Episode 37: A Look at Pregnancy & Birth from a bygone Era: Lily’s Story
Episode 37 SN: A Look at Pregnancy & Birth from a bygone Era: Lily’s Story
Since it’s Thanksgiving weekend, I decided to make this episode about family. And in that spirit, I interviewed my mother about her experiences of pregnancy and childbirth. My mother, who is in her late 70s, had four kids starting in 1966, and ending in 1978. You’ll hear her reference my two older brothers: Josh who is the first born, and Teddy who is the second. I was the third in line, and there is an 8 year gap between me and my sister Samara. It’s surprising to hear about how much she changed and how much the medical apparatus around pregnancy in general changed in that 12 year period. Of course, this is just one woman’s story, and my father was a doctor, so she had very good access to different medical technologies, which you’ll hear about, but I found it really interesting to hear about how her experiences were so different from how pregnancies and births are managed today. And I hope you do too.
Hypnosis in pregnancy
https://www.mayoclinic.org/tests-procedures/hypnosis/about/pac-20394405
Female Gynecologists in the 70s
https://www.latimes.com/health/la-me-male-gynos-20180307-htmlstory.html
Audio Transcript
Paulette: Hi Welcome to War Stories from the Womb. I’m your host, Paulette kamenecka. I’m an economist and a writer and the mother of two girls. Since it’s Thanksgiving weekend, I decided to make this episode about family. And in that spirit, I interviewed my mother about her experiences of pregnancy and childbirth. My mother, who is in her late 70s, had four kids starting in 1966, and ending in 1978. You’ll hear her reference my two older brothers: Josh who is the first born, and Teddy who is the second. I was the third in line, and there is an 8 year gap between me and my sister Samara. It’s surprising to hear about how much she changed and how much the medical apparatus around pregnancy in general changed in that 12 year period.
Of course, this is just one woman’s story, and my father was a doctor, so she had very good access to different medical technologies, which you’ll hear about, but I found it really interesting to hear about how her experiences were so different from how pregnancies and births are managed today. And I hope you do too.
P: So hi, mom. I appreciate you letting me tear you away from Thanksgiving mingling, thanks for coming on the show.
Lily: Thank you for having me, anytime.
P: Exciting. So I thought I would focus on a couple things. with you because you started having kids in 1968 is that when Josh was born 66 Oh, wow. 66 Okay, so you’re you’re pregnant and 65 Right. You obviously wanted a family?
L: Yes.
P: And and you got pregnant easily. I know that part of the story.
L: Yes.
P: Did they have home testing kits when you were pregnant?
L: I’m trying to think no, you sort of found out the hard way. Once you got sick nauseous.
P: Oh, that’s interesting, so you just. You started to feel poorly and then what you went to see the doctor.
L: No, I didn’t I had a doctor in the house.
P: What you need to know here is that my dad’s hematologist.
L: Yeah. So when I started getting nauseous in throwing up, you know, a couple times a day and my lasted like a whole day so my husband figured I’m pregnant. Because after all I was fine before
P: and you guys never thought oh, it’s the flu or Oh, it’s something I ate or
L: well, but you could do that the first day but if you keep on having morning sickness and chucking up at anything that you drink or eat.
P: And then once you think you’re pregnant, then do you have to go to the doctor’s office for a blood test or how does it work?
L: No, no, we really didn’t go right away. Dad at the time was practicing at Kaiser Permanente. So I was sort of the housewife because he was in the house. And first time I met my gynecologist obstetrician, he says, oh, a doctor’s wife like that. Like, oh, boy. They’re difficult patients. So this was my first first meeting. And I told him, I what my symptoms were. But also what happened is that I had a lot of chest pains and we didn’t know what that was for. And that’s the only reason I started going to the obstetrician. And he sort of blew it off. He says, oh, maybe you’re worried you’re anxious, whatever it is. He checked me out and I was fine. And, you know, I was pregnant. And that was it. But yet I was having these these chest pains and I guess later on we found it was more anxiety because of my past experience.
P: Okay,
L: from after the war.
P: So my mom was born in the middle of World War Two in Poland to Polish Jews. That’s what she’s referencing here. Yeah.
L: So he had nothing for me and he didn’t spend any time with me either. He just said, Well, you know, doctors, wives are always difficult. Nice. So, what happened is that we decided to go to another obstetrician. And this one, both my husband and I went to a seminar on hypnosis. And that’s when this obstetrician presented his use of hypnosis during pregnancy. And if he started early enough, you could by the time you’re ready to deliver, you could be so relax and use the auto hypnosis that you could deliver without any medication without spinal.
P; Yeah.
L: So this is this is his reasoning, and he sort of exuded such confidence and warmth. So my husband turns to me, he says, Should we try him? Okay, because I didn’t like the obstetrician at Kaiser. So we made an appointment with him. And I told him my story, and he wanted background. So I told him where I came from and the experiences that I had, and he was fine. He says, Well, he uses auto hypnosis would I be willing to try it? So I said, okay, and he had the kind the chain with a little ball that moves back and forth.
P: Oh, you’re kidding…And I was just asked about that. If you have like a watch on a string.
