Episode 21 SN: Pregnancy & Birth when the Internet was a baby: Julie’s story

Today’s guest encountered her own set of surprises in pregnancy and birth. Because she gave birth almost two decades ago, she didn’t have easy access to the overwhelming amount of information that’s available now, we had kids before the iPhone was a thing and before the internet was the endless warehouse of information it is today, but she forged her path to parenthood, without immersing herself in the baby and parenting books that we had access to and learned a lot from the process itself. Another thing to know about Julie: she is a radio personality, which means, among other things, that she’s charismatic, she can talk and she’s got a voice like butter.

You can find Julie’s book, From Conception to Confusion, here

Breech position

https://www.verywellfamily.com/how-to-turn-a-breech-baby-2758443#external-cephalic-version

Breast milk during pregnancy

https://www.romper.com/p/does-your-breast-milk-taste-different-when-youre-pregnant-your-baby-may-notice-a-change-53748

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 I took the path of most resistance on my way to becoming a mother of two kids.  Like me, today’s guest, Julie encountered her own set of surprises in pregnancy and birth. Julie and I are about the same age. We both have older teenagers, so we didn’t have easy access to the overwhelming amount of information that’s available now, we had kids before the iPhone was a thing and before the internet was the endless warehouse of information it is today, but she forged her path to parenthood, without immersing herself in the baby and parenting books that we had access to and learned a lot from the process itself. Another thing to know about Julie: she is a radio personality, which means, among other things, that she’s charismatic, she can talk and she’s got a voice like butter….Let’s listen to her story. 

Hi, thanks so much for coming on the show, can you introduce yourself and tell us where you’re from.

Julie: I’m really excited to be here, Paulette thank you so much. My name is Julie Davidson and I hail from the Midwest, and we’re talking birth stories today, huh?

P: we certainly are. I’m very excited, before you got pregnant, I think he just mentioned he had two kids so before you got pregnant with either of them. You must have had some idea of what pregnancy would be like, what were you imagining,

J: Don’t we all think we know exactly what it’s gonna be like, right, and I don’t know, I think you and I talked about this briefly in our correspondences, I wrote a book and I am telling you that not so people go by the book, but because I was blindsided. I thought this was going to be like. Easy peasy, and I said no, somebody needs to hip people the fact that it’s not textbook, right, and it’s not what you might think, you know I babysat starting when I was 11 years old. I came from a two parent household I went to college, 

I checked all the boxes that I thought would maybe help me get a leg up, so to speak, you know, when it comes to parenting again babysitting I came from a family of six, I you know 

P: Oh wow

J: I, yeah, I’m the youngest so it’s not like it didn’t need babysitting in my family except maybe for my, my nephews at some point. So I thought, I mean, how hard could it be right I mean there’s books there’s doctors there’s millions, billions of people in the world right, so it just can’t be that bad. I figured it was going to be–it’s not that I thought it’d be easy, I just thought it would be different than it was. And I intentionally also did not read pregnancy books because I didn’t want anyone to spoil it for me. Plus them, I don’t think I’m opinionated, but I wanted to have my own idea of how is this, you know how this is going to go down, but fortunately I actually was pregnant, concurrent with a friend of mine from college. And so she was a couple weeks ahead of me and so she would tell me certain things and I was like okay so I would look for this or look for that but I think it was especially the birth was much different than I had planned, even taking birthing classes was just, you know, I thought it was going to be a riot and it was, I mean, there was like homework I don’t remember exactly what it was but I remember thinking, oh shoot, we didn’t, we didn’t go through this part of that plan, you know, And you know as far as like the education piece, just kind of didn’t even pay attention to the part where they’re talking about, hey, if you have a Cesearan this is how this might go and guess who had a cesarean in the first time around.

P: Yeah. Yeah,

J:  it’s me, so that was that was rather interesting for me. I think if anything, I would want people to know, everybody’s experience is different, and if you feel nauseous and I’ve had friends who felt nauseous their entire pregnancy. That’s not necessarily a bad thing because maybe your sister didn’t feel nauseous and you do. It’s okay, you know, but I think you have this being growing inside of you, you feel like no, I’ve got to get it right. What does that mean, you know, what does that really mean. So,

P: I definitely put that to the test. So, I’m with you. So let’s start with the first one did you get pregnant easily.

J: No Yes, yes and no. I think one of the biggest things that I struggled with were people giving unsolicited advice before you get pregnant, you know when you’re dating somebody. It’s when you get to get engaged as soon as you get engaged when you get married when you get married, then it’s, what are you gonna have kids, when when when. And so the moment you start telling people you’re thinking about it I was getting all kinds of advice and I have not had the best gynecological history, meaning I had periods that were really long and then I would not have periods so I was, I just knew this was going to take years and people said, you’re on birth control, you’ll probably need to be off for you know maybe upwards of, 12 months and I thought, you know, this is this is going to be interesting. So, I include them in my book, is that even getting pregnant, like, obviously there’s a science to it, but it’s not just, hey let’s, let’s be intimate. Let’s make love, and, you know, have a baby but I was pretty intent on. Hey, this ovulation thing which no one, by the way, Paulette no one talks about ovulation, until maybe when you’re trying to get pregnant I didn’t, I didn’t find that out in like middle school and high school biology my girlfriends and I weren’t talking about it, maybe I was just in the wrong girlfriend group, right, but no one talks about ovulation. So when I finally realized what it was, I had it, you know down pat, I was like, Okay, it’s time. You know I really, once I was. And I remember it, we got to a point where my husband said, I might regret this. But I don’t think I can have sex for a really long time. You know, we were doing it that often because I really wanted to I was, I was in a hurry I wanted to get pregnant. I think it went off the pill and within three months, I was pregnant.

P:  Oh good, good so relatively quick. That was quick. 

J: However, we did six weeks in I did have a miscarriage and I was just I was just a deflated and I just thought, What did I do wrong, you know I must have done something wrong, and I knew I didn’t do anything wrong, but I still felt like. But, that being was inside me like how did, how could this have happened. And another thing when I was doing more blogging, that I every time I would write about miscarriage. I would get people messaging me and saying thanks, I had one too. Again, something we’re not talking about I’m not saying we need to go on Facebook Live and say hey I had a miscarriage, did you, but people really feel isolated and they feel bad and you know, maybe some a certain amount of depression. When that happens, and kind of loss, who do you talk to right, get in when you get a puppy. You’ve got a friend to call you know when you graduate from college, you’ve got family there for you, but when you have a miscarriage, it’s kind of like, oh, who can I tell, so you’re part embarrassed part, you know, and then physically you’re also not quite, you know you’re a little bit of a hormonal mess or you can be. So, we were excited, and then we weren’t. And, but we, you know, so to speak, back up on the horse, there’s probably a bad expression to use but 

P: Your husband won’t mind. 

J: No, he won’t thank you very much. And then we kept at it, and I honestly can’t remember exactly how long but I think within a few more months, I was pregnant again. And then we’re pregnant with our first, our first son who is now 18 years old. 

P: That’s awesome. And what was that pregnancy, like,

J: you know, you hear stories from people saying, I’m craving this I’m craving that and that’s a crock Don’t be crazy or anything, you just, You’re just hungry because you’re just because you can be bright or whatever cravings are real, those cravings are so real. Chili Cheese dogs. Those were so good and they’ve never been so good since. Chili Cheese dogs and bacon cheese biscuit. And whatever you call about the cravings were, don’t get me something else like don’t just give me a bagel and cream cheese and tell me it’s bacon egg and cheese biscuit. If I asked for bacon, egg and cheese biscuit, could you please give me a bacon, egg and cheese biscuit, and they weren’t like I didn’t have anything in the middle of night, nothing like that no pickles and ice cream, but my husband was definitely going on some runs and it seemed like that was done after the second trimester.  I’m not a huge fan of vegetables. I forced myself to eat broccoli, I was walking I was intentional, you know that this kid was gonna if they’re gonna have bad eating habits. Okay, minus the beginning of cheese biscuit. They weren’t gonna it wasn’t gonna be my fault, so I tried to walk I tried to eat as much broccoli as I possibly could. I stopped, I have ethnic hair, I’m African American and so I was relaxing my hair up until I got pregnant, so I was putting chemicals in my hair and I talked to my doctor after the miscarriage and I said, Do you think that this could cause a miscarriage and he’s like no I don’t think it would cause a miscarriage, but there are other things that it does to your body so I think if you want to stop now may be a good time. So I stopped and I haven’t gone back and never smoked. I mean I smoked previous to being pregnant like casual and socially and I’m pretty social person so that ended up being more smoking than anybody should ever do, but just completely stopped that no, no soda, while I was pregnant, 

P: Yeah

J: coffee, you know, none of that so I, I followed some rules or things I thought were, you know, helped me be as healthy, you know, for the baby, and just really, I just remember being really tired. Yeah like so tired, thinking wait a minute, we actually have to legally work when we’re pregnant, like, this is how am I going to, how am I going to, how am I going to do this, and my own physician told me when she was in medical school, my OB GYN she said there was no mercy. She said we had to you know go along with the rest of the group pregnant or not and so I now have much more empathy, you know for for pregnant people I’m I’m holding that door I’m getting your groceries I’m doing whatever I can because I just it was good sleep, it was good tired but you said I still had to go to work so that that’s what I remember most mainly about the first trimester. 

I’m a nervous person. And I think through the second trimester, I was, you know, just getting everything in order, and probably on the range of, you know, OCD and I mean that truly, and I wanted everything to match. Cougars are crap with the baby, because when they puke, that you know you. You’re not thinking thank goodness I got a matching swing to the you know the pack in play here 

P: but it’s the it’s the only thing you can control. 

J: You know what, thank you. Thank you for saying that, you’re absolutely right, is only thing I can control. So I remember we had just gotten some cool furniture and I was like, Oh, we’re having a baby and now this cool furniture is gonna be interspersed with all this kid stuff, grateful. I’m grateful. And these are, when I say this, I also understand, I am coming from a place of like, first world, you know,

P:  yeah, yeah, 

J: you know, mentality. But nonetheless, everything was kind of a sage green checkered color the swing the pack can play the baby, the infant carrier and the stroller and I just thought this is, this is great, we’re so set, you know, so it’s constantly getting the house ready, and also the car seat, you know we have Children’s Hospital here in Milwaukee, and actually made a really good friend there who was kind of the head of the safety division there had to make sure that well in advance that car seat was in correctly because I remember hearing a lot of very smart people say, car seats are really, really tricky like it’s not just popping in, like, you can, 

P: yeah, yeah 

J: your kid is rolling around and I know that I rolled around, probably as a kid, but we know that that’s not safe, like that’s not that’s not the way to do it. So you know getting things like that in place the baby’s room, and then you’re gonna have to worry about what if the baby doesn’t like me. What if he comes out. Just 

P: Julie all I can say is I’ve known you for 20 seconds and that seems impossible to go let’s forget where we’re going. 

J: But I remember thinking, what like what is this child is comes out I was like, like I’m not. No, I don’t. And so there were these, you know these anything people have these a lot like your self sabotage and, yeah, that wasn’t long lasting, but it was, it was definitely there and we did decide to find out as much as I think life has so few surprises. Why would you find out the sex of a baby except that you do like to control some things and you might want to know, and I believe it was when we’re having one of the sonogram,

P: yeah the 20 week ultrasound? 

J:  Yeah. and I think the tech was just getting annoyed because my husband was like well we should find out and I was like no, I don’t know. And then he said no we probably shut down like but you know we really don’t want to. And my husband said, Oh, it’s better to girl, I bet it’s a girl. And then the tech said well it’s a good thing you’re not a betting man, and it’s fine if you don’t really I mean, honestly, it’s like come on speed it up I’ve got other patients to see and you’re having a boy and, you know for planning purposes. I don’t get caught up in the pink and blue but I didn’t want to start off, you know, necessarily putting our son in a dress if he wants to later I don’t have a problem with that and I mean that sincerely but it was kind of helpful, like, 

P: Yeah, 

J: who wanted to get things for us. I had some worries and just kind of getting things together and organized through that second trimester third trimester. I don’t know if it’s hormonal what kicks in, but something protects you because I, I’m gonna tell you right now I am a wuss. And I can take care of cuts I can deal with throw up if I absolutely have to like nobody’s around within 20 miles, but I remember, before getting pregnant being really petrified of birth, like this is gonna hurt, I’m going to die, or I’m going to pass out i just i That’s all I could focus on was the pain. Right, and that’s that’s kind of how I am and that’s not good, I realized that come third trimester,and maybe because I was just so physically uncomfortable. Yeah, I was I was okay. Any day now just, just let let this child, you know, so that last trimester, you know, the first trimester, you wonder when you’re going to start showing. 

P: Yeah, 

J: because you kind of want to tell people we’re praying or pregnant and he and I want to also say when we had the miscarriage I wanted wanted to know should I tell people we’re pregnant the first time should we. And I did I have a big mouth surprise and so I ended up having to tell a lot of people that you know that we had a miscarriage and so this time I don’t I still don’t think we waited any longer to tell people, that’s just, that’s just how I spent the first trimester, wanted to be a little bigger. And, you know, showing off and buying maternity clothes because it was fun, you know, you get to go to your special section. 

P: Yeah, yeah 

J: get to register for baby stuff, and that cuteness kind of wore off by, you know, I’d say month seven. 

P: Yeah, yeah, 

J: you know, but what other time of life can you consider being larger than your standard size queue, because right now I’m not my standard size now. I’m also not feeling so cute but still that those last few months, I was just feeling, you know, big, and ready, and not as nervous, just because I think I was more focused on right now, when’s this gonna happen. No, how’s this going down, right at that point I’m adopted. So I don’t have any birth stories to compare like biologically, some people say oh my mom went through this so I’m going to, I didn’t know any of that at that point. So, everything was just kind of like, you know, bring it. And I want to say he was early oh we had some Braxton Hicks, or they like false

 

P: it’s like contractions but you’re not you’re not progressing toward labor.

J: Yeah, though they need to outlaw those, because when you start getting something in they’re like well yeah they’re kind of contractions that I’m packed, I’m ready, like can you just reach up there, just grab him, you know, so I was having some Braxton Hicks and then they said, No, you’re this is you’re not near it. Another thing people don’t really talk about. Maybe I should have read books but I didn’t want to, is that mucus plug. First of all, it’s that sounds disgusting it kind of sounds like what clogs up your drain right like 

P: it definitely needs better marketing for. 

J: Right, exactly. And I remember hearing about the mucus plug well i When mucus plug came out, I was, I was never so excited to have some bodily fluid exit my body I don’t think ever. And so when that happened, it was kind of, you know go time, and we went to the hospital. And I was so excited cuz I’m having contractions and I’m thinking this isn’t bad. What are people complaining about like this is nothing. And we got there and the reason it was nothing is two centimeters or something and I got a younger nurse, a less experienced that younger but she was not as experienced so she’s doing a thing with her hands and 

P: wait, one second….where are we in your pregnancy…was it 30, did you say is it like 38 weeks?

J: I think it was like two weeks early. Yeah, two weeks or two weeks early, so not super early not not overly concerning, but I was mad because they sent me home. And they said the nurses, you know, she’s a little newer and you’re not dilated enough I’m like, but I’m packed, I’m here I’ve got really good insurance, just you know what, yeah, literally the car seat, all of it. they said, Oh, you need to go home so I’m now mad I’m like, oh, And so now like okay, every I’m hypersensitive to everything can happen now, do I have to wait on you know, immense pain when the I  started bleeding. I thought, oh okay this this is definitely this is definitely not good, not, not heavy bleeding but spotting. 

P: Yeah, 

J: I don’t think this is part of it so this is now I’ve gone in, they’ve sent me home, that next day, responding so I go to my doctor. And I’ve known her now probably for just round up to 30 years, I mean she’s she’s fabulous.  I go in and she’s, you know, got me on the table and she says, When did your water break. And I’m literally thinking to myself, I’ve been pissing on myself for three months, how, what do you want to break like what what is, how would I know like nobody there was no alert to say, you know, water breaking water, I didn’t know what I just said I sometime in the last nine months I really didn’t know how to answer that. And I, you know, I said what what do you think, and she said, Well, he’s breech. And he was, butt first, which isn’t that a way to enter the world, you know, look at me folks as out first. Remember I was afraid this kid wasn’t gonna like me. And so she said very little fluid flinch when I even think about her saying this and she said, I don’t feel comfortable reaching up and turning up, like what do you do that with like a plunger, like, 

P: a little unclear, 

J: you know, like I yeah maybe we shouldn’t be sticking any hands up there right now.

P: Here’s some details about the breech position. It happens when the baby’s feet limbs or butt is basically cervix is further head and breech babies can be delivered vaginally, but it looks like there are risks to the baby associated with this kind of delivery and often a C section is recommended. It’s common for a baby in reach position to flip before delivery, only about three to 4% of babies are in breech position by 37 weeks. Although there are a number of different ways to try to get a baby to flip one that’s been studied is external cephalic version ECV. It involves a doctor trying to manipulate the baby’s position by pressing on the pregnant woman’s abdomen.

J: So she said we need to do a C section and at that point, I just remember her talking and it was kind of like going on I did it in the six o’clock office did it doctor and just, I didn’t, I couldn’t focus. Then I said wait what are we, what’s happening. And she said, you need to do, cesarean. I said, Well, who’s on call. I didn’t want anybody else. 

P: Yeah, 

J: and the perfect thing and she said I’m on call. And this is wonderful. She later told me that she was concerned for my anxiety level because she the due date, she was planning to be out of town. She knew that, You know, I probably follow her, right, like hey, sorry about your Disney plans, 

P: Yeah, knock knock

J: It’s me. So the reason my contractions weren’t the kind where you scream, is because I didn’t get to full on contractions cuz I remember thinking, This is bad. I am really amazing, I am tough I am strong. I could do this all day long, so we spent the better part, I think you the Cesarean was planned for 630. So I think about four o’clock we’re in the hospital and calling people and telling people and, you know, that was really exciting, it really was like I’m gonna have a baby, and you know everybody’s saying I’m gonna pray I’m gonna come up there and just I just feel emotional sorry. Just amazing. 

P: That’s all right. That’s awesome. 

J: Wow, I don’t know where that came from, but it was just it was more beautiful than I ever thought it just, I mean, on one hand it was kind of, it was very scary, because I’m in a room and you know people have their faces covered up, I can see my doctor, but I remember shivering, quite a bit because it was cold in that room. So I’m on my back and they’re prepping me for the series and then. So my knees are up, legs are spread open, and if I’m not mistaken, and this, this, annoyed me is my arms were down, like they kind of had me restrained, I think that what they would do with everybody but I just remember not being able to like move around and you know they’re sharp instruments, I think that’s a good thing. So, I just remember them, kind of, minute by minute telling me what we’re doing, just saying, you know, we’re almost done. Now we’re at the second layer and I’m like layer like 

P: this is getting graphic. 

J: Yeah, it was like yeah layer like this like a seven layer like a salad like what how many, and then you just wish I wish I paid attention to biology or in that pregnancy class maybe a little bit, because I didn’t again I didn’t pay attention to the Cesarean part because, I wasn’t gonna have one right yeah, there was no pain I felt really no pain I was pretty much numb. And I just remember, okay you know we have them and I gonna try not to lose it and they, you know, they held them over me and you know most babies because they come out of the vagina or I believe most babies do right, they have kind of that conehead that kind of, you know. Noooo, perfect, perfect shape perfect color. And I just remember looking at them, and they had to hold them over me and I’m like, oh there’s a baby in the air. They just held it because I could not sit up and just said, he looks healthy. And I just remember, you know, I looked at him and he just great, which of course the beautiful month, but it was, I was scared I was like, Well, you’ve just got here do like you really shouldn’t be upset, and then my thoughts turned to, They said, Well now we need to take in for testing, you know, just honestly, I don’t even know what they do, you know, I think they tested for hearing and heart rate, you know, just, yeah, I don’t know but there’s probably a million like a checklist that they have I’m sure there is. And I really wasn’t privy to that but I remember, like, where’s my kid. What are you doing, where you going, and where’s my husband and he said, I’m right here. I said okay, and I said well you go with a baby so I will and I was just I was so afraid that I can’t get up, I now can’t touch my baby. Where’s my baby. Where’s my baby going I mean that wasn’t fantatical about it like I was fairly calm but at least in my head I remember thinking, Where is he so me back up all those layers, and I get wheeled into what I think would be like a recovery room and a waiting room. I still haven’t seen my kid. My husband comes in. My friends come in. And I think, like, what, there’s just so you know there’s nothing wrong to baby, there was nothing wrong, it was just doing whatever they do with babies when they don’t give them back to mom, because they had to run tests. And so, I’m a little loopy, because they have you on something.

 

And remember saying, so I’m African American adopted by a white family it is important because I said something to one of the nurses about. I was expecting my brother to come see me. And I said, Oh, yeah. My brother’s coming he’s got blond hair, I’m only telling you that and maybe in case you see him and she said well, actually, he’s already held the baby. So I’m like, Okay, folks, is there really a baby, because apparently everybody seen this child. And I want to really make sure there’s a baby, and she said yeah he came in at the right time. I think my husband was with our son, Myles is our son’s name. My husband Charles I believe that the baby and then handed them, handed him to my brother or the nurse to I don’t know if my brother was like, they might need to tighten security you know because he said I got to hold this baby pretty quickly but, you know, and I wish I seen this my brother said, I guess he started crying, immediately we held him he’d never he’d never held such a tiny being his life, 

And now if you put the my brother with my son, my brother would have to look up to my son because my son is about six six, you know, six foot one and then I remember being happy that my friends were there but just some of the things that they give you just not filled out completely, they’re one of my friends said you know what, why don’t we leave so the first time you meet your baby you can be alone. And I was like thank you because I didn’t want to tell anybody that yeah, you know, and then I remember there were some antics with one of my friends with her husband whom they’re, they’re now divorced and he was kind of being as normal and it just goes. It’s funny how life still happens, right, like all this other background noise, and I was like, I just want to see the baby. 

And then they brought him in, and I don’t even honestly remember my first thought I had already seen him but then I got to hold him. And, you know, you’re just like, wow, I’ve been planning for this and it’s like, wow, you’re here, you’re really here. And after that, It quickly turned to how to breastfeed him and I had that was probably the most difficult thing with him is breastfeeding him, which you think are could this be I’ve had boobs all my life this is what they’re for. Come on, let’s go you know it’s not for ladies night anymore now it’s for the baby right, and it was difficult because he would, he was not latching correctly, it wasn’t his fault. The nurses were always around me, trying to get these nipple shields and just getting it right and I was able to give him milk but it was, it was wrong, the way it was happening was wrong because my head hurt intensely from my neck up to the top of my head. And so they tried, you know as best as they could. 

Luckily a few days after I got into the hospital, my sister in law who is a an OB GYN nurse practitioner and lactation consultant. 

P: oh my G-d

J: She left her family and permanently. She, she, my brother had three boys, and she left them and came to take care of us I think for the better part of a week or more, I don’t know it might have even been two weeks it was, it was like a godsend because my husband’s mother’s passed away. My mother is not living and so we’re just we’re going to do it on our own she offered and we’re like, oh this is golden. Yeah, but in the hospital I had problems nursing, and I was kind of freaked out. I mean when I was coming out people in the hospital, it seemed like for ages, and now it’s like, treat them in street em… and I think to maybe day three, I want to say with this this area near a little more, I think there’s three days, and I remember feeling kinda weak being kind of like, Oh, what am I going to do, how do I do this, and I said to the doctor, can I stay another day. I said I’m not ready and usually that wouldn’t be like me I would be really tough and I can do this, I got it, I wasn’t feeling tough. I was feeling really freakin scared, and she said, I don’t, I don’t know if you can usually four days is the max but she said let me check your insurance. My husband has a really really good insurance and so I get to stay another day, 

Our son was born in Friday the 13th think you know superstitious until you have to have a child on Friday the 13th And I thought, Well, isn’t this interesting, not a lot of people up here in the in the, the baby Ward on Friday the 13th as if they’re all closing their legs just wait until the 14th or push it out and let’s well so I thought, I remember hearing him just the nurses would bring him down, he’d be screaming, you know, it’s feeding time, like we’re all the other moms, so where are the other babies, I’m sure there were some I just didn’t pay attention to that so I got an extra day. And, and it was, it was time for me to go. And I’m sweating. I don’t know how much is hormones and how much is, I don’t know. and getting dressed.

and just feeling that sad, just a little bit scared, yeah you know like, I’m supposed like you’re getting give me this baby like, do I need to I need to sign something. Do I have to get a certification, like, should I take another class, 

P: it seems way too easy right when you walk. 

J: Yeah, like, I mean this whole time, this is what, you know, women’s bodies in part, are made for, but all of a sudden I was just, oh no about this and so we went down and my husband was going to go get the car and drive it up and I just remember I couldn’t even get him in the car seat I’m like oh my gosh I can’t you know the straps and I’m already like I’m losing it. So I finally got him in there. And then that unsolicited advice starts, I got enough unsolicited crap. When I was pregnant, and so this older woman, she looked at me and she said well how do you think I felt I was like oh no, no, what do you 

P: what does that mean, right, and she said, 

J: My baby was colicky till he was six months, years, six months old and I was like, Oh, I’m sorry. I just thought, what a nice way to send me off from the hospital, 

P: I totally agree. I totally agree…totally wacky…got any good car accident stories? because we’re about to get the car 

J: and that’s another thing the whole car right that’s another thing. I just, I just realized how bad of a driver everybody in the entire world was. 

P: Yes, totally. 

J: And I kept thinking why is this car so close, and should my husband be breaking right now. Are they did you put the blinker on, is it, did you check me just literally and it’s about a 20 minute drive from one side of town to another, and we made it home made it home, and as you’re putting him in his crib and I’m like, good Lord this crib is huge. He just looked like a little peanut in there, and we waited for my sister in law a lot of come a couple days later because we were very nervous that we weren’t feeding him enough, and so I was, I would talk to my brother and he’s like, maybe you can give them, like, just regular like, you know, formula, and she’s like, don’t tell him that. And he’s like, Are you afraid that you’re not good that he’s not going to gain any weight, and I said yeah, and so we went to the doctor said okay if your sister in law is coming that’s fine I mean we were feeding him, it just wasn’t the amount we wanted to but as soon as she came in, I call her the nipple whisperer.

She came in 

P: that’s some title. 

J: Right. So you went to school and what do you do I’m a nipple whisper,

P:  I hope that title comes with a  sash,

J: it does it does she just doesn’t do remember that. And so she came in, and dropped her bags you know her husband went to the airport, she came in, and you know you have to understand she’s an oldest child and she’s very, very smart, very caring, very giving and very knowledgeable with this this is her knows what she’s doing and she said okay, like what what’s going on. She’s like, shut up. She’s like, get him on this side. He wasn’t rude and we should, but she was like, Okay, we’re not just here to watch you know HGTV, we did do a lot of that but at first we had to get the baby to latch. And then she said, Excellent. And I was like, what, what, she’s never even seen my boobs like how are you. And she said, Okay, let’s take them off, put them on the left side, you know, do whatever she needed to do and, and that was it. I mean and I just I couldn’t, I could not have done it without her. There was absolutely no way because it wasn’t, we weren’t gonna hire anybody and I wasn’t gonna keep running back to the doctor’s office, I would have caved and I thought this is the one time I can really start them out right, I mean, for all the good things that breastfeeding has and I just I cannot thank her enough. 

A few months later, another sister in law came to town and I wanted to be tough, I had to go give the baby, you know, give him his shots. And she said, Do you want me to come with you. No, no I’ll be fine. I’ll be fine. Oh my gosh, those baby shots.

You know they’re trying to kill my baby. I mean obviously they’re not, but it was, you know, so people are always, you know, very happy to help and, you know, reach out as they could, but most of my family doesn’t live here in town, I have one brother and sister in law. So that was that was my first was my first birth story. 

P: That’s awesome and you know it’s a steep learning curve right is it is, it’s a ton of on job training that you like. Luckily the baby doesn’t hold it against you. You don’t know anything right there’s just, there’s no, I remember the exact thing you’re describing leaving the hospital thinking you’re sending me home with this child and you’re imagining I know what I’m doing or that I’m responsible and who could say, right, you know i There’s no proof of that every plant has died under my care. So it does feel like a giant leap of faith to

J: it’s huge. 

P: Yeah, leave the hospital.

P:  It’s so huge, and I didn’t think that going into it, it was just really those final hours and then upon arrival at home. And I think there’s just a mixture of it I think there’s a lot to be said for your biology, right, like, your body has just gone through this in hormonal change, and when you left. Leave. Three people you’re returning your I return three people you know and so that was, you know, and then I was probably not too kind to the dogs was afraid the dog would get too close and it just, it was, it was a little, I was a little bit of a hot mess, and I feel like, each time I had a child, I feel like it took me about six months to really fully engage with the world in a fairly normal way, I think some people jump back in more quickly, but I just took me a little while, I was also the person who didn’t want to get a babysitter, like, ever, ever, ever, ever. 

And then finally we got a babysitter. I made it. I made it the first I think it was six months old, she was awesome. She went to the University of Marquette University here in Milwaukee, she’s a nursing student and happened to date one of my nephew’s at one time it was awesome, but I was sweating bullets. 

P: Yeah, Yeah, 

J: everybody, everybody, everybody’s enjoying their dinner, and I’m getting up from the table to make a call to see, you know, the baby, the baby fart, you know, did he is he sleeping what foot what’s he doing, you know, is he going and I probably should have, you know, trusted other people similar to that but I just, I didn’t. So, 

P: that is, oh I think an experiential thing, right, it’s hard to know ahead of time and I think it’s probably best to be consistent with your feeling so it sounds like he did have a right 

J: I did, for sure, for sure. 

P: So the second one comes pretty quickly. What is that planned or 

J: yeah you know it’s funny and some people might not appreciate this, people would look at our boys because they’re so close in age and there’s, they would say, Irish twins. And I would say no African American twins and that never really goes over very well because they’re like well what is that. 

P: Oh my god. That’s so funny.

J: It just makes people feel really awkward and it wasn’t intended to I was just trying to, you know, I was Irish twins to under 12 months. Yeah, yeah, that’s a, that’s a really special vagina right there’s all I can tell people, I just I can’t even imagine their data how that happens, but I know how it happens. So our boys are 16 and a half months apart. Every month counts, I mean literally like I think 16 and a half would have been easier than 15 and a half would have been easier than 14 and a half. It really was planned. You know, we knew we wanted to expand the family, and I think it was 34, the 3436 34 I don’t, I don’t know how long it was, but we thought why not like we’re already down on sleep. 

P: Yeah, yeah

J: we’ve got everything we need. And let’s do it and I remember. We weren’t trying all the time we just knew that we weren’t going to, you know, start up a bet on birth control. One of the signs was our oldest when he was nursing he pulled himself off one day, and he just kind of poked my breast and he was like, oh, like, This doesn’t taste right so I have a feeling that when you get pregnant, you know, something may have made the milk taste a little differently.

P: So, technically speaking, I don’t know how this question has been answered, but according to numerous sites on the Internet, the flavor of breast milk does change when you get pregnant because of hormonal shifts, and it may become less sweet and a bit saltier. 

J: We got pregnant very easily I should say, I again kind of had those thoughts. What if, you know now what if our oldest son who now completely bonded with right. What if our oldest son, mad at me. And I like really lady, you live in a lot of what ifs and what about, but I was concerned because he was going everywhere with me, I was hanging out with him during the day, you know my husband would come home and he would you know take over, but during the day he was going with me we owned a rental property he was going over there if I had to clean him out or show a property, do the grocery shopping, I didn’t even my friends had their own kids, so I really didn’t have backup it’s not a boohoo, it’s just you know what, you know, It is what it is. And so I was really concerned about that, which never, it didn’t manifest everything was fine. And that birth was so you know when you have a C section, it’s risky to have a vaginal really know that at that time, I didn’t, and I’m glad I didn’t because I would have freaked out. Yeah, but the one thing that should have, you know, been a nod to that is the doctor said okay we need to have him delivered at a hospital. Your first son because if something happened to I think it’s like your uterus can collapse or something, you know, we have to be somewhere else, like, things can happen with a vaginal after cesarean, and you need to be prepared. It’s weird to go to a different hospital and we knew that in advance, it wasn’t like we switched during, you know, the birth. That was real birth.

That was the one that was the one 

P: more respect for contractions coming from that experience

J: our oldest was always an early riser, so it was like okay, who’s gonna put five on Saturday morning. Okay, I’m praying that you when he got up, either Saturday morning, you know, five, I think, and he screamed really loudly we both remember he wasn’t feeling great and he screamed. And after that, husband just said, I’m gonna take you mommy’s looking pretty intense here and said, I think he needs to just just go downstairs and watch cartoons, and then all of a sudden, I let out a scream moves on, it was very, it was almost like I couldn’t control it, it wasn’t the pain. It was my water broke. It really breaks.

It’s, it’s, it, it was like, Oh, that’s…I’m glad I was at home because it was you know, a substantial amount amount, and I immediately started having contractions I think they started after the water broke.

And those suckers hurt, and we’re remember I’m the one who couldn’t, you know, people are like no could focus on mountains or an ocean, or listen to your breath. We don’t live by mountains, we don’t have an ocean. Yeah, and I don’t even know if I’m breathing, so like I all I could think of was the pain. And again, it’s the same side of town, we have to go on for this delivery, and my brother lives on that side and was going to come watch our older son, and I just said, Call, call my brother Jack. If he can’t make it here by X amount of time we’re taking our kid with us. 

P: Yeah, 

J: and Jack is a filmmaker, and so he directs commercials and all kinds of things I don’t even know all the things he does. But I say that because he will be on a shoot. Yeah, to what you know 11-12 At night when when places close and I think he had just gotten home at midnight, and maybe slept, you know, went to sleep at two and here we call him. He made in record time and this is February, you know, it’s to be careful on the roads in Wisconsin in February, and he made it, and I just remember being really relieved and just kind of like here’s the kid stuff just, you know, not my normal like over I’m sure I’ve written like I probably had three notes throughout the house on what to do and where to find stuff but I knew he was capable. 

And I remember the pain was so intense kicking a cabinet at home like I was thinking it was like a nightmare, you know, I remember my brother saying to our son. Oh and mommy’s kicking things let’s go over here. I mean, I wasn’t hitting anybody, but I was just like, I was I needed an outlet, and it’s difficult because, as you can tell I’m fairly comfortable talking and these, these nearly stopped me from talking, and I thought well, this can’t be this. This world can’t have me not talking. So, we get to the hospital, and I’m just in so much pain and I’m petrified because I had not been through this before this is birth but this is birth, you know, with pain. And I remember my mouth was dry there’s a bottle of water in the van, and I’m watching it roll from one end to the other and I just wanted to open it but I was so afraid if I, I felt like any movement hurt more so I just tried to be really still and I was like, all the bumps on the road, this is just horrible. You know, fill these potholes already, we roll up to the hospital. It’s kinda like a movie, you actually get to drive up where it says emergency. 

