn’t. I felt like I was putting a lot. I felt like I was putting on a lot of like water weight. You know, I felt very swollen. But I wasn’t really gaining that much and I just felt like I blamed myself. All the time, because it must be me because I remember when I was sharing with my husband’s mom one time how anxious I was. She said Don’t even worry about it. The baby’s going to be fine on our side of the family. We’ve never had any trouble with newborns. They’ve always been perfect. And those words were just ringing in my head like okay, so you’re saying if anything goes wrong, and it’s 100% me, it’s not your side of the family. I hear that. I’m going to take that in. That’s all I could hear but she was trying to comfort me.
P: also Pregnancy is a weird state have 100% responsibility and no control.
J: totally right. Yeah.
P: So it is hard not to feel responsible for something going on inside you. Yeah, but you really obviously you didn’t put the umbilical cord where was
J: I did not. Not intentionally,
P: that there’s not you know unless you’re not like, you know, smoking or you know, drinking too much alcohol like there are limits to what you can really do.
J: Right.
P: But I’m sympathetic. We’ve been into trouble during my pregnancy that required a lot of extra monitoring. I’ve never been a smoker, the anxiety of the waiting between those scans. definitely piqued my interest in becoming one. This is like a terrible…
J: Yes, completely.
P: It’s very hard not to feel like you’re personally being evaluated in those scans. And it’s hard to separate out, you know, the distinction between what my body is doing and what I’m doing.
J: Sure,
I think honestly, during pregnancy was the beginning of a long journey that I had with hyper vigilance. So during pregnancy, I was extremely by the book, you know, I was checking every single thing before I ate it. I wasn’t taking any medications that weren’t on the list even you’re drinking tea right now and it reminds me I was checking tea. What tea can I have? What do you can take out, you know, things that most pregnant women I think don’t worry too much about. I was hyper focused on the safety of my baby. And that was before I even knew about some of her health issues. So the whole time I was trying to take control of the situation that I had very little control over
P: let me ask you this. Were you were you physically healthy before you got pregnant?
J: Yeah. Oh, yeah. I’ve always been pretty healthy. I mean, even now, I haven’t ever had any health issues, which was why my pregnancy being the way it was, I think came as such a shock.
P: Yeah, that is super hard. You know, once you dig into the details, like the chemistry and all that a pregnancy is a miracle that anyone’s born ever. Like, it’s so so many things have to go right in just the right way. that it’s it’s a tricky thing to nail totally. So anyway, we’re in your story. We’re we’re getting ultrasounds were 30 weeks and what happens then?
J: So I think we were at the 35 week scan, or maybe it was right before the 36 week scan can we go in it’s just a regular growth scan. And the night before I was a wreck. I remember I was crying my eyes out with fear of what was going to happen at that next scan. And again, I think that’s going back to some of this like, anxiety, but also some intuition. Like I was really feeling like something was wrong. And it had been, I think, I think I was at a month between scans. So the last one was 30 and this one was 34. Somewhere around there.
P: Yeah.
J: And I was just feeling so scared. So I was there anything
P: was anything physical going on. Like did you feel pain or no nothing. You just had a sense
J: and she was kicking like my kick counts for good. I just want to correct myself. It was 36 weeks. I had the last one at 32 This one was 36. So when we were getting ready to go the morning for we would do our appointments before my husband had to go to work. So he was in his work uniform. He had his lunch all packed. We had our coffees, but I had my go bag ready pretty early on, just in case. And we drove separately to the doctor’s appointment like we always did. And they took my blood pressure. And it was crazy high. And so they were like that can’t be right. And I remember my eyes were swollen my whole face. was swollen, but I thought it was just because I was crying so much the night before. And so they took it again and it was extremely high. And then they didn’t tell me it was high. They did the scan, and she had dropped below the fifth percentile. So she was like somewhere in the second I think. And I remember the maternal fetal medicine doctor came in and with like, tears in her eyes almost, she was like just so sorry. You need to go to the hospital. You’re not going to be able to leave without your baby. We think you have preeclampsia. You gotta go
and I was just like, what you know this was not an outcome I had prepared myself for preeclampsia.
P: did you know what preeclampsia was?
J: I did from my you know, feverish research throughout the pregnancy of all things birth you know, I listened to a lot of birth podcasts. And I read a lot of birth books. And so to me preeclampsia was almost like a death sentence. I was really scared because I had heard a lot of really terrible outcomes. So she seemed scared. And that made me feel scared.
P: Yeah, yeah. Yeah.
J: And she basically said for the safety of you and your baby, that you got to go. And so I remember they put you in a wheelchair, wheeled me over the hospital. It was just like, This is crazy. Pierce called out of work. It’s like I think I’m gonna be on paternity leave now I got a you know, so I was already you know, I had already taken leave, I think for my job that so they wheeled me over, took my blood pressure again. I think at that point, like normal is 120 over 80 And I believe it was to 220 over 120
P: Oh my god. It was Yeah. Oh my I think the cutoff for preeclampsia is 140 over 90.
J: Yeah, it was very it was like scary high and so they put me on, I don’t know some kind of medication right away They put me on a high dose of low beta low almost right away and that actually I continue to take for a long time. And I remember one of the first things they did when I got into my emergency triage room was they gave me a shot in my back for pennies. Like a steroid shot for her lung development.
P: Yeah,
J: is there like this is happening now. We need to get this baby ready so that she can survive. It’s just, I mean, those kinds of words being thrown around pregnant mother where she had probably stopped growing somewhere between those two scans. So not only was I having a 36 weaker, but it was a 36 weaker who was probably the size of like 32 weaker.
P: So but she was still kicking for that. Those weeks right between 32 and 36.
J: Kicking. Yeah, yes. Okay. Yeah, she was still moving really great. So when I would do my kick counts and stuff that was all good. She seemed, you know, she seemed pretty strong to me. Yeah. And, you know, she, they were checking her so they put a monitor on my belly pretty quickly as well. And that was kind of the beginning. of my birth story, right then, you know, kind of suddenly on a random Monday morning at 36 weeks.
P: And so are they saying it’s gonna be a C section or are they saying you can try to like did you have had you have imagined what the birth would look like?
J: Yeah, I had a doula who unfortunately was out of town because we were away before my due date. And they told me that they were going to try to induce because they, they wanted to avoid a C section. I don’t remember why. Something about losing Blood, I want to say they wanted to do it naturally, at all costs. That was the birth plan. So they were going to bring me in and have me stay in a room and induce me. And because I didn’t have my my midwife or like my actual doctor there. They were changing care plans a lot. So it was like, Alright, we’re gonna get you in a room now. And start inducing you or we’re gonna send you home and have you come back Friday and induce you no if you go home. You probably won’t be okay. And so they were kind of changing up my care plan a lot because the way Badal did lower my blood pressure.
P: Oh, good.
J: So that that worked pretty quickly on me. It was a very high dose but it didn’t have too bad of side effects or anything. And it was just funny because I felt fine. Like I felt swollen but yeah, I blood pressure. It doesn’t really feel like anything for me. At least I didn’t have the tunnel vision that they talked about or the headache.
P: Yeah,
J: I wasn’t really getting any of those. So it was just kind of a real surprise for me that I was even sick. And I remember them saying, honey, you’re really really sick. And just being like, how I feel fine.
P: That is kind of a weird disconnect. Right?
J: Yeah.
P: So how did the How did the induction you know?
J: That’s okay. So they ended up giving me a room and I spent about five days being induced. So I was there a long time.
P: Oh my God.
J: They had such a hard time stabilizing my blood pressure, like the labetalol would work one day the next day, it would not be working anymore. So they try a different dosage and they tried it intravenously. And then Penny is like her heart rate would go down with too much medication. So that was on Monday. I think the Pitocin didn’t even start until Wednesday, because they were still just like trying to get me stabilized. And the Pitocin and the magnesium I think happened on the same day.
P: So are you in the hospital feeling anxious? Do you feel like I am where I need to be and we’ll sort this out.
J: It was kind of a blur at a certain point. Like the first couple days I was really glad to be there and I was really against them. sending me home. Like I do not want to do this at home like my anxiety is going to be out of control if you just have me sit there and monitor my blood pressure. Because you know, all throughout the night and day I had this monitor on my belly for a penny and then I had a cuff and I think every hour the cuff would go off. And then I could hear Penny’s monitor every moment. And so I was just like in full on hyper vigilance mode.