L: Right, right, with a crystal ball, and he would just go back and forth and you had to concentrate, and he would try to get you under, and I was a good candidate. So I went under. And under hypnosis, he asked me why do I have this tightness in my chest and why does it hurt so much? What am I afraid of? Am I afraid of the pregnancy? And I said to him, it’s my experience of being in the hospital in Germany, and I needed to have my belly button. Because I was born during the war and with my parents running from the woods and everything. They didn’t close my belly button correctly. So with an outie instead of an any, okay,
P: so my mother and her mother survived the war. They’re getting ready to go to America. They need all their medical affairs in order and for some reason, there’s some belly button issue that needs to be fixed before they can board the ship for the US.
L: I wouldn’t be accepted in the US unless it was it was operated on and it was pushed inside. So okay, so that’s what my mother had to do. So she, she took me to the hospital in Germany, but she never told me about it. And I was seven years old, and she said I would get treats. And when she took me to the hospital, she came in the nurses took care of me and she had to leave. Well, I found out that the this doctor’s coming within like a big needle. I was terrified because I didn’t know what was happening. And I ran away so they had to chase me at 7 years and finally they found me and they just held me down, put me on the operating table and there was this big big light up on top. You know, the the light for operations, ya know, within the surgical ward, and all I could remember is that big shiny light, and they’re giving me an injection. And that’s the only thing I remember after that I recovered, and I had the surgery. So I think the idea of going to the hospital for the first time because I didn’t need to go to the hospital ever since.
P; Right
L: So the idea of going to the hospital and seeing that big light and being on a surgical table to deliver. I get that pack petrified. So once he knew that, he could work with that. And through a couple of sessions with the auto hypnosis I recovered and I wasn’t afraid of that anymore. So he just released me from from this this anxiety that I had,
P: but what I love about this story is that it feels very, you know, 60s hippie out in California, which I totally dig. And and amazing that helped him like nice of him to take walk the extra step to say why are you anxious and how can I help you and
L: yes, well, that’s why he was so special. Yeah.
P: So while I’m talking to my mother, I’m enjoying the story of auto hypnosis like it’s from a bygone era. But when I went to look it up, it’s still around now more likely called hypnotherapy. It’s still used to treat anxiety and is used specifically to treat anxiety and pregnancy
L: by auto hypnosis if you were a good patient that you could go under and, and he could ask you questions you would respond. That’s what he did. So after several sessions, I felt more relaxed and I wasn’t fearful of that situation. And my pregnancy moved along very well.
P: That’s awesome. And so after that medical intervention, you don’t have ultrasound, right.
L: No.
P: So what what thing like that was so what’s the doctor’s visit? Like? What do they do when you get there to check you out during the pregnancy?
L: You know, they feel around the size, you know, with their hands and they feel around your belly. They listened to the heartbeats and you could hear them, they let you listen to it. And the only internal exam was right in the beginning and everything was fine. And from then on, it was not every single month till towards the end. And then it was like every two weeks by the eighth month.
P: So did you get to 40 weeks.
L: Oh, yeah, because I was over I was overdue by two
P: by two days?
L: I was over two weeks.
P: Oh my god. Two weeks is a long time at that point. So how did you know that you were going to give birth that day?
L: Oh, well, it was different since I was two weeks overdue. And you know, he figured out a date and when he was he was to be born but it didn’t exactly fit on that day. So he was going to go back to New York for a conference. And he really wanted to deliver me because he had practice with me with the auto hypnosis. Yeah. He didn’t want to turn me over to another obstetrician. So that’s when he induced me
P: so his induction in 1966. Does that involve like an IV with Pitocin? Or what does it look like?
L: Yes. Yes
P: Okay. Yeah, that sounds painful.
L: Well, that wasn’t so painful until the labor really started.
P: Did you get an epidural?
L: I didn’t get an epidural. Because he at the same time because I had a 17 hour labor. So he had given me all the pain medication during that time. And he was worried because the baby was so big. So basically all the pain, pain medication during this, this labor for so long. That when I went on the delivery table at the time that I came in, I had nothing and he gave me laughing gas
P: and didn’t work at all
L; with the laughing gas, but no, not really
P: well, because since then you had your other gym. With epidurals so you can compare
L: Yeah. Oh, yes. Once you got the epidural, it was a nice relief.
P: So he basically had a natural childbirth for your first one.
L: Yes, yes. Yeah. And he was nine and a half pounds. So I had a lot of tears that he had to prepare.
P: Yeah, that sounds hard. And then you stay in the hospital for like a week?
L: No, three, four days. Okay.
P: And in 1966 Where you were, was breastfeeding a thing or it wasn’t a thing?
L: No, it was if you wanted to you you can. But unfortunately, Josh was such a big baby. That I didn’t get enough milk.
P; Yeah.
L: And he was always crying because he was hungry.
P: Yeah.
L: And of course, if you were nursing, you couldn’t give him a bottle as a supplement. Yeah. So eventually, we found a pediatrician who had nine kids of his own so he knows. He knows about babies. So I went we went there. After three weeks. We just couldn’t figure out I was still not getting enough milk to feed, feed a big he was like a three month old baby and they’re in the nursery. Everybody said, What’s I think baby doing? He’s not a newborn. But the pediatrician said, look, he said you’re not getting enough milk. He’s hungry. He said, Give him a bottle of formula and see how much he drinks. And if he drinks, a full eight ounce bottle, then change them over for the sanity of you and the baby.
P; Yeah, yeah.
L: And he did he guzzled up that bottle of formula. And he was happy and he finally went to sleep. So I said, I’m done.