P: Yeah. 

J: At least, that’s, that’s what we did, and the registration, and I’m like, I need something, I need something for the pain. I’m like, Can I get something like a beer or anything and my husband’s like, Oh my God, he’s like, this is the registration desk for everybody, like this woman can’t give you anything. And I’m like, but she needs to know I need help. And there weren’t a lot of people in the in the waiting room at that hour I think there’s a cleaning person who probably was really like oh my gosh, so we get rolled into a room and I’m basically like in so much pain that I’m just not an ideal patient, and I do recall one of the nurses saying we don’t scratch here, like she was trying to help me get my clothes off and somehow I scratched her. Oh my gosh this is such a mess, so they’re getting more and more intense. I mean these were like we were supposed to be where we were so that’s good. 

And then they’re even discussing was there going to be time to give me an epidural, I said oh there’s going to be time. Give me, 

P: We’ll make time

J: Give me the time, you can do. Give it to me. Just tell me what just tell me the general vicinity where I gotta poke myself. And as soon as that happened, I was right with the world. I will never pretend to be somebody who can withstand pain or have a natural birth and I really give kudos to people who, It’s possible I know people who did it, I’m not one. And I was, then all of a sudden just almost talking smack with people, it was, it was really it was very comfortable. And then I remember the anesthesiologist was there talking, and He said I’m going to leave. He said so and so was going to finish up and I said, oh, and I was really kidding I just said. So do you guys like split the proceeds then since they’re finishing and you started and he, he literally went into this explanation of how they get paid, I was like no I don’t, I don’t, I don’t really care like I was just being, this is how I am comfortable now, you know, so I’m sure he was happy to be off the job, I just remember hearing as a doctor here the doctors here okay doctors here and then just all of a sudden, boom, it was go time and it was, you know, telling you to push. I remember thinking, but I can’t feel anything like I don’t, I don’t think they’re like push towards your bottom but I’m like I think you took it away because I don’t feel my, my, but, and they’re saying push, and I’m trying to push and get sick once, and then, you know, some other things happen.

And I think he was out literally, like it was a dream like literally I think within a half hour 45 minutes like this was just, and there he was. And you know the phone’s ringing in people are talking and then the doctor had set aside the placenta,

P: yeah 

J: and she knows my husband, and she knows he’s a science teacher, directly has taught science, and she said oh good you’re here want to show you the placenta so like they’ve got this field trip already there, and his phone’s ringing and it’s his best friend and I answer and he said Julie I said yeah. He said when you don’t answer the phone is what are you doing calling.

So, it was just much more different than the first one, and he, I nursed him right away. 

P: Oh wow

J:like he, he went to different kids though I mean and I also was different mom to an extent now having that experience, and a few hours later that coincidentally my sister in law, she came back with this baby too. She didn’t know what they were going to have the baby, and my husband goes to pick her up and she sees he’s got a hospital band and she said, The baby came in, he said yeah today. So the timing couldn’t have been better. So they go and they pick up our son, or older son and bring him around just petrified that he is going to hate me…he didn’t hate me, even maybe at all. What do you know mom, he was more kind of curious about the you know the things in the hospital room and did anything have wheels can I push it around and that he looked at the baby, you know, is our younger son Max and that was it, you know, but much different birth, and two is more than one I can say that so that was more difficult but I had my self confidence was back and I physically felt better. 

Even, you know, even though this is vaginal birth I mean I didn’t have any issues after having, you know, the cesarean, the first time around so, so all was good, and now they’re healthy and thriving. Through the pandemic chaos 17 You know 17 and 18 year olds and it’s funny, our oldest is working on a psychology project for high school for senior project, and he’s ta almost cried when he sent it to me he sent me this picture, it was a professional, you know you get professional shots with this, the first one, the poor second one, he didn’t get any but we’ll work on that. He sent a picture and he said, he said, look at this and I just said oh my goodness, and then he asked how he wanted to know more about like his births and how old he, you know, wasn’t that picture and it was just, it was very you know, it was very, very sweet to see him kind of taking an interest, you know, in that. That was really good about keeping bait photo albums until they were like five and six. And then, I don’t ever reason just nothing. So, 

P: I’m impressed that you did that because it sounds like our kids are about the same age and like we didn’t have an iPhone. 

J: I know, 

P: I don’t know how you got those pictures right i Aren’t my kids don’t have like three pictures of their infancy and then like once the iPhone comes around this is Tuesday, right?.

J: That was supposed to be a project I thought before all this is at will now he’s 18. The struggle is, I literally everyone used to laugh I would have disposable cameras and then I had a digital one, but I would immediately get like two copies. Two or three I would either get like three or two, and one book for him, one book for his baby brother, and then a family album, so there wouldn’t have to be fighting and I just put them together and it was easy and that was sort of easy, but actually it got harder I think with the digital camera to now I’ve got to find out the smart cards or whatever the sims or whatever in there.

And then how many phones do I have I had census I probably had easily six phones. Yeah, there’s I did the photo album so what do I do dig up the phones in the car, like, how do you know, put those together so I’ve got to do some backtracking and I’ve just had to show myself some grace and do the best that I can but I really want each boy to have, you know something through their 18th year, and it’s not looking good at this point, you know, 

P: I’ll keep fingers crossed for that for that a resuscitation of the old phones.

That sounds amazing, and, and you so clearly learned a lot from the first one, right, like the second one was different in a lot of way.  If you could go back and give advice to your younger self, what do you think you would tell her.

J: Calm the f down….you know, which people would love to people tell me that now, it’s part of my nature is calm down, trust the people in the process.

Think I can trust the people, because you can kind of up who your people are, but the process was like, you know, scary, and maybe enjoy it more. I don’t think I dislike being pregnant I don’t remember thinking, Oh, I hate this and I was why I was mindful that there are people who cannot have cannot bear children. 

P: Yeah, 

J: right. I am very, I try to be very mindful that there was a point when, before I met my husband I bought real estate thinking, Okay, well I’m going to adopt babies because I’m clearly not meeting someone to have children with. So I It’s okay I will be a single mom, but I want to make sure to adopt. And we kind of joked about that now i i have commented about we’ve had babies everywhere except adoption one through the vagina one through the you know cesarean… adoptions, the only way left. But I think, to also enjoy that time right if I feel like with her first. When I was pregnant I remember thinking, you know, there’s a lot of laughs like it’s not going to be just my husband and I anymore so there was a lot of that but maybe to enjoy it more, I was home, ish. Both boys when they were little, I worked, I was able to work around having them with me at home during the day and then I would do radio at night. So, I appreciate that because there’s just, you don’t get those years back and those are some tough times being with them though too, and maybe ask people for help. Yeah.

You know, I don’t think it’s so much pride is I don’t want to be an inconvenience and I want to be a good friend. And I know if I ask for help. This is kind of horrible somebody else might ask and I might not be able to help them so it’s this weird mindset but don’t be afraid to ask. But I was because most of my friends were in the exact same spot, there are a couple of friends who, who chose not to have children and maybe I could have, you know, involved them a little more ask them for help, but I didn’t know what I didn’t know. 

P: Yeah, 

J: I know. And now and now I do, but I survived and I just I cannot believe people tell you that the time goes by so quickly. I know yes for one thing, but you’re going to get through it, whatever that moment is because, you know those nights where they’re sick.

And maybe you’re sick at the same time, or, you know, you find out maybe they, they have some special need of some sort, or, you know, you don’t know if you should stay home should you quit your job, all of that stuff. Those are, those are just their moments, their moments in time, and you’re going to get through it, but I just remember thinking, I’m going to be rocking a kid on my chest for the rest of my life and this is, this is really hard, and yeah, not at all. Ask for help, I think, 

P: yeah, that’s a good message, and, and tell us about your book since it sounds like it’s about childhood and pregnancy and this, this process 

J: from conception to confusion, it came from a succession of blogs I was blogging for my publisher, mimosa publishing, and they had put out books, it was a series called mommy, MD guides. These were books that were written by doctors like Who better to give advice than doctors, And they said, Well, we’ve never had anybody humorous…like you could be our first non US writer and I thought well this be great. That sounds very cool. And I will put a link to your book in the show notes so people can find it. Thank you so much for sharing your story. Perfect, thank you I appreciate that. I appreciate that.

P: thanks Again, Julie for sharing her story, I’ll put a link to her book from conception to confusion in the show notes. If you liked this episode, feel free to like and subscribe, and if you get a chance to leave a review, we totally appreciate reviews because it helps other people find the show. We’ll be back soon with another inspiring story about braving the many challenges this transition can hold.

Episode 20 SN: Take Love and Determination, Add Science: Emily

If you have the slightest bit of doubt about the complex chemistry needed to inspire an embryo to develop into a baby, a casual stroll around the details of IVF will quickly disabuse you of that notion. Today’s guest set out to get pregnant a few years after she’d turned 35 and pretty quickly turned to IVF. Agreeing to IVF is agreeing to become a science project. Because she so deeply wanted children, she willingly gave all the blood samples, took all the shots, attended all the appointments that are required to re create this complicated chemistry… Through it all she had her eye firmly focused on the goal: babies…and was ultimately rewarded with two beautiful children. Listen to her inspiring story

cover art thanks to Pamela Gallegos Find her work on Etsy: https://www.etsy.com/listing/553161813/custom-ivf-embryo-watercolor-8x-10-or-11

You can find more about Emily and her company, MyMomCrew here:

Mom Crewwww.MyMomCrew.comInstagram: @MyMomCrew
Facebook: @MyMomCrewFacebook groups in NYC, Boston, Philadelphia, Washington D.C., Chicago, Los Angeles, and the San Francisco Bay Area 

History of IVF

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140213/

https://health.usnews.com/health-care/for-better/articles/2018-07-26/weve-come-a-long-way-baby-the-history-of-ivf

ICSI

https://www.reproductivefacts.org/news-and-publications/patient-fact-sheets-and-booklets/documents/fact-sheets-and-info-booklets/what-is-intracytoplasmic-sperm-injection-icsi/#:~:text=In%20the%20ICSI%20process%2C%20a,the%20woman’s%20uterus%20(womb).

https://rep.bioscientifica.com/view/journals/rep/154/6/REP-17-0308.xml

IVF and Birth defects

https://rscbayarea.com/blog/birth-defects-ivf

https://pubmed.ncbi.nlm.nih.gov/30189770/

Pre genetic screening and risk of miscarriage

https://www.sciencedirect.com/science/article/abs/pii/S088985451730150X

Causes of early miscarriage

https://ada.com/causes-of-miscarriage/

NIPT

https://medlineplus.gov/genetics/understanding/testing/nipt/

Mosaics

https://www.mdpi.com/2073-4425/11/9/973/htm

https://www.sciencedirect.com/science/article/abs/pii/S0015028220327163

Induction at 39 weeks

https://www.ajog.org/action/showPdf?pii=S0002-9378%2819%2931142-1

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6821557/

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 have two kids.  When trouble hit my first pregnancy I learned about the complicated chemistry involved in growing another person. Another way to gain this insight it to a casual stroll around the details of IVF. Today’s guests set out to get pregnant a few years after she turned 35, and pretty quickly turned to IVF.  Agreeing to IVF is agreeing to become a science project. Because Emily so deeply wanted kids, she willingly gave all the blood samples, took all the shots, attended all the appointments that are required to recreate this complicated chemistry. Through it all, she had her eye firmly focused on the goal, babies, and was ultimately rewarded with two beautiful children.  After we spoke, I went back into the conversation to includ some medical details and we also have the fabulous insights of a great OB.

Let’s listen to Emily’s inspiring story. 

P: Hi, why don’t you tell us your name and where you’re from.

Emily: I’m Emily Anderson. I currently live in Los Angeles, California, we moved out here in May, after the 

P: oh, wow 

E: from New York City. 

P: G-d, that must have been an adventure. 

E: It was yes, especially with my six month old and a three and a half year old at the time so, wow. Yeah. 

P: Are you feeling a little more settled now?

E: Definitely, yeah, more fresh air and easier outdoor access during everything that was going on,

P: God, no kidding. That is, in some ways that’s really well timed right to not be.

E: Yeah,I mean it wasn’t planned it was pushed up by a year after the pandemic hit. 

P: Yeah, so it sounds like you have two kids. 

E: Yes, I do have a daughter who now is almost four and a son who just turned one year.

P: Oh wow, nice. 

E: Yeah. 

P: So, before you got pregnant, I’m sure you had ideas about what it would be like, what did you think it would be like,

E: I don’t know if I had really clear ideas of what I thought it would be like but I knew it’d be like a very interesting experience. I knew it was something I wanted to do, I didn’t know how it made me feel but I always wanted to have kids so I knew whatever it was that would be worth it. 

P: Well, that sounds great. And did you get pregnant easily?

E:  No, I was a little bit older at the time I got married 36 I just turned 36 When we got married, we started planning I had a feeling that maybe it was going to take a long time or we would need to get help and my husband was like, Oh, I’m sure it’ll be fine. You’re not old, you’re so young and I’m like well, biologically, can’t really say that, and so I wanted us to just get checked out after a few months just to see if everything was looking normal and if it was, we would keep trying and if not you know we would explore other options and that’s when we realized that there was an issue that was likely going to require IVF. 

P: Oh wow, so I had trouble getting pregnant too but it was like hard to identify our problem.

E: So ours was pretty clear as it. 

P: Oh, okay. Yeah, 

E: I had had, I’m blanking on the name right now but one of those tests to just see what sort of shape my ovaries were in it was a blood draw, so it wasn’t, you know, if you had a good result that didn’t necessarily mean it was going to be easy to get pregnant, but it meant that you know, sort of, everything was looking kind of normal so I had a good result for that, it turned out when my husband just did, you know, a sperm sample that he had low sperm count and low motility. So it seemed like that was probably the problem, 

P: and so they tell you right away that the way you approach that is IVF. 

E: They said it was, it was probably likely there were a few things they wanted to try in the meantime, and so they started by having my husband. I think it was like first stop a medication had been taking, and then, you know, every time you have to wait 90 days, to see how the sperm regenerates. So 

P: Oh, wow, 

E: you know, I was definitely feeling a little impatient and Lego I’m just getting older, as this is going on, then they had an, try and taking a medication to see if that helps. So that was another 90 days. At that point we had been living in San Francisco and we knew we were going to be moving to New York, and so it seemed pretty likely that we were going to have to do IVF since nothing really helped, but we couldn’t start until after we got to New York and that was going to be another several months down the road so you know we just kind of put it on hold for the time being.

 

P: So let’s talk a little bit about IVF tell us about like what do you have to do for IVF and my only powerful impression is that it’s expensive.

E: Very. So, different people can do it in different ways depending on your age, your history, you know what your doctor recommends and it is still a relatively new practice, 

P: The first live birth of a “test tube baby” was in 1978 in England. The mother had a normal cycle, physicians grabbed one egg, fertilized it in a petri dish, and implanted the eight cell embryo in her womb. 3 yrs later, in 1981, after 41 failed attempts this experiment was successfully repeated for a couple in Massachusettes . Now, IVF accounts for between 1 and 3 percent of all births in the US and europe. The doctor who pioneered this approach almost 40 years ago won the nobel in 2010 for 

E: As far as things go so kind of amazing they’re learning new things, each time so even between my first and my second, There were some really big differences. So for my first I had to do the actual egg retrieval, so for that you have to take medication, usually in the form of injection or maybe only in the form of injection I had to inject myself with a needle with a medication for I think it was for two weeks, I had to go in frequently to the doctor’s office between seven and 9am I think, and if you got there too late, there was usually a very long wait so I tried to get there, you know, set my alarm for 530 and get there early, I also started a new job and I wanted to make sure I was there, you know by 9am It was an hour commute.

P: good lord

E:  I had to end, and ever react to the medication in different ways and I had actually I was fortunate that very healthy looking ovaries, but it meant I was having big production so I was actually reacting too strongly to the medication and then they give you one to slow things down so you don’t ovulate prematurely. So that was another injection I had to start doing a few days in, I had to go in for very frequent monitoring. So then, what they’re doing is trying to figure out how follicles are growing, how many you have one year going to ovulate so they start tracking very closely, and then they have you do a trigger shot, they call it that forces you to ovulate within a certain number of hours and it’s very specific, I had to stay up or set my alarm for midnight, so that I could give myself a shot with within a 30 minute period or even shorter a 10 minute period and that was a big shot. Even bigger than the other needle I was a little nervous for all of it. I also just felt terrible doing IVF because I’m a pretty like thin person and I just, it made me like so bloated and I just didn’t have a lot of room to expand and so yeah it the whole thing was very uncomfortable physically, and I had a really hard time with it, so that was a couple weeks worth of my life you know I knew there was going to be and ending. They then you go in and they also give you a very specific time to come in for the egg retrieval, and they go in they put you under it was actually the first time I had ever been put under in my life. I started crying right beforehand I got so nervous and you’re all alone in there, your partner isn’t allowed to come in and say I got a hug from a nurse and then passed out, and then woke up something like 45 minutes later, and then you know it’s pretty painful. It is kind of like a minor surgery, I guess, so you can take some pain meds and recover but then I have something called hyperstimulation where, because I had a very large egg production. I actually started feeling worse and worse for a few days afterwards, and sometimes it can get so bad that people have to go to the hospital. Fortunately for me, it stopped just short of that, but a little rough. I couldn’t go into work and I was making up excuses like I had the flu. I just started this new job.

P:  What does it feel like? 

E:  I was very sore, like in my lower region, you know, I think I was using either ice packs or heat packs, I can’t remember now taking Tylenol or Advil, the hyperstimulation though it feels like. It felt like I was so incredibly bloated like it was just it was less painful more uncomfortable, but like, extremely uncomfortable I could barely walk, I mean I was basically lying on the couch I could barely eat, but you’re supposed to eat and there’s certain things to eat or avoid and you’re not supposed to drink too much liquid and they get worse and so it was just feelings like that I think I had some shortness of breath, I mean, it was pretty miserable, but I was happy that you know, had a lot of eggs. So that was the upside, but then, you know, it continues to just be a very stressful process emotionally so even after the physical side is over, and you’re feeling better, you know there are a lot of phone calls that come in from the doctor to let you know how many eggs you got and how many fertilized and how many grew over the course of four to five days and then we had decided to do PGS testing, pre genetic screening. So neither my husband nor I showed up for any genetic disorders but because of my age, the doctor said, the average would be about one in three would be a normal, normal embryo so a healthy embryo without any potential birth defects or, you know, major illnesses, so we decided to go ahead and do that as it turned out I had something like 35 eggs with a lot of eggs, so probably three times as many at least for a woman of my age normally would have had

P: I brought some IVF questions to Dr. Patricia Robertson, a perinatologist at UCSF who specializes in high risk pregnancy. Hi Dr. Robertson, thanks so much for being on the show. Here’s a basic question. The surgery to harvest eggs how exactly does that work, and why is it painful?

Dr. Robertson: well they take it, they usually stimulate the ovaries, there’s something called natural cycle but usually patients take medications ahead of time, and have lots of follicles and little cysts so they can harvest as many eggs as possible because then they have to fertilize them and not all will fertilize, and then some patients will get them tested ahead of time before implantation so each step of the process you can decrease the number of potential embryos. So they either do it through the vagina, and you know that’s painful having a needle go in to the vagina into your ovaries under ultrasound guidance, or if it’s done it, let’s say a laparoscopy because they’re looking for other things at the same time, they’ll harvest them through a needle through the abdomen, 

E: the doctor thought, ixsi which is when they forced the sperm into the egg, would be the best way to go about it since the sperm did have low motility, we had extremely low results from that that batch of eggs I was really disappointing, but then the eggs that were left to fertilize naturally actually did better than the doctor expected so we still ended up with, I think 15 fertilized embryos and then 12 grew over the course of five days to what looks like a good size and shape and so then we did the PGS testing where they take some cells samples, and then they test to see if it’s you know for normal or not it’s not 100% accuracy but, you know, based on what we learned from our doctor it definitely seemed like it would be worth it instead of just blindly trying 12 embryos with the risk that two thirds or more could be non viable.

P: right

E: So as it turned out we did get exactly 1/3 back that were considered normal for, which at the time felt very disappointing, we thought we would have more than that and we weren’t sure if we should go ahead and do another round or not but all in because of the whole round of egg retrieval and the embryo fertilization the PGS testing and then the fact that when you do PGS testing you actually have to do a frozen transfer, they have to freeze your eggs while they’re testing everything and then you have to wait until your next cycle, and then you have to pay for the frozen transfer it costs almost $30,000

P: wow

E: and it’s not covered by insurance,

P: this was my feeling when we had trouble getting pregnant was, I was instantly a science project. 

E: Yeah, 

P: which was weird to me because I guess I hadn’t anticipated it would feel like that. 

E: Yeah, you’re both kind of amazed about all the information they can gather and everything that you can do and at the same time, there’s a lot of gray area right where you just don’t know 

E: Yeah, yeah, 

P: the limit is hard on in terms of what they know.

E: Yeah, it’s really hard and we had a doctor who was very experienced, he had been doing this for many years very smart knowledgeable but not, not the warmest bedside manner which it was okay for me I didn’t feel like I really needed hand holding I just wanted you know I wanted the results I wanted the numbers but he just said everything like very matter of factly you know like, there’s no guaranteed like you. You could have zero embryos, the guy was very straight with us. Yeah, it is hard since there are no guarantees and I think I felt very, very nervous about the whole process very stressed because I knew, you know I had always wanted kids for my whole life I knew this was something I would have had kids in any way possible, you know, even if it meant adoption in the end, but my husband didn’t necessarily feel that way and you know I’m a planner and I always think of contingency plans and here I am:  I’m like five steps ahead like what if this doesn’t work. What if he’s not willing to give a sperm donor whether he’s not willing to consider adoption, what would I leave him, I mean literally this is where my mind is going during this whole process. It was very stressful for sure and very emotionally taxing,

P: it’s also like basically being evaluated on your stats and so I definitely felt like my fitness was being examined and potentially challenged, which is a weird feeling also 

E: that it’s hard, yeah I know so many women who have gone through IVF and so hard because if I’m friends who barely produce any eggs and I really feel like there’s something wrong with them like why is their body just doing what, what their body should do and why are they only producing a few or why are all their embryos bad, and, you know, they said like I was very fortunate to have a lot of eggs and to produce pretty good embryos but I even felt that way at times like, Oh, two thirds of mine are bad, it’s probably because of my age you know and that definitely was hard.

P: yeah

E: I think it was certainly the hardest on my husband, you know, because it more frequently is an issue with the woman and my husband’s not like even a macho kind of guy, but it really does take an emotional toll on them too, especially when you just assume you won’t have a problem and this is something that you’re supposed to be able to do with a man, you know, as you always think just going to go the natural way and that’s not like is how we made babies in this petri dish. 

P: Yeah yeah

E: and it definitely feels a bit impersonal at times, which is hard, I think, but yeah but I knew we were so fussy, we did the PGS testing had four good embryos we decided we should go ahead and try them instead of thinking up more. And the only reason we consider doing more is we knew we wanted to have two children, and I didn’t want to have to go through IVF again, I couldn’t imagine doing it with a young child since I was like, off my feet for basically for three weeks. And so but we decided, you know, given the cost the time the, you know, physical toll, for me, we would try implanting an embryo, and we thought we probably could implant to up to two if two don’t work, we’ll go back to the drawing board and try to bank up some more embryos, but if it works first try, we have three left that’s pretty good odds. And so, as it turned out it did work, the first try, and that was amazing

P: That’s amazing. 

E: Yeah, and we actually another unusual thing is we knew the genders because we had done this pre genetic screening, you can choose not to find out if you don’t want to but we’re like, find out you’re kind of like to know if I’m definitely not going to have a girl you know or what the options are, and it is a turned out we have to have two of each gender. 

P: Oh wow!

E: Yeah, so for the first one, I didn’t want it I really wanted to girl, but I didn’t, I didn’t want to try to plan it in case it didn’t work out so we just told the doctor put the best looking one in, and we’ll find out, you know, a 20 week ultrasound of everything’s been looking good up till that point and so that is what we did, but yes, that you know it’s so exciting to find out that you’re pregnant, but from a call from the nurse but it also is just so scary. I think there’s so much more at stake when you go through IVF and you’ve had trouble. And so, you know, many, many women go through miscarriages and it’s always hard I’m sure in every single case for the woman, you know, I felt like it was that was even so much more heightened of the possibility when you go through IVF and, you know, have done so much to try to get to that point it’s not as easy as being like, Oh, that was terrible, but we’ll try again, it’s like, oh my god, now we’re down one embryo and, you know, 

P: yeah, yeah

E:  $30,000 

P: as of today, the most common cause of early miscarriage seems to be chromosomal abnormalities of the embryo, given that you think that pre implementation genetic screening with Dr galery of miscarriage for women who undergo IVF, but it seems that a lot depends on the ability of the pre genetic screen to accurately assess the quality of the embryo. This process is complicated as you can imagine, but more recent research from 2017 and beyond, suggests that in fact, pre genetic screening can dramatically reduce the rate of miscarriage, 

E: until really I made it. The 20 week ultrasound I was, I was really nervous about a lot of things and every appointment going in, hoping there was still a heartbeat, you know, very nerve wracking 

P: if you do IVF Are you high risk or you just go to regular OB practice

E:  different consider it in different ways, I think, I think the default is to consider it high risk, but I didn’t have to go to a special high risk practice, although I also was over 35 already so you know it’s probably considered high risk anyway, You know I’ve heard some things that with IVF there could be an increased risk of birth defects but I don’t know the numbers behind that my doctor did not mention it to us.

P: So are there more cases of birth defects, among couples who use IVF. It looks like the answer to this is yes, the rate is slightly higher, but Is this because of something about the IVF process that’s unclear, people using IVF have fertility issues and tend to be older, and both of those factors fertility and age also lead to higher rates of birth defects, but with the constant improvement of PGS testing, potentially the difference between IVF and natural conception may be eliminated in the future. 

P: So given all that you had to do to get to 20 weeks after that, did you get to enjoy the pregnancy or what was it like,

E: I enjoyed it a little bit I think I always joke that I felt really awful during the first trimester, you know, nauseous, pretty much like all day morning sickness and tired and everyone would say oh wait till you get to the second trimester, you’re gonna feel so great and I got there and I was like well, I feel less bad, but I don’t feel great. 

P: Yeah, 

E: like I was not like going to spin classes during my pregnancy I mean I don’t know how anyone was doing that but I think some people feel amazing. Some people feel very feminine and they look amazing and they’re glowing, I did not really feel like that during any point of my pregnancy. I think probably during the second trimester, I was the least worried about anything. Oh, and one other hiccup that had happened in the first trimester was with the, the nuchal ultrasound, which we had, I think around 12 weeks that looked good, but there was a blood draw, they did this fingerprint right at the end of the test, and the Oh what’s this for, and I was so confused on like is it just like identification or something and they didn’t really tell me and then later my doctor called and said that they weren’t supposed to give me that blood draw, it had been discontinued but out of habit they did it by mistake, and now she’s obligated to tell me the results which showed there was an increased risk of downs, and she said she wasn’t worried at all since we had done PGS testing and she thought it was just my age skewing it but I of course was very worried and suddenly can do and an amnio if you want to I don’t think you need to but you can think about it, you can talk to a genetic counselor, and that was so stressful because I mean I know the risk is very small, during an amnio that you could lose the baby but after going through so much, I mean I didn’t want to take the risk if it was just me being nervous about it. So, that was tough. We did meet with a genetic counselor and once she went through all the numbers. Oh, because also we had done that DNA blood draw. The nipt, NIPT test.

P: Real quickly, the nips are non invasive prenatal screening is a blood test that looks up placental DNA fragments placental DNA is usually identical to the baby’s and effort to determine the risk of the fetus will be born with certain genetic abnormalities like downs and Trisomy 13 and Trisomy 18 Because it’s a screening test it can only tell whether the risk of a certain condition is increased or decreased,

E: and that had shown good results with nothing concerning and that also had a much higher accuracy rate than the new goal, blood draw. So that’s why the doctor and the genetic counselor said they really weren’t worried went through all the numbers we decided not to the amnio tightening during the second trimester, I kind of enjoy the pregnancy like I wasn’t feeling great physically but emotionally I was fine in the third trimester that and I think not only does it get more uncomfortable physically, but I started getting very nervous about, you know, the possibility that the baby wouldn’t be healthy when she was born and I should have done the amnio, but it’s too late now and they’re a little bit stressful. And then, other than that I mean it’s, it was a fine pregnancy, I did get some really bad SI joint pain and I couldn’t really walk for about a week, and that was tough was my last week of work an hour away, commuting and my husband had to drive me a couple days and I had to take Uber shares a couple of days because I just couldn’t manage commuting, but then it, it went away, so that was good.

P: So take us through the birth, you know, what were you doing did your water break like how did you know, it was time,

E: so I for some reason was convinced I was going to be late and have to get induced a week after my due date my thing my mom had been a week late, and I wasn’t showing any signs of, you know, being a face or dilated or anything. And then one day before my due date, I woke up at 4am felt this little rush of water and thought oh my god who knows my water breaking, and I called the doctor and they said, come in when their office open so I kind of paced around for a couple hours woke my husband up at 6am and said okay we have to go in. And at first they couldn’t confirm it and then they, they did confirm that it should. The nurse kept saying are you sure you didn’t pee your pants? you’re like I’m on 100% Sure, I actually haven’t done that at all during pregnancy and I know it did not feel like that. So they finally confirmed it and then they sent us straight to the hospital, and that don’t even stop to get your bags just go check in his New York City and it can get really crazy so they said it can take a few hours and since I still wasn’t dilated at all they wanted to start me on induction medications, since they do have goals of trying to get the baby out within 24 hours once your water breaks. So we went straight to the hospital they got a room they started me on induction meds, I got the epidural, very early, like at one centimeter so I was already in so much pain, and then it just turned out my epidural didn’t work that well, which I did not even know was possibility. But I guess with some people, it just doesn’t work that well for some reason, 

P: what’s that mean? You could feel below your waist?

E: I was in a lot of pain, so I was still feeling really terrible contractions. At one point it was just on half my body so they said, Turn, turn this way and let them in, kind of drain it and I was like, is that how this unscientific and they’re like yeah pretty much so I did that and it helped a little bit, I still could feel like contractions, they weren’t pleasant, some of them were getting pretty painful and then I started to tell the nurses I was in a lot of pain like down there and they’re just like, really are you sure, what’s the feeling and I was like, just so much pain like I you know we’re trying to play a card game and I really couldn’t even focus on it, and they try not to check you that much after your water breaks because they don’t want to introduce the possibility of infection but they had the doctor come in and check me and they were like, oh you’re eight centimeters dilated already and, 

P: wow, 

E: this had gone much faster than I expected. They had said, you’re gonna have this baby till tomorrow and so then they were like, you’re gonna be ready to push in the next half an hour and I was like oh my god, and so the doctor when it felt like I was ready to push the doctor came in and then I don’t know, I thought I was pushing. Like, are you even pushing, like I don’t feel anything happening and I was like, Excuse me, are you kidding I don’t know what I’m doing. and I kind of realized that that point the birth class we had taken through the hospital didn’t really cover pushing in much detail and I thought well that was kind of a big oversight. So I was trying my best not really knowing what I was doing, and it was hard because they had tried to increase it, but they’re a little bit of a, you know, it sounds like kind of numb but also still feeling a lot of pain and at this point I mean it was like nine or 10pm I had been up since four I’d barely eaten anything all day I was so exhausted and I think I just started like begging for a C section at some point, it seemed like I was not making a lot of progress so it turned out I ended up pushing for two hours, and the baby had made its way down the canal and everything goes as a matter of getting her out and then at one point I heard that a doctor nursing at the heartbeat, you know, kind of in hushed tones and I was like, oh my god they’re talking about the heartbeat and they’re like frantically pushing. Finally she came out, she had had the thing, when the meconium where the baby poops in during labor and so on and so they had to have a pediatrician there and whisked her away immediately and and you’re crying right away right just like she helped me because I’ve been very nervous at that point that maybe, you know there’s going to be something wrong and the doctor said yes she looks great. So they sucked her lungs she  cried, everything was good, but then my placenta wouldn’t come out. So, it had to be manually extracted, which, since my epidural still wasn’t working that well I really could feel a lot more than I was supposed to and it was, it was unpleasant so the doctor basically says like reach up and, you know, pull it out in pieces,

P: wow

E: was it like it was still stuck to your uterus? 

E: or like, yeah, it was like stuck to the wall of the uterus. 

P: In Emily’s case the baby is born, but the placenta seems like it’s stuck to the wall of the uterus, it will not come out what’s going on there,

Dr. Robertson: so we call that a retained placenta and it’s actually more common than people could imagine the usual style with birth are to wait until the placenta sells itself or gentle traction on the umbilical cord that depends on the provider and, but everybody does agree that once said he hasn’t delivered after 20 to 30 minutes, it’s probably a good idea to get that placenta out even if you have to go up and actually with your hand, create a plain grab the placenta and pull it out, because mom’s that’s a big risk factor for hemorrhage, if you ever retained placenta. It’s painful so there isn’t any anesthesia, usually, unless the mom is a hero and has a huge pain tolerance you wouldn’t do this with a little bit of anesthesia in the operating room, and once you

have retained placenta you’re at risk for it happening again with the next birth so you just need to educate your provider, and know that you may need to have extra care. 

E: I was reading this article in People at one point later or Kim Kardashian was talking about how traumatic her birth was because her center wouldn’t come out and the doctor believes there are mouth and pull it out and she was crying her mother was crying and that’s why she decided to use a surrogate for the next birth and I was like, that’s funny. That’s what happened to me. I was like I want to describe you that’s so dramatic. I mean it was very unpleasant, but yeah so basically that’s it, pull it out and afterwards and I said you want to see and I was like, I guess so. And you know She held it up, it was like roadkill and I was like, put it back, get rid of it I don’t see it anymore. Yeah, it was pretty terrible and then one of the risks with that is they don’t get it all out, because they’re they’re trying their best, but a piece could still be stuck there which could cause problems, then you have to go back to the hospital and sometimes surgically removed. It’s also too late, no production, the doctor thought she got it all out, and we were just hoping for the best at that point I didn’t have any hemorrhaging or anything that was fortunate to, I did tear in four places, the doctor said, Good news, you only have minor tearing, but it’s in four places. How is that considered minor. So then I could feel like every stitch going in and out which are worse because you know I still wasn’t none down there like your supposed to be, I mean while my husband was doing skin to skin with the baby since I still couldn’t hold her yet. He kept telling me to be still and I was like, writhing in pain, but finally it was over and I just, like, kept looking at the baby and being happy she was healthy and happy that I had a partner there with the skin the skin with her and then eventually got to hold her which was wonderful and she latched straight on to breastfeed and so it’s great. And then I really didn’t dwell on the bad birth experience at all, just, you know, very happy at that point that everything went well and I have a healthy baby. 