P: Yeah.
J: And like my mom was there my husband and like, luckily, this was pre COVID. So I could have, you know, a couple people there with me, but I just I wanted to stay in the hospital at all costs. And they weren’t going to send me home anyway. I don’t think so. The first couple days. I was definitely feeling like part of the care team. You know, I was really trying to make sure whatever medication I was on wasn’t affecting her and trying to manage my dosages and stuff. And then once they put me on the magnesium on Wednesday, I was kind of I was kind of useless to the world. There were a lot of side effects for the magnesium. I was very shaky.
P: Yeah,
J: like almost tremors they put me on. They put me on some drug at some point that they told me it would be like a glass of wine. And it was not like a glass of wine. It was like a bottle of wine for me. My husband always teases me and says that I asked the doctor I kept calling him man. I was like hey man. How are you? Like what? He said, I just seemed like I was my old self. But like way before being a mom like I was at a party.
P: I feel like that’s the way to do it. That sounds right.
J: I wasn’t worried about anything for that amount of time but I was still very shaky and so the cervadil and the Pitocin. I think those both started really working on Thursday. And then I was about four centimeters dilated on Thursday. And there was a point where they felt like, although the induction medications were working, they were actually putting too much strain on Penny. So every time I would have a contraction, her heart rate would go down. So they started talking about a C section at that point. They were like this induction is actually going to be too much on her. If we keep trying to go this route. She might not make it. You might not make it. So we were talking about a C section and I was really pushing for that. I was like I do not care about natural birth versus a C section. Whatever is safest like, please just take me down there. I want to be done like I want to be safe. But they were really adamant on doing it naturally. So we kept laboring, things kept moving. And then finally very early Friday morning she was born.
P: Wow. So have you slept at all of these five days. I feel like….
J: no
P: I feel like the blood pressure cuff alone would wake you up every hour.
J: Certainly not more than an hour at a time. No. Wow. I I was in a fog. I hardly remember. My husband was kind of updating our family in a group chat. I remember watching movies. We watched Shrek at one point I think it was sort of like a dream state.
P: Can you can you push when you have magnesium?
J: I did. I guess
P: Wow.
J: can I say something kind of gross.
P: Yeah.
J: Is that okay on a podcast like? So I’m very stubborn. And I remember when they finally took me into the birth room, so I had been laboring in a labor room and then they are going to take me into the birth room where they had a NICU team at the ready. And they had like a warming table. It was a huge room. I think this was the room they take women who are having a high risk labor so there’s like 10 people in there. Yeah. And it felt like a spaceship. I was so out of my mind. And for some reason on TV, there was a space show. So I felt like I was giving birth like on a spaceship. And they were like okay, they gave me the epidural.
P: Yeah,
J: there was nothing. That was fine. I was like that was fine compared to all the other things you guys have been doing to me. And they were going to do a catheter because after you have the epidural, you know, you kind of need to do a catheter. And I was like, I’m not doing that. I’m not gonna get a catheter because I didn’t want them to have to take it out later. After all the drugs had worn off
P: where’s fun bottle wine girl.
J; Those drugs had worn off. She would have been fine with it. This was like hungover so fun bottle of wine girl was no more and now it was hungover shaky magnesium girl. Yeah, and she was refusing a catheter. So they were like, I don’t think this is your choice. You have to go pee right now like we can tell your bladder is full and you don’t have any control. of your body. And I was like yes, I do. If you put a bedpan under me I’m gonna go pee right now. They’’re like that’s not possible. And I was like yes if this so they put it under me and I did. I totally went pee right there. And I don’t know if the epidural totally like took because I felt a lot of labor in my back. So I guess maybe it like, halfway worked because I had total control of my bladder as well.
P: Yeah.
J: Which was I mean, it wasn’t super painful. It worked where it needed to work. Yeah, but I just I remember that because it was a good example of me just being so stubborn and of all the things like catheters don’t hurt that bad when you take them out. It’s not fun. But I was about to give birth and I wouldn’t let them just so stupid.
P: gotta’ plant the flag somewhere
J: that’s where I draw the line. So the actual birth it was hard. I pushed for probably an hour and a half. Because I was so exhausted, like my body was tired and magnesium made me very out of it and I hadn’t slept. So I was just having a really hard time mustering up the strength to push so it took quite a bit of time for me to deliver her. And she was born at 1:44am on the Friday.
P: Wow. Oh my god, what a long labor.
J: Really long
P: Yeah. And what was her state when she was born?
J: So she was about four pounds. 11 ounces.
P: Well done.
J: Thank you. Not so bad. Yeah. She passed the Apgar tests greatly. So that was all good. She was cold. So she didn’t need to be in the warming table. They let her do skin to skin with me. She lashed right away. And then she did skin to skin with her dad under the warming thing or I mean like, I remember I had him wear a button up so he could do skin to skin with her, but it was like a wool button. So he was just sweating. It was way too hot. But they kind of stitched me up I had a couple of tears and yeah, she was tiny. But she was mighty.
P: That’s awesome. And did she stay in the NICU for long?
J: So they didn’t put her in the NICU. She was just rooming with us she had like mid level jaundice. So they were just having us nurse her a lot. And unfortunately, I think our care team maybe dropped the ball. I think she probably should have gotten in the NICU. And I think she should have been observed more closely. Because they sent us home the next day that I think maybe it was the Sunday. Yeah. So we spent Saturday there and I think they sent us home on Sunday morning.
P: Wait, this this is too fast for me to send you home.
J: I agree.
P: wait, your blood pressure is fine. Now
J: my blood pressure had stabilized but I was on the beta low. Okay. So I remember they were discharging us and she was doing the carseat test, which is what they do for infants under five pounds to make sure that they can like sit in a car seat. Yeah, when she passed him. And I remember being like to the doctor, hey, do you want to test my blood pressure again before I go? And he was like, No, you’re probably fine. Like they had completely stopped taking care of me. And they were just focused on her. And she seemed to be doing fine and they tested her jaundice just the one time and it was medium. So they’re like just put her in the light and feed her. Like okay, so we got home on the Sunday and she was getting yellower or and yellower and I hadn’t been able to get an appointment to get her seen for her first ever doctor’s appointment. until Tuesday. So Monday came around and it’s like she wasn’t eating very well. And they hadn’t given me any information on like supplementing with formula. I remember calling and being like, can I give her formula because I don’t know if she’s getting anything like I don’t have that much milk coming out right now. I think it’s just colostrum. They’re like hers. Her belly is the size of a nut. You know, she doesn’t need very much. I was like But she has jaundice. So we ended up getting an earlier appointment with a pediatrician. And she opened up her diaper or I did and there were crystals in the diaper because she was so dehydrated.
P: Yikes.
J: And she was like so she’s really dehydrated and she’s really yellow. So we’re going to need her jaundice. You know, we’re gonna have to check her jaundice. So what we’re going to do is I’m going to get you a room in the children’s hospital, so you can just go ahead and go straight there and you’ll get right into a room
we were like what? We have to go back to the hospital. And as it turned out her jaundice levels were like, off the charts. And she had to be she my little one day or two day old baby had to get an IV of fluids because she was so dehydrated. And that that was really hard, you know, high jaundice levels and dehydration that can that can kill an infant, you know, and I just feel like my care team really dropped the ball with us. So we ended up actually being at the children’s hospital for a few weeks, because while we were there, they found some other issues and she had a heart murmur. And it turned out she had a PDA.
P: Okay, according to the Mayo Clinic, a PDA is a heart condition. It stands for patent ductus arteriosus and it involves an opening between two major blood vessels that lead from the heart. This opening is supposed to exist in the fetus, and at birth is supposed to close for a baby that’s born at term. Whether it becomes a significant issue or not depends on how big it is. If it’s big, it can allow poorly oxygenated blood to travel in the wrong direction. And can weaken the heart muscle and cause all kinds of complications.
J: for babies that are preemies that haven’t developed all the way it doesn’t close completely. And it’s supposed to just close over time but because she stopped cooking, it never did. So you can just hear this big murmur this big opening in her heart. And so we had to, they had to decide if they want to try to close it with a surgery or if they’re going to do a couple other things. They decided to just let it close over time. And as of today, she’s 19 months old, it still is not closed completely. It went from really big to really really microscopically small. So we’re gonna check back when she’s two to see if it closes. But she was having some issues. Like with her breathing, she was having some issues with her heart and then her jaundice was you know she had all of these different problems that probably should have been caught and taken care of in the hospital. And she should have been in the NICU getting 24 hour care, but they just kind of sent us home.