P: sold
L: So yes, exactly. Yeah, I’m one because I’m suffering. I was crying the same time the baby was crying. I didn’t know what to do. Yeah, so yeah, so that’s all
P: A couple of questions here: first, what were the first few months like with with a newborn? I’m assuming that you didn’t get much help.
L: Had no help. No help. Plus, my husband got, you know, he was recruited to the army because of Vietnam. So we had to leave he was a month and we left for Texas
P: Wow.
L: We left for Texas,. Yes. And we were really nervous. And we lived in this terrible terrible rooming house, because we didn’t realize that the Army gave you some kind of funds so that you could stay in a motel, which would have been air conditioned and not plus bucks. You know, real big bucks.
P: Yeah.
L: So it was a very unpleasant experience. Until later we found out that tickets daily pay out for hotel room. So we left that darn place so darn fast we moved into the Holiday Inn and it was like having that
P: that’s awesome. Yes, but the baby but Josh is asleep right is asleep or had all that go.
L: He was wonderful once once he was fed, all that he needed. He was wonderful. So he slept he just got up once or twice during the night. And that eventually changed. And he was so good. Once he was asleep. You could take him anywhere. We used to take him to the officer’s club. Hide him under the table, but the long table clocks were able to eat and nobody realized it was a baby in there. And when we left they sort of
P: I can’t believe you’re going out after the baby’s like two months old.
L: Yeah, yeah, we did. We did. So as long as the baby slept once I put him down at six. And you know, he slept to half the night. It was a big baby and he ate so he was fine.
P: It occurs to me as I will say this that my mother was 21 when she had her first child, so of course she’s going out when a baby is two months old. Were you surprised at how hard it was to take care of a baby or or no, that seemed appropriate.
L: You know what? I’m with the first one that had a baby in my group.
P: Yeah.
L: So I couldn’t ask anybody because nobody had any experience. Right? So mine within and my mother had no idea and no interest.
P: Yeah.
L: in babies So she said if I have to feed him Do not leave him. That was a clear answer. Right?
P: Yeah. Yeah.
L: So I enjoyed it because I really was very happy with him and he was just such a lovely baby. You know, I enjoyed every minute of it. And that’s why I was so broken up when he was crying. I was crying and my husband come home and he said why? Are you crying? I said because she’s crying. And then I don’t know what to do. And I couldn’t call anybody because nobody had children.
P: Yeah. yeah, yeah
L: I was the first one Married and I was the first one that had a baby. Yeah. So I had and I don’t didn’t have cousins or aunts and uncles or whatever task so I was really on my own.
P: Yeah, that sounds tricky. And was it was it cloth diapers or what was that like?
L: It was cloth diapers. It was and we had a service. Thank goodness we had a service. But in the army, they started having plastic diapers. So that’s what I use because I didn’t want cloth diapers because you know who am I going to call? We’re in a motel.
P: Yeah, So it’s like an old time milk man?
L: We’ll get a service. No, no to get a service.
P: No, what’s a service? What does that mean?
L: Oh, the diaper service wouldn’t bring you cloth.
P: You leave them a bag of dirty diapers and then they replace it with clean ones,
L: with clean ones and they count how many I returned and that’s how many I got.
P: Wow, that’s a good deal.
L: Yeah, yeah, that was a saving, saving grace. Because we didn’t have a machine in our apartment.
P: Oh, a washing machine.
L: Yeah, yeah, washing machine. So where was I going to go wash diapers with the baby? Yeah, and I didn’t have a car because my husband’s up the car. So I so I needed something and we didn’t have the paper the paper diapers.
P: Yeah.
L: At that time. So you know, was a whole mess and we just decided that was a good investment.
P: Yeah, that sounds like it so when you’re in the military, that you’re pregnant with number two.
L: Right.
P: And that also, I’m assuming was not planned?
L: Yes. We decided that let’s have a baby in the military so we don’t have to pay anything.
P: Okay. All right. That was planned. And that was the second one easier because you knew what to expect and
L: yeah, I had the same the same episodes with with the nausea. You know, that kind of thing. But, you know, luckily, everything went very smoothly and I had a very nice obstetrician in the army. Very nice.
P: And then so for that birth, this the second one come on time.
L: Ooh, it’s army time. They give you the date. babies delivered. But yes, I was full term I my due date was was February 17. And I came to see my obstetrician. He says okay, you’re ready. Oh, you come in on come break the water and you’re ready to go.
P: Wow.
L: Yeah,
P: now people get really excited if you if you break the water that’s not considered cool for the doctor to break the water unless like things have gone wrong.
L: You know what? I was clueless again. Who knew? Who knew? I certainly was hoping that I wouldn’t have such a long labor as I did with Josh.
P: Yeah.
L: And he felt this baby was big enough.
P: Yeah. So you had an appointment on your due date. And you went in. He broke your water and then did that start contractions? Are you needed to be induced?
L: No, no, I came in on the day before that was my came in the 16. And he says, You know what? You’re ready. Your your due date is tomorrow. Why don’t you go home, make arrangements for your other child and set it up? And come on in. We’ll break the water in and you’ll have the baby. So we did.
P: So you went in like it was a business meeting because you weren’t having contractions. Right, right. And he broke the water and then did your contractions start?
L: In a little while? Yeah, yeah, definitely pretty fast. Labor was was very fast.