P: yeah, I think, to some degree, your entrance into pregnancy gives you a lot of perspective.

E: Yeah, maybe it’s like, I’ll get through whatever I have to do like, yeah, this alternate child. 

P: Yeah, it just sounds also like it was a little bit faster for a first time mom 

E: yeah I leave that the labor was a bit fast, so that that was probably the one outside. And how was it when you brought her home. It was great. We ended up leaving the hospital for about 36 hours which was very quick, but because you only stay two nights in New York, and I had her at 1030 in the evening, we didn’t get our room till 130 in the morning but that counted as our first night. It’s kind of weird, they’re just like good luck. My parents were coming to visit a week after my due date. We really thought I was gonna be late. And so we had no help for the first week, which I actually really liked, and I think I might have thought about getting some help, but my husband was like, oddly confident about caring for a baby, I think I had never changed a diaper before and really had no experience with, with new babies but was like, We can do this and make our one big hiccup was the first night we had our home, that there was an emergency heat shut off, And it was late January in New York City, and I had lent, our space heater out to someone because our apartment was usually very warm, so you know I realized this at like 930 in the evening that was freezing cold and I start freaking out and like, this tiny baby that’s less than two days old, like, you know, we need some heat in his apartment and so I like sent my husband out in the middle of the night to find a space heater. So, that was fine. And then, yeah, she was like a really amazing easy baby especially for the first couple weeks my parents came to visit, which was nice for an extra pair of hands and eyes, and yeah it was it was great. 

P: That sounds like a very good ending to uncertainty.

E:  Very very good. Yes.

P: And what is she into now. Well, she’s almost four, she’s into, let’s see unicorns and princesses and dresses very girly things that I was not into as a child and I don’t know where this came from but she’s a very girly girl that’s very sweet. She loves to dance. She loves gymnastics, she goes to preschool and, you know she’s, she’s in a really good kid, I mean she has a strong personality so there are some, some lows with the highs and highs with the lows, there’s definitely strong opinions and tantrums, but she’s also I think it means very independent very confident. She’s so so so funny like she makes us laugh out loud and has been the time she was, she was a baby, pretty much, it’s really wonderful to see her personality develop. 

P:Sounds adorable for is a very funny age, like you, my friends were going to get me like black onesies for my newborn because I only wore black and I’m not girly at all, and my daughter is super primo girly, it is fun to see some aspect that that does not come from you and this little individual that you have created 

E: definitely…it’s a lot of fun. 

P: So let’s talk about your son, was that process smoother because you had been through before 

E: It was a lot smoother. At the time I, I was getting pregnant with my daughter to do a frozen embryo transfer, they had to take progesterone shots for weeks and weeks and weeks so it was something more shots and this time in your butt and I made my husband do every single one because I couldn’t even see back there I was like, you’re going to be involved with and posing, so they have you started can’t remember but maybe a week or a few days before doing the transfer and then if the transfer is successful, to continue for several weeks I think I did it maybe for nine or 10 more weeks. By the time I was trying to get back on my son, the doctor said, Well, we’ve learned in this time, that it actually doesn’t make much of a difference. So, he said well it worked for you the first time if you feel more comfortable doing it again you can but we haven’t seen numbers wise to change and I was like well I’m, I’m a numbers person I believe in the science and if I don’t have to inject myself with shots for weeks on end I will definitely skip that part, they just have you do a progesterone suppository for a few days I think or maybe a week which was a piece of cake, you know, compared to the shots, and, and then the transfer was successful again. So first try, and this time we did actually choose the gender, which was a little weird, you know, I think, the doctor said your three remaining embryos are all the same quality. Seems like you should just pick, you know, and just pick what you want, and we had always talked about how nice it would be to have a boy and a girl, and we had the girl first thing I would have been happy they’re having two girls or a boy and a girl but and I probably would have just said to the doctor just put in whatever looks like the best one and we’ll find out again at 20 weeks but my husband thought we should try for the boy and so we did say, you know, put in the best looking male embryo and that turned into our son. So, yeah, 

P: that’s kind of amazing, and that there was that there was so much learning between your first and your second which aren’t that far apart. 

E: Yeah, I mean that’s that’s talking about earlier, just being still a relatively new science and technology it’s amazing that they’re still learning. Another major thing is mosaic embryos when they do the PGS testing, there are some embryos that look like they have clear birth defects but there are some that are called Mosaic or some cells look okay and some don’t. And they don’t know what that means. And that’s actually a really crazy thing which I think, you know, in the next few years, they’re probably going to learn a lot more about it.

P: So it looks like previously in IVF pre genetic screens. Doctors identified either totally normal embryos, and those with chromosomal abnormalities, but new technologies make it possible to make this into a spectrum, which includes mosaics embryos that include both normal and abnormal cells, looking only at research from 2020 and beyond. It looks like some of these mosaics can be used as embryos, but mosaic embryo transfers have a higher rate of miscarriage and a lower rate of live births a fraction of cells that are normal relative to those that are abnormal may be an issue in the viability of mosaics.

E: Typically they recommend you don’t use a mosaic embryo just because they don’t know what’s going to happen with it, but some people don’t have a lot of embryos and they’ve had a very hard time and that’s all they have, and I do have two friends who ended up using it and their kids are perfect, and out of our eight that tested not normal three or four were mosaic so you know it may it may be that those were perfectly fine 

P: so with your second pregnancy, what do you get to enjoy that one or were you equally nervous 

E: I’m so lucky. I don’t need more than one child, and the second one is I actually, you know, when we were talking about trying for the second I started having some reservations, I’m an only child and I always wanted a sibling and that’s why I always wanted that more than one, And whenever I asked my parents why they didn’t have more than one so we had the perfect child we didn’t, we didn’t run any more out of it, like, whatever, that’s not a reason to do, and then I, like, actually I get it now like I you know I felt very close with my daughter and I was a little worried about adding a second you never know how it’s gonna go if they’re gonna get along or not, and I was a little worried about, you know, ruining our relationship and also we could feel life starting to get a little bit easier and I was like oh my god, are we going to do this again and go back to the drawing. And you know, I was 40 I was already I think, you know from like, I’m getting older. This is more challenging than if I were 10 years younger, but you know we did decide to go for it, but I think, you know, because probably in both those things I was just much, much, my anxiety was not there the second time, which is great, physically I think it was harder, you know, just having a toddler at home I was so, so tired, and you know get to the end of the day and just have like no energy left by bedtime, so that part was difficult. I also got bigger, faster and just bigger overall and it just like I have a very small frame so it just felt pretty uncomfortable for most of the time, I felt like I had like a lot of pulling like I was certainly not going to any spin classes. So like all I can do the walk around normally, at least in New York. Did you get a lot of blockings, but yeah, then by the end I mean, it’s just so uncomfortable all the time, so that was, that was pretty much what second pregnancy was for me. 

P: And was that birth, fast also, like the first one, 

E: yeah, it was much better, I had made it very clear that the epidural did not work the first time and I really wanted to try to get it to work the second time it worked better I think. Toward the end I was having really painful contractions so it still didn’t work quite to its full extent but that was hard but the whole thing was much faster so I think I had been asking to get induced at 39 weeks, partly because of my age, I thought, well there’s, you know, a study had just come out saying it was really no different than 40 weeks.

 

P: So Emily’s talking about the ARRIVE trial that tested the consequences of induction at 39 ish weeks when they only looked at births with one baby for a first time mother who had no risk of fetus was in the right position for vaginal delivery the study found that there were fewer complications and a lower frequency of respiratory support and these newborns at lower rate of C section, it’s not clear if this generalizes to all births,

E: and a lot of doctors were inducing women over 40 at 39 weeks. Also I was due on October 30 And I didn’t really want to have a baby on Halloween. So I thought, well I can do this one week earlier was just being so uncomfortable I thought, you know, I’d rather just not be pregnant one extra week if I don’t have to be at my practice they weren’t doing that and so I really had to try to fight to get that request in and finally one doctor, you know who strongly believes that it should happen helped make it happen so we had an induction time set up, we’re supposed to go in at 9pm one evening, my parents had flown in to help watch our daughter, and then my water, coincidentally broke a couple hours before that. So it was very unusual but it was, It was getting we were going in anyway I still needed the induction medications since I wasn’t very dilated, it was kind of the same as last time but you know since we went in, in the evening, the New York hospitals can get so crowded sometimes so we were in this triage area for a while and you know that took a few hours to even get our room I think we didn’t get a room till after midnight and then it was another hour or two before they could even get there with the induction medication so you know it happened pretty late, but then labor moved along quickly enough and so I ended up having the baby at 10am that morning. Yeah, other than the painful contractions, I only pushed for for 30 minutes or something, and that was much easier, and it was it all felt much more calm, like I don’t know it was morning not evening like that just felt kind of better as a doctor, it was supposed to be the doctor for my practice that I liked a lot. I was at a good practice, you never know who you’re gonna get and I was very happy it was gonna be this one doctor, and then the reason she wasn’t available so there was supposed to be this other doctor and I was like, Okay, well, like her, that’s fine. And then if she wasn’t available I prefer like being a second time mom was good because I was like, whatever whose delivering me I don’t care. And so it was like this other doctor from like a sister practice who I’d never even heard of before but she, she was great and she was very calm and it wasn’t that busy at that time so she kind of just stayed in there with me the whole time and she gave me more tips about pushing than my original doctor had so that was actually helpful. It was weird, it felt like I was making no progress and then all of a sudden the baby was out so I had no tearing the second time which was miraculous. The babies is a little bit bigger than my first, they immediately put him on my chest, and that was a weird experience, my husband was much more calm and present the second time and, and he started taking a video and I’m like paid through this like naked purple crying baby on my chest and I was like, like sounds kind of funny, my face in the videos like bewilder and I’m like was avatar, but it was really nice and I think you know both of us were just a lot more kind of calm and present too, and then the baby looked great, 

Both my kids I think from the start were like, oddly calm and also making eye contact from like minute one which was amazing, you know, and so they, they were both cool just like hanging out. My husband went to get breakfast and I had like a truck drivers breakfast and it was amazing and a giant latte from Starbucks and, and I felt like I was fine and you know send the baby with the nurses to the nursery overnight, I get a little bit of sleep and yeah it was it like weirdly felt like a little bit of a vacation because I had actually never spent a night away from our daughter, before that, and at one point in the hospital I was like, eating ice cream, they had brought me and reading a magazine and watching a TV show on my iPad and the baby’s peacefully sleeping in the bassinet and I was like, This is amazing. Relaxing was nothing to do right. 

P: That sounds like a great experience. 

E: Yeah it was. And our daughter was great when we brought the baby home, we had done a lot of prep around that and we had her come to the hospital to meet him it was really wonderful and we were able to time it with the hospital photographer so she got like the first look, you know my daughter seeing her little baby brother for the first time and holding him for the first time, kissing him is really really sweet. 

P: That’s cute.

E:  Yeah. 

P: What is he doing these days,

E:  he started walking. It took his first steps on his first birthday. Oh, it was really about yeah it was about a month until he really started walking. He’s being very cautious for a little boy, which I was not unhappy about and so yeah now he’s like walking everywhere and starting to try to run a little bit. He loves to climb. He’ll do things that he thinks are funny and then look at us for a reaction and like really good natured. Yeah, yeah, although like my daughter is extremely chill until one year and then it’s almost like a switch flip for both of them where they just started developing much stronger personalities, so it’ll be interesting to see how that emerges,

P: yeah that sounds fun. Yeah, yeah it is the well that’s a completely triumphant story after you know an uncertain start right where yeah, you have no idea how it’s gonna work or if it’s gonna work and all the waiting and, yeah, testing and so that’s an amazing story to share and very hopeful so thank you. 

E: Yeah, thank you.

P:  If you could go back and give advice to your younger self, what do you think you would tell her. 

E: You know, it’s funny, one thing I think I would tell her is to just freeze your eggs when you’re like 20 years old. You know, 25 or something like that i A friend had asked me when we were 30 If I was thinking about freezing eggs. I was like no, are you crazy we’re so young, you know, but I think knowing what I know now you just you never know how it’s going to work. Worked out and you know when you’ll meet somebody when you’ll be trying to have kids how that will go how your body will react at that point, so that’s probably one thing I would have done, and other than that I mean I don’t know like I think, you know I always say it would be nicer. It would be nice to be a little bit younger at times just to maybe have a little more energy, but that’s just how my life went, you know, 

P: yeah, 

E: I wouldn’t have chosen to be, you know, 40 years old, having a baby but I’m, you know, that there were no other options and also when I look back on, you know, when I was 30 I mean I was nowhere near ready to have kids yet I was having the time of my life I just moved to San Francisco I was making tons of new friends it was like, I mean I can’t imagine already being settled, I would have I would have missed out on such a big chunk of my life. So, you know, I think you just kind of go with it and, and that’s how it works out.

P: Yeah, it kind of all comes in its own time right you can’t 

E: Yeah, yeah. 

P: Do you want to tell us a little bit about it sounds like your business is related to your experience with pregnancy. 

E: Yeah, 

P: tell us a little bit about that.

E: Sure. Basically I, we had just moved back to New York, not long before we were trying to do IVF and get pregnant and I had lived in New York twice before so I did still have a few friends but a lot of people had moved out of the city and the friends that remained were all scattered so we literally all lived in different quadrants of, you know the city or the boroughs, I just wanted to meet some new people that, that were having babies around the same time and live near me, I figured once I had the baby I probably wasn’t really traveling very far to see people. So I started a Facebook group and I called it winter babies 2017 and I posted it in a couple of the local moms groups I was in on Facebook and said Oh If anyone’s having a baby around this time, I just started this new group you want to join us. It was started slowly and then it kind of started snowballing. I planned. I think one meetup for coffee for those of us who were pregnant, and there were probably like, maybe eight or 10 people who came so that was really nice just to meet a few people and then once the babies were born more and more people are joining and telling their friends and I started planning weekly lunches and we would all be chatting on this Facebook group all the time and at all hours of the day, you know, post a question at 3am and like 10 Do I answer, usually, you know, and I started planning some mom baby happy hours and after the baby’s got to mobile I started planning mom’s night out at night and I planned a Halloween party for our first Halloween and I sold tickets so that I could help purchase them, you know, share food and, and everything and it’s sold out and I you know it’s like trying to get more space with the restaurant, it was really crazy and so then people started asking if there were any other groups like this because they had friends having babies and I wanted them to have the same experience, they felt like it has really transformed new motherhood for them, and, you know, that kind of gave me the idea for this business, 

And I thought well you know a lot of expectant moms and new moms, it’s a lot of people feel very isolated, they don’t know how to make new friends as adults or are nervous about it and they don’t, maybe don’t have a lot of friends that have kids or at least who live near them, and so I based the business around the idea of just providing opportunities for social connection among expectant and new moms, so I run Facebook group for moms do every six months in New York and then I just recently changed it to be by year, and then I just launched groups in a few new cities as well, and in New York where I launched it I was planning monthly mom to be meet up weekly new moms happy hours in different neighborhoods. So, you know, people could connect to the Facebook group, they could connect in person they could make their own friends set up their own playdates, you know it’s really what you want to get out of it but the happy hours, and they were amazing, I, I would get a 40 to 60 moms coming to these things with their little babies and I mean this was obvious help pre COVID Yeah and it was so much fun, and people, you know a lot of people made like real genuine friends from these experiences, and it’s, it’s unique because there are other mom groups that happen, new mom groups but they’re usually a much smaller group they’re more like a support group, you know, there’s, there’s maybe eight or 10 other women with you and if you happen to connect with someone in that group that’s great if you don’t, you know, you know, they’re also usually very expensive so it’s like okay well I spent a lot of money into this for six weeks and that and then people move on, whereas, you know what I was trying to do is provide like a little bit of like a 360 experience with like even come to the happy hour you can meet people in person, you can keep chatting on Facebook or vice versa, start chatting on Facebook, then put a face to a name, you know, and it was, it was really great they were unstructured, they were free for the moms of getting sponsored by businesses, and so it’s kind of low pressure too because I think you know I found it is hard to commit to a certain date and time with a newborn when you just don’t know how your day is going to go and I was reluctant to sign up for anything that wasn’t drop in because I didn’t want to waste my money and I didn’t want to feel pressured if it was a bad day, you know, And so, so these were low pressure fun, it was every three weeks in the same neighborhoods that would rotate neighborhoods, and they were really great usually people would would come and just start chatting because I’d have name tags and you have a baby, which is almost like your little wing man and kind of a natural icebreaker, but I think you know I’m someone who will pretty much just talk to people will talk to anyone and I’m not shy if I connect with someone I don’t know I’m not shy about saying they should hang out sometime here, let’s exchange numbers, you know, but most people won’t do that. So I think, setting up an environment where it’s very friendly and supportive and everyone’s just coming in their own works really well. and, you know anyone who did look a little bit shy or was hanging back I’ll usually try to talk to and make some introductions. But, yeah, they’re really nice events, and a lot of people made their, their closest mom friends,

P: that’s awesome and it is. I was surprised by how isolating it is in the beginning but you are exhausted and running round and you sort of don’t have control of your day at all, and that sounds like an awesome opportunity

E: yeah, yeah, they were a lot of fun. Everyone looked forward to them so hopefully I’ll be able to log them again at some point. So how do people find it what’s the name. It’s called mom crew, my mom crew, com. and yeah so people some people go find it just by searching for mom groups in their area. I do post on local Facebook groups and other moms like neighborhood mom groups just to let them know if there’s an event coming up, and then some people it’s spread through word of mouth so people tell their friends and invite their friends to join, and a lot of people have been asking for a while if it’ll be in other cities because they’ve moved or they have friends there and they’re interested so I decided, you know, just to, since this is the time I can’t plan any in person events I would just see if I can start new social communities in other cities.

P: That’s very cool. Thanks so much for sharing your story. 

E: Yeah, It was so nice to talk with you.

P: If you didn’t catch that, it’s mymomcrew.com. Thanks to Emily for sharing her story and thanks also to Dr. Robertson for her insights. If you liked this show, feel free to like and subscribe. We’ll be back soon with another inspiring story of overcoming.

Episode 19 SN: Expect the Unexpected, Sarah’s story

Today’s guest went into pregnancy without many expectations about what the process would be like. This openness likely helped her and her partner negotiate the challenging things she had to manage in delivery and the postpartum period.  After her first birth, the baby encountered an issue that landed her in the NICU, and a few days after her second delivery, my guest wrestled with some scary postpartum issues, sending her to the ICU. Now a few years out from those experiences, everyone is thriving. Listen to her inspiring story.

Cover Art comes from Hailee Wilburn-Ervin, see it at https://www.etsy.com/listing/947825013/birth-abcs-placenta-sticker (note: this is an illustration from a birth book called Birth ABCs, also available on Hailee’s Etsy site)

Spotting in the first trimester

https://americanpregnancy.org/healthy-pregnancy/pregnancy-concerns/spotting-during-pregnancy-5374/

https://www.marchofdimes.org/complications/bleeding-and-spotting-from-the-vagina-during-pregnancy.aspx

Round ligament pain

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/round-ligament-pain/faq-20380879#:~:text=During%20pregnancy%2C%20pain%20in%20the,irritation%20of%20nearby%20nerve%20fibers.

https://www.webmd.com/baby/guide/pregnancy-round-ligament-pain#1

CPAP

https://eijppr.com/storage/models/article/ZIa0vPwpWifRCLLmRHFq1tEJIG9otSpXl7LizjyhrIoltIQWGQZduLUjsp0O/early-management-of-newborn-with-meconium-aspiration-syndrome-using-continuous-positive-airway-pre.pdf

Meconium aspiration

https://www.hopkinsmedicine.org/health/conditions-and-diseases/meconium-aspiration-syndrome#:~:text=Meconium%20aspiration%20syndrome%2C%20a%20leading,is%20past%20its%20due%20date.

https://www.stanfordchildrens.org/en/topic/default?id=meconium-aspiration-90-P02384

Kick counts

Statistics about maternal mortality and race

https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html

https://www.cdc.gov/reproductivehealth/maternal-mortality/disparities-pregnancy-related-deaths/infographic.html

https://www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/

Audio Transcript

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka. I’m an economist, a writer and mother of two who had trouble with almost every aspect of the process of growing a family.  Before I had kids, I didn’t necessarily understand that pregnancy and birth could be a daring adventure. The same was true for today’s guest. Sarah went into pregnancy without many expectations about what the process would be like. And she and her husband got a fast education in the many challenges that can come along with birth and the postpartum period. After her first birth, the baby encountered an issue that landed her in the NICU. And a few days after her second delivery, Sara wrestled with some scary postpartum issues, sending her to the ICU. Now a few years out from those experiences, everyone is thriving.  After our conversation, I went back and included some medical details and also have the insights of a fantastic OB, who specializes in high risk pregnancy. 

Let’s get to the story. 

Hi, thanks so much for coming on the show, can you tell us your name and where you’re from.

 

Sarah: Thank you for having me. My name is Sarah and I’m from Connecticut. 

P: Cool. And how many kids do you have?

S: I have two daughters, my eldest is four and a half, and my second will be two in April.

P: Wow, that’s a lot of work, that’s a busy time. 

S: Yeah I mean it’s definitely been different this year given everything that’s happened, but it’s been fun having two girls close together and watching their relationship grow and it’s been special.

 

P: Yeah that’s awesome…. so I have two girls also two years apart. 

S: Okay.

P:  And they’re besties now. 

S: Yeah, that’s what I’m, fingers crossed, that’s what I’m hoping for down the road, you know, we had, they have their moments. 

P: And what did you think pregnancy would be like before you became pregnant?

 

S: I don’t know if I ever really thought specifically about what the pregnancy would be like I kind of just took what I had seen from movies and TV, but I always knew that it was something that I wanted to do, even as a young girl I always love to pretend that I was having a baby or that I had a baby, you know, so it was definitely something I’ve thought about a lot, but I don’t think I actually thought about the actual pregnancy or delivery or any, any of that stuff really.

 

P: So the first time was it easy to get pregnant?

 

S: So yeah, so my husband and I got married, September of 2015. And we, we weren’t trying, but we weren’t not trying, and in January 2016 I was about 10 days late, which I’m never late, I’m one of those people who is annoyingly regular, but I kind of just attributed it to like the holidays and you know I was a teacher, and maybe just the stress of kind of getting back into the groove of break and everything. And then one day it kind of like slapped me on the head You need to take a pregnancy test. And sure enough, it was positive so yeah we found out in January that we were expecting.

 

P: Well that sounds like a pretty gentle entrance. That’s nice. 

S: Yeah, yeah, I mean it definitely, it was a little bit of a adjustment for me mentally and I had so I suffer from anxiety and panic attacks and so it just took me a little bit of time to wrap my head around it, but then once I was there, you know, I was very excited and happy but I was also the first in my friend group to get pregnant and to, to have a baby, and you know we weren’t wildly young I was, I was 28 when I got pregnant with my daughter, and I felt a little isolated and alone just because I didn’t really have anyone to talk to you about it except my mom and her standard answer to things I don’t know this along I don’t really remember, I guess I felt isolated and a little scared and just kind of anxious about it in those first few weeks.

 

P: Yeah, all that seems like spot on, right, that seems like the appropriate reaction. And I always think nine months is a nice long time to get used to the idea.

 

S: Yeah, actually my mom did say that I remember being like it’s not like you’re gonna have this baby tomorrow like you have a lot of time to kind of, wrap your head around things. And, and she was right. 

P: nd how was the pregnancy,

S: it was interesting, I guess to say I was working I was teaching I had spotting my whole first trimester, I didn’t know that it happened, I would go into my OB, quite a few times to kind of check it because it just kept happening and they would do ultrasounds and every time they kind of reassured me that everything was fine and that it was probably just my uterus, you know, shedding the old blood or whatever it was they couldn’t find a cause for it and the baby was growing and developing fine so they were just kind of like, take it easy and there’s nothing we can do.

 

P: Spotting can definitely be stressful, especially if you don’t expect it. According to the American pregnancy Association spotting in the first trimester is pretty common, about 20% of women report this happening, and other sources say it’s one and four many things can cause spotting like implantation sex hormone changes and changes in your cervix.

 

S: But that kind of, it just set me up for being even more anxious because every time I would see the blood, I’d be like, well what’s happening but then I got out of my second trimester and it stopped literally right when I hit my second trimester the spotting stopped and then I started having really bad round ligament pain I had heard about rounding a bit pain but I did not expect it to hurt this month.

 

P: I file this underneath the heading, it’s hard to throw another human being inside you were going to have mid round ligament pain is one of the most common issues in pregnancy. Where does it come from. There are several thick ligaments that surround and support your uterus, one of them the round ligament connects the front part of the uterus to your groin. As the baby grows ligament stretches and can become strained certain movements can cause the ligament to tighten quickly like a rubber band snapping.

 

S: One time I even actually ended up in the emergency room because it was just so painful. I was worried something else was going on but they said everything was fine,

 

P: so did it feel like cramping or it felt different?

 

S: no it felt different, it was like, sharp pains, and it just didn’t feel right to me and I felt like I didn’t really hit my stride until the end of my second trimester, and then I started feeling really good. I had my energy back and I just, I felt that pain was gone and I was enjoying my pregnancy more and I just felt like I was in a good place, from about 26 weeks to like 35/36 weeks I felt really great, and then I went in at 36 weeks, for my checkup and my blood pressure was starting to go up. And because my blood pressure, I’ve been in the low pretty low, The whole pregnancy, they kind of reacted strongly to an elevated, reading, and they were like, alright, we’ll try it again in a few minutes it was still up so they sent me over to the hospital because they wanted to do some monitoring and more tests, and, you know, all the standard things because they were concerned about preeclampsia, even though I had no other symptoms of it except for elevated blood pressure, it was also the middle of August and I was 36 weeks pregnant and you know I anxious person to begin with. So I think there was a combination of things, but they wanted to be safe, so they sent me over.

 

P: It feels like every day we get updated information about the short and long term effects of preeclampsia and gestational hypertension. So I asked Dr. Patricia Robertson, a perinatologist who specializes in high risk pregnancy at UCSF, about what the current criteria are for diagnosing preeclampsia,

 

Dr. Robertson: you can have gestational hypertension, diagnosed, no proteinuria usually not severe range pressures, and a third of those women will turn into patients with preeclampsia. So, if you do get diagnosed, and the definition is to elevated blood pressure’s four hours apart. We’re still using 140 over 90 or greater, then that puts you into a high risk category and then you usually to get labs once a week for preeclampsia, you go to antenatal testing, twice a week to check the function of the placenta and the fact that baby is doing well. I also want to emphasize that we have several readmissions for patients with gestational hypertension and preeclampsia, so they have to be really careful for the first 12 weeks after birth and take their blood pressure at home, sometimes they’re discharged on oral anti hypertensive medication, trying to avoid severe maternal morbidity and mortality is one of our goals because you look at the leading causes of maternal deaths in the United States, it’s hemorrhage. It’s hypertension. It’s embolism, whether it’s pulmonary embolism or amniotic fluid embolism, and infection. So anything we can do to avoid those is good.

 

S: They did blood work they monitored the baby monitored my blood pressure, my blood pressure, then was normal, at every reading when I was in the hospital there, they did blood work it all came back fine but they sent me home with a 24 hour test for preeclampsia, so it was a 24 hour urine collection where literally every time, you pee you have to collect it in this job, and then you have to bring it in to the hospital for them to test it, and

P:  that sounds glamorous, 

S: yes it was so glamorous, one of our favorite stories from the whole pregnancy is that they gave… it was one jug, I mean it was pretty large, but it was summer and I was supposed to be hydrating a lot so I was starting to run out of room and I started panicking, so my husband had to run the labor and delivery, because my OB was luckily on call and she gave him another one because they were like, usually people don’t feel too and I was like, well I need an l came back negative, so they just said it was kind of, you know, pregnancy hypertension, but that they since I only had a few weeks left and I felt like I was working and it was… end of the summer they just thought I should be on modified bed rest till the end just to be safe. again a little isolating but you know friends visited and my mom was with me every day, thank God and I just kind of waited it out.

 I woke up the morning of the six, my due date and I don’t know if it was like a mental thing because it was my due date, but I was definitely having like some cramping and they were getting more close together. A little more intense so my husband said, Well, you know, I’ll stay home today and let’s call and see what they say and they said come in and get checked. So I was like, Is this really happening,is she really coming on her duty and you know we just were like wow, so naive right. So we went in and they said you’re only two centimeters, go home, and we’ll probably see you within the week I went home and just kind of like went about life for the next two days.

P: How did you feel, were you having more contractions?

 

S: has definitely having them on and off. I remember the on call OB, he told me that you’ll know it’s like a real, it’s really time when you have a contraction and it takes your breath away and you can’t talk through it, so I was like, All right, and I was definitely disappointed, I think I was done, you know I was just ready I was 40 weeks, I was a personally a month early so I thought maybe I. This baby will come early since that happened to my mom and you know so on the eighth at about 130 In the morning I woke up and I was having definitely having contractions and kind of just tried to move around our bedroom, before waking up my husband and then they started getting more and more intense, and we called, and they were like, come in. I went in and I got there at about 4am, and I was four and a half centimeters so they were like, you’re, you’re staying and I remember being like, yay, I get to stay, and the doctor was like Yeah. Yay. I was positive for Group B strep and they took blood and then they hooked me up for fluids and antibiotics, and then once they did that and did some monitoring on the baby, they basically told me I could take my IV bag and walk around the halls,

 

P: let me ask you, are you hoping for a natural birth or what are you hoping for?

 

S: well yeah I guess I should say you know people always say they have a birth plan and I said my birth plan was just showing up, we took a one day class at the hospital, it was a full day Crash Course, so I didn’t really think I retained much of that but I was open to like, whatever, you know, I was kind of like if I need the epidural look at it if I don’t, great, I won’t. I’ll do what I have to do now, looking back, I wish I had been a little bit more of an advocate for myself and maybe understood a little bit more but I was again a little bit naive and just our first baby and kind of had a lot of trust in the system and just was kind of like they know what they’re doing, and then the contractions were getting stronger the contractions but again I wasn’t in terrible pain, but they came in and they told me that the anesthesiologists had five scheduled C sections that morning. 

P:Wow, 

S: if I wanted an epidural now was the time, because he was going to be really busy all day. And if I change my mind at some point they were going to have to find someone else to come up and do it, which was kind of a weird thing to say, in my mind because it made me feel like, okay, they’re kind of telling me it’s now or never. And if I change my mind in two hours they’re gonna find someone from, from where, like, you know, the way they presented it was like, we’re just trying to find someone 

P: exactly….we’re going to go out on the street and see who we can rustle up….. 

S: Exactly, they were like, think about it for a few minutes, you know, up literally like a few minutes, and so my husband and my mom and I talked about it and my mom was like, I mean, you seem to be doing well but you know what if you do end up wanting it, my husband kind of had the same thought and I was like, I guess I should get it. I told them Yeah, let’s do it. They came in to get started, it felt like forever. When they have you hunched over holding a pillow and the nurse was holding me, because I also have slight scoliosis so he had a harder time getting it in the right spot, and you have to save so still and that was the hardest part because the contractions were definitely ramping up at this point, and just trying to be still, I’m an anxious person, especially in medical situations so I kept being like, is it in is it in and he kept like No, he didn’t have the best bedside manner, but whatever. No, it’s not a no and then finally he was like it’s in wow you’re, you know you’re like made a comment about how I’m a terrible stick or something like that so I was like, okay, like thank you. And he left, and I instantly had a panic attack, I did not like the feeling of being numb it sent me into a tailspin, I started freaking out my heart rate started going up, I was asking them if they could take it out, or turn it down, and they were like, um, we don’t really do that and the nurses, I could tell were getting a little nervous because my heart rate was spiking. I could hear them calling the anesthesiologist and explaining to him what was going on and I guess he said, just watch her. And then I explained that I also had panic attacks and I could see this like sense of relief come over the nurses face that they were like, Okay, this is probably not anything to do with the epidural it’s probably just her having a moment. 

P: Yeah, 

S:so my OB came in and she was actually very like kind of sat with me and put a cold washcloth on my head and talked to me for a few minutes and then I just calmed down and kind of leaned into the epidural and was honestly feeling pretty groovy. At that point,

 

P: I also freaked out I didn’t have a physiological response but i grabbed the anesthesiologist as he’s leading by the shirt, I was like, What have you done to me. Yeah, feel my legs. It’s so he was like trying to pry my hand off his shirt, I was like, This is what we want, you know, supposed to be or whatever. It’s such a weird feeling. I didn’t expect that either. It’s not like a numb tooth…it feels very different right 

 

S: yeah and I think it’s also like you have this fear like well what if I know, like, never regain the sensation. So, but then once I kind of realized that this was fine and, and okay, I just was like, Alright, it’s time to relax now and we just kind of hung out for a while, you know, I wasn’t really feeling any contractions i They told me to try to rest Scrum, you know, 830 to 334, I had only progress one centimeter. So, she was like, let’s break your water. And I was like all right, again, just kind of like sure, do whatever you want to me. So, 

P: does that feel like anything?

S:  It feels like a little bit of a sense of relief, it’s just kind of like a Gush, it’s like a little pop. So when she broke my water I kind of heard her whisper to the nurse, there’s meconium you know and I didn’t retain half of the things from the lesson at the hospital but I remembered hearing about Meconium, she was like it’s, don’t be concerned it’s very common, especially in babies that go past 40 weeks. The only thing that’s it’s going to change for you is that we’re going to have a nurse from the NICU in when you deliver.