P: Yeah, that seems like a weird decision. Also, I guess when you told me it was going to close on its own and I wasn’t thinking of a two year timeline. Is that what you were imagining?
J: Most of them don’t take that long. So usually when they say it’s going to close on their own, it’s like before the three month appointment or so.
P: Yeah, yeah.
J: But sometimes it does take longer, just depends on the kiddo and how big it was to begin with. There’s other ways that they can do it like when it’s really big and not getting smaller for really tiny infants. I think of them like Tylenol, or ibuprofen or something like there’s there’s non invasive ways for them to fix it. But if she does end up needing a surgery, it’s pretty not easy, but it’s not even open heart. It’s just like a catheter that goes under her chest and into her heart and it just kind of like this little tiny filler where that hole is so it’s kind of you know, almost 100% success rate, but they’re not, they’re not really important. Yeah, no, no, it’s not something that’s going to follow her throughout her life. Like a lot of people who have that condition never even know about it until they’re in their 50s or 60s and they have their first heart attack. And their doctor is like, oh, when you were a baby. This part never grew in. And it’s a lot harder to do this surgery or this procedure when you’re an adult than it is when you’re a baby which is why they find it. They’d like to nip it in the bud.
P: Now talk to me about you How are you feeling in the fourth trimester and what’s going on with preeclampsia? And does that all work out?
J: wouldn’t you know it, I was still super sick. I remember when I was in the children’s hospital I felt pretty bad. And I don’t think I was taking any medication anymore. I think they just let it all come out of my system because traditionally they say the number one way to cure preeclampsia is to have a baby. I did that. And sort of I think just assumed it would solve itself. So my mom had encouraged me to get one of those at home blood pressure. cuffs at one point but we were in children’s hospital so I wasn’t going to leave her for even one second. I was having some really bad postpartum anxiety and depression and seeing her in the lights, the biliruben lights that was very traumatizing for me. So I couldn’t leave her I just couldn’t step away even for a second. And so I think it wasn’t until like a week later that I finally got out and got my blood pressure checked and it was super, super high.
So I called my midwife or my doctor and they’re like, Yeah, you have to go to the emergency room. I had to leave my infant, go to the emergency room with my mom. And they were trying to decide if they were going to admit me, put me back on a magnesium drip because they were like you have postpartum preeclampsia.
P: Yeah,
J: you’re still a risk for a stroke or a seizure. We can’t like just let you walk around like this.
P: Yeah,
J: but I didn’t even notice and I think even if I was having symptoms, I wouldn’t have done anything because I just wanted to be with her. Like my my mom’s sense was too strong. I couldn’t take care of myself. But it was actually my mom. You know, convinced me so I have my baby but I’m still her baby. You know. So that was kind of a special moment for me that my mom was so involved in making sure that I was getting taken care of as well. So they ended up not admitting me I remember I was crying asking them begging them. Please don’t make me stay here. I need to get back to my baby. She’s in the hospital. And they just put me on more labetalol and I think one other medication and had me monitor it again every day on my own and it actually took three months for it to stabilize.
P: Yeah, that’s how it goes sometimes, right?
J: Yeah.
P: And how’s everyone now?
J: Oh, good. I’m good. I mean, I checked it for a long time, I think up to the six month mark. And then now whenever I go to the doctor and it’s been completely normal since Penny is growing amazingly well. She like skyrocketed in growth because I ended up pumping for the most part at the Children’s Hospital. They had me kind of 24/7 hooked up to have planned and so they could measure her feeds because they we had this big chart up on the wall and we would write down exactly how many milliliters she would take. You know it was like that my and then we would supplement with formula or donated breast milk as needed. So for the first few months of her life, I was nursing concurrently with pumping and doing measured feeds. And so between the first and third month she like bumped right back up to a decent percentile. You know she’s still not huge, but she was back up to like that 20th percentile range good of like, not even one.
P: Yeah,
J: but between birth and that first doctor’s appointment. She went from four pounds 11 ounces to just four pounds even. So she lost 11 ounces just the first day of being alive. She was really having failure to thrive, basically And the pediatrician who sort of sent us to the Children’s Hospital the first time is still our pediatrician now and every time she sees Penny, she’s like, I cannot believe this is the same baby as that stick of butter you brought it as she was the size and the color of a stick of butter.
P: That seems like a triumph. Right? That’s that’s a great endorsement of all parenting. Yes, I’m working on another episode of the show that includes the story of a woman who experienced preeclampsia in ways that are different from yours. And I’m putting together that story. I talked to a maternal fetal medicine doctor who specializes in preeclampsia research. And she said we need to get away from using the word cure because there’s no quote unquote cure. Preeclampsia has this extended reach and that even after delivery, both the mother and the baby from the preeclamptic pregnancy are at higher risk for cardiovascular disease going forward. In her lab at University of Chicago they’re working on biomarkers to help identify preeclampsia much earlier. Oh, she said preeclampsia comes with all these kind of vague symptoms like swelling, or you might have a headache really have a little hypertension, but there’s no protein in the urine and so it doesn’t get caught. And so her lab has figured out the ratio of these two chemicals that a preeclamptic pregnancy produces if you look at the ratio and so they can predict, you know, a month beforehand, kind of which path that you will go on because some people have hypertension and it doesn’t develop into anything.
J: Sure.
P: So talk to us a little bit then about your ongoing care of yourself or like what you’re doing
J: so I think preeclampsia basically what led to us being one and done. First and foremost. Yeah. It took me about a week from having, you know, been past that experience to say I’m not doing that again. Yeah, and talking to doctors because we’re in the hospital setting and saying Is this likely to happen again? And I’m saying well, yeah, if you’ve had it once, it’s not unlikely that you’ll have it again. It’s not 100% Guaranteed right? And then talking to my primary care doctor after having postpartum preeclampsia. They told me that because I’m like, so predisposed to hypertension, and then it kind of stuck around for so long that he would think it actually is more likely for me to have it a second time. I’m 29. Now so if I were to get pregnant again, I would be a little bit older. And for me, from what I can tell from my care team, it feels like a 5050 split, whether it would happen again in my second pregnancy. So that was my first decision. We were gonna have several kids and we decided to cut it short at one.
And aside from that, I’m just a lot more involved in my care, you know, I go to my doctor’s appointment, I do yearly physicals, I try to stay active, all these kinds of things. I actually just found out that I have like permanent damage to my eyes. My optic nerve was damaged somewhere in my pregnancy. It’s possible that it was that time of very, very high blood pressure that did damage my optic nerve, but it puts me more at risk for Glaucoma. So that’s like another thing.
P: Can you do you feel any symptom of that now or no?
J: Well, I just got new glasses, but I went to the doctor just to get a routine eye exam because my vision had changed a lot pre pregnancy to now about 19 months later. And that’s normal, right? When you have a baby your vision changes, but it had gotten substantially worse. And I had this new optic nerve issue. So that’s something I have to do yearly eye exams and eventually I might have to do some glaucoma risk care. So there’s like these eyedrops that you can take to make sure there’s not too much pressure on your eyes. It’s actually very treatable if you catch it early, which luckily I seem to have done.
P: So Pregnancy is a stress test, obviously on everyone’s bodies, and that’s one thing it is hard to, I think, carry the burden of a potentially chronic condition. At the same time. It feels like you’re getting in at a time where maybe you can affect that trajectory.
J: Yeah,
P: so. That’s kind of you know, if there’s any good news to be had in this
J: I feel like you know, my husband and I met and we pretty quickly got married, like within a year and a half of our first date. We are married and how to house like we moved very quickly. And we had already known each other a long time so his sister is my best friend.
P: oh lovely
J: So we knew each other but like our first date, I should say not really when we met anyway. It just all moved so fast. And sometimes I wonder like wonder what made me want to move so quickly. And I wonder if somewhere deep inside like I wanted to do my pregnancy as early as possible before I was any older, because maybe my intuition was telling me like this isn’t going to be super easy on your body. And I don’t know. I just wonder if the universe helped me out with that or something. Because
P: Yeah, no kidding.
J: I kind of got out lucky all things considered. And so Penny,
P: totally, totally. I’m curious here. We’ll say this. If you could give advice to your younger self, what do you think you’d tell her?