P: did you get an epidural for this one.
L: Yes, he did the epidural. He didn’t call him in an anesthesiologist which surprised me but he did it and the only thing I have to say he didn’t stress about drinking water. So I had a lot of spinal headaches when I came home, miserable in the hospital and when I went home, so if I had known that I would have been guzzling water constantly.
P: Yeah.
L: But I didn’t know that in grandma was watching Drush. And she never never heard of it and didn’t know about it either.
P: Well, she didn’t have an epidural. There’s no
L: right but he would think that she’s a general physician. She would have had some idea of women having epidurals and you could have a headache, spinal headache, because you don’t take enough fluids. But she didn’t know anything about that. So
P: that’s totally interesting. And so did you remember how long the labor was with Teddy? Four and a half hours?
L: Oh, that’s quick.
P: Yeah, no, it’s Yeah, yeah.
L: So I like that.
P: No kidding. Yeah, that’s a great reduction. Did you feel the birth or no, because the epidural work,
L: the epidural work, so that was really slow. Everything worked out very well. I said geez, the army.
P: The mission is to get this baby out. Right So did you get to stay in the hospital man Are they kick you out? What do they do?
L: Yes. Oh, no, no, no, I got the royal treatment because my husband was an officer. So unfortunately, the baby got a real treatment. He had his own bassinet in his own room by himself because it was no other officers wives that had babies.
P: Oh they segregated the kids, that’s funny.
L: Yes, yes. Yes, they segregated the wives and segregated the babies.
P: That is strange So what was it like when you brought the second one home because now you have two and you still don’t have much help was my guess.
L: Right? Well, it was work. It was constant constant and you had an almost two year old. You know, when he was a little jealous of the baby. Yeah, he kept pushing when I and I didn’t breastfeed the second one at all. He was 8 12
P: Yeah.
L: But he was a big baby too. And you know what, I didn’t want to go through that and whether he’s getting enough milk or not and I had the two year old. I said, You know what? I’m okay. You know, so I saw with the first one that giving him formula. He turned out pretty well. Yeah, so I just went straight ahead to give him formula for the second one too.
P: Well also this is 1968. So I think the fashion of breastfeeding comes and go
L: oh, at that point. Yeah, at that point, and 66 It wasn’t really an 68 Absolutely not everybody sort of used formula.
P: Yeah. Well imagine postpartum is tricky because you’re exhausted. And have too little babies.
L: You know what, I was just happy to have two healthy kids. And that we were together because Vietnam was hanging over us every single day. Yeah. So in that sense, and and we had, what, six months left, before he got discharged, you know, dad a discharge. So I’m keeping my fingers crossed that we don’t get any letters.
P: Yeah. I would guess that’s a giant dose of perspective.
L: Yeah, right. Yeah. So all in all, you know, there were too many other stresses around. So I just concentrated on the babies.
P: Okay. And then from there, you move.
L: We went back to California. They had a position waiting for dad because he signed and then he got drafted. So they were holding that position for him.
P: So why did you leave California?
L: And that was other things. This was a general practice and they really didn’t explain that to Dad. And he had to do everything from pediatrics to wow, you know, geriatrics to, you know, everything in between. And he just didn’t like that kind of practice. And there were a lot of wealthy communities there that demanded you to come out for a headache.
P: Yeah.
L: So during the night he’d have to drive in the wilderness to find his house. And he says, oh, Doc, give me something. And he’s there stained by the fireplace with the with the drink. And he says, I have a headache. And I just came back from Japan or whatever. So dad does not like any part of it.
P: Yeah, I can see it was I can see what’s not appealing there.
L: And we decided to go to the east coast because he wanted to go back to New York. Plus, we thought we had family. For Kids. Yeah, and stuff. So yes, we headed to New York.
P: Okay, now I want you to walk very carefully through this next pregnancy which is me. So then planned again, am I planned.
L: No, that just happened in my surprise. What happened is I I had my time, it wasn’t a copper T.
P: It’s some kind of birth control.
L: Yeah. So I had, you know, different things inserted. What was on 68? Yeah, but I decided since we’re going east coast, and I was having issues with these new new thing that I would have it removed. Not thinking, yeah, you can get pregnant again.
P: Yeah. Yeah.
L: And that’s what happened on our way across.
P: Oh, wow.
L: Yeah. So I found out that I was very tired and sleepy and totally exhausted to New York. And I didn’t realize that’s one of the symptoms to have early pregnancy. So that’s, that’s when you came around.
P: wait So there’s still no home pregnancy test.
L: And no, we didn’t do anything like that. Okay, we didn’t do anything. So yeah. So we came to New York, and we thought of the heat and the humidity. It was during the summer. And of course, you know, I wasn’t used to that. And that’s why I was so exhausted and everything. But eventually, I got nauseous again. That was one little symbol of what’s what’s coming.
P: I was trying to send several signals at first, but no one was getting it.
L: Nobody was listening. I’m sorry.
P: That’s okay.
L: So how was that pregnancy that pregnancy? It was normal in that sense. It’s just that we were stuck in a motel room with, you know, with four of us. Yeah, two little ones and I was pregnant again, and I was sick. And dad was starting this new practice. So he was gone all day.
P: Yeah.