I was a little concerned but they kept reassuring me everything looked great, and to not really think about it, and again as a first time mom I was just kind of like, okay I guess it is what it is… they kind of left me alone after they broke my water but they came in to check a few hours later and I was, I was stuck at a seven I was not progressing and so they decided to start Pitocin slowly making progress, I guess, at 10pm they checked me, and I was eight centimeters, I was starting to get pretty frustrated I was tired I was hungry. I was emotional, why am I not further along in the morning, they were kind of joking that I would have a baby by dinnertime and and you know it was 10 o’clock and I still hadn’t had her so they were just like there’s really nothing we can do because I had had the epidural so it wasn’t like I could move around. Finally, around midnight I was fully dilated, and it was time to push and I was a little nervous but I was also kind of excited because they said, a lot of people find there’s relief in the pushing. Unfortunately though, I pushed for three hours. So, 

P: Wow

S: yeah, yeah, so it was not like this kind of immediate release for me 

P: was it tricky because you couldn’t feel your legs ?

S:  I don’t know because they, they said I was a good pusher, you know, they, they can tell and they were pushing great I don’t know if she just hadn’t descend like she wasn’t down enough and just had to come down I had she looks great on the monitor and like I was doing okay so they just kind of let me keep going at around the two hour mark, they brought in a I’ll never forget this woman she was amazing, a seasoned very seasoned nurse, and she basically was stern but compassionate and got in my face, and he gave me the pep talk I needed she was just like you need to do this now, because at this point I was like, I want to go home. I was like, I don’t want to do this let me out of here and they were like, all right, she’s freaking out, and so she came in and she was like helping me through multiple pushes and contractions and she was great… 3:47 in the morning. Our daughter was born, I didn’t feel anything, but it was this relief and just like everything and, and they had mentioned to me that they weren’t going to let her cry because of the meconium. They wanted to immediately suction her and not let her cry. So when she came out I kept being like why isn’t she crying Why isn’t she crying, and they were like, we told you we need to suction her, we’re not letting her cry than they are, they’re

 

P: so they are worried that she’ll aspirate the meconium, that’s the issue? 

S: Yeah. So then they pulled her out and they held her up and they showed her to me and like I briefly saw her like I don’t even really remember. My husband got to go over and see or my mom latched over and sear and they were you know weighing her and doing all the things so I kind of thought things were okay, I had a secondary chair. So they were stitching me up and I was trying to look over, they wrapped her up very quickly, and she was crying at this point but they said, she’s having some trouble breathing, so we want to take her to the NICU for supervision, and that was it I mean they like wrapped her up. They took her. I told my mom husband to go with her because I just wanted people I knew with eyes on her.  I was kind of like, I’ll be fine. Go which in hindsight is so funny cuz it’s like I literally was left alone almost in there but I told them to go, so I got stitched up the nurse gave me a hug and she, you know, was encouraging and she brought me some snacks because it was for morning there was an open, you know they make you stand up and take your first pay, which I didn’t know could be so horrifying, I never thought that having to pee would be this horrific experience but standing up, I remember thinking, oh my god are my legs gonna work and they did. Once I peed and was able to walk around, they were like okay we can reel you into the Nick you so you can see her. And so I went in, and she had a C pap in her nose.

 

P: According to the March of Dimes, with C pap, or continuous positive airway pressure. Air is delivered to the baby’s lungs, either through small tubes in the baby’s nose, or through a tube that has been inserted into her windpipe… the tubes or attached to a machine which helps the baby breathe, but does not breathe for her, which is unlike a ventilator which does breathe for the baby. The C pap the baby breathes on her own, but the steady flow of air coming in through the tubes keeps enough pressure in the lungs to prevent the air sacs from collapsing after each breath.

 

S: And she had an IV in her arm and she had a little like heart monitors on, and I just remember thinking this is not what I signed up for this is not what it was supposed to be but she was so beautiful and I just couldn’t, like it was just a such a weird feeling of, she’s so perfect and beautiful and I can’t believe she’s mine but also, I’m so scared because she has all these machines and we’re in the neonatal intensive care unit and just never had I thought that that’s what would have happened, and then the neonatologist came in and he basically explained that she had aspirated the meconium. It was common. Most times this, they see this in babies and they’re able to come to the back to the parents room into the regular nursery later that day. The next morning you know it’s, it happens and do not worry, she would be fine. 

P: Dr. Robertson, can you tell us why Meconium aspiration is such a big issue for a newborn, 

Dr. Robertson: because it’s very irritating to the baby’s lungs, and it can cause a pneumonia is very rare meconium aspiration syndrome, it’s very common to have, like, greenish or yellowish fluid at UCSF, we have a pediatrician present when there is meconium. So the pediatricians are there so the baby comes out vigorous and it’s processing the meconium coughing and all that stuff. We leave it alone, and do the bonding skin to skin. If the baby comes out blobby and blue, then we hand it out to the pediatricians and they suction meconium out first, hopefully to help it might go into the lungs and then they vigorously resuscitate which sometimes means putting a C pap mask on the baby and pushing them sometimes the meconium as well as the oxygen and that’s not ideal. So they’re sick meconium. They’ll do a lamb and gossipy and go down the baby’s lungs suck that out the baby’s really quiet during this time it’s really hard and the parents with the babies that crying. They don’t want the baby to cry, so they want to get out as much meconium amount as possible before they start the resuscitation. I’m in a very tiny proportion of those babies do get meconium aspiration syndrome, sometimes they end up on a ventilator in the NICU it’s very upsetting.

 

S: He left and my husband and I were just sitting there and it was this moment of this is just not how I pictured it. I pictured my baby being next to us, and then I just wanted to be in the NICU at all times. I didn’t even get to hold her until she was about 12 hours old, my best friend did come, and I just remember kind oflaying in the bed trying to hold a conversation but also just kind of being catatonic we laugh about it now and she was like yeah I just like to tell you it really gone through and so I was just there to be a support person, I didn’t sleep much. I just would rest a bit. Go back. Watch her…. 

P: and they’re, they’re feeding her intravenously at this point, 

S:yes. And then the next day, they put a feeding tube in her nose, and I was able to give her my collostrum through the feeding tube, and any milk I was producing and also they were giving her formula, and the neonatologist was like, you know she’s doing well, they were able to start weaning her off the C pap she was on room air at this point.  she was turning a corner but he was concerned because her white blood cell count was elevated, and he said it could happen from stress, but usually at this point, it would have been down. So he basically told me that he want to do chest X ray, they diagnosed it as neonatal pneumonia, from the aspiration and the decision was that she needed to be in there for seven days for full IV antibiotics, and they were also going to do blood cultures and if those came back positive, it will be longer, which, when I heard that I just internally flipped out but yeah,

 

P: this is a really hard thing to hear right it’s really hard to be in your room without a baby, 

S: yeah 

P: in the maternity ward….Now it sounds like they’re gonna let you leave but keep her.

 

S: Yeah, because I think in the beginning, I held on to the hope that alright maybe the first night, she’ll be in the NICU and then she’ll she’ll come in with us, or maybe she’ll have to be there the whole two days and then we’ll get to take her home, but this was a pretty concrete she needs to be here for seven days for the full round of antibiotics, I had taken a shower I put on real pajamas I was starting to like feel like a little bit more of a human but it still was like this weird pays and emotional feeling.  Our hospital does a celebration dinner the night before you’re discharged, they bring you this big, beautiful meal, it’s something I’d heard about my whole life, I delivered to the town I grew up in so I knew all about this and I had envisioned a sitting at this table eating this dinner with my baby next to me and I just cried through the whole dinner, and My poor husband was just trying to do everything he could to make it somewhat enjoyable. Yeah, and I just couldn’t I was just not there with it yeah I couldn’t

So I was discharged that Sunday morning, we had our bands on, I went home, I tried to get settled. But I just wanted to go right back, it was just this kind of back and forth from the hospital. Home hospital home hospital home until it was time for the last feeding which was around 930 And then I would stay home. So at this point she was off the C pack the feeding tube was out, we tried nursing, it was a little iffy, but she took bottles well, and she was really turning a corner, but I should also know when I was discharged, kind of talking about your when you asked about expectations, again, you know, in the movies and TV and whatever you always see people being wheeled out with their baby and I was being wheeled out with all these beautiful pink flowers and it’s a girl balloons and, No baby and I just felt like everyone was probably staring at me. What was her baby, it was just such a weird experience and pulling away it just felt like my heart was still in that building. 

P: Yeah, 

S: I did wake up every night for the whole seven days around 4a.m. and called the nurses, and to check in and I mean I just have to say. The NICU nurses, they are the most some of the most amazing people I’ve ever met in my life, they were just angels and above and beyond, never made me feel like I was annoying them or bothering them loved on her so much. It was so hard but knowing that she was in good hands.

P: Those people clearly have a fast pass to heaven. Right, 

 

S: Oh yeah, yes, I think all nurses in general but NICU nurses… we had this week, every time we go they would teach, teach us how to give her a bath. Teach us how to do certain things, you know, they were just wonderful and like I just thank God for them every day, and the seven days and her blood was great, her she was feeding she was gaining weight. She was wonderful and they send us home. I often feel guilty because I felt like it was so hard this week in the NICU and if you and I know that there are some families that it’s like, not a week it’s months, and it just, we were very fortunate, but it did set me up for some, I think some postpartum depression. And just because I think everything was so out of my control and unexpected that I struggled with postpartum for that, that, that first year of her life, and looking back I think it was a culmination of the birth and then leaving her as in the NICU experience and it always envisioned, giving my child a sibling just because I was an only child and I wanted her to have that but I was like I don’t, I don’t know,

 

P: so two things: it’s interesting because on your way in you are the first person I talked to who doesn’t have this very intricate birth plan. So while you’re telling the story I’m thinking oh she might be fine with whatever happens because she doesn’t have, but it seems like buried in there and you did have some expectation, and it wasn’t, you know, part of this disconnect is holy crap, it’s not what it was supposed to look like,

 

S: yeah, right, because I just think anytime I’d heard of someone having, you know, someone I knew we’d get a check saying I’m going in and then the next morning, there’d be a picture of the baby and it was just kind of like this, everything was fine, so I was just, holy shit, what was this whirlwind experience that I had like what happened, You know, and it just took me a really long time to wrap my head around at all, and I was just really anxious and depressed and I isolated myself a lot from friends, it wasn’t until, I think she was about till her first birthday that I felt like I really turned a corner.

 

P: So your next meeting with the OB do you say I’m not feeling right, or

 

S: No, I mean because it might so the next meeting with Toby was what six weeks and I think I was kind of just still in the haze of it all, and then I just didn’t really tell anyone I mean, like, I, my husband and my mom I don’t even think realized it until I was out of it when I told them that I think this is what happened, because I was just internalizing it all and just like doing what I had to do to kind of get by,

 

P: I think it’s a giant transition that’s really hard to manage and harder if you’re anxious, and 

S: yeah, 

P: harder if it, you know goes off the rails and 

S: yeah, 

P: so all that sounds like, I mean it makes sense,

 

S: right. Yeah, definitely. And when my daughter was about a year and a half, I guess, I found a therapist and I kind of talked through my birth and we went up you know my anxiety and I felt like I had gotten to a better place with, with the idea of, of doing it again because in that first year and even a little after I was kind of like, I don’t know if I ever want to do this again, or two months before she turned two my husband and I were kind of like, let’s like try and see what happens. And again, I know this is not everyone’s story so I feel so fortunate, but I got pregnant that first time. 

P: take the easy ones where you can get them. 

S: Exactly like thank you yeah I’ll take that one because the other end sometimes wasn’t easy but I got pregnant with our second, I found out in August of 2018…felt pretty similar to my first pregnancy except I was just way more tired because I had a toddler, there will be time to go out on the Forgot I was pregnant, I think because I just had other things going on because you’re caring for another child and it was a pretty easy pregnancy, we found out we were having another girl. So I was so excited, just, you know, for sisters, everything was pretty easy and straightforward and then around 32 weeks I went in for an ultrasound. And I could tell something was up. Because of my blood pressure, kind of like jumped around a bit. Throughout both pregnancies, I was also seeing a maternal fetal medicine doctor who was amazing and she came in and she was so great and she just said everything’s great, the baby’s measuring fine your fluid is on the low side of normal, the plan going forward now would be weekly non stress tests weekly ultrasounds and I would have to do daily kick counting, which I never even heard of was, I know like they tell you to make sure you’re feeling the baby move but I’ve never done kick counting during my first pregnancy or anything like that.

 

P: Counting kicks is exactly what it sounds like you’re tracking the movement of the baby in utero, and it is actually an evidence based practice to prevent stillbirth, you can check out countthekicks.org to get more information. 

S: When I heard that I was kind of like, Is this serious, and they but they weren’t like overly concerned, they just wanted to keep a tab on it and so I did that every week, and my fluid continued to be on the low side of normal, but never to the point where they were like, We need to induce you forgot to 36 weeks, and I went for my weekly checkup and my doctor was like, You’re not dilated at all. I think it’s gonna be like with your other daughter the whole time, the whole 40 weeks. And I was kind of like okay so I like scheduled on my appointments for the next week, so the next day, I was feeling uncomfortable, but it almost felt like I had kind of a UTI like maybe the baby was just sitting on my bladder in a weird way or I didn’t really think much of it because I had a two and a half year old and I was just going through the days and trying to get her to school and home and you know being with her and I felt like that for that whole day and then Friday I woke up it was still kind of there, it would come and go, but I like took my daughter to school didn’t my errands still was feeling kind of weird, I had dinner plans that night with, with my girlfriends and I actually canceled it.  So my husband got home from work, he picked up dinner and I didn’t have much of an appetite, and I had a contraction and then my body started shaking which I didn’t experience my first time around, maybe because of the epidural, but now I know that’s common. Luckily we only live about five seven minutes from the hospital but we were I will never forget we were at this red light stopped in front of the high school, and which is like kind of the halfway point, I had a contraction, and I was, I couldn’t see through it, and I remembered from way back. And my husband was, are you okay and then I just started banging on the window like I don’t know what came over me but like I needed to like find a release of it, in some way and he was like, should I speed up and I was like yes, so we got there and they come down to greet you and walk you out to labor and delivery. And I had another one and this nurse looked at me and looked at my husband and she was like, your labor and but I was still not sure like I didn’t know when I was just, I don’t want to be sent home like I get in the room they, the nurse comes in. She was so wonderful, and she just, you know, get changed we’ll see what’s going on, let’s check it out. I had also again, tested positive for the group B strep so, so she checked me, and she looked up at me with this face and was like you’re eight centimeters dilated. 

P: Oh My G-d

S: Yeah. And I was like, what, like, I was shocked like I, the way they started moving to get the IV and to get like they really started hustling, and then she was like, Do you want an epidural. And I, this time, did not want an epidural, that was really my only part of the plan like I knew that I didn’t like the way it made me feel the first time I really wanted to try to do it without it and the fact that I was already eight centimeters, I was kind of like, I think I can do this, and she looked at me and she said, Okay, well, I used to be a midwife, before I was an RN and let’s do this.

She was fully on board, and I guess it was it’s pretty rare in our hospital where I live for people to forgo the epidural, but she was excited about it and I was excited about it so it really kind of gave me the confidence I think to do it, 

I was admitted at 10pm and I labored for a bit, it was really painful like I mean you know like I was still able to obviously got through it but it definitely hurt, much more than the first time, And then all of a sudden around 11:30 I was like I need to push, and they were like okay don’t like hold on, and they checked me and I was fully dilated, I started pushing and in two pushes, she came out and she was born at 11:54pm. And she was perfect, she was six pounds 10 ounces, so she was great and it was just night and day, to what had happened the first time, and I had another second degree tear, but it was so different because she was on my chest this time while they were switching it up, I was weirdly aware though I was like, Did, my placenta come out and they were like, because I felt something come out and she said no, that was just to large clots. But she said but that’s normal, and then a few months later she like okay your placenta is out, and I was like okay, I didn’t really think anything of it. I went to my postpartum room with the baby which was exciting for me and we were just in shock that she was here, and just a really nice two days.  

As a second time parent, and I think because my daughter had been in the NICU. The first time I was a little more comfortable letting her sleep in the nursery and bring her back in the morning and I was also, I guess I should have mentioned this before but I think breastfeeding also contributed to my postpartum, the first time around because it was really hard for me, she didn’t latch very well and I felt like I was like failing. So this time around I was way more of an advocate for myself and like when they were like, do you want us to do breastfeeding or formula, I was like, both, but you can give her a formula in the night, it’s okay, like I was just a way more open to whatever like I didn’t feel the pressure anymore I took that off myself. And then Saturday, my mom and my 94 year old grandmother got to come and meet her. And then my mom came back with our daughter and it was just such a special moment to see your first baby, meet your new baby, and then we had our celebration dinner and she was there and it was like, all these things that like I felt like I had lost out on last time I got them, and it just felt very healing, and wonderful and we went home, and that Sunday and things were really great and she was a very, very easy baby and I just felt really blessed, it was like felt like it was the birth I needed. Don’t speak too soon right Monday, so this was now the day after discharge, you know things were fine. That night I kind of started feeling a little weird, but I was, you know, it’s like you never know what after your baby like it was just normal postpartum What’s something else, and I was really emotional really feeling anxious, but again like my hormones could have just been leveling out, and I was also having a lot of digestive issues and I was just kind of like well, I have IBS, to begin with, my body’s probably regulating, I was just playing it down. 

So Tuesday morning I woke up, I was having without TMI, a lot more digestive issues, pretty crummy, not just normal postpartum so our hospital they have a standard kind of thing where you have to follow up with a lactation consultant you bring the baby in. They weigh them they check the bilirubin and they check how you’re doing and I actually called and tried to cancel it so that I’m not feeling great. And they were like, well, because your baby was 36 weeks and five days, she really needs to be seen to be weighed. So, if you’re not going to come here to the pediatrician and I was like, Fine, whatever. We’ll, we’ll, we’ll come in there, they also check you so she did my temperature my blood pressure, my heart rate, my temperature was normal, but my heart rate was high and so with my blood pressure, and I just instantly felt annoyed because I felt like it was this back to this whole blood pressure thing where like anytime I love her was up they would freak out and do all these tests and she kept checking it and it kept was still elevated and I was like, I have been having stomach issues I feel like I’m very dehydrated like that probably when my heart rates up, but she gave me a lot of water, she tried calling my OB she couldn’t reach her. She called the on call OB for my practice, and they, she her answer was, basically, she should come to a triage room, in labor and delivery and we should do bloodwork, and rule out postpartum preeclampsia. I was just, and this is not like me, I don’t like confrontation I’m very calm go with the flow person but I was so aggravated at this point, like I was tired. I didn’t feel good I was just like I don’t have postpartum preeclampsia, like, I just want to go home. I want to be with my baby I want to be with my toddler please like you guys have tested me so many times through this, I know the symptoms of it I don’t have any other symptoms of it, I want to go home. And I kind of threw this fit in the middle of the nursing station, and they were like, silent, and they were like, Okay, you can go. They didn’t know like what they were like, just, if you feel weird come back and I was like, Okay, thank you. So I stormed out I was like, I advocated for myself go me kind of thing, you know, but I still didn’t feel well and when I got home, it started to get worse. I was really tired. Again, some things were happening, and then I got really really cold and I could not get warm. I went upstairs, I changed into really cozy warm clothes I got into the bed and put lots of blankets on me and I was uncontrollably shivering, and I called my husband, he came in and I was like, I think something’s wrong, and so he got my mom. And immediately she was like, we need to go to the emergency room, it was one of the scariest moments because I knew something was very wrong. 

And my daughter had just woken up from her nap my two and a half year old when I was, my mom was like rushing me out the door, and I like saw her from the stairs and I was like I love you I’m okay I’ll be back. She didn’t know what was going on but it was really just so scary and surreal, 

we got to the hospital. They took me right into triage my heart rate was really high and they said I had a temperature of 104.5 

P:Wow, 

S: yeah, I was shocked. They put me in a room and there were tons of people in there, and they did an EKG. They wanted to do an EKG first because my heart rate was so fast and like I just remember they like you have to lay still and I was so hot all the sudden, I was like I can’t. So then it was just, every test, they could kind of think of the EKG chest X ray of flu test, blood work, urine, they ordered an ultrasound like the doctor was asking me tons of questions about my symptoms, he looked at my stitches he like examined everywhere to see if there were any signs of infection anywhere, those first 30 to 40 minutes of being there, I honestly thought that I was gonna die. I never experienced something like this I was honestly like this is it and I’m a

 ER/ Grey’s Anatomy medical drama junkie and I was like, in my head I was like, This is the story, this is how it goes. A mother died four days after giving birth. This is it. I can’t believe this is how my story is going to end. And I was saying to my mom, I was like this is it like please take care of girls she was, she was amazing, you know my husband decided to stay with the baby because he knew girls routines and she came with me and I can’t imagine what it was like for her to watch your daughter being like this but she was so calm and rational and like I was so now looking back delirious. Yeah, theater, but I was like, get a priest, I was really like thinking this was it pretty quickly once they give you the IV of acetaminophen and my fever started to go down and I was drenched and I and my vitals, started to stabilize and they were like, now we can really try to get a diagnosis, and let’s also give her something to help her relax so they gave me, you know advant or something in an IV and I was okay maybe I’m not dying like I was kind of, whoa, like, and they brought in the ultrasound tech, and he was just this amazingly sweet man, I was very high at this point on whatever they had given me so I felt like I was just like running my mouth, and he saw it right away. He said that he saw something. And the doctor came in and they said that there was placenta, still attached my uterus basically and what they think was happening was that it was essentially rotting inside of me and, you know, causing early sepsis

P: Oh Wow.

S:  Yeah, things moved pretty fast like I felt better because they had lowered the fever and I was on ativan and I had a diagnosis but the OB on call for my practice came down and she was like we’re taking you in for an emergency D&C, the anesthesiologist came in, he was like, I think because of your stress your body has been under today, it’s just best that we put you under general anesthesia, I think I was admitted to the emergency room at around 4:30 and by 6:30 I was in the operating room, and I remember like picking up and seeing my mom, and I was being wheeled to a room and I was like Is it over like Have they started and she was like it’s, it’s over like it’s finished. And they found a piece of placenta they, you know, scraped everything else out, and they made the decision that I should spend the night in the ICU for monitoring just because my vitals had been so wild when I was brought in. So, yeah, they, it was just so bizarre because to go in so sick. 

P: Yeah, 

S: and then to get better so quickly, kind of like you know like once I was out of surgery, my and I know I was on medication but my fever was gone, they were already seeing improvement in my blood work, I felt better. My mom and I were like in this room, watching Real Housewives of Beverly Hills, we were just what just have like it just felt like such a surreal moment.

 

P: Dr. Robertson, let’s talk about retained placenta. I definitely heard of it, causing hemorrhage, but it can cause other issues too. Right, 

Dr. Robertson: right, right, it can cause most likely it’s bleeding but it can also cause an infection and when someone’s admitted with endometriosis, which is what we call an effective uterus after the baby’s been out enemy treatise, we want to make sure that the uterus is empty so we do a formal ultrasound, as well as give IV antibiotics but moms can get very sick, and so having a high heart rate can be a sign of that it can also be a sign of preeclampsia, with something called cardiomyopathy. You just have to remember that maternal deaths, half of them happen postpartum. And, yes, it’s really a drag to be readmitted to the hospital, but these are life threatening conditions and early sepsis sometimes women end up needing to go to the ICU for fluid resuscitation and their care that’s more frequent than nurses on the front end for can provide. So even though and often they won’t let you bring your baby back in and then you have to pump in someone’s got to feed the baby at home it’s very disruptive. I can understand the reluctance of acknowledging something might be wrong, but that lactation appointment may have saved her life

 

S: It was just like, I went from truly believing I was going to die to like watching housewives with my mom in the ICU, like it was just like what is happening. And I didn’t need a blood transfusion I should mention that when I was in the O R.  They just gave me blood because, you know, I had just given birth and I was losing blood from the D&C and so I was on IV antibiotics. The next morning they came in and they also told me that I tested positive for norovirus, which was such a weird. They think it was like a weird perfect storm like no one knows where I got it. No one knows how I got it, and they think that my immune system was, you know, suppressed from being pregnant delivery and the placenta than the Noro and it was just this perfect storm so then I had an infectious disease doctor come in I had my OB I had my general practitioner, like so many people but they just kept being like, we’re just kind of shocked at how quickly you’ve turned this corner, and they decided to move me to the regular floor for for another day. Everything continued to improve. I remember walking out with my husband to his car and like sitting in his car and just being like, I never thought I’d sit in this car again, just these little things, it ended as quickly as it began, I don’t even I don’t even know what else to say about it, I didn’t have postpartum. This time around, but I definitely had some PTSD, not from the birth, but from the after math, and that experience, I just tried to not let it bring me down because I was almost not here.

 

P: Yeah, that sounds like a whirlwind, that sounds like so lucky to be in the right place at the right time that you went in that they figured it out quickly and could respond

 

S: right and and that’s what kind of has sparked a lot of my recent interest in maternal health in this country because I just think about it like I live seven minutes from the hospital, I have good insurance, you know my hospitals affiliated with Yale, it’s a good hospital, I think about women who don’t have that, and I, it just could have been so different, and unfortunately for a lot of women it is, it kind of sparked this passion in me, so I’m actually going back to school for a Master’s in Public Health at George Washington University, because I just want to understand this more and I want to understand why there’s all these racial disparities when it comes to healthcare, especially in maternal health care and why black women are dying at such an alarming rate when they’re giving birth and I just kind of want to know why it’s like this. 

 

P: that’s awesome that you took that experience and I’m using it in this way because we definitely need help right there. Those statistics for black women are dire, and it feels like a five alarm fire so I’m glad that you’re on it. 

S:Yeah, I actually, I think, like, I just looked at it the other day and it was something like, black women are three times more likely than their white counterparts to die from pregnancy related complications or childbirth and it’s just, yeah, it’s, it’s not good. 

P: Yeah…if you are unfamiliar with these statistics, I’ll put some links in the show notes so you can see what Sarah is talking about… 

if you could give advice to your younger self, what do you think you would tell her about the birth experience.

 

S: I think I would tell her to expect the unexpected to trust yourself to be confident in your choices, and to also know that it’ll be okay, you know, It’s just, it takes unexpected turns and I really think it’s expect the unexpected. Because if you didn’t talk like, you know, my birth, birth was one thing but then if you had told me that I would have had this like wonderful delivery. And then I would be end up in the ICU, and never in a million years would have believed it, I didn’t even no I mean I knew your placenta had to be delivered within 30 minutes of giving birth, but that’s like the big, the whole placenta, I never even thought that a piece of placenta could attach to my uterus and cause this reaction within my body.

 

P: amazing, amazing. Thank you so much for sharing your story I totally appreciate it.

S: Thank you. Thank you for having me if I can help anyone not ignore their symptoms or anything just kind of, 

P: yeah, that’s good advice. 

S” Yeah, cuz like I said, I think as moms and as women we’re, it’s easy for us to kind of brush things off and to worry about everyone else when, especially when you’re postpartum you need to take care of yourself.

 

P: I’m going to end the conversation here because it’s such an important point, and regrettably true. In the postpartum period, as it stands right now, you really do have to take care of yourself…in most places in the US you won’t see your doctor again for six weeks. And, as sarah said, we can’t ignore what may be troubling symptoms. Half of all pregnancy deaths occur after birth so it really is a time that you or your partner needs to pay attention to how you are doing after growing another person in your body for ten months and then releasing them…

Thanks again to Dr. Robertson for her insights, and thanks to Sarah for sharing her story, and thank you for listening. If you like the show, feel free to like and subscribe, and if you have a minute or a view is really helpful because it helps other people find the show. We’ll be back soon with another story of overcoming.

Episode 18 SN: Communication is Key to a Good Birth, Lessons Learned: Stacey

The challenges of pregnancy and birth can be useful mentors for future parents. Today’s guest learned something significant from each of her three birth experiences. The first taught her that she’d need an advocate in birth given that it’s such a powerful and vulnerable experience. The second taught her that trust could be restored in a situation when a real partnership was at work, and the third taught her about physical limits and flexibility. Her experiences also encouraged a career change, from a police officer to a trauma practitioner. Listen to her inspiring story of growth.

To learn more about Stacey, you can find her at www.facebook.com/StaceyWebbEFT and  www.instagram.com/_staceywebb

If you are looking for the insights of an empathic OB, look no further. This is my whole conversation with Dr. Matityahu

Audio Transcript

Paulette: Hi, welcome to war stories from the room. I’m your host Paulette Kamenecka. I’m an economist, or writer and a mother of two who had trouble with every aspect of growing a family. But today, Stacey will share her own story. The challenges of pregnancy and birth can be useful mentors for future parents. Today’s guest, learn something significant from each of her three birth experiences. The first taught her that she’d need an advocate in birth, given that it’s such a powerful and vulnerable experience. The second term of that trust could be restored in a situation when a real partnership was at work. And the third taught her about physical limits and flexibility. Her experiences also encouraged a career change for a police officer to a trauma practitioner. I also include the insights of a fabulous OB only clips of our conversation are included in Stacy’s story, but if you want to hear the whole interview, Go to the extended show notes on war stories from the room, calm. Let’s get to Stacy’s inspiring story.

Hi, thanks so much for coming on the show, can you tell us your name and where you’re from.

Stacey: Yeah, my name is Stacy Webb and I’m from Sydney, Australia.

P: Lucky you. Oh my god,

S: it’s a it’s a beautiful place on earth.

P: Yes, It is right. Wow, that’s cool. So, how many kids do you have Stacey,

S: I have four kids in total, I have an eight year old a six year old in two and a half year old twins.

P: Wow, that’s a busy house

S: very chaotic.

P: So before you had those kids, I’m imagining you had some idea of what pregnancy would be like, what did you think it would be like,

S: I guess, I assumed that you know you get pregnant, and you would see a midwife throughout pregnancy, in my case here you’d see a midwife at the hospital, and then when it was time to have a baby, you would go to the hospital, maybe experience a bit of pain and then you’d have a baby.

P: So, Pretty straightforward.

S: Yeah, and any my sense I always thought if you ended up in a cesarean, that there may have been problems throughout the pregnancy, and really, so I guess in my mind cesarean was very it was never the front part of a conversation when it came to a pregnancy and giving birth as well unless it was discussed throughout.

P: Yeah, I think I think I’m the same I think I thought as like a last ditch effort or I don’t know like I just thought it wouldn’t happen to me. You’re setting us up for the story once you let’s, I’m interested to hear. So, with the first pregnancy was easy to get pregnant.

S: Yes I, we weren’t actively trying. My husband and I, at that point in time in our lives. And so it was a surprise pregnancy I guess some muck around and say it was a love pregnancy, but nonetheless, you know, we had spoke about children, it was just any awkward a lot of speeches voted be a little bit later so I was about 28 when I got pregnant with my first, it was a very smooth, pregnancy, you know, really didn’t feel like there was any issues at all. So my midwife, appointments, and everything was always awkward. And so, again like nothing when it came to giving birth. It was always okay, a, you know, a vaginal birth, and it was going through the pain options in regards to epidurals and things like that, but a C section was never really discussed, no real issues throughout the pregnancy that arose, I just then stayed with a midwife, which was also very lovely because, you know, it was also very calming.

P: That sounds lovely so it’s gonna take us to the first birth take us to that day. How do you know this is the day what’s going on.

S: I was coming up to being 42 weeks pregnant with my first

P: Wow

S: I was overdue. Yes, that was when I spoke about induction they, I was, you know, if everything was safe was happy to try and wait as long as, as long as possible, but then again I didn’t really know much, I just thought, okay, at some point. I knew that they would induce me and I would have a baby, I had a scan to check how the baby was. And at that point they said oh look, the fluid, and I apologize if I’m wrong, because the amniotic fluid, fluid around the baby was getting low. As I was approaching the 42 weeks that having an induction needed to happen. So I had that scan in the morning and they said in the afternoon you’re, you’re coming into be admitted and we’re going to induce you, I wasn’t really fully aware that that day was going to be the day when it was going to happen.

P: Did you not have any contractions or anything.

S: No, no nothing at all. She just wanted to say that my husband was working that day so I called him up and said, Look, this afternoon is apparently the day that we’re going to go in and they’re going to induce me, so we went into the hospital in the afternoon and got admitted, and they said for me to be induced they needed to use the Foley bulb. Yeah, so when it came to doing that my cervix was too high and they needed to manually bring it down. And that

P: that sounds comfortable.

S: Yeah. And they never really fully explained it and I think I was in a state of shock that I normally I would, I’m a very inquisitive woman, and I would ask a lot of questions, and I felt like I asked questions and on reflection I probably didn’t ask as much as I should have, you know, I asked you know, would I be able to have pain relief and they said yes, but the doctor had come in to do the manual, bringing down of the cervix, but they didn’t give me the pain relief, and so they did that without an I was in excruciating pain. I remember telling my husband going. If this isn’t even labor yet I don’t even know if I could go through labor in the birth because I, I was in so much pain. To be honest, it was, it was extremely traumatic for me because it wasn’t something that was expected, I was telling them that I was in pain, and I was kind of given the thing of well you have pain relief, but I kept saying to him, I don’t think I’ve had anything, you know, like you’ve given me something to breathe but it’s not doing anything to me. It was because it wasn’t turned on.

P:  Oh my god,

S: yeah. And so, I’m saying to the midwife midwife that was in the room and the doctor who’s bringing down this cervix manually that you know I’m in pain, please stop it and I just felt like I wasn’t really seen or heard and I was kind of dismissed, until another midwife came in and realized that the pain relief wasn’t turned on so she you know immediately stopped everything can to do that but in my mind, it was kind of already done the damage had already been done, I was, you know just still extremely shocked and traumatized with that.

P: To learn more about what happened to stacy, I took this question to an OB. Hi, thanks so much for coming on the show doctor Dr. Matityahu will you introduce yourself and tell us where you work

Dr. Matityahu: I’m happy to introduce myself and thanks, Paulette for inviting me on the show. So my name is Dr. Deb Matityahu my patients call me Dr. Deb and I am an OB GYN at Kaiser in Redwood City, part of the Permanente Medical Group, and I’ve been there for about 18 years. Another point of interest. I also have a nonprofit in Kenya, it’s called Beyond fistula, and we take care of women who have severe childbirth injuries so women who have prolonged labor and pushing and have end up with internal damage and sometimes causes injury to the baby. And so I work with a fistula surgeon in Kenya, and he does the repair and then my organization does vocational training educational scholarships and business grants and training for women, after they’ve survived, what’s called obstetric fistula.

P: Wow, that’s super cool,

Dr. M:  it’s a rare complication for childbirth at this point. Yeah, in the US, but not, not in areas where women’s health care is overlooked.