J: I don’t think I would change anything. I wouldn’t have wanted to have a baby any earlier. That’s for sure. Yeah, just like emotionally and maturity wise. Yeah. Right. So I think I would be pretty proud of my younger self for everything that she did to get me here and get me to a place where I can be a good mom and and survive this really difficult pregnancy.
P: It is amazing, right? I’m sure you look at Penny as she grows every day and think I can’t believe it.
J: Yeah, I absolutely do. She’s my lucky penny. That’s what I call her.
P: That’s awesome. So how old is she now? She’s she’s not too yet.
J: No, she’s 19 months old.
P: So we’re her tricks. What does she like to do?
Unknown Speaker 13:40
Oh, she’s got a big personality. She’s really funny. She likes to make people laugh a lot. So she’s like our little comedian. If she does something that makes you laugh once she will like do it a lot to try to keep getting a rise out of you
P: super cute.
J: She likes to copy what you’re doing so like today, or yesterday we were doing like a Baba Baba bad and then she would do it back to us. Yeah, like she’s very musical. And I don’t know, I think she’s going to be somewhere in the entertainment world because she just like she likes to be the star of the show. And being an only child is only going to add
P: I was gonna say to the stage already. Yes. Nice to know, totally carved her path is awesome, Jessica. Thanks. So much for coming on the show and sharing your story. It’s an important one to share and one that I think is totally hopeful.
J: Oh, good. Yeah. Thank you so much for inviting me and if there are any parents out there who are struggling with the decision to relive anything that they went through with their birth experience, I would just like to say to them, you know, your mental health is really important. And your physical health is really important. And if that means your family has to look different than you thought it would, that’s okay. And you can give yourself a little bit of grace for that.
P: Yeah, that’s a great ending message. Thank You
J; Absolutely
Episode 52 : The Right to Choose your Reproductive Destiny: Tova’s Story
Episode 52 SN: The Right to Choose your Reproductive Destiny: Tova’s Story
This show is focused so far on the unexpected elements of the emotional or physical toll of pregnancy and birth. Today that story is extended to include the emotional and physical impact of a pregnancy that didn’t find its footing and ended in abortion. Abortion is obviously a topic most people have strong feelings about. And unfortunately, those strong feelings tend to flatten the conversation, when in reality like all elements of reproduction, thinking and talking about abortion requires nuance. Some people may seek out first trimester abortion early in their pregnancy and feel like this choice. This procedure is like any other medical procedure. For other women. It comes with more personal or cultural or religious baggage and it’s in no way easy for them to make that choice. In today’s episode, my guest has a second trimester abortion and her pregnancy which many complications arose. And her experience of working through the grief of this loss is impactful to hear and very much a story that I will carry with me for a long time.
To find Tova’s book, Finding my Muchness, here
And her current Venture, Spark’d Earseeds
Statistics on Abortion
https://www.cdc.gov/nchs/products/databriefs/db136.htm#:~:text=The%20estimated%20number%20of%20pregnancies,2007%20has%20been%20well%20documented.
https://www.guttmacher.org/gpr/2019/09/us-abortion-rate-continues-drop-once-again-state-abortion-restrictions-are-not-main
Twins in the Womb
https://www.verywellfamily.com/twin-chorionicity-explained-4114659
https://fetus.ucsf.edu/monochorionic-twins/
https://women.texaschildrens.org/program/texas-childrens-fetal-center/conditions-we-treat/monoamniotic-twins#:~:text=Monoamniotic%20twins%20are%20identical%20twins,they%20also%20share%20a%20placenta.
Di/Di, Mo/Di, Mo, Mo
Audio Transcript
Paulette: Hi, welcome to war stories from the womb. I’m your host, Paulette kamenecka. I’m an economist and a writer and the mother of two girls. This show is focused so far on the unexpected elements of the emotional or physical toll of pregnancy and birth. Today that story is extended to include the emotional and physical impact of a pregnancy that didn’t find its footing and ended in abortion. Abortion is obviously a topic most people have strong feelings about. And unfortunately, those strong feelings tend to flatten the conversation, when in reality like all elements of reproduction, thinking and talking about abortion requires nuance. Some people may seek out first trimester abortion early in their pregnancy and feel like this choice. This procedure is like any other medical procedure. For other women. It comes with more personal or cultural or religious baggage and it’s in no way easy for them to make that choice. In today’s episode, my guest has a second trimester abortion and her pregnancy which many complications arose. And her experience of working through the grief of this loss is impactful to hear and very much a story that I will carry with me for a long time.
Let’s get to her inspiring story.
P: Thanks so much for coming on the show Can you introduce yourself and tell us where you’re from?
Tova: Hi, my name is Tova and I am coming to you from Las Vegas.
P: Oh lovely. Is it is it 1000 degrees there?
T: It is a basically about 1000 degrees. Yes. Yes Today is particularly hot I think perhaps the hottest day
P: so today’s episode is on abortion, which is a tricky topic and looking for people to talk about it in 2022 There’s still a lot of shame around it, which I’m disappointed to see. I’m the mother of two teenage daughters. And I hope they don’t grow up with the same context that many of us grew up with. particularly unfortunate given that abortion is relatively common. I think the numbers I’ve seen and suggested that on average in the US there’s something like 6 million pregnancies and just under a million abortions a year. I’ll put links to these numbers in the show notes. Having said that, I only know one person who’s had an abortion and I only know about that because I was there right
T: that you know you only saying that I know of right which can’t be right.
P: Like can’t be right. There must be people around me doing that. So I appreciate that you have offered to share your story which is a little bit of a of a different version.
T: I think it’s probably a lot of a different version. But yes, yeah. Well,
P: I’m imagining that most people who have to make this decision when you did have to do it for similar kinds of reasons.
T: Yes, yes I. At this, you mean at the stage of pregnancy where I was when I met my students? Yes, I believe most. Most, if not almost all people who get to that point, though I can’t speak for everybody and I personally know from not only my experience, but then post my experience the women that I connected with which were a huge part of my story. My journey as they say,
P: so do you want to sort of walk us in is Was this your first pregnancy? It was not.
T: No, So this was my second pregnancy. My oldest I was married my oldest daughter was just about one years old when I got pregnant. Me and my husband. We had a plan as everyone does that, right. That’s what the whole show is about.
P: Yeah. Yeah.
T: Like we’re gonna have two kids. We’re gonna have them close together. They’re gonna be best friends. Yeah. And then we’re done. And then we’re like getting back to life as usual. That was our plan. And so we had our first daughter that pregnancy was a little there were some issues that came up but ultimately everything was okay. And then as soon as she turned one, we were like, Okay, let’s get working on the second. So we can get through that we had decided like on her first birthday. We’re like that’s the start to try. I also apparently in retrospect, doing some dad got pregnant on her birthday.
P: Wow.
T: So like, we were like, Okay, let’s try and that second pregnancy turned out to be identical twins. They were girls, which was really surprising because that stuff happens to other people and not that it’s not hereditary identical twins is completely random. They say and there are no twins not there’s definitely no identical twins in my family like I don’t know any.
P: So how far along Do you find that out? Is that eight weeks or 10 weeks or
T: we found out? I was like literally already showing it five weeks? Like I’m a little girl and I was like, this is weird. And I joke to my husband the night before the first ultrasounds like five or six weeks, you know, I was like, Oh my God, why am I already showing like is this gonna be twins and then lo and behold, we shut up at the ultrasound. And they relied like that.
The tech didn’t know how to communicate, and was like, Oh, it’s twin… There’s two and I was like, What are you talking about? No, you’re mistaken. And my nose was like, yeah, no, we’re no, she’s like, No, there’s no there’s the one and there’s the other but I don’t see a separation between them. She said. I was like, What the hell does that mean? Like I don’t know anything about what you’re talking about.
P: And it sounds like conjoined twins.
T: And that’s what I said. I said what are they like, conjoined. I was like, she looked at me like I was the idiot. And she said, No, there’s supposed to be either in two sacks, but we’re not there in the same side. And there’s supposed to be a membrane between them. But I don’t see it. You have to get a higher level ultrasound to see the membrane. I said, Well, what does that mean? And she was like, well, basically, if there’s no membranes, really high risk. And you know, it’s basically a done deal. I’m sure. I’m sure it’s there. We’ll send you for the ultrasound. Like yeah, yeah. So immediately, I went home and I was like, Hello, Dr. Google.