L: Sometimes in the evening, too. So I was just, you know, it was just hard there. It was very hard, and to be stuck in the motel with the heat and the air conditioning, not working and no car you know, so yeah. So that that was a difficult kind of thing, but not because of the pregnancy.
P: Okay. And then okay, and then for my birthday, do you? How did that happen? How did you know? My birthday was the day
L: well, that really annoyed me because I my obstetrician who I loved, and I think he was so great, but he wasn’t available. He had emergency, you know, delivery or something. So I saw his partner. And he he said, oh your Do you know and I was you know, maybe closing in on my ninth month. And he says, Why don’t you come on in and because you tend to have big babies and we don’t want to worry about that. Make it easier. Just come on in. And you know, we’ll give you some and we’ll induce labor. So I said no, I don’t want to do that. I said, Maybe this time I will wait till the baby is telling me yes, I’m ready.
P: Yes. Now you’ve got wise. Yes.
L: Yes. Yes. You know, you learn from each one. Yeah, but the thing is in the army, I was really due. Yeah. And everything was was just just the right timing. But what happened is that Dad told his mother, that this is what the doctor said. And we had to figure out if she would come and help us take care of the two kids at home. And that’s when I could go in the hospital. And at the time to was February, and he wanted me to come in on the 17th. I said, No. I said I’m not having two kids. Born on the same day.
P: Yeah.
L: it’s Not necessary. I’m not sure we due. feel any. I felt Braxton Hicks kind of things, but not labor.
P: Your kids appreciate that. Way to stand your ground.
L: Yeah. So then, he said, Well, your taking chances he tried to scare me. I didn’t. didn’t appreciate that. So I said thank you. I’ll think about it. And I just wanted to get out of his office because I said no to I called my obstetrician. And we were at that point on first name basis, because of the doctor community kind of thing. Yeah, he was just the warm person. And he didn’t want me to call him Dr. Stall. So he’s just call me. So I called him up. And I said, your partner, which I named, he wanted me to come in that you would do pit and just induce labor. But I didn’t want to and I said why can’t I wait and have the baby when when this you know, I didn’t know what your boy or girl there’s no way of testing that. I said I’ll wait till till I’m in labor. So he says okay, okay. But then what happened? I got pressured into the following week, because grandma said the only time she could come with the following week to take care and help me out.
P: So Grandma decided my birthday.
L: Yep. Yeah,
P: was she still a practicing doctor at that point.
So, to give a little background here, my grandmother is also a doctor, now living in NYC, and my parents have moved from the west coast to the NY suburbs to be near her. My grandmother and my father were also war refugees who came to the US in 1950…so although she’s a doctor, she had to start her life over again in the US, and had now been in NY for about twenty years…as you can hear for a variety of reasons she and my mother always have kind of a contentious relationship
L: Yeah, I wasn’t happy about that. But dad didn’t want to be left. Taking care of kids. Yeah. So he sort of pressured me to go in the follow me. Yeah. And, you know, with with all the arrangements and the baby with was fine, and you were in position, so nobody saw any problem with that. And Dr. Stall said, Look, we’ll give you pit, if it doesn’t work. You could go home and your weight of it works, then you’ll have your baby.
P: How far from the due date?
L: Pretty close to close? But I think babies gain most of their weight the last two weeks, yes, three weeks.
P: According to the american…
L: And the other doctor told me that you were smaller than than the other two users. Oh, you had only bruisers. We don’t want that. You know, that kind of, you know, attitude. So he said it’ll be easier on you and get on everybody. And he was he was always concerned about you know, problems with the umbilical cord and all that kind of thing. He was trying to scare me into certain things.
P: Yeah.
L: You know, so when I said that’s the only time she could come. What am I going to do? Yeah, I didn’t know anybody here either at a new place. Yeah. So I couldn’t get somebody else to come in and help me and I wouldn’t trust a new sitter to come and take care of the two kids. That’s how we did it. I went in. They gave me pit and, you know, I had you
P: and how was that delivery?
L: Fine, and I had the epidural, and you came out and there is no worry about the umbilical cord or whatever. But you were seven pounds six pounds. Okay. Yeah. So you were much smaller than my other two.
P: Yeah. Yeah. Yeah.
L: So, so by the fourth one, I lay down the law I said I’m not coming in You know what, this baby is going to tell me when it’s coming in and I’m not coming in at all. So until it until it’s it’s time, but this you know, the fourth one of course I had the amniocentesis
P: wait so let’s go go slowly. Then the fourth one because there’s a big gap between me and the next one.
L: Yes, you came out. Everything was fine. You’re beautiful. You’re healthy and and it was like three and a half hours. An hour off.
P: You’re shaving off the hours that well done.
L: Yes. Three days in the hospital that out? Yeah, that’s not too bad. Yeah, yeah. Well, I was fine. If everything is fine. You know, and how we’re
P: we’re still doing formula but now we’re doing plastic diapers is my guess.
L: Yes. Okay. Yes.
P: Okay. Yeah. And then there’s an eight year gap between me and the next one. Right. So that one is a surprise.
L: Yeah,
P: were you 35 for that one?
L: I turned 35. in December. She was born in January.
P: Yeah, so you just turned 35 But nowadays, they call the geriatric pregnancy
L: I know, but yet a lot of people have them this late.
P: No, I’m not saying they’re right. I’m just saying what was the reaction? Were you older at the time to be having another baby?