P: Yeah. Wow, that’s amazing. Well thanks so much for coming to talk to us today this will be, I think these issues are more common that our guest today that we’re talking about. So when Stacey goes into get induce the doctor says her cervix is too high, it has to be manually lowered. Do we know what that means

Dr. M: I’m going to just try and guess what that means since clearly I wasn’t there, early on before you’re fully in labor before you’ve had a lot of contractions, the cervix and the uterus are a little bit high so when we go to check you meaning we’re putting our fingers inside and we want to feel to see if the cervix is dilated, the cervix can be high up in the vagina or even sort of pushed a little bit back because of the way the uterus is growing. And so early on before you really are in active labor, it can be hard to essentially reach your cervix and get a finger up inside to check your cervix, and in order to do the Foley balloon. What we’re essentially doing is we’re putting a catheter up through the cervix so the cervix has to be dilated, a little bit so we want to at least be able to get a finger or two, up into the cervix, and then feed a catheter that has a balloon on the end, one to the catheter is all the way in the cervix you inflate the balloon and it just mechanically stretching open your cervix for you so that you can have an early induction without, without medication to cause contractions, you know just stretching your cervix will eventually cause contractions. So, from what you’re saying on Stacy, it sounds like it was really hard to reach the cervix. And when that happens. Sometimes what we’ll do is we’ll try and put a finger behind or inside the cervix and pull the cervix down closer, closer towards us, like sort of pulling it forward and try and get the other finger in so we can feed a Foley balloon or Foley bulb into the cervix, and it can be incredibly painful and it sounds like for her it was really painful and really traumatic.

S: So that had happened, where they then, you know, finally brought it down, and you know they did the induction and everything sort of was then going to plan, you know I was then starting to get contractions because of the inducement, I did say yes to an epidural and so that happened as well, which I wanted, especially at that point as well. I got up to eight centimeters, but during that time, especially towards the end because it had been go for quite a long while, I think at that point in time from the beginning of, of the inducement, after the cervix had been brought down until the point where they said no this isn’t working, would have been about 20 hours.

P: Oh my god

S: And, yeah, you know, they’re probably, you know, gave me all these things in between but I just honestly don’t remember, because my main focal point was, was being so traumatized at the beginning, and they said that I wasn’t progressing well enough, or fast enough. And that a emergency C section needed to happen and I, I feel like a little bit of the wait was in hopes to obviously not have food in your stomach when when going into surgery and things like that,

P: are they taking you because the baby’s heart rate is reacting or is it something wrong with the baby or go on understand like what yeah happening fast enough means

S: yes….And that’s the thing I don’t, I don’t really remember too much in my mind, I felt like everything was going okay, in my mind, I felt like the baby’s heart rate was going well, and again when I’m asking these questions, I’m not really being told much, and I’m also in a state of shock. My husband’s in a state of shock, because again there was no talk of a cesarean and so we’re all thinking why all the sudden, now we have an experience so you know when I’m thinking, you know, these people are professionals they definitely know more than me when it comes to giving birth and having a baby, and you know if they think that this is the safest option, you know, they must be right. And so I ended up having an emergency surgery and at the end, and it wasn’t like a rushed process like okay, we’ve got to rush through because the baby’s in danger. It was still, you know, as I said we waited quite a while before I could go in, that was the birth of my first child.

P: I’m so sorry that happened to you that just sounds like the word that comes to mind is manhandled, whether they were men or not

S: Yeah, no, that really was

P: they were not taking you into account in a way that you would want to be and I’m, and I also relate to the deference to vertical authority like I assume they know what they’re doing. So, I could just easily see that happening to people and I’m so sorry that happened that just it sounds traumatizing,

S: I didn’t really get to have a debrief, as to why the cesarean needed to happen, especially that point, there was nothing to say, you know, look, Stacy. The reason why we chose a cesarean and to do it this way is because of all these have been, you know, it wasn’t just as progressing, you know, fast enough, especially afterwards it was really trying to push me out the door, I’d never had surgery before besides this cesarean I’d never really been in hospital for anything to have a cesarean and it was extremely scary to me, although this is Erin was going to happen, just knowing that I was going to be supported and I guess you know, held in a sense to go you know you’re not alone. We’re here with you I really feel like I got that and from having a very nice, lovely easy pregnancy, it really put a sour taste in my mouth, that that was the birth that I got in the end,

P: God, no kidding. What is failure to progress, how do we measure that and is it reliable, what does it mean

Dr. M: that is a great question, before I even answer that. What I’m hearing about Stacy’s delivery is that there just wasn’t really great communication and communication is so important, because knowledge is power, and if you don’t know what’s happening to your body and you’re just experiencing pain you’re just being put through a process and you don’t understand what’s happening. It can be scary, it’s painful and if there’s not a lot of communication or poor communication it makes it much, Much worse I mean it sets someone up for really having a traumatic experience and and people can carry that for a really long time, and so I just wanted to put that out there and as far as failure to progress, we pretty much presume that you’re in active labor when you’re about four centimeters dilated and you’re having regular contractions and at that point, there’s a sort of a standard normal curve that we expect people to generally follow, like how they progress in labor for us to say that it’s a normal progression and that things are going well and so about a centimeter or so an hour in our dilation, If you’re not dilating and progressing as we expect, we look to see are you contracting well enough, we have ways to measure the strength of the contractions we can give you Pitocin to improve your contractions strengthen quality and frequency, you know, and we’re constantly checking and yes we checked by feel, you know, any OB GYN can tell you how many centimeters, their fingers are apart because we’ve checked so many cervixes. So we check and we see you know are you four centimeters are You five are you six are things are things progressing, every hour or two or three, if there’s no change in the call dilation effacement is helping the services and station is how far down the baby’s head comes, if there’s no change in those three parameters with what we can measure as appropriate frequency and strength of contractions, then we say something’s holding up this baby and we call that failure to progress because there’s been no progression in 234 hours, and usually leading up to that you’re doing some interventions to maybe give Pitocin and try and increase the force of the contractions maybe you’re putting in a catheter to measure the actual strength of your contractions just to see that we’re doing everything to get this baby down and out, and if nothing happens, then at that point we say okay it’s been three, four hours. Let’s, let’s talk about another way to get this baby out and that means C section, and often when this is happening, like you had said like there’s, there’s not this urgency that we would have if the baby’s heart rate is going down and we’re doing a C section emergently because of a baby in distress, when you have lack of progress with dilation, a effacement or station, yeah we we watch get Pitocin. We check the baby and often the baby’s doing fine. There’s no distress on the part of the baby, you know, once you have a discussion with the couple and you say, there’s no progress we’re trying this we’re trying that, you know we’re trying everything we can and the baby’s not coming down on its own, and it’s been a number of hours, and we should proceed to C section. And so then you ideally do the C section. Shortly after that, but it’s not urgent, so it can wait.

P: How was your daughter was fine.

S: She was perfectly fine she was. She was 8 lb baby, she was. She was beautiful and healthy. Nice still beautiful and healthy. Yep.

P: So how was it when you got home after the C section and taking care of your first baby,

S: it was really, it was really rough. I was in a lot of pain. And I again I wasn’t really given a lot of pain relief afterwards as well. And I just felt like it was a really rough recovery and I had troubles with breastfeeding and I really wasn’t feeling like I was getting the support in that. And so it just really felt like everything that I thought on what motherhood was, I just felt like I really wasn’t told the real truth, or really, or maybe I just didn’t want to understand the real truth beforehand and it was a bit, it was a big wake up call for me.

P: Yeah, the breastfeeding is also really tricky because it’s portrayed as a must, and everyone can do it.

S: Yes,

P: I think that’s not true, I think. Not everyone can do it and not everyone produces enough milk and your kids latch well, like there’s just a million things that make that interaction really hard and so it’s so glossing over the difficulties to say everyone should and everyone will.

S: Yeah,

P: because not everyone can

S: Yeah, I really, in my mind I wanted to be, you know, the perfect mom and there’s there’s no now obviously I know there’s a perfect mom is easy in so many different forms, but I felt like I had to breastfeed and if I wasn’t I was failing. When I was introducing formula and she didn’t end up being on formula full time, I really had a hard trouble mentally transitioning to that. And when I was reaching out for help I really didn’t feel like it was there until quite some months later and then I just kind of felt like it’s too late now, like wanting to come earlier. I kind of had that bit of a mentality of well I don’t want you to help me out. At that point in time and, and, you know I’ve done this by myself already and, you know, I’ve been asking for help for so many months and no one will help me, and I don’t want to forget there wasn’t that person’s fault who actually came out to help me. And she, she, you know, I thought bad, but just letting it all out then but I guess it was that no one had listened to me. and I guess it’s coming also from the birth, and having no one listened to me, I just didn’t want to do one of our burning one by then. Yeah,

P: so that sounds hard but she’s eight now right she’s,

S: she is.

P: What’s she into?

S: She’s a very creative and creative soul and she loves drawing and reading and really using creative, making creative art as well as dancing around the house so she’s just.

P: That’s cool. So now, given that you’ve had this hard time with the first one, what happens the second time do you and your husband have a discussion where you think we’ll blow past this or. Let’s keep having kids or has that happened.

S: Yes, so we had discussed, we will have another child. And I knew then that I felt like I knew I would be able to speak up more, you know, I knew what had sort of happened throughout the first time, and especially obviously then having a cesarean and I knew that, you know, in the possibility of persevering could happen next. So we had a discussion to have a second child, but I ended up falling pregnant before we originally had planned so we had another love baby, In a sense, and so, throughout that pregnancy, I really felt like I was becoming more aware of my body, I would be more of an advocate for myself and really speaking up for myself so throughout that pregnancy was still a very good healthy pregnancy, and I had some spoken up that I would like to try for a VBAC for a vaginal birth after some cesarean, and so the midwife that I saw throughout that pregnancy was an amazing, amazing midwife who really listened to me and took into account what happened throughout my first pregnancy. We had extra scans to, I guess, check the scar and all of that type of stuff throughout pregnancy, towards the end of the pregnancy, my goal was to avoid any induction if possible, because I felt like that would give my body, a better chance to be able to have a successful VBAC, , I ended up with her being about 41 weeks pregnant when I actually went all spontaneous labor.

P: Good, good

S: So, yes, so that was a completely different experience. I was asleep when I was feeling, the pains of of labor. I’d never experienced the slow, the slow part of it at the beginning so I’ve woken up and had pains and, you know, the night before because it’s it was around Easter time and we have a little Easter Show here, where we took our eldest there and I bought a couple of chocolate showbags and that night I just ate all the chocolate from the show. I got so super threw up so I thought when I woke up and I was getting a little stunning paper, I thought it was because I was hungry because I’d thrown up everything the night before. So I got in, you know, some little biscuits and I’m sitting there like a little mouse eatingmy at my biscuits hoping that that would ease this, you know, little needle in my stomach, and it didn’t it sort of, you know, after it would come in waves and I thought oh, is this the start of what contractions feel like because I had no idea. And I had a little app that would let me know how many minutes apart that these waves of feelings were coming in. And as each time it would come was getting a little bit more intense, a little bit more intense. So then I thought, oh well, okay, this is actually contractions.

And so when it came to a point where I felt like I you know we’re standing over the bed, taking really deep breaths for each contractions was when I woke up my husband, we’d always sort of joked throughout the pregnancy that you know this time, when it came time to have the baby would probably be during the night where I’d have to tap him on the shoulder to wake up so that sort of had actually happened And so we got, I got my daughter in the car and my mom was going to meet us at the hospital to take my eldest, we had set off, and was driving. So we, we were traveling, and we’re going down a very big hill so we can see that down towards the bottom of a hill that a police car or highway car had pulled out and was driving in front of us, and we sort of had by that time managed to be right behind the highway car and they must have seen us going a little bit fast like when I say look we fast, we went traveling extremely fast but we would have, you know, been a couple of Kay’s, maybe over the speed limit. And this, this highway car is driving extremely low, so where we’re in a 15 Kilometer belt probably driving 30 in front of us and I and it’s a one one lane road each way and also to my husband said not this isn’t happening, like, pull him over you like you get you put your high liens on and attract him to pull over because we aren’t driving 30 Ks to the hospital, this isn’t working, and I’m saying usually between contractions, and I’m a police officer myself. So the place folks that had pulled over and banned him you know when he’s Everything okay and I said all Amin labor, you’re going too slow, too slow in front of me and he’s like oh do you want to call an ambulance said no I’m a police officer myself I just want to get to the hospital so he said, Okay, follow me. And so he drives in front of me in front of us, I should say, with, with his lights on and wages driving behind him so you know when we were driving and I said to my husband, he’ll pull over soon and asked me to go in the car with him, because it’s obviously a lot safer. And sure enough, a little bit down the road, he pulls over and says I you know my supervisor says you need to come, come in the car with me, so I can get you to the hospital, quicker rather than you guys follow me. So, in between contractions and getting out of the car and getting in the highway car. I’ll try and find, you know, a piece of towel in the backseat and I was like I’m not a cat, it’s fine.

I was like the last thing I want. And so I went into the highway car and we took off.

P: This is made for TV movie by the way

S: it was it was. And and we were chatting in between, you know, about both are works of sleep I’ve been in the place, and we’re having a bit of a chat while I’m in between contractions on the way to the hospital and at that point in time, I was very vocal when midwives were coming in and stuff that you learned, I would like to try for a VBAC, and if anything keys have happening throughout the pregnancy, we want you to be upfront with me because I felt like I was being lied to, or information was being withheld. I wasn’t really going to take that in my birthing room I was very really stood up for myself, because I didn’t stand up for myself in the first one. And I had an amazing lovely midwife who was very supportive with me wanting for the back and it was really a great advocate for me as well I really extremely value her…this birth was also very different. I really felt seen and heard throughout it all, every time they’d come into the room, they must have seen my shock of are you going to come and tell me something’s wrong because that’s what always happened the first time you’re going to come in and tell me. We’re not progressing enough, I always felt like I was rushing against a clock, whereas this time they’re coming and going. Look, it’s fine. Calm down. The baby’s fine, you are fine we’re just checking, which is doing a checkout was really a lot different experience. I then ended up having the midwife come in and say, Look, we want to check your cervix to see how it was compared because of what’s happened last time. And when they checked it, it was still high, where they said we need to manually bring it down. And so I started to become in that panic again. And that same midwife has sort of come out says look, you’ve got it on here in this gig writing must be given pain relief we will make sure we give you pain right well the doctor even comes in to touch you, as I said it was extremely different experience because they were sitting there listening to me, calming me down and actually take into account my previous birth trauma into trying to ease any trauma retriggering reactivating in anything else throughout this one so I was given pain relief, it still hurt a little bit but definitely not as bad or as traumatic,

 I had that at the cervix is brought down and the labor was progressing really well, so everything was going really well I said yes to an epidural again. And so I had that. And then I actually had the midwife coming and goes, Stacy I actually have your notes from your first birth, and the reasons why you had a C section, and she listed a bunch of reasons. She actually gave me the debrief that I never had the first time. And so it gave me a little bit of closure, the epidural was starting to wear off a little bit so I could actually feel when the contractions were coming so I knew when to push but I wasn’t feeling the pain of when I pushed if that made sense, which was, to me I actually quite enjoyed that.

 But again as the midwife said when it came time to push Stacy at this moment you are like a first time mom because you’ve never had to,

P: Yeah…

S: in terms of your first time on giving birth vaginally you have never had to do this before so I was listening to their cues as to winter portion and when it came to the, I realized that I could, you know, no so you know if you can feel it coming on you can also let us know which I do, and I ended up having a vaginal birth with my second daughter,

P: whoo. Triumph

S: Yes, yes, I had a very small tail, she was eight pound baby. And I guess a really different experience. After I had my second daughter, and then for both pregnancies my first and second, we didn’t know the sex of the baby until the baby was born so when it came to having my first, my husband had told me it was a girl, and, and for my second, because the baby was brought immediately onto my chest, I was able to look and I told my husband that we had another girl, so it was a nice experience to be able to do that as well. And then also very different experience from the cane moving from the birthing switch to the maternity ward. When you have the cesarean and you go into a bit of a recovery room, and then you go into, you get wheeled in a bit so they’re like okay we’re going to the material now and okay and I sort of sat down on the bed because I used to being wheeled and I didn’t realize, oh, actually yes I can walk and I’m here I am pushing, you know, in the, in the little cribs and I’m pushing the crib to the maternity ward I was such a real different experience, it was just, it blew my mind at how different just even that part of the birthing experience was so

P: interestingly between your first and your second your first got. So, immediately medicalized when you got to the hospital.

S: Yeah,

P: like all your control was taken away and it seems like with your second, that it’s very much in the spirit of, you know, this is not a medical procedure you’re giving birth and you’re capable of doing that…it sounds lovely

S:yeah and it’s yeah, it really was and you know they were listening to me and if there were any problems come up they’ll actually sit and talk to me about it and letting me know you’re telling me information because it’s relating to me my own body and, and my birth of my child so it was such a different experience that I really felt I really felt happy with that somehow that I actually really got to speak up for myself and that I also was seen and heard throughout that birthing experience regardless of what the result ended up with being in terms of a vaginal or cesearean birth,

P: that sounds awesome, was the recovery much easier for the second one.

S: Yes. The recovery was much easier. Yes, it was a lot more of a smoother transition, I still was having trouble breastfeeding, but I was getting help from the beginning, which, in my mind made things easier. And also I wasn’t so harsh and so critical of myself on wanting to be this perfectionist mother so really made that postnatal experience extremely after so much more easier to me,

P: yeah that all sounds lovely.

S: Yes, I have quite a few months afterwards, though I was really I guess I started to feel really harsh on my body, postnatal body, I’d have been somewhat of a reasonably fit person before my first and got myself back to a stage where I was happy with my body before I got pregnant with my second, and we were actually planning my husband are actually planning our wedding, when I fell pregnant with my second, we’re in the middle of that where I ended up being married when I was about five months pregnant with my second so after I had my second it just felt like it was harder for me to get back to a state within my body that I was happy with. And so I was really harsh on myself for that. I just started to become really sort of reclusive within myself I avoid going out unless I really needed to with my children because I didn’t have any clothes that fit me and the ones that did I wasn’t really happy with how I looked. I was used to baby wear a lot with my second, I would happily go out. If I was babywearing because I felt like it was covering my body, so I felt like I was able to face the public world because I was somewhat covered, so it really took me a long time mentally to understand what my body was going through, no one really spoke to me about that and no one really said, your body may take a little while to adjust to things, just, just the way I guess you know how your, your stomach is after you have a baby and it’s very normal and natural whereas I thought you had to get back into your post baby state, you know, I don’t think that now, but at that time I did and I was really harsh was awful why I never did that. And, and because of that I really affected how I do things as well, so

P:  that’s super hard and I, I had a conversation with someone yesterday where I realized that bounce back is like a trigger word for me, I think that’s a term that’s commonly used and you’re imagining like I will have the body I had when I was 20 before I was pregnant. Even though your body has been used for the better part of a year to grow a human being.

S: that’s right…That’s the emphasis from other people like, Oh you had your baby six months ago. So, why do you still, you know, like you still have a stomach, and it’s like well, because that’s how my body is right now like and why do you care, but that’s how my body is

P: Stacy was uncomfortable with her postpartum body and people making comments about her, not getting her body back, or quickly enough after the birth. What are your thoughts about that what is postpartum. What is a woman’s postpartum body is supposed to look like,

Dr. M: I don’t think the phrase, get your body back is helpful for anyone, because you’re right, we don’t get our body back we have a different body we have, you know, for a mom, and our body changes and it changes pretty much forever. You know you can get stronger you can get tone you can do different things but your body does not go back to pre pregnancy, state, and never does. And I think the more that we can embrace that and be okay with that, the better off we are. This just adds to another way that we as moms judge ourselves and feel bad about ourselves, it’s emotionally exhausting having a child, and then you’re feeling guilty that am I doing a good enough job, how is my breast milk it was my baby on the right schedules aren’t they’ve eaten the right stuff is the diaper material. The right one is, do I have the right bottles, you know is my body look the way I’m supposed to look. And now my husband wants sex like I’m so f’ing tired that like I don’t even want to have that, why aren’t I, as good as I was before. And so I think that there’s a lot of judgment that we put on ourselves instead of just embracing the fact that I’m different, I’m a mom and I’m not going to bounce back overnight and I’m not going to look like my teenage self, and if I do okay maybe in the future you will but that shouldn’t be the goal for the first year after you’ve given birth.

When I gave birth to my first Cindy Crawford was giving birth to her first and there was this huge write up with her in the newspaper where she was interviewed all these beautiful pregnancy photos and all these postpartum photos and someone made a comment about how quickly she bounced back. And what I love about her and why I just love her now, is that she said, I want to be very clear, it is my job to look good. And so my full time job after giving birth was to go to the gym and get my body to be more tone and ready for camera again but for a normal mom, who’s not a model that’s not their full time job and shouldn’t be this should not be the expectation of a normal Mom, this is the expectation of me because it is my career. But if this wasn’t my career I would not look like this, because it’s exhausting and it’s a full time job to look like this so I was like yay Cindy, I’m not a model and so I’m not going to look like that. I’m not going back to quote unquote my body, I have a baby, I’m going back to work and just trying to survive and be the best mom I can be without feeling horrible about myself so that, that being said, let’s, let’s now go back to, yes, our bodies change and what can we do about it. And there’s a whole bunch of changes that happen, you know, one is especially if you have vaginal delivery, things are really loosened stretched out down there. And so, you know there’s a lot of talk about the benefit of doing cables and pelvic floor strengthening and in our hospital and I’m hoping it’s getting more common, just across the country. We have a handful of pelvic floor physical therapists, these are women who are really focused on the pelvic floor and the vaginal tissue and can help you with exercises to get things a little bit tighter and toned and stronger, you know, so that you don’t have back pain so you, your core feels more stable. So the vagina doesn’t feel so overstretched. Sometimes you’re leaking urine afterward, you know during pregnancy. And so just strengthening the vaginal musculature, can help decrease or stop any of the urinary leakage. So there’s a lot of changes that the body goes through. And there’s a lot that we can do for it.

S: I took me caught a few years to sort of get my head around that, which thankfully I did, I understood within my head that my body is different, and I was still very active and healthy and and reasonably fit, and had gotten myself to a weight that I was happy with however my body was a completely different shape to what it was before children, and I was very accepting of that and it didn’t worry me regardless of the weight I was very happy with my body, so it was at a really good stage in my life, but it took me quite a few years afterwards,

P: you’re responding to every cue around you. It makes total sense why you would think that it’s just like, I think it’s unfair and unrealistic expectation that people place on Mothers, that you should bounce back, you know, now looking back right even for you I’m sure looking back I think that was crazy.

S: Yeah, it was crazy and and even looking back it was always. the focus on how much weight you lost, or what weight you’re at, rather than how your body feels, and for me like I do, I did a bit of running and a bit of weight so it was like okay I’m really happy that I was able to run at this, you know, at this pace that was more important to me than what my weight was, and so that was such a really big eye opener for me which I’m really glad I got, I got to that point.

P: Yeah and actually very useful to have done the for twins, I’m guessing.

S: Yes, yes, my husband and I had discussed on having a third child, when it came to the twins, we have planned, and we’re actively trying for our third baby when I fell pregnant. It was expected that took me about five months to get pregnant,

P: did that feel like a lot or you were okay with it?

S: It felt like a lot. Yeah, it felt like a lot, because the first few times, yeah I felt pregnant without Yeah, so, but I also knew I had not long before that had a back injury. And so I thought maybe it’s just because I have been injured, not long ago, and then we

P: I can’t wait to hear when we, when we found out we had twins.

S: And so, with us, are deciding on having a third child we had decided that we would trade in one of our cars and buy a new car, my husband had been researching on a car that he wanted to buy with our trade in and that I don’t even know what type of car was but it was a five seater car I know that. And so we booked in for an ultrasound, and the technicians, rubbing the jelly on my stomach and doing all of that and so suppose the screen he goes oh what do you see and I said oh, oh, there’s a baby in, and there’s my bladder I thought because you have a full bladder when you have ultrasound, and he’s like no it’s not. Oh no, why What do you mean I was so blase about it he’s like there’s one baby, and there’s a heartbeat and shows her how many guys, and what you think is your bladder is actually another sack, and he’s another baby, and he’s like you’re having twins, and I thought he was joking, I just and I had that nervous that nervous laugh around with me so I was like smirking because that was just correction I was just like are you kidding me. Are you joking. No, that’s not right. No, you’ve got some check up on your, on your thing there i My husband hadn’t spoken at that point I think he was still in shock. And the first thing you said when he was able to talk was like I guess I’m not buying that car then, but it was obviously also still a blessing. That’s how we didn’t buy that car because it would have needed to trade it in again and

P: that’s awesome.

S: Yeah, so, so my twins are fraternal twins, what’s known in, in Australia, he’s DCDA twins. So again, we didn’t try and find out the sex of our twins until birth as well

P: can you use a midwife if you’re having twins, that seems like the more complicated thing,

S: twins will always is a high risk pregnancy so therefore, I had to see an obstetrician for each appointment instead of a midwife, I had said that I would like to try for another vaginal birth with the twins, and it was purely to me just thinking how the recovery was afterwards that it might be a third of might be easier on me if I had a vaginal birth with having to handle two babies at once. The doctors a bit hesitant at the beginning thinking, you know, of wanting to book me for the C section how I was always also pretty adamant on myself that I’m not walking in the C sections so this is what we’re doing, but I’m also open to the fact that I could end up in a C section

so when I got to the thirty seven weeks I’d seen the doctor again. And we had spoke about, you know, when would be the rough time point that we would be looking at, you know, to having the babies in terms of inducement if needed. Obviously for me I was wanting to avoid inducement unless it was medically necessary for the babies, but I had a very healthy pregnancy, and I was still very active and doing things throughout the pregnancy that if I haven’t gone into labor by the time I’m 39 weeks, I will consent to an induction. So I hit 39 weeks pregnant and I was still pregnant, but at that point. Especially that last week, I was, I felt like my body was having a really hard time then being able to cope with the twins, I was having a really hard, trouble breathing.

P: My husband said well I was pregnant with just a single term like Darth Vader at night.

Trying to breath Right, so I can’t even imagine how you’ve gotten this far.

S: Yeah, I at that point it was, it was getting to the point I could walk from my bed to our on suite, and I would sound like I was an asmatic….my stomach was so big I just felt like all my organs are really constricting and I was just sort of like, like gasping for air. So I thought, this is the point I think I can’t, I don’t think I could do another week, when it came to that, we had the had the induction and again I was worried about the cervix, but when they did the check my cervix was down, so it just felt like this way the worry and it wasn’t as big as the worry because of what happened during the second birth, but it was still a concern within my mind because I still had that sometimes that little bit of a trigger as to oh my god, am I going to feel this game, I had the, the Foley bowl. And that was successful that had fallen out, I was getting contractions. I had a grade two an epidural as though I was happy for that in the birth was progressing really well. And when I got to about six centimeters, baby, as heart rate started to then drop really low. Every time I was having a contraction, to the point where I had so many people in the birthing space in terms of medical professionals. When this was all happening. And so I knew that things were changing and the lack of product necessary was likely to happen. And so, before they even told me I knew it was going to end up necessary, and they were really lovely about a really took the time to sit down and brief with me as to why this is Erin was going to happen but concerned about baby’s a heart rate, I could see the heart rate drop really low, even like my husband each time when the first time it happened he stood up really concerned as well so I understood the severity of it, and really appreciated that I was being told up front on information, you know, my husband was getting changed again and that I, I did have a little cry, and it wasn’t so much on that I was gonna end up zero. Yeah, it was just like it’s really acknowledging what was happening at that time and just to sort of let that out so then I could approach the next phase of the birth in a really good mentality site because I didn’t have that mentality so when I had the searing for my first, and this one was more of a rushed Susteren so I was you know that bit more of rushed down the hallways, and even though it had that more urgency to the birth. In my mind it was also a lot more calm up because I was more conscious of what was happening, and it wasn’t a trauma for me, compared to what happened in the first, so I just had one recommendation when we’re in there I said I don’t know the gender of the babies so when you get the babies. Yeah, I don’t want you to tell me the babies, I want my husband to told me. So when they, when baby a came out, it was, you know baby eyes out, and they didn’t tell me that they’re six, my husband had said to me off. It’s a, it’s a three to one. Now when it comes to babies and we’re you know, have we got a boy you only guys here can you believe it, we’ve got a boy and a girl because we always joked that we were going to have girls, and my husband just needs to grow up in a house of women. It was a surprise to, to then have a boy and a girl so a baby a was a boy, and Baby B was that girl, they think that the reason why baby’s heart rate was going down extremely low every time I had a contraction was because the cord was wrapped around his neck, three times. Oh well, I was in the hospital for a couple of days, I was the one who wanted to leave the hospital early so they said you know between so we’re happy to have me evening longer in the hospital. In the end this is still a public hospital system, but I wanted to get home because I knew going home, I would have my support that I needed my support network. I also knew that I had my other children, I felt like the recovery from that C section was extremely better than the first as well I don’t know if it’s whether because I knew what was going to happen. And so to be aware of how I move and things like that, and had these two healthy babies that were 6.7 and seven points counts, so

P: Wow.  That’s amazing. And how was it having them home but twins seem tricky to me, like, like a lot of work. Yeah,

S: I was really grateful that my babies were healthy and was able to take them home. It was, it was different having to try to get my groove on feeding the two and sort their sleeping arrangements and stuff, one would wake up half an hour before the other and stuff like that so, which is understandable because they’re two completely different babies so it was trying to each of their cues and and different stuff like that. And I guess also for me and especially as I’ve grown older as well like understanding the urgencies of their cries as to which baby I may need to attend first because the other hand is organizing getting their bottle ready or things like that as well. I especially if I was by myself so not being so hard on myself I can pick both up at the same time, and not put so much guilt and shame, you know, shame on myself if I couldn’t do things so I felt like because I, after my second year, I managed to mentally get my head around to a degree that I was happy with that I really felt like it gave me a good chance throughout the twin pregnancy to really be compassionate to myself because I wasn’t after my first, and I was learning from my second, and then with the twins, I was a lot better off that like I did learn a lesson from each one and you get better mentally within my mind after each one as well.

P: Yeah, that seems amazing and lucky that the twins came last because,

S: oh yeah,

P: like I mean just I would imagine you’re just feeding all the time, right, there’s Yeah, people and they both need stuff and

S: see and then you still have two other children to care for and

P: thank you so much for sharing this story, it’s such a good story of learning, yeah evolution is pretty quick because you’re able to squeeze the lesson of each pregnancy in time to use it for the next one.

S: Yes.

P: So, one last question. You were a policewoman but you changed careers, what do you do now.

S: I am a trauma informed EFT practitioner AF T stands for Emotional Freedom Techniques and really is more acupuncture for emotions so to speak, use your meridian points, and instead of using little needles you use your fingers and fingertips, and you tap on your meridian points, which is predominantly on your face, upper body and your hands, and with that it really just helps calm your nervous system. So helps you get out of that fight or flight response as well as your freeze response back into your social engagement sewing is only feeling safe from working in emergency services of I was surrounded by trauma, all the time, whether that’s with the public that I was helping that my colleagues, or even myself so I used EFT on myself, and I found at times when I was in certain situations with the public that I would be helping them, calm down by doing EFT tapping with them, and it just you service sort of comes becomes your medicine so to speak, and so I got my qualification and now I help others.

P: That’s awesome. Well thank you so much for coming on and thanks for sharing your story, it’s a it’s a great one to have out there.

S: It’s okay thank you so much for having me Paulette I really appreciate it.

Thanks again to Dr Matityahu for coming on the show and sharing her insights, she and I had a much longer conversation that I included here if you want to hear the whole conversation, go to war stories for womb.com and check it out. Thanks also to Stacey for sharing her story. And thank you so much for listening. If you like this episode, feel free to like and subscribe. We’ll be back soon with another story of women’s strength and resilience to overcome the many challenges involved in creating a family.

Episode 17 SN: On Both Sides of the Line, An OBs Story: Dr. Shieva Ghofrany

There are three reasons to tune into today’s episode: first, it is a chance to see pregnancy through the eyes of an OB who is both the emotional individual experiencing what we all experience when we try to grow our families, and someone endowed with much more experience and information than most of us. Second reason: when you hear the story of a fully trained OB, who has seen how pregnancies and births can progress in a multitude of ways, but still cannot control her own experience it’s a powerful reminder that (spoiler alert) no one can control this experience. And finally, three, Dr. Ghofrany has a significant following on instagram for a reason: she’s a great combination of articulate, charismatic and warm, and, it turns out, a particularly resilient person who shares her challenging, beautiful and inspiring birth story

Endometriosis

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656

https://www.womenshealth.gov/a-z-topics/endometriosis

Audio Transcript:

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka I’m an economist, a writer and a parent to two children who rigorously tested my ability to reproduce. Today I’m talking to an OB and a friend. Dr. Ghofrany’s best friend in high school was my college roommate, which is lucky for me because she is an amazing person and a force for good in gynecology. If that wasn’t reason enough, more reasons to tune into today’s episode. First, it’s a chance to see pregnancy through the eyes of an OB, who is both the emotional individual experiencing what we all experienced when we try to grow our families, and someone who dealt with much more information than most of us. Secondly, when you hear the story of a fully trained OB, who has seen how pregnancies and births can progress in a multitude of ways, but still cannot control her own experience. It’s a powerful reminder that, spoiler alert, no one can control this experience, and three, Dr Ghofrany has a significant following on Instagram for a reason. She’s a great combination of articulate charismatic and warm. And it turns out a particularly resilient person who shares her challenging, beautiful and inspiring birth story.

Let’s get to the interview.

Paulette: Hi, thanks so much for coming on the show, can you introduce yourself and tell us where you live.

Dr.Ghofrany: Yes, thank you for having me. I’m Shieva ghofrany I live in Connecticut, and I’m an OB GYN for 20 years,

P: amazing so that’s the also interesting facet of your story is that in some ways you know too much. Which will be interesting to hear. So before you got pregnant. I’m wondering what your ideas were about pregnancy, and how far you’re training you were or your experience.

Dr. G: Do you know how many times I’ve talked about this, no one’s actually ever asked me that question, kudos already i What were my thoughts about pregnancy well I had had endometriosis. That was diagnosed when I was 28, so I’d had a long history of really bad painful periods that literally led me to at age 27,28 I remember saying, in medical school. I’m never going to have a baby, because it sounds, it’s just so painful, I would like a hysterectomy because I was in so much pain from my endometriosis, so that was my like what were my thoughts about having a baby. That was my thought.