P: Yes.
T: And I started immediately learning what the risks were a if they don’t see the membrane, and then everything else that falls into that pocket have identical twin pregnancy complications and it’s a big bucket.
T: Okay, a little twins anatomy here. Baby sits in a sack connecting to the placenta with an umbilical cord. That SAC has two membranes and inner one called the amnion. And another one called the Korean majority of twins have their own placenta and their own amniotic sac. twins who share the amniotic sac, so no inner membrane separating them. Also share one placenta 70% of identical twins share placenta, but only 1% share both a placenta and a single sack. Sharing a placenta the source of nutrition and oxygen and waste removal can cause issues Tova will talk about some of these two I wanted to outline our resource sharing and blood supply with resource sharing. The umbilical cord that connects the babies to the placenta can attach the placenta in different places. If they attach it away that doesn’t share the placenta evenly. The fetuses can grow at different rates. Second issue is that when those two umbilical cords send out blood vessels into the placenta, these vessels can grow together, meaning twins will be sharing their blood supply, which can lead to issues 90% of the time, it does not lead issues and everyone’s fine and 10% of the time, it does lead to issues.
T: So when there is no membrane, the probability of those cords getting wrapped around themselves and each other tied in knots and everything is tremendous.
P: It sounds right, that makes sense. Right? And so that’s the risk. That’s what’s creating the risk.
T: That’s what’s creating one of the risks Okay, all right. So then the membrane they went for the higher level ultrasound they saw the membrane so that mitigated the risks of the take most of the risks of the tangling, all the risks are still there to a degree, but that main tangling up
P: just a quick word here before we dive into some medical terminology. There are three different categories to describe how to ensure the amniotic sac and the placenta, die, die mo die, and Momo die die is like to singleton pregnancy sharing the uterus. Everyone gets their own amniotic sac and their own placenta. Mo di refers to monochorionic di amniotic twins, so one placenta, but each baby gets their own amniotic sac vomo refers to monochorionic mono amniotic twins who share a placenta and a Sac
T: so hours were Momo that’s what they call them. A one placenta one sack but it did have the membrane the primary risk when you have a Momo identical twin pregnancy is that the placenta itself isn’t feeding into both umbilical cords evenly, and that the blood flow flows through the placenta from one baby into the other. Or that there’s you know, the veins and arteries across the surface of the placenta they overlap and where they overlap things don’t always go where they’re supposed to. One baby generally would get more of the blood and nutrients and one baby would get less. So both babies are at risk, one for overload and one for deficiency. And when that happens, it’s called twin to twin transfusion syndrome or TTTS. At the time, this is 13 plus years ago, it was very hard to find people who knew what they were talking about very hard. Even the doctors there were there were like three doctors in the country who say that they understood this disorder and it was so rare. And I would say one of the biggest points of pride or just a positive outcome from my experience and the collective experience of a lot of women or families that experienced this at that time or since then, is that we found each other and collectively that community has made a huge impact on awareness and Doctor knowledge and ability to treat this. So that’s a little sideline
P: that’s amazing.
T: It was amazing because back then like it was like finding a needle in a haystack. I don’t know if it’s just that I’ve been in this haystack. Now that I know I can see all these needles, but I can get to that to
P: you guys find each other on Facebook.
T: It was pre Facebook groups. There were there was a twin to twin transfusion message board and anonymous message board, which is where I started and there was just a handful of women who were like I was just diagnosed, they don’t know what to do help. I mean stuff like that. Now now it’s all on Facebook. So anyway, we we found that we were pregnant. I read all the research on TTTS. Ultimately, the goal was not to get it right. Like ultimately, if the placenta is doing its job, right baby a baby B they’re both thriving, all is good. So I found a new doctor. We saw him I think at like 12,13 weeks, and he was like oh everything is good. There’s a membrane I have a picture. It’s beautiful. One baby on top of the other. They look like they’re in bunk beds. And they were like, right, he’s like, okay, come back in four weeks. We’ll see how they’re doing.
So we came back at 16 weeks. And he saw the very first morning signs of TTTS. So the first warning signs are an imbalance of fluids. So each baby surrounded obviously there’s a membrane and you want each sack to be about the same. And one of them was smaller one of the sex was a lot smaller than the other. And he basically said here’s the deal. At this point at 16 weeks, they’re already showing it imbalance This is most likely going to develop into TTTS and you’re probably going to lose them both. And if you don’t, they’re probably both going to be born with like severe disabilities and you don’t want that I imagine so you probably want to just terminate the pregnancy and I’ve done all this research. Yeah, I was like well first of all, I know that there are like treatments for this. So there was this laser treatment, which was relatively new. At the time, there was like an amniotic reduction which removes some of the amniotic fluid from the baby that has more to allow for self correction and the other baby to get like there weren’t things and I was like, can we talk about those things. He’s like, they’re probably not going to help too much. And he’s like the laser surgery like nonsense. Like, okay, like, is it even possible to terminate one in order to save the other?
P: Yeah.
T: And he was like, no. I was like, what? I read it on the internet, like,
P: yeah, yeah, yeah,
T: what are you talking about? So I was like, we can’t talk or be doctor. It was really, like I’m joking, but it was obviously horrifying. And then he literally said, I have to go teach a class now. I won’t be here in two weeks. I have vacation. So you’ll come back in four weeks and we’ll see if everything’s still okay.
P: That’s a weirdly long leash.
T: Yeah, he basically was set and then he left he left us in his office to go teach a class B my husband sat there looking at each other like, what just happened? Sorry. Yeah, a lot of curves and you’re totally allowed to curse. Yeah, I was like, what what?
Like, like, basically you said, Come back in a month and we’ll see if your babies are dead yet. I mean, that’s what he said to us. Yeah. We were like to find a new doctor. And we ended up going to New York to Presbyterian Hospital where they had an expert on staff who was one of the few people trained in the laser surgery that is used to ablate the overlapping veins and arteries. On the surface of the placenta or otherwise deal with high risk pregnancies of this type. And we started going there. And we were going every two weeks.
P: Was that prognosis more positive? Did they think the pregnancy could still work out?
T: They did all the ultrasound the high level ultrasounds, all the things and I’ll be honest, it was so early, they were excited air quotes since we’re not going to see me but they were excited for my case, because they believe these things to be so rare and they had just started like the guy who technically was trained in laser had just finished his training in Europe on how to do it. And he had never actually done one yet here in the States. So I was like, his potential to to do this big surgery. The way TTTS progresses is in in five stages, or five stages. The first stage is an imbalance of fluids. This second stage is when the imbalance maybe reaches certain measurements like they would measure the widest gap of a fluid in the baby that was more tightly packed. And when it hit a certain stage, you were officially stage two when a certain measurement then and this was back then, not only has it hopefully changed, it probably has changed but we change these layers. So they would not do laser surgery unless you hit stage three, but we were not there.
P: Yeah,
T: we were basically at stage one, one and a half and he was like this is good news. You know, we’re going to monitor this carefully. We’re going to do high level ultrasounds throughout the pregnancy, baby B had a lot of fluid and baby A had less but baby it had she had a healthy amount of fluid. It was just less the secondary and third signs were like kidney failure because the baby was less the kidneys fail to develop. So when they start seeing that there’s other secondary signs and I had none of that. I was all wet all of it was just a fluid imbalance. So I was coming in. Believe it was every week, maybe twice a week, driving into the city paying $40 to park high level ultrasounds, keeping an eye on it. And the thing that we knew was that if we were qualified for laser surgery, we would do the laser surgery. We talked about doing an amniotic fluid reduction.
P: Yep.
T: But some people had done a fluid reduction and then subsequently did a laser surgery if they still needed it if the amniotic fluid reduction didn’t work, but the amniotic fluid reduction increases the risk of rupture, and so they don’t want to do it if a laser surgery has the potential to be needed.
P: Yeah,
T: especially in my case where they were super excited to maybe be able to do it. They didn’t want to do an amniotic production. They wanted to wait and see.
P: Yeah.
T: Because if it stayed and each baby was developing well and their kidneys were developing well, and there were no secondary signs we were we were good and we were aiming for 24 weeks, like the bare minimum, because also they said and again, I think they know better because of the accumulation of parents who voiced their experience. They said after 24 weeks, the risk goes down. A lot of anything happening, whatever. It’s not true, but that’s what they said. So we were aiming for 24 weeks.