L: You know what, after the three normal births and I never had any problems or issues my obstetrician wasn’t worried.
P: Let’s talk for a second about how different it was between the first and the fourth. Okay, for the first year 21 of your child and for your 35 so
L: 3434 Because that’s my whole pregnancy. was when I was 34.
P: Yeah, that’s true. Yeah, that’s a good point. So 34 for the second one. How much has the doctor’s office changed? And do you get a home kit for this one to know that you’re pregnant?
L: Well, I went in and they did the test. Okay. I didn’t get home. They didn’t take it at home. And he he examines you so he knows right away that you’re pregnant,
P: but did you go because you felt nauseous? Or what was your
L: I had the same thing and I just, you know, I said, I’m pregnant. You know, I knew that after we were out in the motel once we got a rental and moved into the house I was looking for an obstetrician. And it was funny because we we met the obstetrician at one of the doctors parties, and he bumped into me and he spilled a drink on my dress. I got so upset because I sewed it. I made the dress and it was a pregnancy. Yeah, very elegant dress. And he says, Oh, he says I’m so sorry. He says, please send it to cleaners. I will pay for it. Don’t worry about it. And he introduced himself and they said, I see you’re pregnant. He says who you’re going to
I say don’t have an obstetrician. A pretty good one. It was very, very sweet and very, ebbullient genuine
P: I hope you looked around the party to see if he wasn’t spilling drinks on everyone and that wasn’t
L: no and I asked around and they knew there were three of them. The other guy was his brother in law. And another guy but he was cold. I didn’t care for him. He was a good technician. Like cold.
P: Yeah,
L: that’s how I met sigh and then I you know like you fall in love with your obstetrician. He was one of those guys that so, so nice. You know so caring.
P: In this taped conversation i didn’t press to know more about the idea that someone would “fall in love with their obstetrician”, but I called her back to ask about that, and it sounds like this doctor was very solicitious when it came to my mother’s care. If she brought some fear up in her appointment, he’d call her a few days later to check on her. I’m guessing that this kind of special treatment is a reflection of the fact that she is a doctor’s wife, and when she says “fall in love” I think she means, you form a real emotional attachment to someone taking such good care of you during this vulnerable period
L: When I got pregnant the fourth time grandma just seated Him with all these What if something is wrong? What if you know, baby has such and such whatever so dad said you know we are taking a big chance we always throw the dice when we have kids.
P: Yeah.
L: You don’t know there’s no test. There’s nothing and I said you know what? Whatever happens, I will take care of it. You don’t have to do anything. You haven’t done any You haven’t changed a diaper you have the baby.
P: Good news. More of the same
L: what’s the Difference. What’s the difference? I said this is what what I’ll be doing again. I would love to have another child.
P: I’m guessing he because he was worried about the baby big do an amnio?
L: Well, that’s why I went back to Sy and I said look, Hank is up to the very upset about it. So is there anything I could have as a test to see if everything is okay with the baby. So at that time, that procedure was just coming out and insert that big long needle and draw the fluid out. And you know his story. He did it the first time with all the students around and dad was there front and center to watch him and he drew blood And everybody gasped and he took the needle out real fast dad was so white they walked him out.
P: his concern is that if you draw blood, it’s an increased chance of aborting the fetus
L: aborting Yeah. So he begged me when he could do it again. And carefully because he’s working with the monitor.
P: Yeah.
L: To see wherever it is. And he just to insert the needle again. And he said he promised it would be quick turnaround to the students and he said I don’t want to sound or else out of here. You know, yeah, I didn’t want anybody saying anything. So since I was already there, I said just do it because it would ease so much other things.
P: Yeah,
L: at home. So he did it and it worked really well smoothly. But he told Dad, to drive as fast as he can. put me to bed, put my feet up and not to move for a whole day.
P: Okay.
L: 24 hours. So once I pass that it became sort of safer, that I’m not aborting. Okay, but I would have been would have been very upset.
P: How far along were you?
L: I think it was three and a half or four months at that point and that was so hard for now. was later on? Yeah. It was wait. It wasn’t like six weeks?
P: Yeah, yeah, that’s like 16 weeks. And at this point you’re probably showing earlier because you already have three kids.
L: Right, right. Right. So and we had a wait for a month.
P: Or oh my god that’s crazy
L: I was ready to just just scream by the time it came. And at the same time dad got the Tay Sachs We never did the Tay Sachs and we should have done it for the other two because we are both European jews
P: Yeah, you mean he just got the test for it while you’re waiting for the amnio .
L: Yeah, yeah. And they said you want to do what do what tests? No, I’m having big tests. Like,
P: was he negative?
L: Yeah, if he’s negative, I’m okay.
P: So Tay Sachs is a terrible disease that causes all kinds of problems for babies who usually die by the age of five. Anyone can be a carrier for this genetic disease, but it’s much more common in Jews of European discent…about 1 in 27 people in this category are carriers, carriers don’t have symptoms, and to pass the disease on, both parents have to be carriers. if both parents have the genes, the baby has a one in four chance of having the disease–
L: yeah, yeah. So that’s that we did that that time.
P: When you get the annual results, is it a letter in the mail?
L: Oh, with the whole packet. Sy got the report, too. But he called me in because he didn’t want to say it on the phone. I was so nervous and he gave me a kiss on the cheek. He says everything is fine.
P: Oh, good. Okay, good.