P: So what’s endometriosis. It’s a condition where the tissue that normally lines the inside of your uterus, the endometrium grows outside your uterus. Endometrial-like tissue outside the uterus, acts like it does inside the uterus. It thickens breaks down and bleeds with each menstrual cycle, but this tissue has no way to exit your body surrounding tissue can become irritated, eventually developing scar tissue and adhesions. The main symptom is painful periods, it may affect more than 11% of American women between the ages of 15 and 44. It’s especially found by women in their 30s and 40s, and may make it harder to get pregnant.

Dr. G:  I always assumed I’d have children because I come from a more kind of traditional household, but my pain was so bad that if you asked me in the childbearing years when I was of age, I didn’t want to have babies because it was too painful. Then I did get married when I was 29, and started getting pregnant, and miscarrying when I was 32, and had my first child at 34, and I was a resident at the time.

P:  Okay, so let’s go back over here. So, did you get pregnant easily.

Dr. G: So I was 32 went off the pill, I was a resident, didn’t want to necessarily get pregnant, because I thought let me just go off the pill, let my cycle get back to normal. We’ll try in a year got pregnant quickly. Oh, right, which was great, in retrospect because then I didn’t have to worry about it, except that that ended up being a miscarriage. It was what’s called a blighted ovum, which is where it’s a gestational sack meaning the sack was inside my uterus, but it was empty, so the egg and the sperm had gotten together created the pregnancy but that pregnancy never would have gone on to have a heartbeat or anything so it, so it didn’t.

P: It didn’t develop

Dr. G: it was an empty sack and it passed on its own, except that I had to have some of the SAC removed, like in a little office procedure because not everything came out on its own so I was a resident and bleeding and cramping and running out from like the hospital to the doctor’s office and back to the hospital. So that was my first experience with like women tough it out. We go through things, and we kind of compartmentalize, right,

P: that sounds really hard. Good Lord, I’m sorry to hear that you did you because you were a resident like you knew exactly what was going on and scientifically or

Dr.G: I knew exactly what was going on, scientifically, which made it easier and the good news was I could look at it kind of pragmatically as Oh well, at least I can get pregnant, and I’m still young enough at 32, and I didn’t start to kind of delve into the like, I was very overweight, I was very overworked, did that have an effect, you know, we were still in the mindset, this was back in 2002 of, well, people who are stressed and overweight get pregnant all the time so it can’t be any of that effect, and I would still say that’s somewhat true but it’s, you know, I think we know more nuances now. But yeah so that was the first miscarriage. And then pretty quickly. A couple months later I got pregnant, a second time and got a bit farther, and almost saw a heartbeat, that was kind of lagging in the measurements and had started bleeding pretty quickly after the positive pregnancy test, and that one miscarried. That one unfortunately miscarried didn’t go away altogether on its own meaning I didn’t pass all the tissue so I needed a D&C the dilation and curretage the procedure to remove everything. And because my uterus is tilted very kind of aggressively like at an acute angle. I had to go back a second time for a second DNC

P: Good Lord and are you as, kind of, are you as kind of pragmatic about the second miscarriage or  this is upsetting

Dr. G: this time I’m upset because  sort of upset because I didn’t even know if I wanted to be pregnant, you know, with my first pregnancy that quickly. But then, as you probably know like once you get pregnant once like your appetite you like your you get your appetite so you want to be pregnant again. So now I’m more upset, but I’m still telling myself, what we what we used to say clinically, you’re, we’re not worried until you’ve had three miscarriages in a row. Now we kind of actually have altered it to about two in a row if you haven’t had a child at the time was three. So I kept trying to be pragmatic and not let myself be too upset. And the truth is, you know, I’m a workhorse so I kept working. I did start to get really frustrated with my husband whose a wonderful soul, but just didn’t know how to deal with this, you know, the emotional toll of having a husband who is great, but has zero idea how to cope with pregnancy with miscarriage, and with a wife who happens to work a lot in the field so she’s somewhat obnoxious about like pushing you away as it is.

P: Yeah,

Dr. G: the extra layer of challenge there, you know.

P: Yeah, that sounds hard.

Dr. G: Yeah. So did you were you trying again or where are we and the luck was that despite me having endometriosis, that was bad enough that I had had surgery again back when I was 28 I got pregnant quickly, each time I’d get pregnant, so I got pregnant, and that one, I spotted and bled, but turned out to be a good pregnancy, meaning that is, who is now my almost 17 year old son.

P: Oh my god.

Dr. G: That said, that pregnancy was really fraught with challenges by that point I had gotten up to 250 pounds and I’m only five foot three so that’s not healthy anyway you cut it, I was mildly hypertensive so my blood pressure was always a little bit elevated, and from the beginning, the tests that we had done for him were during the pregnancy showed that his placenta probably wasn’t that healthy, meaning at the time the tests we did for Down syndrome. When they were abnormal, but didn’t show Down syndrome, really meant that there was probably something placental going on and in my case, what happened was throughout the pregnancy, his growth started to lag, the fluid around him was really low. And so we ended up having to induce me for growth restriction. And that was like a very challenging labor. In fact, your friend Sarah was at that delivery. It was a 30 hour labor with three hours of pushing and within eight hours after the delivery, he ended up having some seizures and went to the NICU where we found out he had had an intra uterine stroke in the previous week, At some point the MRI could time when the stroke occurred in a general scheme

P: let’s go slower here one second here, where are you in your pregnancy when you get induced

Dr. G: 39 weeks.

P: Okay so late

Dr. G:  Yeah, working all the time, watch the baby, he’s starting to lag in his growth. Probably I should have agreed to be induced at 37 ish weeks but I was like, wait I’m working, I’m working. Finally,

P: do they give you a scale in terms of growth restriction like he’s, you know,

Dr. G: right, like he was when we worry about growth restriction we worry about two things really we worry about a deceleration and growth like where are the babies falling off their growth curve we call it, or once they get below 10th percentile, and he was falling off his growth curve sticking around 10th ish percentile with the fluid, being not as much as we’d like. And that’s a secondary part that we look at, Because if the fluid is less that really shows the placenta is not giving the baby all the nutrients, and then finally by 39 weeks he was like just below the 10th percentile. His head circumference was not growing, that’s something else we look at and his fluid was low, so I got induced.

P: And that sounds, the induction nobody talks about induction with like loving terms right.

Dr. G: Well, I mean, you know I have a catch 20 I will have a love hate for deductions on one hand deductions nowadays we realize that if you do, most women 39 weeks. This new trial that’s coming out called the ARRIVE trial really shows that you can have lower rates of really dramatically bad things that we don’t like like God forbid fetal death and higher rates of vaginal deliveries, but it does mean you’re there at the hospital for a longer period of time potentially if your body doesn’t want to go into labor, mine did not want to go into labor, nor was I in great shape from a stamina perspective like pushing was really challenging, but you know listen when he came out, I kind of naively was like, Finally he’s out. That’s it. Forgetting that things can happen afterwards. And the truth is, he is a very healthy, almost 17 year old now, with some learning disabilities and other, you know, side effects later but overall I’m, I feel very fortunate that it was not as bad as it could have been.

P: Yeah, no kidding. Wow, so was the labor what you thought it would be because you probably had seen Labor’s, are you.

Dr. G: Yeah, at that point. So at this point by the way I had finished residency I had found out I was pregnant with this pregnancy, right, right when I basically started my practice, so I joined my office at the time this is now 2003 I’m a new attending, I’m working crazy hours we delivered a lot of babies, it was three of us I was on call every third night. And so I ended up, then getting induced like close to the end of my first year of being in private practice and I’ve been a doctor for five years I’d seen, You know, 1000s of deliveries that point, and my delivery was kind of like what I expected it was long, it was challenging. I had an epidural early, you know, there was points throughout the entire labor were touch and go. Should we do a C section should we not the heart rate tracing which is what we look at as a reflection of oxygen status during labor was never terrible but never perfect, so it was kind of a challenge the entire time, and then the pushing was also three hours with my mother, my sister, my husband, my best friend who’s your friend in the room, three nurses, two doctors at time for the delivery, and like I said then eight hours later he was a little bit like pale and blue. And it turns out his oxygen level was dropping. And so we sent him to the nursery to get checked out, and they realized he was having seizures. So, that kind of turned into a 10 day, NICU stay, me trying to recover from three hours of pushing which is not pleasant or fun, and actually what’s interesting that I learned a lot about then was just that the whole notion that everyone should deliver vaginally, that’s when I really cemented my ideology that that is just not true. Some women deliver vaginally and it’s an amazing process and some women do not deliver vaginally, Nor should they and my delivery was really not a great delivery and it was no one’s fault. It wasn’t my doctor’s fault I trust him and he did everything that he can and should have done, but it made me realize that this push to really force women or shame women into thinking they should deliver vaginally is very damaging and I actually say this a lot. I think it’s, I think it happens at the hands of other women as well I think it’s very anti feminist, and it’s women who are perpetuating it in my case my catheter in my bladder stayed in for 48 hours after my delivery because I was so swollen from pushing, whereas after a C section it comes out after 12 hours right so again, I’ve really tried to encourage women to understand that when it’s a great delivery it’s great and when it’s a challenging delivery is challenging, regardless of whether it’s vaginal or C section. And the more we can really discuss that both deliveries can be wonderful in different ways, and each can be challenging in different ways. I think will really get parity and equity, with regard to respecting either delivery.

P: Do you think vaginal deliveries become not the right choice when there’s some physiological issue like you said your uterus is tilted in a certain way, like that.

Dr. G: Yeah I mean I think that it depends on so many different factors right the patient the her, her anatomy, her emotions, the baby’s position everything and I don’t think her emotions should be discounted and I think they are, in my case the baby was sunny side up. Have you heard that term where we’re what we call occiput posterior it’s actually very common. If you have friends who are like I pushed for three hours and the baby came out with a cone head and I had back labor. Those were all whether or not the patient knows it their baby was most likely what we call sunny side up, meaning the head is down where it should be. But instead of the face looking towards mom’s spine, the face is turned up, looking towards the front, and that means that the diameter of the head that’s trying to come out of the pelvis is a bigger diameter than if the head was the other way. And so my six pound baby. We three hours to push him out and came out with the craziest conehead. And so my sacrum I had like my, my cocksix was fractured so my sacrum really hurt

P: Oh my God.

Dr. G: I was so swollen from again pushing for three hours that my bladder needed the catheter in for 48 hours, so I think no one could have predicted that and I have other women who were also 250 pounds and small babies and they come out easily, or skinny with big babies who come out easily, so that I think that the really important thing is that every patient, every situation and every baby is so different in the OB world we call it power passenger pelvis. So the power being how big your how good your contractions are the passenger being the baby and the baby’s position and your pelvis, meaning what shape is your pelvis and your uterus and are those going to allow the baby to be in the right position to come out and any of those varying factors can alter how easy or how difficult it is for the baby to come out. And I think unfortunately what we see nowadays is this big push, no pun intended for women to deliver vaginally, and because of women’s backlash at wanting to deliver vaginally to take back. You know what they deem is something natural from the medical community, the medical community’s response has been to say okay well we’ll look at things and you’re right we can we can allow you to push even longer than we thought and we will get more vaginal deliveries out of this and that will be satisfactory for moms because moms want vaginal deliveries, they get more epigenetic changes and all these things that are evidence based, but in reality I think what we’re ignoring is the physical physiologic and psychological toll on those very difficult deliveries that either don’t end up bad you know and have harder C sections or do end up vaginal and have really challenging recoveries, or, you know, babies that end up not being as healthy as they could be. So I think there’s a lot of aspects with that are really complicated and it’s become oversimplified into vaginal delivery good section is like, you know, we just, you know, step cousin, kind of thing

P: can you use those three metrics that you talked about the power the psychology and I forgot what the third one was

Dr. G: power,passenger pelvis,

P: can you use those three to predict, like who will have a good birth and who won’t to to say to them ahead of time, it’s likely that you’ll do X or Y, right…

Dr. G: Yes to a degree right like if you’ve been doing this long enough, just like any field, you’ve seen enough to know like when I’ve seen, you know this mom with this psyche, with this pelvis, with this passenger in this position, blah blah blah. Here’s what I think. Now, even the best of doctors who’ve done this for a long time we’ll be wrong sometimes. Not a lot. In other words, when I if I think before at the beginning of every delivery or even a week before the delivery, what do I think is going to happen. I’m not always right for sure I’ve been wrong sometimes. But I’m often right. And the hard part is that sometimes, if you know the answer is the doctor is not an easy thing to inform the patient of right like let’s say I knew the baby is sunny side up at 39 weeks when I’m going to induce you. But if I say to you, Paulette you know baby sunny side up so I think this is what’s going to happen anyway. It sounds good, like you as a rational, reasonable person sound like you might be like well I wish you would have told me because then I would have done things differently, But it’s not that easy because you have had not only nine months of your pregnancy 10 months really of your pregnancy of reading things and researching, but then also being told that the medical community just wants to induce babies or just wants to do C sections because they get paid more, which by the way is not true, or that they just want to be home by five o’clock, which is a joke is never true like no OB is home by five o’clock, or that like, of course you have to deliver vaginally because it’s natural and because it is better for the epigenetic changes so you can’t hear that information and really digest it that

way, some women can but many women don’t want to hear it.

P: Yeah, yeah

Dr. G: and it sounds negative to them and they’d rather just kind of go into it in a more positive way which I actually love manifesting and I love positivity, but I think it has to be metered with some realism in order to actually achieve better outcomes and I, I’ve said, frequently, patients who come into it realistically but optimistically saying, I’m gonna try this gradually. I hope that’s what it is, I fully realized that I might need a C section and that’s okay too. They do great meaning anecdotally, they have a higher rate of vaginal deliveries, I think, and those who end up needing a C section, have had a very good experience and felt very validated and felt very heard by their doctor. And so either way it’s a win win, whereas those go into a dogmatically saying it has to be this way, has to be vaginal, with no epidural or whatever it is that they think it has to be, then no matter what happens, they’re really, they’re unhappy, and sometimes maybe even have more complications because they are trying to control a not controllable situation that we can respond well to, if we have a partner in it who kind of has faith and trust in what we’re doing.

P: Yeah, this is an important narrative to publicize because this is contra to the cultural pressure to do otherwise right and this is, I’ve already talked to so many women who said I had to be natural I you know I had pictures in my head and have to look exactly this way, and that’s, I think our diet of what birth looks like is so unrealistic and so thin and so like it’s in the movies or whatever

Dr. G: and honestly it’s, it’s not just in the fiction movies, it’s in the very present population of documentaries and things that are, and I listen I did an integrative health and healing, fellowship, right, like a Masters of sorts, so I love things that are Eastern an alternative, but the unfortunately the Eastern alternative or even just like Instagram world of things should be natural, really glorify the ability of nature to always do the right thing. The irony being and I say this a lot when people say things like the women have been delivering bad generally in nature for millennia, women have been dying,

P: I was just gonna say what’s the death rate right now

Dr. G: currently die in other countries. Right, yeah, or have other side effects so which I say to patients like if you are willing to accept those consequences that I’m, God bless you. That’s okay. I don’t mind. But to go against nature by women being older than we used to be heavier than we used to be, reproductive techniques like IVF been in or, you know, women who are having, having babies through IVF with a donor sperm donor egg with their female partner, all things that I support, as I always joke like we have not set the table for nature, and then we expect nature to show up to our party ready and willing to like do the right thing, and it’s obscene and absurd and it leads to a lot of problems and the problems end up being for those very women that want this to work the way they want it to work. Like the men, it doesn’t affect the patriarchy.

P: Yeah, yeah, yeah. So wait, let’s get back to your story although this is totally fascinating, your sons of the NICU for ten days, sounds stressful and as a doctor does it feel. I mean, not that you have another frame of reference, but are you panicked like the rest of us or do you think like,

Dr. G: Oh no, I think I was like, in a weirdly surreal state of denial, and I’m not joking when I say that so I, in fact, so he has the seizures eight hours after delivery, he ends up being in the NICU and for about 24 to 30 hours, we couldn’t touch him because he was on a continuous EEG machine to find out what was happening with his brainwaves. The MRI shows ischemia ischemia is the medical term for loss of oxygen, so ischemia to two parts of his brain. Now, in our vernacular ischemia or loss of oxygen kind of mean stroke, but in my mind I don’t. I do not equate that word, I just keep saying ischemia Yeah, because in my mind it’s so medical but like, oh, he lost the oxygen and he had seizures and then he’s going to be better the seizures are going to be done and that’s it, until three years later, when a patient of mine who I delivered her son, he had an intrauterine in stroke, and she and I were talking about it, she’s in the nick you at another hospital to transfer the baby, and she says something and I all of a sudden said, Oh my god, I never even thought that my son had a stroke, and I remember her saying Shieva, of course you know that your son had a stroke, I’m like you I kept using the word ischemia, but that’s like in this situation, he had a stroke. So I think that power of denial was actually very, very beneficial for me, and very protective, because I was really able to be in the mode of like, okay I’m trying to nurse, I’m not great at nursing my milk is not coming in, I’m going to nurture who do what I can. I had really excellent NICU doctors who kept reminding me that babies do very well because of the neural plasticity and our ability of their brain to really respond to stimulation. And, you know, I’d say the challenges during that time, or probably more managing my husband and I and how much again he did not know how to deal with this well, and he’s a wonderful person, but really did not show his best side at that point and it was that was emotionally really hard. I think that was the hardest thing for me at the time. And again,

P: he was upset or he was distant?

Dr. G: he was distant, he was like at the time unfortunate he was like interviewing for a job so I was in the nick you like I always had someone with me like between my friends and my family and my parents are both positions and I was never alone but I didn’t feel like he was a partner in the whole thing. And I think again the narrative is very much like the partners, The man man is like the most supportive person and I’m so glad and blessed to have a husband who does these things and again, my husband is an amazing person, but this was not where he shined and so that felt very lonely to me, and certainly nothing that people talked about because everyone like acts like their husband is amazing and like wiping their butt, after the delivery.

P: Yeah, yeah,

Dr. G: and I know that that’s not true, but that’s how I felt at the time. Now I know that,

P:  but also that may have been his way of dealing with it right? It was too painful…

Dr. G: maybe… it was like taking our baby. Yeah, but, but, even if that is the case, it’s still

not a, a, that is not a wonderful way to deal with something when the other person is then left taking over.

P: Oh, it doesn’t help you at all. I totally agree. I’m just saying like, you never know what’s gonna look like on someone else and  we also had distress in my pregnancies and stuff and it was, you know, I’ve never seen my partner in that context before so I didn’t know what to expect and hey, like right now. Yeah. So you brought him home and how is that?

Dr. G: so I brought him home. I will never forget the drive home it was 10 days later, all of a sudden you’re like, I don’t want to be in the NICU and you find out you’re in the nick you and then you get used to all the alarms and bells and whistles and the nurses and then 10 days later, you’re like, you’re not going to come home with me I got to go home and our drive home I hope we get our drive home being like, I literally thought we were in a game of Frogger, I remember we were like in the car and I felt like, so vulnerable at any moment, a car was gonna hit us or something was gonna happen we got home, you know, our 12 minute drive home and I remember being like, Thank God we got home like it just felt like we had battled to get home when in reality it was just like a drive home from the hospital, and he was a challenging baby he was not a delightful easy baby until eight months he did not sleep well. He did not nurse well so he got formula right away. I really felt like I couldn’t sit for about six weeks because of my fractured tailbone. And I was swollen…I had so much edema meaning swelling in my hands and feet imperative and everywhere because I was so overweight and so hypertensive and retaining fluid, and then went back to work at I think seven weeks, and frankly, I can’t say like I was miserable, like I look back, when you’re a physician and you’re training and you’re a resident, like working 120 hours a week you’re kind of like prepared to do all this stuff. So I did it all, and I didn’t have postpartum depression, but I would never go back to the first year of any of my three children’s lives like and I say that, openly and happily to people, not because I want to act like it’s the worst for everyone, but I want women who don’t love that first year of their baby’s lives to not feel bad about it, I am not one of those people who’s like I go back to infancy and want to snuggle I’ve zero desire to go back to their infant lives and when I hear babies cry I actually still get a little chill down my spine. And I’m, I’m not embarrassed to say that I’d rather us talk about it some people love the infants, my mother still loves and adores infants. I do not, you know,

P:  infants are very very challenging. That is for sure. I remember when we left the hospital and I was like how are they just letting us leave,

Dr. G: like, with no infection or manual or anything. Right, well good I’m glad that worked out. What about the next pregnancy was that, no, no, no, because then I had so he was a year. I had him in April 2004 By July of 2005 I was pregnant again. Great, I got pregnant again. Bleeding like stink. Having to go see my, my husband’s family abroad, in the middle of a miscarriage.

P: Oh my god,

Dr. G: and I thought okay well okay I’ve already had, you know, now I have a baby, now the miscarriage isn’t as upsetting because I know I already have a baby. And if I never have another baby, at least I have one and I know my body can always do it, I’ll probably have another baby. And so I ended up having three more miscarriages after that so four miscarriages after the first baby, some of which needed a D&C, some of which didn’t and the interesting part is at the time if you asked me I would remember exactly like how many leads how many days in D&C, the D&C you know for the miscarriage only thing I know I’m like six miscarriages for DNC is, I cannot remember which ones have D&C is or not and I say that again happily because in the moment that any of us are going through anything. It feels so dire and like just like the details are ingrained in your brain, and I really want all of us to remind ourselves whenever we get through something and actually forget some of the details how good that is that like, it’ll, it’ll always feel better. Like, not necessarily soon after and it doesn’t mean you forget I don’t forget those six miscarriages I actually very much feel attached to those these materials in what have turned out for me to be good ways, because I’ve learned a lot from them, but I’m so glad that it’s reminded me time and time again that all the details that you thought you’d never forget because also, why’d you do. So then I got pregnant with my now second son and that pregnancy, I got antsy, because I wanted to be pregnant I was tired of miscarrying I took the medication to help you ovulate more so just because of timing, I had an agenda, I had to be pregnant. And I got pregnant, bled a lot at seven weeks thinking I was having another miscarriage and as it turns out that was a twin pregnancy and so one of the twins went away before I even knew it, so when I went in to get my ultrasound. I said okay I’m having another miscarriage just like, let’s get through this and I have like one more in me before I’m like done trying, and the doctor said oh actually you know what, there’s a great heartbeat, but the other one. It looks like there was another one that is no longer going to continue, which was not sad to me because I was just happy to have one heartbeat that baby boy is now almost 13 He had a clubfoot, which is where the foot is literally turned up and inward completely deformed, that we knew of, during the pregnancy, and it had to be repaired when he was born so he had casts every week for six weeks, and then these special boots for four years, but compared to a child with a stroke like you know a clubfoot was nothing.

P:Yeah, yeah, yeah

Dr. G: it was cumbersome and annoying. We had to go to the city like once a week every week for six weeks after his delivery, but like, it was fixable, so it’s fine. And then I was done, then I thought, I’m done, and I did not want to go through vaginal delivery again and I planned a C section, and my partner’s at the time, who had not delivered my first baby though I loved the doctor who delivered my first baby, but my medical partners who were still my partners, said, Do you want to go through that again. I laughed, I did what do I want to torture myself my partners are men, by the way and I submit a hell no, sign me up for a C section we’ll all show up in the right time and place and get this done. And I was so happy to do that it was so comforting for me to know that I knew the time and the date and the place and how he was going to come out, which is not to say that a C section is easy, are always the right choice, as I say to everyone. There’s no one right answer.

P:Yeah,

Dr. G: For me the right answer was the C section, it might not be for other people, maybe my second delivery would have been easier, but I did not want to take that chance for my recovery and what my first one had gone through so the C section I learned a lot from that too I learned a lot of little things that I say to patients during C section that I’ve kind of altered since then, I learned what to tell patients to like eat and not to eat before the C section. So I looked at it as, you know, street it was like me learning on the street, how to do things, and I really thought I was done after that I was never going to have another baby. Yes, I was that I didn’t have a girl but it didn’t matter I was blessed to have two boys I’m done this body is done. And then I did weight loss surgery when I was 40. So my first son ended up being 34 My second son was at 3840 I did weight loss surgery, I was done, never gonna have another baby, lo and behold for four months after that surgery I got knocked up by surprise. My surgeon said, I thought I’ve heard you a really great gynecologist what happened I said I know God I relied on my husband. And that was my surprise baby girl who’s now 10 And that was the healthiest pregnancy because I have lost, about 80 pounds. So despite being almost 41 When she was born. It was healthy, and she’s healthy and I had another C section and I had my tubes cut finally at that point, I think, like, each time you go through these things, they, they suck and they’re amazing, right, like I’ve learned great things and terrible things through all of these experiences, and I would not go back and undo any of those miscarriages because now I have my three babies. Right,

P: yeah, yeah,

Dr. G: I think, I what I say to a lot of patients whenever they’re going through miscarriages is that there is a very small segment of the population who will never or can never have a baby but that’s relatively small. So as long as women we are willing to go through either help getting pregnant or help staying pregnant or donor egg or donor sperm or whatever it ends up being. I can pretty much guarantee every woman will have a baby and if we remind ourselves of that almost before we even gotten pregnant, it would be so common because then, Each miscarriage wouldn’t feel so desperate. Yeah, for me, the desperation initially felt like this might be a sign that I’m never gonna have a baby. Right, but I knew I would be maybe I just wasn’t in the mindset of telling myself that and now I’ve learned that that’s really powerful to tell ourselves the fact it’s not snowing yourself it’s telling yourself the truth, you know,

P: yeah, that would be super calming I had trouble getting pregnant, so I know the weight of that, like, this may never work out right which now I have two kids, so we’ll obviously do work out but that that is very common to have that out there.

Dr. G: Yeah, and I think it’s something we should reiterate, and make it a really, like, make it a, a fact for people to remind themselves.

P: Yeah, totally. Do you think the miscarriages are attributable to endometriosis or we don’t know what,

Dr. G: no, I don’t  think there was revealed endometriosis because at the time I didn’t you know I endometrioma which was the 17 centimeter growth of endometriosis that I had was removed and I had no other obvious sign of it. I really do think and I don’t say this to be inflammatory to any woman out there who has weight issues I have many many many extremely overweight patients who have very healthy pregnancies. I think in my case, I had a lot of inflammation, and I don’t use that in the kind of Whoo, you know, Eastern like just general sense I had inflammatory markers that were measured on blood tests that dramatically dropped after I lost weight, and I really do think that that was a lot of it because my placenta was not healthy. The miscarriages we had reviewed by a pathologist and each of them that she could look at she really saw some vascular insufficiencies meaning the blood vessels that had formed between my uterus and the placenta weren’t that healthy, and in fact this is something I glossed over. I forgot that in my second and third pregnancies. I used Lovenox which is, if you know what that is but it is a form of heparin so heparin is a blood thinner. Yeah, there are like women who have antiphospholipid antibody syndrome women who have had other blood clotting issues will use heparin during pregnancy because it’s such a high likelihood of a clot or other pregnancy issues like miscarriages, or abruption where the placenta comes off early. And so I did not necessarily need to use the Lovenox my blood test markers at the time didn’t necessarily support it from an academic perspective, or an evidence based perspective but enough people that I respect felt like it might work, and my eighth pregnancy, ended up being my second child. So to me, it’s not a coincidence and he was healthier the clubfoot was probably a coincidence, he was healthy, he was seven pounds he was well grown, and then with my daughter, I probably didn’t need it because I’d already lost weight and my inflammatory markers were already dramatically lower, but I felt superstitious at that point. And so I continued to do the Lovenox which is a daily shot of a blood thinner,

P:  that makes sense and that inflammatory markers are an issue because your immune system is so keenly involved in the development of the placenta in the early part of your pregnancy

right and how it’s attached to the uterus and

Dr. G: when that embryo implants into the sidewall, that’s the inception of what is creating the placenta and and the placenta is the interface right where you’re getting your nutrients so a faulty placentation is really what can give rise to preeclampsia diabetes growth restriction, God forbid worse things right, nowadays we’re giving so many women baby aspirin low dose aspirin, starting by ideally, you know 12 To 16 weeks because we know that can improve their likelihood of not getting preeclampsia, and that’s because that comes from how the placenta has invaded into the wall of the uterus. So yeah, decreasing those inflammatory markers just created a healthier environment for the third one, you know to do better.

P: That’s awesome. So it knowing what you know now because you’ve been a doctor for many years after those births, is there something that you would have told young Shiva earlier, maybe that she didn’t know

Dr. G: well here so hard right, if I put on like my coaching mindset I would say, well I could have told her, but she only did what she could have done at the time, right, so at the time, I was working like crazy as a resident, I’m still I would say very food addicted I have a lot of like food issues right like I love food, I use it as a comfort it’s, I haven’t cracked that code yet so what I have said she admits unhealthy to be 250 pounds and you probably should try to be less stressed at work, and you should exercise. I guess they would have told me that but I knew that right like I definitely regardless of being a doctor, we all know that, could I have done anything differently. The fact is, it would have had to take a lot of work, mental health and emotional work right I was a very mentally healthy person I’m happy I’m engaged I’m, you know I don’t tend to go become depressed and things like that but, but I also like, I just I’m going to do what I’m going to do and at the time I had to work I was a resident I worked a lot, there was no way around it then I was an attending, I liked working I like involving myself with my patients so yes I would tell myself that but I don’t know that it would have changed anything. I will say that I think that and this is why I always joke about my street cred right because of everything I’ve been through and my weight issues I feel like I can talk more openly to patients, and most of the time, at least I think they don’t think that I’m like shaming them or blaming them or you know acting like you should do better. I really can emote with them because I’ve been through it, but I still find the weight issue to be so hard, not because I’m reticent to talk about it openly, but I think that many women understand and know what we need to do to be healthier as far as weight and exercise, but it’s hard to do it for a million, like purely academic reasons like time and for a million emotional reasons right. So I don’t know how much us telling patients that is going to help right, I think there’s a small group of women who have I say, by the way, do you know if you exercise more, and eat less carbs for example you’re gonna be healthier in your pregnancy. I think there’s a small group that’ll benefit, I think the rest of them already know that, and then in fact maybe hearing it over and over from the medical community just leads them to feel more like shame and avoidance and feel like this is paternalistic group of people telling them that they shouldn’t be doing these things so, so I actually, I talked about it but I don’t talk about it as much as like I should, according to the medical professionals, But I think I try not to talk about it too much because I think it shames women and I don’t think it’s beneficial.

P: Yeah, yeah, I can see that pregnancy I found really stressful, I’m just not even like putting aside my issues before I’ve had any issues. It’s just, it’s so much uncertainty, and it is for me and probably for a lot of women, the first time where you really are confronted with the fact that you have no control over this, like wildly important and powerful process going on inside you. It’s such a weird dissonance between kind of your outside life where you feel like you’re in control of everything and kind of what’s going on. So…

Dr. G: and the world keeps telling you, I mean the world as it stands right now, where they get social media and this entire other world of like pregnancy, telling you like, you should take control, you should empower yourself against the medical professionals, don’t let them try to tell you what to do. And I think that’s equally confusing right because then you have this the medical professionals are clearly trying to harm me, which is just not true. Like, there’s plenty other ways I can harm people, not this, and it means that women like you and I who are very type A and work really hard and are used to being able to control things. We’re going to try and, damn it, we’re going to do it. But the fact is we’re not going to do it because it’s undoable, you cannot control it, and then it just leads to more and more that cognitive dissonance, you feel self doubt, you feel doubt in your practitioners, which just creates more and more angst, and I really feel like it is like the demise of the doctor patient relationship and what leads to, again, an anti feminist potentially really dangerous situation for women. I think it’s what’s driving a lot of people to feel like they should deliver in in their home for example, and some women will do very well but we know the data stands that there is a higher rate of postpartum hemorrhage and other problems when they’re delivering at home. So it’s it’s a challenge, and I do think like you’re to your point, you’re used to controlling things you can’t control things, but yet no one’s actually explaining to you like it’s okay that you can’t control it and here’s why it’s okay that you can’t control it because not controllable but together we can still give you a great outcome and that’s really what you want, and the is you don’t want to control it but you’re being told that you should.

P: Yeah, yeah, yeah, I think that’s true, you’re doing a lot of amazing things in the world of data ecology and medicine. Do you want to tell us a little bit about your path forward or your hope for the future.

Dr. G: Well, I’m trying, I mean I’m as you can tell I’m like really really aggressively and obsessively wanting women to like just understand their psyche, a little bit more and you know I really I want women to trust their intuition, but when I say intuition. I think women supplant thinking their intuition is actually like listening to someone on Instagram and I keep saying like that’s not your intuition. That’s someone else’s intuition telling you. So yeah, my business partner I built this platform called tribe called V and it’s initially, the two products that we’re now, one has launched one is launching are pregnancy products but then the third is going to be a gynecology product and when I say product, a platform where we’re really trying to encourage women to have a lot of pre emptive information. So our my OB and new pregnancy program gives them an ebook, and then two to four lives every month where I talk about pregnancy issues and we do q&a My whole purpose being if I give you pre emptive information and explained to you. Hey, you’re gonna go for your ultrasound next week, here’s what might happen. Don’t be alarmed if you hear, you know, XYZ, like cysts in the baby’s brain, or a spot in the baby’s heart because those things are common and don’t freak out, the more preemptive information I can give you but in a calm way that educate you without freaking out, the better you’ll be because then when you hear those things because they’re common your brain did not devolve to like death and destruction or in the gynecology platform side, I want to really educate people about HPV and herpes and menopause and perimenopause and birth control and, you know, bleeding and endometriosis and all of the things that, because we don’t hear about them, We only then hear again on the internet or from our mother or from our aunt or from our sister or from that woman who almost died and then it becomes horribly anxiety and inflammatory provoking. So if instead we all talk about it more, and you hear it from someone who’s like not only teaches about it but has been through all these things, then hopefully it won’t. I’m not saying that any of the things are not easy like endometriosis still sucks anyway you cut it miscarriages are terrible anyway you cut it but they are less terrible when you understand them, when you understand how common they are when you understand what can be done to help them, then you’re not blindsided by it, and again if you hear about it ahead of time, you’re just not as worried.

P: Yeah, I agree. That’s amazing. So, I’m gonna sign up for the perimenopause thing because that seems like a black hole in my limited experience. So how do we how do we find these things.

Dr. G: Well, so the gynecology platform part will be out enrolling hopefully in the next like I’m going to say three to six months so people can go to tribe called v.com and just get on our mailing list for now. If they’re pregnant or trying to conceive, they can enroll in our pregnancy program, because then they get immediate that the PDF or the ebook, and they get to be part of our lives every month, so we do literally two to four zoom lives where we talk about all this stuff and the community of women is already starting to kind of bond with each other and everything, and then our pregnancy course will be coming out, but again the GYN platform will come out in the next couple months where all this stuff will be discussed, really, like, in detail in detail by like the woman who has you know I’ve been through menopause because I had my ovaries removed four years ago and I deal with it every day with my patients, and most of it is not complicated. When someone explains it to you but no one ever had the time to explain it to you.