P: God This feels like a bit of a sprint.
T: It was horrible. It was I mean it was it was just like in the thick of trauma day after day after day not knowing and you’re like you’re living and your body is doing this. And you don’t know what’s going on in there. Like you’re just like I don’t know, you just don’t know like day to day is was it where’s the fluid? I’ve been like feel does it feel fluid on the right side or like what do I know like and then they’re not doing anything but watching it. Right? Right? If we had the laser ablation and they each were just getting 50% of the placenta and they were kind of functioning on their own things. And one died, it would suck, but it wouldn’t affect the survivor.
P: Yeah,
T: since we couldn’t get the laser ablation we never qualified for it. We knew if God forbid one died, that would create basically a de oxygenation of the blood in her system, which could then flow through the placenta into the healthy baby and shut her down you know, create damage of some degree and you don’t know don’t know the degree, you don’t know anything. You don’t know anything. That was it. That was our that was our situation just after we go get the things consistently. The baby that had more fluid, they were like she’s fine. The baby that had less fluid was the one they were more concerned about. They were like She’s good. She got like two and a half centimeters, the other one had like 12 or 13 centimeters. Again, my numbers might not be 100% but they were optimistic. And then at 23 weeks and 2 days maybe I went in for my weekly ultrasound. And I was feeling actually really good because the pressure on my stomach was less than it had been and I was getting bigger and I’m small I’m like maybe 5 foot one and so it was a lot, a lot of carry weight. And we went in and did the ultrasounds and they were like, oh, have you eaten anything? And I was like, I’m like okay, and the doctor came in and basically he was like so the baby with the more than one they weren’t worried about died.
P: ugh
T: sometime between our previous ultrasound which was like five days earlier and that day she had died. And so that’s not anything more profound to say. It was horrible, horrible, horrible,
P: so unexpected.
T: It was very unexpected, because for the first time I was feeling good, of course I was feeling good. Because her fluid level because we’re in so anymore because she wasn’t super fluid. Yeah. And so the baby they were more worried about Baby A. She was doing fine on camera. But there was no way you know, her fluid levels were more balanced now. But there was no way to know what happened to her brain.
P: Yeah,
T: which is where the damage would have happened at the impact of the death of her sister. And so we were at like I said 23 weeks and it was 23 weeks and five days.
P: Oh my god,
T: we discovered that. And they specifically by the way, scheduled that appointment before the 24th week when they were scheduling it, they look at the calendar, they look at my dates, just because of all the impact that those numbers have on so many parts of this process. So basically they said to me, so here are your choices. And we I mean we obviously had discussed this at length throughout the prior weeks like what happens if what happens if what happens if what happens if and we had decided that without the laser surgery. If one of them passed away We were going to terminate because the risk to the survivor was too great.
I mean, and I was in the at this point. I knew women who had had their twins and last one and a half survivors who had severe mental and physical handicaps. I mean across the board from similar situations. I didn’t know a ton, but I knew enough I had seen even the ones who some of them who had the laser they’re survivors still had issues. But there was one in particular as the woman in Europe who her her daughter at that point was maybe eight or nine her survivor and I mean it was heartbreaking but she was going through raising this child could not was Yeah. And so we had 24 hours to make a decision because they needed to start the process on the 23rd day 33rd week and sixth day in order to fall within 24 week guidelines of New York City. And so that’s the decision that we made.
And that’s what we did.
I guess you might want to ask a question.
P: I’m so sorry. are covered with goosebumps that’s so traumatic to make it that far. And I think I wrote to you that we had a very touch and go pregnancy till the very end and then she they took her early she had open heart surgery. We never talked about it.
T: Really
P: we never talked about what happens or what it was too scary for some reason. And this is a complete fantasy. I’m imagining that articulating it puts it out in the world in some way that I can’t manage. Right so
T: I would agree with you there the the talking about it. I make it sound like We’re so mature and coming to the table like two thoughtful adults. That’s not exactly what it looked like. I mean, I think with with the twins having our daughter at home, and she was like one and change at this point and she was not an easy child. Or an easy teenager but I just knew I couldn’t. I couldn’t manage I wasn’t equipped and I wasn’t going to burden her with that. My sister in law has a special needs daughter who is high level needs not high level. Like she needs a lot of help and still not as much as many other you know special needs kids. And I look at my sister in law in Awe, I’m not equipped for that I am far too selfish, if that’s what it is. And I’m like, No, well,
P: are you making this decision for your daughter as well? Right. So,
T: I mean, I’m making the decision. For everyone. My marriage, my daughter, my future like thing and and even I hate to say it in a way but like for in my situation where they were twins that were bonded. Like there was something about them being able to rest together that brought me peace.
P: Yeah, yeah
T: I mean, I know that for a lot of people in my circumstances. Obviously you just don’t want one. If you can have one you’ll yeah but considering all of the all the moving parts of this, you find comfort where you can
P: Yeah.
T: And then there was comfort in that you know that they come together
P: and you did everything you could right You did everything at 7 million appointments and different doctors and you know kind of tracking you down and doing your own research and finding the people and
T: I mean, we knew more than most of the doctors, even the specialists. And in the months and years afterwards, the amount of work or like I was saying achievements or knowledge that has happened in this so rare again, air quotes because you can’t see them. It’s not as rare. As one might say it is rare, but it’s not that rare.
P: Yeah,
T: I was saying that we only at the beginning when I was pregnant. It was 2009 basically 2009 so I guess Facebook existed but didn’t really have groups and stuff like that. And the message boards that I was on were anonymous message boards on other platforms you just find it like and and what I noticed on those boards and they had sub groups and stuff, but it was almost like people would come in and say help I got a diagnosis. I don’t know what to do. And people would come on and be like, Oh, you’re gonna be fine. I got my diagnosis last year with your pictures and my beautiful twins. They ended up fine we got the laser everything’s fine. You hear a lot of that it’s gonna be fine because in my case, it was fine.
P: Yeah.
T: In the years post our loss, a lot of those groups started to reform on Facebook.
P: Yeah.
T: And a lot of the people from those groups that were anonymous in those groups, now we’re showing up not anonymous. On Facebook, in new groups. And it was the same pattern where somebody new would join the group and say, Oh, I just got a diagnosis. I don’t know what to do bla bla bla bla bla and people would chime in, everything will be fine or now. They ultimately I mean, they said other things too, obviously. But what I eventually started to realize was that you would sometimes see these women who would post and you would follow along we had our appointment above and then they would post bad news. We lost them both we did the surgery one was fine and then the other day, and then you would never hear from them in the group again.
It’s not that they weren’t there that nobody wanted to hear from. Right. Like if you’re a new mom and you’re like, Oh no, I just got a diagnosis. And you’re the mom with two dead babies. You’re not gonna be like, Oh, everything’s gonna be fine. But my babies died..Right? So those women became invisible in the group, except when people would post pictures of their identical twin and it was hell on earth.
You’d be scrolling your feed, already grieving your heart out and then identical twins, which is like the number one trigger like you see that? And it just, it just breaks you. So people would ask to not post pictures. And then the people who had survivors, they’re like, Oh, well, we should be able to post pictures of our children. Because we’re so proud and happy. We want to give hope to other parents who are currently pregnant and we think our picture give hope. And we’re like, no, like you cannot do that. It’s like trigger warning there. was a big rift in this community. And I have a big mouth Jewish mom was like, Fuck this. This is not working for everyone. So I posted and I was like like, I was like you cannot be posting this. It’s too painful. And they basically said, Well, if you don’t like it, go start your own group.
So I did I started a group for those grieving a TTTS loss. There’s well over 1000 Women in that group now.