L: Yeah, yeah. So until until I got the whole report. And they had the X chromosomes, you know everything. I have the whole report. I want to see that. That’s cool. And of course told the sex of the child but I never told anybody. So we made a pack. Nobody knows.
P: You and dad knew.
L: Of course it’s on the test. So that’s a secret you definitely kept from us.
P: I remember saying if it’s a boy, I’m gonna send it back.
L: I was like, sister, I remember being pan I was so excited. I was so excited that you’re going to have a sister never told her friend nothing. I was very excited. And after four months, I finally was able to enjoy the pregnancy.
P: Yeah, it sounds like you enjoyed all of them to some degree.
L: Well, the first first three months were Yeah. And I’d had every, every one of them exactly the same. Nope, nothing changed about one and four. So once after that, it was it was very, very nice.
P: But now it seems like you’re wading into technology in that you have an end of this time you have a definitive blood test to find out that you are pregnant, and did not have ultrasound or you did no,
L: we still didn’t have ultrasound, we still didn’t have
P: so what’s the scan that the OB uses to do the amnio?
L: He’s connected to a screen and everything at that point. But in the doctor’s office, we don’t have that
P: so that they have ultrasound there just for this test.
L: Yes. Just to see where he’s putting the needle and
P: it’s not regularly available so people aren’t getting this.
L: No, no, this is all new. This was all new. That’s why all the students were there. Learning. We were right on the foreground with this test.
P: That’s amazing. And then I remember I remember going to the hospital so you must have started started having contractions
L: on the 16th of January.
P: Yeah,
L: he said on the 16th of January. I woke up with
P: Wow.
L: Go figure
P: nowadays, if you have contractions they say don’t come to the hospital until two minutes apart. Where they tell you
L: Yeah, well the thing is, I went to the office first. Perfect. And he says yes, you’re in labor. But he said you can’t go to the hospital yet. But you have to, you know, wait till till they’re closer. But there was a blizzard coming,
P: I remember that.
L: When I went further along, went to the hospital because his partner was there. So he said to you and he said you better hurry up because ready
P: Wow.
L: So Sy had to zip out and go to the delivery and he broke the water. Okay, just was the final thing and boy that was it. Was a very hard labor. It really came on very, very strong, much stronger than then with you. Or Teddy.
P: How long were you labor for?
L: three hours
P: Oh, okay, so still is almost the same length as mine. Yeah, and no Pitocin I’m assuming
L: no, no. Pitocin and the thing is, by the time he gave me the epidural on the delivery table, yeah, not in the unit. You know when you check in, but um, delivery table, and then she was born and I don’t think the epidural even took effect.
P: Yeah, yeah, it’s too late. Yeah,
L: I felt everything. But everything was was nice. And so I was so happy because the umbilical cord was so short. Which was good because I worry about wrapped up in everything. And he kissed his babies when they were delivered. If it always gets the babies, and he had he had students there. this time? Not the last time but it was great. What’s good.
P: So, so two questions. One is dad is never in the delivery room.
L: No, he didn’t want to go in. He went in with Dr. Cheek with Josh. Okay. And I was in such pain with the contractions and he gave me the laughing gas because the epidural had worn off hours before and when he gave me laughing guess, Dr. Cheek said. You’re not helping at all leave. And he kicked him out
P: It wasn’t common to have the husband in the delivery room or was not. No, it
L: it wasn’t common. The fathers so we sat outside but since he was a doctor, they let him in. Yeah, yeah. But each time after that when they said you want to come in. That’s it? No. Wait outside.
P: Yeah, that’s helpful. Okay. Yeah. And then no female gynecologist were to be seen
L: at that point. No. No, all of them were men. Yeah. All of them were men.
P: so I was curious about this and looked it up: according to the LA times, in the 1970s roughly 7% of gynecologists were women…now its 59%, so what my mom was saying is true, pretty much all of them were men
P: so you seem like you have changed a lot over the course of those four births in that you were such a like deer in the headlights for the first one.
L: oh definitely, are you kidding
P: Right and you just didn’t know how any of it was gonna go right. You know how what pregnancy would be like and what were 50 like and
L: and they didn’t have those classes to come into the hospital. expecting parents to come in and be take you on a tour. This is where the delivery this is whatever. And you certainly didn’t have any lamaze classes. Let’s put it that way. Yeah,
P: yeah. By the time the last one was born, there were like breathing glasses and stuff, right?
L: Yeah, yes. Yeah.
P: You didn’t want to go
L: you know, was my fourth one. You know, I knew what to expect.
P: Yeah. Yeah.
L: And I felt very comfortable in my obstetrician.
P: Yeah, God, you’ve had quite a ride.
L: Yeah, yeah. I got stronger and more confident of telling them what I want. Like, like the last one.
P: It more assertive yah, yah,
Thanks again to my mother for sharing her story and for hanging out with me on Thanksgiving. Women of her generation seem very strong to me, to deal with the massive uncertainty of this process with much less than future generations would enjoy. One thing we didn’t talk much about was the postpartum period, and when I called my mom back to see if I’d missed anything, she said, that there were no lactation specialists…the nurse helped you with breastfeeding in the hospital and then if everything seemed okay, you were sent on your way and the doctor didn’t check you out again until six weeks later…although so much has changed around pregnancy and birth, not enough has changed around postpartum care, since it looks very similar today to what it looked like 50 years ago…that’s a frontier to work on for sure.