P: Yeah, yeah, that’s right.

Dr. G: Yeah, and I think if we can do this, not only for women our age but for our young girls if we can talk to them about their period or about masturbation or about what it’s like you know when we if you decide to have a baby or if you decide not to have a baby or what if you have pain during your period or what if you find out you have HPV, I mean, literally, that the number of things we do not talk to them about is so endless that they all end up being so freaked out when they hear about it, even educated women don’t hear about this.

P: Yeah, that sounds awesome. Thank you so much for sharing your story and for sharing this new platform I’m excited to check it out.

Dr. G: Thank you for being here and thank you for sharing, millions of women’s stories because we need to get it out there.

P: Yeah, Totally. Thanks.

Dr. G:  Thanks, Paulette.

P: Thanks so much for listening to this episode, and thanks so much to Dr. Ghofrany for coming on the show. She was best friend from high school was my college roommate, which is how we know each other, which is lucky for me because she is an amazing person and a force for good and gynecology, you can check her out on Instagram at Big Love fierce Juju or tribe called V. For more in depth information about women’s health issues. If you’d like to share your story on the podcast, go to war stories from the womb, calm, and sign up. We’ll be back soon with another story of a person who’s overcome the many challenges that pregnancy and Birth invite.

Episode 16 SN: The Challenges of a Reluctant Cervix: Stefanie

Today’s guest experienced both extremes of the spectrum when it came to creating a family: uncomplicated pregnancies that led up to more challenging births. She enjoyed an easy step into her first pregnancy and wrestled with infertility leading to her second. Both pregnancies were straightforward while both births, strayed from the script, injecting unwelcome drama. While labor more or less spontaneously arrived, her cervix refused to heed the call, and that led to births she didn’t anticipate, one after another. Importantly, both deliveries ended with healthy babies. Listen to how she navigates this uncertain terrain. 

Amniotic sac

https://prenatalyogacenter.com/blog/everything-you-want-to-know-about-your-water-breaking/#:~:text=Did%20you%20know%20there%20are,end%20of%20pregnancy%20fused%20together.

https://pubmed.ncbi.nlm.nih.gov/25279443/

PCOS

https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439

https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome#:~:text=Who%20gets%20PCOS%3F,can%20have%20children%2C%20have%20PCOS.&text=Most%20women%20find%20out%20they,at%20any%20age%20after%20puberty.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6473601/

Low amniotic fluid

https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/expert-answers/low-amniotic-fluid/faq-20057964#:~:text=Low%20amniotic%20fluid%20(oligohydramnios)%20is,be%20done%20in%20certain%20circumstances.

https://americanpregnancy.org/healthy-pregnancy/pregnancy-complications/oligohydramnios-912/#:~:text=About%208%25%20of%20pregnant%20women,common%20during%20the%20last%20trimester.

Cervical dilation

https://rep.bioscientifica.com/view/journals/rep/134/2/1340327.xml

https://academic.oup.com/molehr/article/6/4/375/1087032

Audio Transcript

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka Today’s guest experienced both extremes of the spectrum when it came to creating a family: uncomplicated pregnancies that led up to more challenging births. She enjoyed an easy step into her first pregnancy and wrestled with infertility leading to her second. Both pregnancies were straightforward while both births, strayed from the script, injecting unwelcome drama. While labor more or less spontaneously arrived, her cervix refused to heed the call, and that led to births she didn’t anticipate, one after another. Importantly, both deliveries ended with healthy babies. Listen to how she navigates this challenging terrain.

After conversation, I added medical information in certain places, and also include the insights of a wonderful OB and from an anesthesiologist.

Let’s get to the story.

P: Hi, thanks so much for coming on the show, can you introduce yourself and tell us where you’re from.

Stephanie: Yes, so I’m Stephanie Hussein Ramadi and I am based in the UK, on the outskirts of London.

P: Lovely I’m wildly jealous…

S: Really?

P: And Stephanie. How many kids do you have,

S: I’ve got two boys, Five years old and 11 months 11 months.

P: Wow, yeah, yeah you’re busy.

S: Sure am.

P: And before you had the kids, I’m imagining that you had some idea about what pregnancy was like, what, what did you imagine it would be before you got there,

S: I just imagine a you get pregnant when you’re ready to get pregnant, you get pregnant and you know you have a smooth journey, pregnant for nine months but in fact is 10 months. And, you know, you go to the hospital, you have your baby healthy baby and somehow you just become a mom isn’t it, so that is how I visioned it be like, I was pregnant I didn’t read up on any other watching videos or read up on stories because I didn’t want anything distorting my thoughts about pregnancy

P: yeah, that’s fair. So let’s go back to the, let’s go back to the beginning that wasn’t easy to get pregnant.

S: So my first one, yes I got pregnant pretty much straightaway. And my second one, it took longer.

P: So, let’s go through the first one first then so you get pregnant easily, and then you find out with like a home kit. Yeah, yeah.

S: So I found that with like yeah home kit, yeah, that’s, I think that’s what everyone uses anyway.

P: Yeah,

S: I found that because probably about six weeks or so already, when I found out I had to sell I had like the sore boobs and stuff, but obviously  I didn’t know if it was pregnancy or not, my first one, isn’t it.

P: Yeah, yeah

S: so yes I just took the test and straight away like literally immediately came up positive. Yes. Okay. Good.

P: That’s Awesome. And how was that pregnancy.

S: that pregnancy was good to get the pregnancy was good, I had no complications during the pregnancy, I didn’t really put on much weight I only had baby weight. My baby balm I was healthy moved around fine. Like, I still felt like myself basically. Yeah, and I think it got complicated when it came to delivery.

P: So what what happened there, were you imagining like a natural birth or what did you want.

S: so I plan to have a water birth. I’ve always had an obsession water birth. And then about just over about a week before I was June I felt like my water had broken. It wasn’t a Gush, but there was just constantly can basically. And after I put down a sanitary towel just to be sure, and it was getting soaked so quickly, so obviously I called the hospital to say this is what is going on. They advised me to come in. And when they did examine me they were like, Are you sure your water is breaking any evidence I had was the sanitary towels and they could see it was so. Yeah, and then eventually they said oh, might be one of your bags apparently we have two bags of water on there by that, but maybe it’s just one of them, that has leaked basically.

P: apparently, there are two layers to the amniotic sac. The amnion, the intersect is the one that holds the baby, and the chorion is the outer membrane. These two bags are in contact with each other. By the end of the pregnancy have likely fused, but it’s possible to have a leak or tear of the chorion, which can repair itself and not be considered quote a ruptured membrane, I found an academic article from 2015, suggesting that there’s a new way to talk about this false rupture of membranes and true rupture of membranes. If the leaking fluid, bears no evidence of vernix that biofilm that protects the baby’s skin in utero or meconium. It’s just the corium that has broken,

S: which then meant that I had to deliver sooner than expected. So I had to come back, I’ve got sent home, and then have to come back in the next morning to be induced…so that basically meant my water birth was out the window because when your water breaks, and it can be risky for the baby. And not only that they found that there was meconium as well. So he had pooed inside me so yeah that was basically it. Yeah, we have to get this baby out, so induced me said I can give birth naturally. So when I say, naturally, and vaginal birth. I don’t want people to feel like C section is not natural. So, um yeah so that process started. Unfortunately, I wasn’t dilating quick enough. And it gave me,

P: were you’re having contractions or anything like Did you feel anything else.

S: I had slight contractions, to meet other names my pain thresholds, but there was contractions, but it wasn’t like oh my god I need to give birth, like it wasn’t like the pain wasn’t intense, to me, but according to the monitor. It was quite intense but I’m guessing it was my pain threshold.

P: My recollection of contractions is like I just that I took my breath away, so it wasn’t super painful but I couldn’t talk.

S: No, I could talk I was talking with nurses at the time, this was just, just beginning though but towards the end when they introduced me and it was now like every five seconds, every minute, every time, that’s when I was like, oh my god, I was so much pain right now. And but I was still bearing I still kept it I still kept going because they obviously wanted me to dilate, they couldn’t deliver. I was having like two minutes, one minute  contractions for, probably, maybe about seven hours.

P: Oh my god, wow,

S:  I still dilated to about four centimeters in that amount of time. Exactly. Go through this pain and I wanted to go in with no colors I didn’t want any of that I just wanted gas and air gas and air where the work was making me feel sick, to be honest. And after a while my mom was like, No, you have to take some painkillers.  This Pain is excruciating. Get some what’s it called again,

P: the epidural

S: epidural Yeah. Get some epidural, but by the time I got the epidural over the brain for so much pain I was just I was the point but I still took it anyways. Then it got to a stage or I know what your baby is now and distressed because you’ve just been in like this for too long.

P: Yeah,

S: your baby’s distress, his heart rate is dropping, we need to get this baby out so unfortunately for you. We have to do a C section because sometimes I really really strongly did not want. And I remember when they told me that I was literally in tears. I felt like my world was ending, not because it’s because I’ve never even thought about C section or even read about it, I just wanted a completely natural birth no painkillers and now you’re going to give me a C section,

P: yeah pretty much the opposite, right

S: Yeah, pretty much the opposite basically but basically you know, gave birth by an emergency C section, he did have an I did have to stay in hospital for about seven days, because he had suspected sepsis.

P: Oh wow.

S: Yeah, so they had to monitor him, but after the seven days, it cleared up, infection was gone. And yeah, and to be honest I haven’t had any other issues with him. Thank God for that. Yeah, healthy way, very active so definitely not the birth experience that I envisioned for myself.

P: How was your recovery from the C section.

S: It was really good I think. I’ve been thinking about it, I was a little weak my stitches were healed. As I was still able to lift my baby breastfeed him. I didn’t have issues. I wasn’t moving as much, but I was still moving like people couldn’t tell that I even had a C section because I was still able to move around, do what I needed to do, and I was blessed that entire because my mom was around with me so I didn’t have to do as much on my own. But I had a blessed speedy C section recovery. Back to my feet in no time.

P: that’s awesome.

S: Yeah, I remember at the hospital as well. Oh, That was another thing, when they did the C section, I lost a lot of blood. I am quite, I have low iron as well. So, another blow was they were telling me I need to, I might have to have a blood transfusion…what on earth is going on, but because of how active I was in the hospital I was able to go take my shower walk up and down there like to really see don’t look like someone who has lost a lot of blood that is low on iron, and if you do that you can maintain it, by taking the tablets, then we’re happy to discharge without having the transfusions, I was like no, there’s no way I’m going to have a transfusion. Like you can’t add any more to my plate.

P: Yeah, yeah. So how is it taking care of the baby and how long does your mom stay like do you have help?

S: My mom was with me for about a month, ideally at least like 10 minutes away from me, but she stayed physically with me for two weeks. Right. And then she came every day. Mom home, and after she left my mother in law actually came so the way our culture works is you know when you give, have that help. That’s you know, if you’re lucky to have your parents alive or close by. Yeah, yeah.

P: So when you say your culture does this, what does that mean.

S: So, I am originally Nigerian so I’m born British but my parents and my husband’s family in Nigerian as well. So in the Nigerian culture when you give birth, your mother or your mother in law, usually stay with you, for… back in Nigeria, they still review for about three months. But, yeah, and you’re not supposed to do anything so it’s for you to get healthy, get back on your feet, and just support you raising your child if your parents are not alive and you have an older sister. Then she usually does it for you. They would come for maybe like four to six weeks, and stay with you in your home until you know you have recovered, and you know, babies well and so yeah, that’s, that’s what I meant by in our culture so as soon as you give birth, you have that support with you, like they already know that’s what they’re meant to do.

P: That’s amazing.

S: it’s a bit more difficult here in the UK because in the UK. Our parents are working as well. So yeah, it can’t stay with us as long as we would like, but they try to stay for at least the first two weeks, or first month even.

P: That’s amazing. Wow.

S: Yeah, I would say for about six months straight I had health, which was good, especially you know, after having a C section being your first child as well.

P: You just don’t know what’s going on right so useful to have someone who does… my husband and I were just saying how postpartum care in the US is really meager. It’s like your first appointment is at six weeks and if you’re not lucky enough to live with near your family or have family living with you like people like your mom and your mother in law who know what to do. Yeah, it’s a really hard road to travel by yourself, right or like as new parents.

S: Yeah, it’s something that mums over here, who are struggling, we get seen, I think, day after you go home, so we get help to come to your house and in 10 days after as well. But after that once you’re discharged from the Health Visiting team, it can be lonely a lot and a lot of moms struggle with their babies is really a big it’s something that really needs to be implemented. I’m sure in the US and UK as well aftercare for months. Yeah, it’s so important.

P: Agreed. So it sounds like you were, you had a pretty smooth fourth trimester because you have people to tell you oh yeah, you’re doing it right or you’re doing it wrong or whatever.

S:Yeah.

P: Yeah. That sounds lovely was nice. It was nice,

S: but I do remember the beginning I was like, I just want my baby like just give me my baby basically is like. They weren’t feeding him, I was I was basically just you know, the milk factory, when he’s hungry they’ll bring it over to me once it’s fed, they will take over. I remember the first time I had a conversation with my husband like, I just want my baby basically like, why, but now that I look here, I am so grateful I had that support.

P: Yeah, yeah, I can totally I can totally imagine that feeling where you’re like, don’t I get to hold them. Right. So what’s your five year old into now

S: he’s at school right now…he’s super active he’s very into video games, which he gets from his father. Yeah, he’s really into video games right now and today was like his birthday back at school actually since

P: oh wow, yeah. That’s exciting. So tell us about your second one, what was that like?

S: my second one. But he, yeah it was difficult getting pregnant with him. So before him, I was actually pregnant, but I had a miscarriage, about six weeks…before I even got pregnant. I actually had an appointment with my doctor, just to check, you know that everything is right, and I had a scan and they told me that I had PCOS

P: PCOS or polycystic ovarian syndrome is a hormone disorder The egg might not develop as it should, or it might not get released during the menstrual periods like it should. That’s the problems with fertility. How common is it in the US, the Department of Health and Human Services is five to 10% of women between ages 15 and 44. Many women notice it when they try to get pregnant and have trouble.

S: And they were like, how did you get pregnant with your first child I was like, I had no issues literally within three months of trying to get pregnant,

P: did you not realize you had PCOS, did you not have any symptoms

S: not at all, because they were like people that usually have PCOS they usually put on weight quite easily, and then put on weight at all. Yeah, come up with them, they’re usually quite hairy as well and I didn’t have any of the typical symptoms so it’s literally when I went into get checked to say, you know, why is it taking me so long to get pregnant this time that they advise I go and do the scan and they saw that basically, even when I was pregnant with my first child, I had, there was nothing mentioned to me about PCOS I had several scans was nothing mentioned to me about that.

P: Yeah, that’s interesting. I wonder what that’s about. Dr. Wilcox thanks so much for coming on the show, it’s great to have your medical insights.

Dr. Wilcox: Well, happy to be here.

P: So after the birth of her first child Stephanie and her husband had trouble getting pregnant again. After scanning her doctor’s office they diagnosed PCOS. Is it unusual to find this out after getting pregnant so easily the first time.

Dr. W: Yeah, I mean, so polycystic ovarian syndrome, you know, can affect up to eight or 10% of women in her case I would say there’s different criteria for diagnosing it, so it may have just gone undiagnosed one criteria one part of the criteria can be the appearance of your ovaries on ultrasound, if they’ve looked polycystic in appearance, but a certain percentage women will have polycystic appearing ultrasounds. Ovaries on ultrasound and not have polycystic ovarian syndrome. So you really have to meet the most criteria for it, there’s two or three different commonly used criteria, you generally have to have irregular periods or evidence that you’re not ovulating regularly. So if someone has regular cycles, monthly cycles, but their ovaries appear polycystic on on ultrasound, I would say that probably is not meets the definition that sort of depends on what her situation was. Certainly if she is not ovulating regularly that can make it challenging to get pregnant, and that’s something that, that would be explored. If someone was having a hard time getting pregnant,

S: exactly. So, I was like okay, so that gave me the option of, you know, I have a keep on trying to dollar been trying for over a year, or I can go through the fertility treatment, right, because they’re like because you’ve already had a first child, you can just keep on trying, or go through this route and I said you know I’ve tried long enough, so let’s go down, down, fertility route and then they gave me an appointment which was about six months, I think it took about six of the appointment for six months. And literally, a month before the appointment I fell pregnant.

P: Ah,

S: and I literally have to call them and say, Okay, I’m pregnant, I didn’t need this equipment anymore, so so grateful for that.

P: That’s the way to do it.

S: So, the pregnancy itself was fine, I obviously still battle, I still battle with my low iron, when I’m pregnant, so I had to be on Iron tabs which was, for me, I don’t think they were working because even though I still got tested Every time I still got my blood tested my iron levels were still low. Well, we still went through the pregnancy the pregnancy was fine. I had no complications. Once again, smooth pregnancy, and then complication came when it was time I’m trying to think when the turning point was what actually happened. This was all during lockdown as well COVID period,

P: I hadn’t thought of that you’re right, a lot of dances in COVID Wow. Was it hard to be pregnant and COVID

S: so it was just starting so I gave birth to my son in March and COVID was just starting in March, okay. And at that time, there was still not allowing partners go into the hospital, you only have to go to your appointments yourself. Yeah, so I had just a routine scan. And when I went into the scan they told me I don’t have enough water around the baby, and they needed to do some more checks and so that’s how I ended up from going for routine scans, Then in the hospital overnight, and them telling me, you know, we’re going to don’t have enough water around a baby, so we have to deliver this child. And I went in as well so you know I want to try natural again so it was called VBAC. I don’t know if it’s cool yeah yeah,

P: so how far along, were you,

S: three days off…Yes, yeah. So a week before I was supposed to go in . So, yeah, So they said to me, we have to deliver this child because you don’t have enough water around him basically,

P: about 8% of women experience low amniotic fluid, if it’s low enough, it’s called oligohydramnios, which is less common, how you manage the situation depends on a bunch of things like its severity what caused it. That gestational age of the fetus, a bunch of different things can cause it like issues with the fetal kidneys, an issue with the placenta or leaking or ruptured membranes.

S: And I said okay on hold my husband, let him know what’s going on because I was on my own. Yeah, and like the next morning we’re going to induce you once again to already knew what this induced process is because that’s what I had with my first son, is that

P: basically like Pitocin or like,

S: yes, yeah, that liquid to make him attract quicker. And so they did. And once again, I had the same issues that I had with my first son was delayed dilation, yeah I was contracting, but I wasn’t dilating and they said, You know what, after about quite a while maybe like nine hours, says, Hey, I think we’re gonna have to do a C section with a let’s wait for a little bit waited for a little bit. And then notice, heart rate was not was not steady, There wasn’t quite sure what it was but they just knew it wasn’t steady so they said okay we’re gonna take it to theater, and we’re going to deliver this baby by C section, this time I was okay with a they already told me the risk because I’ve had a C section before I might actually have to end up having another one.

P: Yeah,

S: I was already aware I was more aware this time. Yeah, so it got to the root the beauty now and they say you know what your scar is starting to open up and we can see his fist poking through so that explains why his heart has been fluctuate it hasn’t been steady and when that happens, they literally have to get this child out within four minutes, but I didn’t know when they put me on GM general general anaesthetic and I was knocked out, I woke up and had a baby,

P: we I need to take a minute here, is that shocking, did you feel him like did your scar hurt or anything.

S: Well I just have epidural, to be honest so maybe that might be why. I didn’t see it myself personally, it’s only when they, when I got into theater, they’re getting ready to do what they need to do. And straightaway, they’re like, your scar is open up. That was one of the risks they warned me about as well. Early days when I said I wanted to have a be back though like there’s a risk there is a low percentage, yeah, yeah, there is a risk that your scar can open up again.

P: Also, kind of surprising since your older one is five years ahead of the younger one, right.

S: So I think it’s probably because of the prolonged delivery so in terms of me dilates me to pressure, yeah, I forgot the name of the delfy was having on my body for such a long time. He was just an active baby he wanted to get out of that, how come I really. So I think that was what actually affected it, that’s what made it actually open up as my pregnancy my scar was fine. It’s never opened up there’s no literally was no issues,

P: so uterine rupture after a Previous section is rare, but it happens in 1% of cases. Let’s hear what Dr. Wilcox has to say about it.

Dr. W: the risk with a vaginal birth after cesarean or sometimes we call it a vaginal trial of labor so if someone’s had a prior cesarean section. The incision on the uterus, where, during the C section where the baby is delivered through is repaired with suture and then heals over time, the concern and we know about 1% One in a 100 women undergoing a national child labor that that scar can break open the forces of labor and that that part of the uterus is a thinner part of that, muscular wall of the uterus. So that’s the danger, and why, they are they’re monitored very carefully. And fortunately, most of the time, the scar is okay but if there has been a rupture, whatever presenting part is down there, whether it’s the head the hands, the placenta is going to be coming through that, that bar and it can be it can be obviously very dangerous there can be cases where babies have died or and or and also that the uterus can get quite damaged because that, that scar can extend into the sides, it can tear into the sides of the uterus where the blood vessels are, and there are cases where certainly where women need to emergency hysterectomy, Just to control the bleeding. So while it’s a rare event, one in a 100 and the risk of a significant damage to baby is about one in 1000 it can be quite dramatic when it happens. So that’s, that’s why, you know, we’re always very careful with monitoring labor.

P: wow

Dr. W: Yeah,

P: and there’s no way to, obviously, even with ultrasound determine like the strain

on the recovered area

Dr. W: Yeah, they’ve done studies looking at that trying to measure the thickness of that area hasn’t that hasn’t provided useful information. Unfortunately, there certainly are women, you know, to be a candidate to be a safe candidate you have to have what’s called a low transverse incision on the uterus which is the typical type for a C section, but But yeah, in terms of being able to predict who might rupture of that 1% is, is challenging, and our most sensitive measure that that might be happening, is how the baby looks and that’s why there’s, you know, you have to have a dedicated anesthesiologist on the unit you because you need if you think that’s happening you move extremely fast.

P: That’s kind of a testament to how powerful contractions are

Dr. W: absolutely, yeah.

S: Yeah, so that’s how in two minutes, they delivered him, he was fine, according to my notes he didn’t brave straightaway so they had to actually take him to a a special unit

P: Yeah, like the NICU, or something.

S: Yes. Yeah, and child intensive care unit, and it was fine. I was fine as well. And, literally the next day we were discharged from the hospital because he had no issues, and well so there was no issues then you can go home.

P: were you vying to go home, did you want to go

S: I wanted to go home. Yes, I do want to another week in the hospital like I did in my first, honestly,

P: I want you to stay but okay, I’m really nervous.

S: Yeah, I went home the next day, I was discharged. Oh yeah, I missed a part, so I woke up and I found that I just saw a baby next to me, that oh my gosh I’ve had their baby. I was knocked out, it was an I think they said I’ve been sleeping for probably about six hours before I woke up to find a baby literally next to me on the beds.

P: Wow.

S: Yeah, it was quite it was quite an emotional experience basically for him.

P: No kidding, what, how big was he,

S: he was about three kg.

P: For those of us, actively avoiding the metric system three kgs is in the neighborhood of six and a half pounds.

S: Now, they were just a little bit smaller than my….he was 2.87 kg. And my first was 3.02 kgs so he was just a little bit smaller. Yeah, he is fine and is growing well you know eats very well his health be haven’t had to touch with any complications or any reasons to go to the hospital or anything like that.

P: Was your partner in the room with you when he was born,

S: because they I had to go into theater he couldn’t come in, and no one was allowed in the theater so I was on my own, until he was born, and he was able to come into the wards, not the theater room.

P: this sounds scary. Were you scared that he didn’t have time for that or.

S: Initially I wasn’t scared because I just felt like it was just another C section procedure. Yeah, I think it’s only when I got in there and they said to me, baby needs to come out and literally like right now. Sweat It really hit home that oh my gosh I hope he’s okay like my emotions were running, running through my head but I didn’t have enough time to even raise emotions because they gave me this, the general anaesthetic and I was literally knocked out. It wasn’t any plan to have a general anaesthetic.

P: Yeah, yeah

S: it was just you know I’ve had a digital we’re just going to get the baby out done. When this happened, they said, Oh, we have to give you this. I didn’t ask any questions so I’m just I just want the baby to be okay.

P: Well also like what do you what are you gonna say no, like,

S:  exactly.

P: You don’t really have much to stand on.

S: Yeah, exactly. I didn’t ask any questions. It was just we’re gonna give you this, and that was the that was the last conversation. I remember having I remember hearing in the theater room as well,

P: I brought this question about anesthesia to an anesthesiologist, Dr. Tammy Euliano who practices in Florida. Dr Euliano, if Stephanie already had an epidural Why did she also need general anesthesia for this surgery.

Dr. Euliano: So there’s two different things we do with epidurals one is what’s called analgesia, which is reducing your pain but not to a level where you could do surgery, and then anesthesia which is complete lack of sensation, and so usually we can convert an epidural for analgesia, which is just less drug really for anesthesia for surgery but it takes a few minutes, and in that case of a uterine rupture, you don’t have a few minutes at the time the baby’s going to be decelerating and there’s a risk that the rupture gets worse and possibly even includes a blood vessel of mom that could make her hemorrhage. So, when it’s a presumed uterine rupture the vast majority of them go to sleep.

S: yeah, It was, I was just grateful that you know he was healthy, he came out well, you know, he had no complications. But Just put me I just thought you know what am I ever gonna have like a normal pregnancy that people just get pregnant, their waters gush, you know, we have great give back. But, at this rate.

P: I mean, it sort of shows you that like for the, you know for every step of the way, there’s so many things that have to be coordinated to make the pregnancy work correctly and you know to get pregnant, a whole bunch of things have to happen at the same time and in the right order and in the right way. And that’s true during pregnancy and in the birth, because clearly you can have contractions, but like there’s some coordination issue with the cervix or whatever, like there’s so many things that have to be working in concert like I, every single person I talked to I think How is anybody born ever anywhere and walking around

S: exactly I’m like, when people told me their birth stories, you know, I just walked up the stairs next thing you know, baby was ready to come like, get my cervix to open up.

P: Yeah, yeah

S: my pregnancy was like so straightforward, all through the nine months so is that is the disconnect. Yeah, where does that come into it.

P: although The time for cervix to shine is often a birth. A lot is happening to the cervix over the length of the pregnancy as the lower part of the uterus, its function in pregnancy is to lend a mucousy helping hand to sperm wanting to enter the fallopian tubes. It acts as a barrier to pathogens between uterus and vagina during pregnancy and during most of those nine months, it must maintain a certain degree of firmness, but then has to soften at a hurry and open for birth. This opening part seems like it’s just happening during labor but preparations for that spotlight event, start early in the pregnancy. When certain hormones that help with softening or  in rich supply that remodeling process move slowly until the birth, at which point rapid changes have to happen cervix has to dilate from the size of a blueberry to the size of a bagel, the chemical cascade at birth includes hormones and immune cells entering at the right times in the right frequency in conjunction with contractions, which have their own chemistry, it’s complicated when you dig into the details, feels a little like magic.

Yeah, that’s one of the bummer of it right is that everything else has been so kind of according to plan.

S: Exactly

P: that it’s hard at the end. So if you could give advice to your younger self, what do you think you would tell her

S: I would still stick with it, read the stories just you know, the process, because that alone can get you over thinking so I’m so glad I didn’t do that, my younger self is, I think everyone’s pregnancy is different. That’s why, all my friends actually everyone’s pregnancy is different, like, is actually okay if you don’t have a normal pregnancy I think that’s actually normal not to have a normal you know fairytale, ideal I do see that you know where envision believe that everyone’s process is different just because this person was able to give back within 10 minutes, doesn’t mean that you are also going to be able to get back within 10 minutes, you know

P: yeah, that’s really smart, it’s hard not to compare but your main point is don’t compare because it’s exactly right.

S: Exactly, everyone’s story is different. And I think that’s why I say don’t read up too much as well because when you beat up you set yourself such a high expectation, that when you don’t meet that expectation you start worrying you start panicking and that’s where sometimes postpartum depression can creep in as well, and prenatal depression, because you just have this expectation unless there’s something…. being your baby and kick today and all of a sudden you feel like we were just going through it and that’s what worked for me and think we read Google is not offering we think is offering specific things is no offering.

P: No, I agree the comparison doesn’t help. That’s totally well Stephanie thanks so much for coming on and sharing your story, it’s super interesting story and I’m glad for people to hear it.

S: Thank you for having me. My pleasure.

P: So much to Dr. Wilcox and Dr Euliano for walking us through some of the medical issues that came up here. Thanks also so much to Stephanie for sharing her story, and thank you for listening. If you liked this episode, feel free to like and subscribe. And if you want to share your story, go to war stories room.com and sign up. We’ll be back soon with another episode that examines the challenges and revels of the triumph that comes with this complicated process of becoming a parent.

Episode 15 SN: Recipe for Happiness: Check your Expectations at the Door to L&D: Tabitha

Our ability to delay pregnancy through various forms of birth control may lead us all to have expectations about our ability to manage our own fertility. It’s one thing to stop pregnancy, and something altogether different to initiate it. Today’s guest, a fan of control like the rest of us, is a master planner.  She planned to get pregnant quickly, have an enjoyable pregnancy, and a routine birth. But the birth refused to follow the birth plan. Pregnancy is, among other things, an educator, teaching hard and often valuable lessons.  All the events of that first birth helped to broaden her expectations in her pursuit of a second child, and as a consequence, she and her partner were able to create amazing birth memories the second time around.

Acupuncture to regulate menstrual cycle

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962314/

https://journals.lww.com/md-journal/Fulltext/2020/05290/Effectiveness_of_acupuncture_in_polycystic_ovary.93.aspx

Melasma

https://www.whattoexpect.com/pregnancy/symptoms-and-solutions/melasma-mask-of-pregnancy/

Water breaks before labor starts

https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/water-breaking/art-20044142

https://www.ncbi.nlm.nih.gov/books/NBK532888/

https://medlineplus.gov/ency/patientinstructions/000512.htm#:~:text=In%20most%20cases%2C%20the%20cause,putting%20pressure%20on%20the%20membranes)

Mode of delivery and microbiome

https://www.embopress.org/doi/full/10.15252/embr.201643483

Audio Transcipt

Paulette: Hi, welcome to war stories from the Womb. I’m your host Paulette Kamenecka.  Our ability to delay pregnancy through various forms of birth control may lead us all to have expectations, our ability to manage our own fertility. It’s one thing to stop pregnancy and something altogether different to initiate it. Today’s guest, a fan of control like the rest of us is a master planner. She planned to get pregnant quickly she planned to have an enjoyable pregnancy and she planned a routine birth, but the birth refused to follow the plan. Pregnancy is, among other things, an educator teaching hard and often valuable lessons, all the events of that first birth, helped to broaden her expectations in her pursuit of a second child. As a consequence, she and her partner we will create amazing birth memories, the second time around.  After our conversation, I went back into the interview to add some details about some of the issues we discussed. I also, for the first time ever, have the insights of an awesome anesthesiologist, who answered some questions, I’m guessing we all have.

Let’s get to the interview.

Hi, thanks so much for coming on. Can you tell us your name and where you’re from.

 

Tabitha: Hi yeah thank you so much for having me. I am Tabitha, and I live up here in Alaska, and I am born and raised. So I’m 100%, authentic.

 

P: wow, what is it like there right now is it, are you covered in snow or

 

T: definitely covered in snow, but I have to say it’s like a balmy 20 above today.

 

P: Yeah, only the locals would call that balmy is my guess,

 

T: well since you’re in California yesterday is still cold for you but that’s more than for us for sure because this time of year it’s actually not uncommon for it to be 40 below 0

 

P: Oh, my good lord. Wow. You just established yourself as someone who’s tough so we can go.

 

T: Well thank you yeah…I think you have to be to live here for

 

P: I’m sure, no kidding. So how many kids do you have,

 

T: I have two kids, a five year old son, and two, almost three year old daughter.

 

P: That’s a fun age,

 

T: so much fun. Yeah,

 

P: so before you had kids, maybe you were thinking about getting pregnant. What did you imagine pregnancy would be like,

 

T: Well, the first thing that I thought is that it would be easy, because from all of your high school sex ed lessons they pretty much say, if you have sex you will get pregnant.

 

P: Yeah,

 

T: so I had no idea that getting pregnant is a thing and that there’s only a small window of time during the entire month, when you have a chance. My husband and I originally didn’t want children, and I just always thought that I’d be a career woman.

 

P: Yeah,

 

T: and it’d be kind of dual income and we could travel the world and all of those things, but then when it was Christmas, and my parents came to visit. I was suddenly so sad because I was like Christmas isn’t the same without children.

 

P: Yeah

 

T: and then I got really bummed out because I was like not even my parents won’t even be here forever and I decided that day was like, I need to be pregnant now. My poor husband was like wait what? But then I just I was so excited to be pregnant, and then I was so frustrated that it wasn’t something that happened instantaneously and like the more I looked into it, the harder it seemed.

 

P: Yeah,

 

T: so that was, that was an interesting introduction that was totally unexpected.

 

P: So, it sounds like maybe you guys had some trouble or what was your experience getting pregnant.

 

T: Well I had been on birth control for a very very long time, and luckily I had gotten off of hormonal birth control, a year prior. And I hadn’t had my cycle for an entire year and like that would have been incredibly frustrating if we were trying to conceive.

 

P: Yeah

 

T: because I always assumed it was just like you get off the pill and then you can conceive, but I was still having long cycles, so my cycle is about 60 days, so we only had a shot, about every other month, and I, I’m kind of the Type A like I just wanted to get it done, I want it now and, I was trying to track ovulation and doing all of that but that was a little tricky because I didn’t have a typical cycle, we did you know quote unquote try for six months, but we only had three shots, and I was doing acupuncture to regulate my cycle which I think help.

 

P: So that’s pretty interesting acupuncture to regulate your cycle. When I went to look it up, I found a number of articles that suggest it can be helpful, but we don’t fully understand how it’s helping another thing to add is that most of the studies I saw focused on women with PCOS, which is not tariff issue. And I was tracking ovulation and

 

T: so it’s kind of funny because I went like zero to 60 I was like doing all the things that a lot of couples don’t do until they’ve been like, trying to conceive for a year. Let’s make this happen. I’m gonna control every factor that I can, which doesn’t really isn’t really much was my first introduction to pregnancy and motherhood really

 

P: yeah

 

T: so yeah we weren’t trying for long, but it definitely did give me a huge sense of empathy for these couples that I hear of who tried for years.