P: wow
T: there’s a lot and that’s obviously just a small fraction of the families who go through this are the ones who are having a find on our group on Facebook, but it is through that platform that these families have been able to come together and compare notes and learn that there’s more than just twin to twin transfusion syndrome that there’s another variation called TAPS, which is they used to call the acute TTTS Where it suddenly showed up, like the baby died, where now you can see warning signs and you can test different blood levels to see indicate like none of this information existed. We have parents in that group who are vocal proponents and teaching and connecting with the biggest doctors around this so that they know better and can do better and train on this It is it’s through the families. It’s through the parents who connect and the ones who go silent in the main TTTS group because they’re like, no one wants to hear from me. And so we I created this new group, this new platform, I don’t run it anymore. I like handed it off to like after like seven or eight years because you can only hold on to that for so long. But I’m still in the group. Occasionally it’ll pop up
P: going through this process. Do you go to the hospital you have to go to like Planned Parenthood or
T: Well, in my case, so I was 23 and a half weeks I went to the outpatient portion of the hospital because it’s a three day process by the way, it’s not like so you go the first day I went and they in my case, I inserted a needle and they stopped her heart with potassium, I think immediately so it was quick and painless. And you can see it on the monitors for me, obviously, and scary and all the things, but again, I was comforted by the knowledge that she felt no pain. She got to go surrounded by my wombI mean that she would not have to be born. I know people who you know know their baby’s not going to start and I respect everybody’s decision to do what they need to do. But for me, being able to know that she never do anything but the comfort of my body and my love. That was big.
And then they are they give you like seaweed insert to dilate you and you wear them. They come back the next day to see how dilated you are to just basically go home still carrying in my case two babies. And then 48 hours later I went to the outpatient portion of the hospital. They had asked me if I wanted D & E or if I wanted labor and delivery but they and my husband highly discouraged me from going through labor and delivery because it would be in the hospital with other moms who are laboring and delivering. And also because I knew I wanted to have another baby. I don’t want that.
P: Yeah, totally
T: to tarnish my future labor and delivery with with with my future babies. That being said of all the decisions we had to make throughout this entire pregnancy. That is the one that stuck with me as perhaps the only one that I wasn’t sure I made the right one. But I don’t think there was a right one. So I don’t know that I made the wrong one. I just I made that decision. I wasn’t aware when you do a D and E or D and X at that point. I went in they walked me into the operating room. They basically knocked me out and I woke up 17 minutes later and the babies were no longer in my body. That’s the process as far as what I experienced. The babies are not fully intact that I did not know had I known that on know if it would have been I don’t know I don’t know if it would have affected
P: your questioning whether you should have gone through labor and delivery.
T: Yeah. Because in the aftermath of it, you feel crazy, right like okay, there’s the grief. And then there’s the what a fucked up story. Like you tell that story you’re like that can’t have possibly happened. And I had no evidence of them. No evidence of them that was what I didn’t have. So I was especially so what do they do with the babies? Right, so in most cases, the hospital respectfully disposes of the remains. And at that point, I could not, I could not make decisions.
P: Yeah,
T: and I was like, okay, like, I keep I don’t know, just do what you normally do, I guess, right? My biggest piece of gratitude is that somebody in my family who had had miscarriages were Jewish. I’m not the most observant person, but they were like the babies have to be buried in a Jewish cemetery. I was like, I don’t fucking want to know anything about what you’re talking about. Like, I was still praying it was in those two days.
P: Yeah,
T: she was like they have to be buried at the Jewish cemetery. And I was like, leave me alone. If this is important, do arrange it. You go call whoever needs to call my in laws, the doctors. I don’t care. But I don’t have the I don’t have the bandwidth for it and figure it out. Because I’m not dealing with it. The only thing I did do is I said to them at the hospital. I said my family is taking care of it so that somebody’s going to make sure they’re buried in a Jewish cemetery. And they were like, oh, so we should just like, refrigerated or whatever. I was like whatever you do, I again, yeah, zero bandwidth. So after everything was said and done, I’m back at work, right? an entirely different person than I ever was everything I ever knew everything I ever was everything I ever thought. Everything I ever saw myself as like not anymore. And I had no proof like people are treating me like I’m normal and there is nothing friggen normal. But did I imagine this? Like I literally started thinking did I imagine this? Did this really happen? I did. It’s that’s a pretty disturbing kind of place to be. And then I called my mom and I said by the way, where are those babies buried and she you know, traditional Jewish history historically does not allow the mom to know these things. Like they think it’s better. Like oh, just pretend it never happened. Because Are you sure you want to know? And I was like I am 100% Sure. I was at work and she told me the name of the cemetery. And I Googled it. And there’s a search bar on the website, where you put in a last name and find out where anybody at that cemetery is buried. So I put in my last name. It popped up fetus A and fetus B. It was literally the first real world acknowledge meant that they existed. Was this our website? Not the original question, but the original question was about why the labor and delivery versus the D and D are just
P: because you wanted it to feel real. So that’s, that’s a legitimate that’s a legitimate thing. And the other thing I was gonna ask is, if you have any rituals around the loss, I know in Japan and probably other places there are rituals around miscarriage and stillbirth and abortion so smarter we don’t have that really here. There’s nothing
T: in the communities that I’m part of people will do like the balloon floating things or they’ll celebrate a birthday steal or some of them will. They’ll buy gifts. They’ll go with their living children buy gifts on that baby’s birthday, then donate them. That’s really nice. Yeah, there are beautiful rituals. That people families create for themselves. I didn’t I have my own private things that matter to me even to this day. It’s been 13 years I wear a necklace with a little sun and a daisy on it, which were their nickname sunshine and Daisy. I mean, Its the only piece of jewelry I wear I never take it off. I think part of it was my husband was very much like a thing happened and now we’re going back to our life. You know, they deal with it differently. He even actually got close to an acknowledgement of actually grieving for years. I think there was like he was thoroughly there to like, support me and protect me or give me the space I needed all the things he thought he was working doing for me, but if you asked him were those your daughter’s key would be like No, I think it was probably at least it’s been 13 years. I think it’s probably seven or eight years before I ever heard him. Even acknowledge them in a slightly more personal like he finally got a space to kind of process it and it happened quickly and quietly. It was only like something I kind of tuned into going on with him. So for me to like do a ritual felt annoying or like you know that it required other people’s involvement
P: Yeah,
T: you know, it was it was.
P: I totally relate to that. And I, you know, my daughter survived and she’s 20 now and I did not use the word dead for 10 years. I couldn’t use the word but all through my pregnancy. They’re like oh, she’s definitely gonna die. She’s not gonna make it. She and I and I literally could not use the word and her name and a sentence for 10 years after and it worked out.
T: Right. Yeah. I fully, fully relate to that. Yeah, there’s there’s certain words constantly like they just you make those associations and there are unbreakable that said,
P: Yeah,
T: but um, yeah, so I did find so much of my own healing feeling or voice. My healing came from using my voice. So for instance, I like the doctor that was so excited to do the surgery but never got a chance. He was a young doctor, he was very ambitious. He was nice guy. He was kind he’s also the doctor that did the abortion. And he you know, he would call and follow up with me afterwards called to see how I was doing. It was really nice. And about a few months afterwards, probably around I saw I went to the cemetery about six weeks, probably within the timeframe of that, I decided to write the doctor a letter I wrote him a four page single spaced letter typed sharing my experience after because a he was with my husband on team like, let’s just do the DNX you don’t really want to see those babies and and that and then also the other women who I was connecting with online who whether they had labor and delivery or some of them also had they would get handprints and footprints like the hospital had a process and I told him we should have to and actually then he called me and thanked me profusely because like you know, sometimes get a car but I never get something like this. This is so meaningful and touching that you took the time to write this. And he’s like and you’re right. He said if you if when we send a patient to the hospital, knowing they’re gonna have a stillbirth. There’s a whole plan in place for capturing the lock of hair and the handprint and it never occurred to them in these circumstances to do that, in fact, the place where I went to have the actual surgery where they removed the babies. It’s like one of those multi surgeries. You’re sitting there with a bunch of other people getting their, you know, ingrown toenails like worked on and just the sensitivity meter was so off as like out to here, walking into surgery. In this. Yeah, the girl that the nurse walking me down the hallway like I was crying, and I sniffled. And she turned to me and she said, Do you have a cold? It’s like, no, yeah, I’m crying. What so stuff like that?
P: Yeah, yeah.
T: In the surgery place. There was like a feedback form. Like after my surgery, they gave me apple juice and some crackers. And I was crying and they gave me these tissues and the tissues were like sandpaper on the feedback form. I was like, maybe try some soft tissues. Your tissues suck.
P: Yeah, yeah. Something comforting, right?
T: Like be comforting. Yeah, I just found like, the more I opened my damn mouth, the better I felt. Yeah, about like making it better for the next person, right and next person who goes through this, give her some Kleenex instead of sandpaper, right, the next person who goes through this don’t let the nurse say something so stupid. Right. And, and that is really what fueled basically my last 13 years. My whole life, everything. Everything became about how can I take this experience and use it for every little bit of good that I create from this it to a degree and it’ll never fully but to a degree amortizes the giant pneus of my loss. And specifically also I’ve been on a mission. You know, I started a business after this a whole women’s empowerment brand around helping these women that I was connecting with refind their light and their joy after grief and trauma and pregnancy loss and infant death. And each little piece of that puzzle was a piece of my healing and a piece of making my loss worth it and a piece of justifying the choice that I made. And I realized that early on that if I had followed through and continued to pregnancy and my daughter was born with all the disability any of the all of it my whole life would have been derailed. And it would have been about raising this child about helping my other daughter cope with a disabled sister. My marriage likely would have fallen apart my finances would not have worked all the things that these families go through. Thankfully, because of a 24 hour window, I was in a position to make that decision for my family.
P: Yeah,
T: and I’m grateful for it every day. Because every day, even now I try to live my life, making that decision worth it, whether that’s building the business to make other women happy, or showing up at the coffee shop with a smile even if I’m having a shitty day because I know it’s going to impact somebody else. Everything good that I can do is in justification of the reality that I’m not home taking care of a disabled child for the rest of my life. The price I paid to have a beautiful, easy life is a huge price. So this would be paying it forward.
P: It is an amazing way to memorialize the twins. to live that goal the time.
T: Yeah, you know, I used to when I was doing the work working with those moms, a lot of them would get so trapped in their grief. Because the grief became the link to the baby to the child right if they if they if they somehow move out of the grieving stage. It’s like they’re leaving that that baby behind and their memories behind or they forget or it’ll show that they don’t really love that baby. So much of the work I did was trying to let them see that it’s not that you’re leaving the baby behind. The baby is pushing you forward. Like do to live find beauty you’re here. That’s what they want for you and to be able to celebrate life and marry that concept to the memory of that child instead of the grief to the memory of that child. It’s so much better. It’s just better.
P: Yeah,
T: that’s what I had done actually with for me with with this. I got pregnant very quickly after the after the twins died. So they died in September. I was pregnant again by January with my youngest, so I’m not a waiter. I’m not
P: so on purpose.
T: Oh very much on purpose. Thank God Yes. Like literally literally I woke up after they knocked me out for to remove the babies from my womb. I fell asleep crying. I remember and I woke up on my husband was standing above very first words out of my mouth where I want to be pregnant again. And I don’t know if I met pregnant with them or like let’s get the show on the road because
P: yeah, yeah.
T: Unfinished business. I don’t know. I don’t know which I’ve never but those are my first words. And through that pregnancy, I was very much obviously still very much in grief. And I proactively was looking for light. So I had a visual of this new baby inside of me I felt dead on the inside. Just black. So it was like everything below skin level. And then when I found out I was pregnant, it was like again, the visualization of this tiny teeny tiny beam of light inside of me that was just trying to grow like trying. And so I started wearing sequined clothing to visually connect myself and my outer skin to that tiny little bit on my deep deep inside. And that’s kind of the platform that actually fueled the whole business I created was like this idea of joy and light on the outside being a catalyst to connect your joy and light on the inside.
But for two years straight straight through that whole pregnancy. Two years straight. I don’t think there was a single day I didn’t wear something sparkly even on like my crappiest days and I came to fully connect, that proactive seeking out of joy with my twins. I mean obviously there were many many, many, many days where I would cry and grieve and you know all the dark side of grief. But be like I was saying being able to anchor them in my memory of them and my love for them onto something positive.
P: That’s amazing, amazing thing to make your connection stronger every day and something that you enjoy visiting and know right like That’s amazing.
T: Yeah, even this interview because like I don’t really have much opportunity to talk about them every now and then in my new business. You know, it’ll sprinkle it in, but it’s not a main, you know, focus. But yeah, it was like I was looking forward to the interview. Because I like to talk about them and I don’t get an opportunity and a lot of people are like, Ooh, you know, like you wouldn’t want to talk about something sad or you know, something so filled with grief. But
P: also the truth of the matter is it’s more complicated than that. Right? There is definitely grief but there’s a whole bunch of other things right. So
T: yes, there’s I mean, the grief is it’s part of the foundation. And a lot of time has passed. I remember early on I was on those boards, the pregnancy loss boards, unlike Baby Center even before Facebook, and I remember seeing somebody post Oh, it’s been seven years since my loss and I’m so sad or whatever, whatever and I turned to my husband and I was like seven years oh my god, I don’t want to feel like this in seven years. Why are you still talking about it? Your perception of it is so different. Before and then immediately after, and then like down around like 13 years. It’s a whole other. Yeah, it’s a whole other thing. It’s a part of me. I couldn’t make them live. I couldn’t change reality. So
P: well and the whole pregnancy the whole process is so transformative, right? I mean, it’s different than you know, I miscarried at six weeks It comes with different expectation and a different experience and a different so it is a unique experience in that way and I understand what you’re saying I can see why
T: Yeah, I look at pictures of myself from before. And it literally feels like I’m looking at a different woman. I was a different person entirely. I mean, I would say especially in like the first seven or eight years, and when I was doing that work that was completely different parts of my old me have returned you know, I’m like naturally kind of a sarcastic cynical a little bit kind of New Yorky and and as I went through the stages of healing and connecting with other women, just kind of seeing how we’re all more the same than we are different even though we’re different than we are the same. Like it really opened me up and really allowed me to learn how to listen and like see people through a deeper lens. It taught me something I never knew before or wanted to know like how to sit with someone in a when they’re in pain. Yeah. Oh, no, no, I am not the person for that. And still now years later, it’s still okay like, hard sometimes but I know how to do that. I know how to show up other people better than I ever would have. I have not experienced any of it.
P: yeah, yeah That makes total sense. We you tell us what’s the name of your business? How do we find it?
T: Well, the business I started back then was called Finding my Muchness. I actually have a book. Like I wrote a book I have been having here because I was cleaning. So that was me a bunch of years ago. You can’t see it on your podcast, but I mean my muchness the website I think has a lot of buggy errors because I haven’t really touched it in many years. It was built on that premise of like the line I used to be much muchier but then I lost my muchness it’s a line from Alice in Wonderland. And I heard that line and I was like I was like there is something I can sink my teeth into the business today. Today. I own I run it with my husband. It’s called ear seeds and we make acupressure products that are worn on your ears for all sorts of health conditions.
I had spent my whole career in the fashion industry in New York City making stuff once I started the muchness project and was doing meaningful work for the first time in my life. I could eventually no longer work in the fashion industry. I started having panic attacks because I was trying to proactively live a life seeking moments of joy. And my job required me to be like, oh China, that’s the wrong shade of pink re do it. Do it like I couldn’t do it. It was just too conflicting. I’m so now actually I couldn’t even this to like this experience.
I had to quit my job in the fashion industry. I did it for 20 years. I couldn’t do it anymore. I learned online business. My husband was an acupuncturist. He was fully supportive of me making that move. And he also has always been committed to kind of finding ways to help in his industry to help the practitioners. And so it’s about two years after our loss when I finally quit my job, and then three minutes later the insurance company that covered like 90% of his patients changed their insurance plan. So both of us found ourselves unemployed staring each other in the face at home with two babies.
And we’re like, What the hell do we do next? And this was eight, almost nine years ago and then we came up with this idea for this business and we started it in New Jersey. It’s been fantastic. Honestly, I mean, to be able to create a business that helps people and then to hear from the people who it’s helping. It’s almost an extension of what I was doing this this idea of learning that for every little bit of good that I put out. It just it’s like reaching out your hand. To help someone originally it was the moms on the message boards, you know somebody saying Help, like I’m drowning?
P: Yeah,
T: I said like on the message boards when I was early in my loss I would want and be like help drowning. And some Mom who had been there before me would like reach your hand across the internet, be like you’re not drowning, you’re fine. Come and pull it up. And then as I started to understand the grieving process and see the patterns that that we all would go through, and someone would come on a message board and say help, I’m drowning and I would reach my hand and say can not drowning. You’re gonna be okay like and pull them forward. Now, even through this new business, which is in total, totally different. It’s just meaningful
Tova it so moving to hear about how you translate this exceedingly difficult experience into something beautiful. That’s helping people. Thanks so much for sharing your story. You’re very welcome.
Thanks again to Tova for sharing her story.