 

P: Yeah,

 

T: I had a small glimmer into that world and I do, it’s tough.

 

P: I think it is, I think you’re right, we’re all fed a steady diet of, it’s so easy to get pregnant, be careful. Which seems just silly like I think you should just give kids the, the real information. I don’t think it’s realistic to imagine that teenagers won’t ever have sex, but I think it would be good for them to know, you know when they’re at greatest risk. Anyway, so you guys get pregnant on that how is it after that

 

T: the beginning wasn’t too bad, and I loved being pregnant, I’m actually, I’m somebody who’s always carried my weight in the middle and I just always hated my belly, but then being pregnant I mean we’re talking like two weeks in and you know you’re just bloated you’re not actually showing I was like, All the maternity clothes like that little baby that was like my favorite thing. I was super lucky that I love being pregnant I had toward the end, I had some struggles with heartburn. That was probably my biggest issue but I was super fortunate and you know, this was, I mean almost six years ago now, so maybe I’m just remembering the good things to be totally transparent, but

 

P: yeah,

T: our son was due in September and so I really loved that I was able to get out and walk even toward the bitter end, which is a sharp contrast to our daughter who was born in February and here in Alaska, it’s very icy I didn’t feel like I was able to get out as much.

P: Yeah,

 

T: I just really loved getting out getting sun, though I did have the dark spots on my face.

 

P: Yeah, that was talking about melasma, aka the mask of pregnancy, and it’s caused by higher levels of estrogen and progesterone, which increased melanin production. I link to an article in the show notes about ways to handle it if it bothers you, but it sounds like it fades after delivery or sometimes after breastfeeding.

 

T: But that was worse because I was getting so much sun because I was outside walking, As much as I could.

 

P: Yeah,

 

T: you know I was a little queasy during the first trimester, but I mean I was like that classic  obnoxious woman who takes a picture every single week and looks up all of the baby development and I did kind of this graphically designed photo of me with all the information about how I was feeling how my husband and I were doing how the baby was developing the first child, let me be clear that did not happen with the second, but I did love being pregnant.

 

P: That’s awesome. Honestly, it’s good to hear a story like that because it mostly sounds like a myth, so it’s nice to have a real person who actually enjoyed it and it was pretty So, why don’t you take us to the, the labor like how did all that started your water break or what happened, how did that work.

 

T: yeah, so I feel like in every story that I hear about you know trying to conceive pregnancy and then labor and delivery. I just always remind myself that nobody makes it through unscathed, you know if you hear about someone who has an amazing pregnancy, maybe it took them years to conceive or maybe they had a horrendous labor and delivery just nobody gets it easy the whole way through. So I feel like I was super lucky that I had a pretty easy pregnancy, but I didn’t get that labor and delivery that I wanted. I was also I was expecting to go into labor late I wanted that mindset and that expectation, because my mom was late with my brother and I and I just heard so many moms, expecting their baby to arrive on their due date and then being so frustrated at the bitter end just like every day lasts an eternity because they’re just waiting for their baby to come and so I just really put my mind two weeks after the due date. So of course, as my first introduction to motherhood, Our son arrived a week early.

 

P: oh wow

 

T: To me it felt like he was like three weeks early. So, it was literally the day of 39 weeks. My water broke at about two in the morning and it was a gush, and I was like, wow, what is this. Yeah, And my husband was sleeping and at the time, we lived only five minutes from the hospital, and I was having no contractions yet. And I originally had wanted to labor at home as long as possible, but I had tested positive for Group B strep.

 

P: Yeah,

 

T: so I had to go to the hospital, in order to get the intravenous antibiotics within, you know, I mean not like rushed to the hospital but you kind of have to get there. Once your water breaks, and I was really disappointed that my water broke. I mean before any contractions, it was the very first thing so I didn’t get to labor at home, at all. And my husband is a really heavy sleeper and also really irritable, shall we say when he gets waken up so we live five minutes from the hospital I was like, I woke him up and let him know but I was like I’m just gonna drive myself to the hospital, make sure that this is actually amniotic fluid make sure yeah I am in labor. And so I got to the hospital and checked in and everything, and they confirmed that it was amniotic fluid. I wasn’t dilated at all like, not effaced, least everything was thick, I mean, none of the other factors of labor had happened yet,

 

P: if your water breaks before labor or contraction start, it’s called pre labor rupture of membranes, or prom. It happens in roughly 8% of pregnancies. In most cases the cause of prom is unknown, the longer it takes for labor to start the greater your chance of infection.

 

T: and so the nurses kind of got me checked in and everything and they kept telling me, like from my doctor that I should start Pitocin to induce the contractions, and I kept putting them off, I was like oh, we’ll just wait for my husband to get here. I was just really hoping for a miracle and just hoping that my body would kick in and that naturally I could have the contractions and everything without having to do the Pitocin. I originally wanted all natural, labor and delivery and so I did not want to start the negative cascade of interventions by starting with Pitocin, which I had been, I read a ton and I had a very thorough birth plan. And while I think it’s wonderful to be very well informed and know what your decisions are I clung to that as things that I thought I could control, that I could not necessarily control and so I had set up a expectation that it really was highly unlikely that it would have been met. And so that really caused a lot of anxiety and stress for me throughout the entire thing, which ironically will cause problems or delay your labor.

 

P: You mean because you were stressed.

 

T: Yeah, yep, I felt like that was, that probably wasn’t helping and then that my mind was just kind of in a negative place and I was so frustrated and to be honest I was mad that I was being told to start Pitocin and then I felt like I didn’t have a choice.

 

P: were they doing that because of the GBS issue.

 

T: Yes, because they were saying that I had to deliver the baby within 24 hours I think it was,

P: yeah.

T: And, and so they wanted to do the Pitocin to give me a chance to have enough time to labor to have the baby to have the baby within that 24 hour window.

 

P: Okay,

 

T: so I was just hoping that my body would kick in and do everything in time on its own. And so my doctor I kept putting off the nurses and then the doctor came in and finally told me herself and then she, I was like okay we’ll start really slow. And then I all of a sudden was like really anxious because my husband wasn’t there and so I had texted him like okay, you need to be here now thinking, we just live five minutes away. And so he didn’t get my text because he was in the shower so he’d been trying to like arrange his work he was gonna hop through the shower and then he was gonna bring my bags with him later. Anyways, I was a little perturbed. When he arrived because I had wanted him to be there. So I would recommend probably going to the hospital with your husband and not trying to be quite as independent as I was. But he got there, and then I had also wanted my breast pump to be able to naturally induce labor and he’d forgotten that. And again, we’re only five minutes away so I made him go get it, but gosh I was just, I have to say I’m sure I was like that. Angry. Angry laboring woman and it also didn’t help that I felt really judged by the nurses because they were like, Is your husband coming and I’m like, okay, he’s not a deadbeat dad he just, I told him not to come yet, so leave me alone, kind of. So yes, I was really angry and then as the contractions got stronger and stronger. I was so angry and sad. And then they told me that, or baby wasn’t getting enough oxygen. And because I was on Pitocin I also had to have a any sort of I guess intervention. They put a blood pressure cuff on me, so I felt like, Oh and I wasn’t able to move around because I had the blood pressure cuff and because I had the oxygen mask and I couldn’t even really position myself comfortably. So I was laying on my side and I just felt like a pinned animal like just strapped to the bed, not able to move. And when a contraction wave would hit me I would rip off my mask whip off the blood pressure cuff and like that was, I couldn’t have the blood pressure cuff squeezing my arm, in addition to the contractions squeezing the rest of my body like it was, it really felt like pure torture, and then My poor husband like didn’t know what to do. And then of course he did the worst thing that even they told us in the birth class is not to do, like, kind of narrate the contractions like Oh that one wasn’t so bad.

 

P: oh good lord, oh man…

 

T: I will murder me.

 

P: I mean, for better or worse, it’s very hard to express accurately what the pain is like,

 

T: well I totally agree. I think he was just trying, he didn’t know what to say. And so he was like grasping at things like trying to comfort me. And it was even hard for me because I remember I was holding his hand, but I did not want to be touched, so I was like holding his hand out for my body.

 

P: Yeah

 

T: I wanted to hold on to him but I didn’t want my arm touching me and I didn’t want him touching me. And so, our son was our baby was in distress and so the next thing that they did was an internal, monitor, and again this is on the list of things that I didn’t want, but it appeared to not be optional, you know, there were the baby was having low oxygen and the an irregular heartbeat, and so the doctor has her like arm up trying to touch the baby’s head to put the monitor on my uterus and the nurse was struggling to open the package and it felt like an eternity that she was like, struggling to open the package to hand to the doctor.

 

P: Yeah.

 

T: Enter homicidal laboring woman again. And then, when the doctor went to put it in. It slipped back out so it didn’t take so then we had to do it again. And then, after we had that in for just a little bit. The doctor was like, we need to do a C section. And I was like, Is there any way you can give me any more time and she was like, 30 minutes. And so I labored for 30 more minutes. And then I was only five centimeters.

 

P: Yeah,

 

T: and I was wheeled to the C section, the O R.

 

P: Yeah,

 

T: the operating room, and, like, this is really where my negativity and anger. You know, started to reach its full potential. Then I was you know they’re trying to do the epidural and the anesthesiologist is like hold still and I’m like, I’m having contractions, You’ve got to be kidding me now.

 

P: this is a question I remember from my own C section. When I was asked to hold still while I was having contractions and iPhone is likely to hold still up here as I am to cook you breakfast, so like Tabitha I’m wondering why anesthesiologists are asking us to hold still. I found one who can give us a great answer. Hi, thanks so much for coming on the show Dr Euliano

 

Dr. Euliano: happy to be here

 

P: okay good. Will you tell us about your specialty.

 

Dr. E: I am an obstetric anesthesiologist at the University of Florida in Gainesville, Florida, so that means that I did. Medical School, four years of anesthesia residency and then an additional year of a fellowship, specifically in obstetric anesthesia.

 

P: So Tabitha is in the operating theatre and having contractions and the anesthesiologist tells her to hold still for the epidural. Why are you saying that to us when we can’t hold still and why are you trying to do that requires us to be still.

 

Dr. E: So we need to get this needle into what’s called the epidural space. So, without a picture, it’s a little hard to describe but so the first layer is skin. And then there’s some tissue between that and, And the ligaments and so then where your spine is there’s different tissue planes ligaments between the top of the spine, the part that you can touch on your back, and then we need to get between those. And then there’s a couple other layers that we have to go through and we’re going through it entirely by feel that by sensing the resistance of the tissues, and when we get to where we want to be, we’re within half a centimeter of where we don’t want to be. And so we’re touching the needle and you move and we don’t move with you, then we can go to a place we don’t want to be, which can result in you getting a really bad headache. The next day, so, so that’s why we asked you to hold still, or at least warn us if you’re not going to be able to so that we can adjust for that, but yeah it’s entirely a feel procedures so, so we need to be able to feel the resistance of the tissues in your back and if you are moving then that complicates that got I don’t know how you did it.

 

P: I don’t know how you do it at all…good lord that sounds impossible, and there’s no like press to like use ultrasound or something so you can see, so it’s not just feel.

 

Dr. E: Yeah, so there’s not really a way to do it under ultrasound, some people will use ultrasound so that they can figure out exactly where to start or figure out what depth to expect to hit the epidural space but those of us who’ve been doing it since long before ultrasound.

P: Yeah,

 

Dr. E: you get pretty used to what the different layers of tissue feel like, and, and you just know where you are but that’s why it’s good to have somebody with experience doing your epidural,

P: good lord that seems like a sixth sense. Oh, my God. Wow, that’s very cool. All right, well, now everyone should remain still critical.

 

T: So I held them still as they could and then just the whole time when they’re setting everything up tears just pouring out of my eyes just like, I didn’t want this, and then I had also read a bunch about how like babies who have C sections have more allergies very often, and I mean, as we all know it’s not ideal, obviously, for a lot of reasons. And so I was just so disappointed that I wasn’t gonna be able to give my baby, the best start. And I was just really negative in my head, and something that was interesting. I’ve never heard anyone else describe the side effect of the medication. The way that I experienced it, but I wasn’t able to really speak, it was like I had all these thoughts racing through my head, but I couldn’t really talk, and my husband was kind of watching the C section like he could see he works in, he’s familiar with medical so they let him watch I think a little more than maybe they would just someone off the street and so he was watching the C section so I felt like he wasn’t paying attention to me. Yes, had all of these negative thoughts in my mind I wasn’t able to tell him what I needed from him, and I was in kind of a negative point anyways, so maybe I wouldn’t have.

 

P: Another thing Tabitha mentions in her experience is that during the epidural she had thoughts racing in her head, but she couldn’t communicate is that a side effect that you’ve heard of before from an epidural,

 

Dr. E: that would be odd from an epidural, in order for us to be high enough that you can’t speak, it would be too high for you to breathe properly and we would have to put you to sleep so, could be an emotional reaction to the situation where you feel like you can’t speak but physically in order to knock out your ability to actually mouth words, we would be knocking at your ability to breathe and then we wouldn’t be able to keep you awake,

 

P: she did say that it was like a very emotional thing for her because she desperately didn’t want a C section and so I think there was sort of an inner struggle for her.

 

Dr. E: Yeah, and it sad the pressure we put on each other as women that somehow you failed if you end up with a C section it’s, it’s a yeah it’s not the way it ought to be, sometimes it’s just the right way. The safest thing for you and your baby and that’s okay,

 

T: but I just felt like I had ruined my baby. I wasn’t giving them the best start and again I’d had the group B strep so I know there was a somewhat at the time. A more recent procedure where they could swab some of the bacteria vaginal bacteria to put on the baby’s face so that even if the baby isn’t born vaginally.

 

P: Yeah,

 

T: they can still get that bacteria, but because we were literally the whole point was to avoid getting the bacteria on the baby. Now that wasn’t an option for me, so I just, oh my gosh I was so disappointed. And this is like, still makes me feel emotional but like when they pulled our son out and they’re taking him over to the little incubator, I couldn’t, couldn’t hear him breathing, and again I couldn’t ask it took me forever to get out. Is he breathing. I could just see the oxygen mask over his face. And my husband, and the pediatrician responded right away now. Yes, yes, he’s fine. He’s doing good. And I just like my first thought was, like, I want to do over like this is ruined, like I already haven’t given my baby. The one thing that I thought I was at least going to be able to give them the perfect start and I was so determined. And I just felt so cheated, that I didn’t get to have that amazing, miraculous experience.

 

P: When Tabitha talks about not being able to give her baby the best start. She’s talking about research that suggested that a vaginal delivery gives the baby a better microbiome than a C section delivery. A diverse microbiome is a community of bacteria that lives in our gut is now being connected to many different positive health outcomes. So that’s why you’d want it. I just stumbled on this research by Dr Keirsey a guard at Baylor apologies if I’m mispronouncing her name on this very issue. She has a 2016 paper that looks at the relationship between mode of delivery and microbiome and finds that there may not be a relationship between how your baby was delivered, and the microbiome they receive current thinking is that what leads to a poor microbiome is a diet high in fat during pregnancy. So it may not be C sections per se that lead to bad outcomes. Her article notes, and I quote, exposures and events during pregnancy, that may lead to a Cesarean section, but not the surgery itself, maybe the drivers of variation in the microbiome and risk of less ideal health outcomes. So importantly diet during pregnancy is key for this microbiome issue, not necessarily how the baby is delivered.

 

T: After some processing because it really was traumatic it took such a long time before I could even talk about it without crying. I had a healthy baby like I should have been so grateful…he didn’t have to go to the Nikki or anything, but at the time I was just in such a negative spiral, because I had these crazy specific expectations that were not met, and I felt like a horrible mother like, What kind of mother doesn’t give their kid the best start and I wasn’t able to do that and so I was kind of like maybe I’m not cut out for this,

 

P: I’m totally sympathetic and I think a lot of this on all fronts is chemistry right like you, I think we all expect that you’ll have contractions, then the water will break and kind of the order of operations which didn’t happen. And I think you imagined that you’ll have the time to have the contractions kind of progress in the way that everyone expects and that also is chemistry too. Right, I mean you can Pitocin them out but that too may take a long time right you just everybody’s different and you are also like, you know, a wash and hormones so yes you’re angry but you know that’s one of many things you probably felt that day.

 

T: And I feel like it was especially challenging for me because I am generally not a very emotional person. And so, feeling like I had no control over how emotional I felt was also kind of stressing me out in addition to everything else.

 

P: Yeah. How was your recovery from a C section and like how did you guys leave the hospital.

 

T: So I left the hospital I think after two days which they recommend for but I was like, get me out of here. And I regretted that a little bit later because we struggled with breastfeeding, which was something I thought would be the most natural thing in the world, but it wasn’t I did heal up really well from the C section. Overall, I would highly recommend making sure you drink enough water and those stool softeners. Don’t skip them because that is an important piece as well.

 

P: Yeah, I remember being afraid to go to the bathroom after the C section.

 

T: Yes, so funny, ish story about that so I was terrified as well. And then when I went to go, I couldn’t. So I again super hormonal I went, ended up going this is embarrassing but I ended up going to the emergency room because I, I, like, again, darn research I’d read a lot about how you can have impacted bowels and I was just like oh my gosh I need to get this taken care of, and you know in hindsight I could have just gone to the store to get an enema for me but basically paid a lot more money to do that in the ER, but it was it was terrifying and it was like confirming my worst fear, and I actually had I thought stayed on top of things like I was supposed to do, but perhaps I’m just a little more sensitive to that than other people.

 

P: Yeah, I remember that being hard I wouldn’t be too hard on yourself and it is a little bit scary if you’re, you know, I remember like trying not to go to the bathroom because you think the C section scar is gonna open or it seems pretty fragile so, so I’m sure you’re not alone. I bet they knew exactly what to do because you’re not the first one.

 

T: Yeah.

 

P: So how was it when you had your son home, like you figured out breastfeeding

 

T: we figured out breastfeeding eventually. Another thing, I ended up. It’s funny because I was also against having to use the shield. The nipple shield I had just heard about how the biggest you get kind of addicted to it and then you can’t breastfeed without it. And luckily one of the nurses who, years later, actually, she’s actually now one of my best friends but the first time we met, she was helping me and she just had like the sweetest gentlest loving way to convince me, you just need to feed your baby like who cares, you have to use shield, like it’s no big deal, it’s not about, you know, achieving perfection or, you know, some unrealistic ideal again or you’re probably noticing a theme here for me. And so we used the shield for a couple of months, and then we were able to get off of the shield and I think he you know you’re just so in gorged, and then my baby was only six pounds, nine ounces, so he was just a little tiny guy, and just physically it wasn’t as compatible and when he got a little bigger, a little stronger, it was no big deal. Oh, there was one night when I was trying really hard to breastfeed him. And I wasn’t able to and I had some formula on hand, again I was against it. I didn’t want to use it but I had to do that and I was all nervous about nipple confusion with using a bottle so quickly, But I mean, he was just screaming in the middle of the night and I literally had no way to feed him so I was really thankful that I had it on hand. And I was able to feed him but there were definitely a couple couple of times when it was just really stressful to try to get him to latch and to eat enough and in hindsight, the field actually worked out well because I did not have nearly the cracking and bleeding that a lot of my friends did. And I think that was because they had kind of a barrier, before I was able to like build up the calluses, if you will, so I, in some ways, it actually worked out really well.

 

P: Good…that sounds excellent. And so I assume you guys found your rhythm.

 

T: He did Yep, and then I nursed him until. Gosh, somewhere between 18 months and two years old, I can’t remember exactly but we had a good long run at it for sure.

 

P: yeah, That’s a long time that that I wonder if that doesn’t override the need to have the vaginal birth for that element of the microbiome.

 

T: That’s a good point, maybe,

 

P: you said you had two kids. So did you start, what, what were your plans for the second child, did you start immediately or what were your, what were you thinking

 

T: we had originally planned to start, I guess our son was born in 2015, I think the beginning of 2017, we had planned to start, and then I actually, we were going to start in January as you can tell, I’m like a planner and so I was still breastfeeding our son. And so that seemed like a good time, a good gap between between kids couple years. And so, we plan to start trying really trying, you know, getting out all the research and metrics and everything. In January, but we weren’t like preventing before that and kind of just, if it happens sooner, whatever. And so I actually I didn’t realize until February. I had actually gotten pregnant in December.

 

P: Oh wow.

 

T: Yes. And it was the reason it took me so long to figure it out, was because I had a really light bleed it was like a weird period I thought but I didn’t realize that I had had a period and then had even suspected it a little bit, and took a pregnancy test. But I had two different kinds of pregnancy tests I had the kind of that was two lines was the positive and I had the kind of that was a plus sign was a positive.

 

P: Yeah,

 

T: and I think I had like, you know, thrown out the instructions it was just the test and I think, I think I had probably tested positive that first time but was looking for the wrong thing, and I didn’t realize I found out about nine weeks that I was pregnant, and then actually we ended up miscarrying which at 11 weeks, which was devastating. Oh my gosh, it was so awful like so much worse than I ever could have expected and so we miscarried. On February 23 And then, yeah, so awful. I don’t want to go into that because I will cry.

 

P: yeah, that’s fine I’m sorry, yeah that’s fine.

 

T: Yeah, but just anyone should know they’re not alone. Um, and then of course I wanted to conceive right away as soon as possible like not that a baby can replace another baby, but I just felt like I needed that and felt like it would be healing, and so I did everything I could to like, prepare my body but also give myself time and so then I think we started trying to conceive again maybe in April, or maybe we did conceive almost right away maybe maybe there was just one or two months of weight, but pretty quickly. And then that pregnancy. I knew right away because I was, you know, paying attention and planning, and that pregnancy was a little more stressful just that I was always worried if everything was going correctly and especially since I miscarried at 11 weeks I had thought I was so close to being in the homestretch, you know, because your, your promised you’re guaranteed at 12 weeks your baby’s going to be fine. I mean, I say that sarcastically but it really feels like that way and you really look forward to that milestone as a pregnant mom. And so I was super nervous the first trimester. And then my second pregnancy was very much like my first pregnancy, the heartburn, again, was probably my biggest issue, and having being largely pregnant in January and February in Alaska was kind of stressful. I was just always worried about falling, and so I just had, I parked close and I had like the, the grips on my boots, and I just I didn’t walk outside, like I had but it was also harder to stay active, I did walk some but I didn’t enjoy walking indoors or on a treadmill nearly as much so I didn’t do it as often. Yeah, but overall, again, I had a really, really good pregnancy, though I did find out that she was breech, we found out that pretty early, I think at our 20 week ultrasound. I tried everything to get her to flip everything natural that I was comfortable with, I was not comfortable with full with a cephalic version because I felt that manually flipping the baby I mean there was probably a reason she was breech you know either she was tied up in the, the umbilical cord or the umbilical cord wasn’t long enough, there wasn’t enough amniotic fluid. I just I wasn’t comfortable physically forcing it.

 

P: Yeah, that makes sense

 

T: I did. I did hypnosis, and I also did a few acupuncture treatments. And one thing that was crazy is one of my acupuncture treatments, right after I hopped off the table I was putting my clothes on, and I could feel her try to flip it was the weirdest feeling like, like she was kind of in a hammock sort of with her head under my right rib, And I felt her head go up like between my ribs, and to the point where I had to like lean back in the chair that I was sitting on to like put my socks on. And she was like, I could just feel her like trying to kick over, and she never did, but that was kind of a crazy, a crazy experience

 

P: that sounds like you gave it the college try. That’s well done.

 

T: I totally did and I did a little bit of like the handstands and stuff but my goodness I was like okay well I’m trying to flip my baby around I might break my neck, I’m not sure that’s a good idea, but it was an interesting experience. And so I felt like I was, again, a little bit cheated out of my natural birth experience but I wanted, but I was a lot more realistic because I’ve been a mom for a couple years at this point, and knew to, for sure is that my intention and know what I desired, but not hang everything on that, and knew that I would just have to roll with the punches, because that flexibility. If you don’t have that motherhood, you’re gonna be so much more stressed and anxious, and you know when you’re trying to control things that you can’t control. No good can come of that.

 

P: Yeah, Yeah, also I feel like if the baby’s breech like some of the visions that are kind of out of your hands right like.

 

T: Absolutely, yes,

 

P: that is, that’s a definite C section, right?

 

T: It was yes and so I scheduled this feast actually which I had kind of chuckled to myself I’m like another thing I thought I would never do. And, of course you know had felt so judgmental of people before who did it but I’m like oh well now that I’m in it I see that that really is a necessary thing sometimes.

 

P:  Yeah,

 

T: I scheduled it as late as I possibly could. I think it was like, 39 weeks and four days, which was a little bit late, considering it was my second child, and that my first child had arrived at 39 and one days.

 

P: Yeah,

 

T: and so I was really hoping to go into labor naturally I just thought that would be nice to at least know the baby was ready, but I did not, and a nice affirmation or confirmation was the morning of my daughter’s birthday. I, there was a huge snowstorm. And so I was just like.

It’s so nice that this is planned like what if there was a crazy snow storm we also we live on a super steep hill we’re just out of town and crazy Alaskan winters, I was like I can’t imagine being in labor, yeah stuck on the side of the road or in a ditch or something like that.

So that was just a really good confirmation that I made the right choice, given our circumstances, I also didn’t really have anyone. A lot of my girlfriends who just had a baby, we all have babies around the same time and so it was my mom was able to come up and watch her son and so I mean, I’ll be totally honest, the logistics were a lot smoother. So that was, I just had to take the wins where I could

 

P: totally. So, so it sounds like you didn’t your water didn’t break there’s no labor you, you went to the your appointment like it was an appointment.

 

T: Exactly. So, it was delayed quite a while but mentally I had prepared for that I’m like I know this is scheduled, but I actually worked at the hospital at the time so I was like, I know that it’s probably going to be delayed. So in my mind I was prepared for that. I also had a doula the second time, which was really helpful even though I had done it before. I really wished I would have had her the first time, but it was nice where you know just hanging out waiting joking with the nurses, laughing, I had prepared like through hypnosis, and then just affirmations. So anytime my mind would start to worry or wander, I would, I had all these affirmations at the ready and so they wheeled me into the OR, and I wanted to see my baby being born so they set up a mirror for me to watch.

 

P: Oh wow,

 

T: I have all of these affirmations in my mind, and then my doctor. Also, let us drop the curtain. So when they pulled her out and pulled her out of my belly, I got to see it, I got to watch her come out of my stomach.

 

P: That’s super cool.

 

T: Oh, it was amazing. I feel so grateful, and then my husband was able to watch the whole thing and the whole thing is on video which is like such a special treasure. I don’t know if a lot of places will let you do that, but, yeah, the experience was completely different. She was, she was able to be skin on skin on my chest which I wanted afterward, which I did not get with our son and I was really upset about our daughter was like snuggled in, and our pediatrician. I knew her also and she was amazing and she was like, Oh, let me take a picture and so we got a picture when she was first born and she made sure my boob wasn’t in it which I appreciate.

 

P: that’s well done, that’s well done

T: was like, well, you should add that to your list of like your resume. Yes, but she was amazing I just loved because I knew her and that was another pro of the scheduled C section I knew that she was going to be our pediatrician, most likely, so that was also really nice and I got to have our daughter’s skin to skin recipes, breast feeding was super easy. But another thing that we were able to do the second time, second time which I think was actually new technology, they’re able to do what I had researched this before so I knew going in was called a tap block. So they were able to do local anesthetic around my incision, so I didn’t have to have any pain medication for, I think it ended up being 48 hours they said up to 72 but around 48 I could feel it wearing off. But I think that probably helped with breastfeeding also because I didn’t have the pain meds in my bloodstream, it was just local.

 

P: Oh, that’s totally interesting I hadn’t heard of that, that’s cool.

 

T: Oh, it was amazing. Like, I highly recommend it was called a tap blocked that made a huge difference because I think the bonding felt so much more amazing to, I still had a little bit of the disconnect from the drugs from the actual epidural and surgery, but it was a lot better and those drugs were off faster, and it was so nice that you do have to be I’d had a C section before so I knew not to push it. That could be the one downside of having that local tap block is having no idea that I mean, you are really healing just because you feel great doesn’t mean you can just say, doesn’t mean you can just do whatever

 

P: Tabitha talks about a TAP block, can you tell us how that works.

 

Dr. E: So TAP stands for transversus abdominus plain which is just the name of the muscle that we put the drug, near, and basically all the nerves that supply your abdominal wall from skin down to right before you get inside your abdomen all come from your back around the sides. And there’s a place on your side where we can deposit up a large volume of numbing medicine that will stop those nerve impulses coming from basically the incision, getting up to your brain and causing pain so we can put medicine there that blocks those impulses and it actually works quite well, if, if the anatomy is good so usually we just do it under ultrasound it’s one needle stick on your side we inject a bunch of local and on each side and we’re done. There was a lot of enthusiasm for a while about maybe 10 years ago. But then it turned out that if we use Derma, which is a long acting morphine that we put in if you stay awake for your C section we almost always put it in the spinal or the epidural and adding the tablet didn’t turn out to add any pain relief because they both sort of wore off at the same time.

 

P:. That sounds like a totally different experience than the first one and quite nice, was amazing.

 

T: And I did still have some reservations about having a scheduled C section, but my girlfriend that I mentioned who had done, helped me with the nipple shield with our son. She’s a labor and delivery nurse, obviously. And so I talked to her about having a scheduled C section and she was like, honestly, it’s really great because you can have the team you want, they are prepared for you and stay on emergency, so it’s safer. Everything felt smoother and I know a lot of it was me because first of all I’d done it before I knew exactly what I didn’t want.

P: Yeah,

T: it was so nice to have her perspective and like her encouragement, just to be like the staff that needs to be there’s going to be there, you’re going to have the people that you want. And it’s actually kind of funny because our babies were doing our second babies were due a week apart and she actually had her son, that morning. In birthday.

 

P: That’s awesome. Wow, it was amazing. Yeah, what are your kids into now.

 

T: Gosh, everything. No, our son is just, oh my goodness, such a loving ball of energy, he is just the sweetest, kindest smartest kid he takes after his dad, and our daughters. She is such a spicy free spirit, but I love it so much because it’s just, she knows what she wants in life and I feel like so often people lose that and it’s such a fun reminder of like there is no question about what she was that girl knows exactly what she wants. And so I’ve definitely learned some from her about knowing what she wants and she is also just so happy and giggly.

 

P: That’s awesome That’s a very good. It’s a very good end to the story.

 

T: Yeah, and that is kind of my I think my biggest blessing was just not having these ridiculous expectations that can’t be met and controlling what you can, which is your attitude right, and so that was a big difference was that my attitude was completely different. The second time and everything went so much smoother.

 

P: Oh my god, that’s so cute oh my god she sounds adorable. Thank you.

 

T: Just a minute, sweetheart, made most of the way without interruption.

 

P: You know I couldn’t add better sound effects and that’s perfect.

 

T: Oh there you go,

 

Unknown Speaker  8:16 

tell us, and thanks so much for coming on and sharing your story today I totally appreciate it.

 

Unknown Speaker  8:20 

Thank you so much, I

 

Unknown Speaker  8:21 

just it’s they’re two of my favorite stories so thank you for letting me share.

 

Unknown Speaker  8:25 

Thanks again to Dr Uliano for sharing her insights with us. She cleared up some questions I’ve always had about the epidural, I appreciate it and thanks to Tabitha for sharing her story. If you like this episode, feel free to like and subscribe. Also reviews are how other people find the show so we so appreciate your views. If you’d like to share your story, go to war stories from the womb, calm and sign up. We’ll be back soon with another story, the crazy messy hard and beautiful things that can happen in this process, and the amazing things we can do to overcome the challenges.

 

Episode 14 SN: Help! This Pregnancy Has Taken Over my Body: Alasen

Today’s guest stepped into her first pregnancy relatively easily,getting pregnant within a few months of trying…… and that was the last easy thing she experienced.  She describes herself as someone who is “not a pregnancy unicorn”.  She had body image issues while pregnant, felt nauseous, swollen and was generally physically uncomfortable for most of the pregnancy. And then postpartum recovery was even more challenging. A hormonal imbalance caused a too dramatic weight loss, she was visited by postpartum depression and anxiety, and a baby who wasn’t particularly interested in sleeping through the night added to her ‘non-unicorn’ status. In an effort to dig herself out of a hole, she started researching nutrition and found a much better way forward for the second pregnancy, and ultimately for life.  I learned a lot talking to my guest today and hopefully you will too. You can find her at https://thenutritiondoula.com/ and in Instagram @thenutritiondoula

Body dysmorphia

https://www.womenshealth.gov/mental-health/body-image-and-mental-health/pregnancy-and-body-image

Adrenaline in labor

https://link.springer.com/article/10.1207/S15327558IJBM0801_04

https://www.sciencedirect.com/science/article/pii/S152169342030033X

https://www.parents.com/pregnancy/my-body/changing/uncontrollable-shaking-during-labor-and-pregnancy-hormones/

Diet and depression

https://www.health.harvard.edu/blog/diet-and-depression-2018022213309

https://www.medicalnewstoday.com/articles/318428#antioxidants

https://academic.oup.com/nutritionreviews/article/79/3/247/5843529?login=true

Audio Transcript

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka Today’s guest first steped into pregnancy, relatively easily getting pregnant within a few months of trial. And that was the last easy thing, she experienced. She describes herself as someone who is as I quote, not a pregnancy unicorn. She had body image issues while pregnant, felt nauseous for a large chunk of the pregnancy and physically uncomfortable, then postpartum recovery was even more challenging. In an effort to dig herself out of a hole, she started researching nutrition and found a much better way forward for the second pregnancy, and ultimately for her life. I learned a lot, talking to my guest today and hopefully you will too. I’ve paused our conversation in places to add medical details and to include the insights of a thoughtful OB.

Let’s get to the story.

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka Today’s guest first steped into pregnancy, relatively easily getting pregnant within a few months of trial. And that was the last easy thing, she experienced. She describes herself as someone who is as I quote, not a pregnancy unicorn. She had body image issues while pregnant, felt nauseous for a large chunk of the pregnancy and physically uncomfortable, then postpartum recovery was even more challenging. In an effort to dig herself out of a hole, she started researching nutrition and found a much better way forward for the second pregnancy, and ultimately for her life. I learned a lot, talking to my guest today and hopefully you will too. I’ve paused our conversation in places to add medical details and to include the insights of a thoughtful OB. Let’s get to the story.