Thanks for listening. If you liked the show, feel free to share it with friends.
We’ll be back next week with another inspiring story
Episode 36: Stroke in Pregnancy, A Postpartum Tale: Lauren’s Story
Episode 36 SN: Stroke in Pregnancy, A post partum Tale: Lauren’s story
Lots of different inputs go into the project of starting a family; for many of us this includes a host of doctors: fertility doctors and OBs and anesthesiologists…and for today’s guest that list is even longer, extended to include pain doctors and ER doctors and neurologists because she had a stroke after her delivery. Some of the doctors who participated in her project did so because the symptoms she suffered after the delivery were attributed to a spinal headache instead of a stroke. Her’s is a story of amazing amounts of resilience and an inspiring amount of overcoming and it’s also one that highlights some of the glaring holes in the medical system.
If you are looking for Lauren’s work, you can find her book, Why She Wrote here, and her podcast, Bonnets at Dawn, here.
Birth control and blood clots
https://www.webmd.com/sex/birth-control/birth-control-methods-blood-clot-risk
Serena Williams birth story
https://www.vogue.com/article/serena-williams-vogue-cover-interview-february-2018
Racial disparities in pain managment
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/
https://pubmed.ncbi.nlm.nih.gov/29688509/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6905121/#R7
Audio Transcript
Paulette: Hi, Welcome to War Stories from the Womb. I’m your host Paulette Kamenecka. I’m an economist and a writer, and the mother of two girls. Lots of different inputs go into the project of starting a family. For many of us this includes a host of doctors: fertility doctors and OBs and anesthesiologists…and for today’s guest that list is even longer, extended to include pain doctors and ER doctors and neurologists because she had a stroke after her delivery. Some of the doctors who participated in her project did so because the symptoms she suffered after the delivery were attributed to a spinal headache instead of a stroke. Her’s is a story of amazing amounts of resilience and an inspiring amount of overcoming and it’s also one that highlights some of the glaring holes in the medical system.
After our conversation I spoke with an assistant professor of neurology to walk us through some of the medical things that come up.
Let’s get to the story.
P: Hi, thanks so much for coming on the show. Could you tell us your name and where you’re from?
Lauren: Sure. Thank you for having me. My name is Lauren Burke, and I am from Chicago, Illinois.
P: That’s fun. So I lived there for many years. Where do you live?
L: I’m a life long northsider
P: Oh nice….So let’s talk about pregnancy before you got pregnant, I’m wondering, what did you imagine pregnancy would be like?
L: So here’s something kind of weird. I was not going to have kids, I decided. So I was sort of like, you know what, I don’t know if this is going to be the right track for me. And that’s partially because I had had so many friends who just had terrible experiences. And then also I live in the city and a writer, money just like that. That whole situation. So I was like, You know what, I don’t think that that is going to be the right scene for me. I was terrified. of childbirth, as well. completely terrified of it. I think this was like my late 20s.
I had done this thing where I was like, You know what, I need to get in better shape and have this like cystic acne that keeps recurring and I keep trying everything and let me like, just really work out really hard. And let me go to the dermatologist and get all of these things under control before I’m 30 this was like my goal. It’s like I have all these goals before 30. So I went to the dermatologist and she was like, Okay, I’m actually let’s put you on Yaz. And that will clean up your sleep that.
P: What’s that?
L: So yes, is a birth control.
P: Okay
L: Because she was like, you know, the reason why nothing has been working for you, is because it’s hormonal. So let’s get you on birth control. And then exactly six weeks later that my follow up appointment. That day, I was feeling really weird. I was like, out of breath. I was really dizzy. My friend actually offered me a ride like out of nowhere. Just offered me a ride to the doctor’s office cuz she was like you You seem kind of weird last night. So do you need a ride? I was like yes. Please. So we go to the doctor’s office, and she’s like, well, your skin looks great, but something’s going on with you. And she sent me to the ER, and I was having a pulmonary embolism.
P: Oh my god.
L: Blood clots everywhere. is basically how the nurse came back and she was like, yeah, they’re in your legs. They’re in your lungs. They’re all over.
P: Oh my god.
L: Yeah. So I was hospitalized.
P: I brought question about the link between birth control and blood clots to neurologist today. I’m excited to have Dr. Nichols sir on the show. She’s an Assistant Professor of Clinical neurology from the Miller School of Medicine at the University of Miami. Dr. Sir, thanks so much for coming on the show.
Dr. Sur: It’s my pleasure. Thanks so much for having me. Why birth control create the risk for blood clots.
Dr. Sur: So the risk there is really due to the to the hormones, mostly estrogen so birth control are basically hormonal pills and there are estrogen in the birth control. There’s estrogen and progesterone, which is another hormone birth control. And the risk mostly comes from the actual estrogen because estrogen increases the concentration of clotting factors in the blood when there’s increased concentration of clotting factors, the blood can be more prone to clotting.
P: So estrogen is sending signals to your bone marrow to make more clotting factors.
Dr. Sur: That’s correct. That’s kind of the pathophysiology.
P: One thing I wanted to add here is that according to webmd, blood clots are rare even with birth control. The rate is something like a point three to 1% over 10 years, you’re at a higher risk for blood clots with pregnancy than you are with birth control. And that’s again because of hormonal shifts.
L: You know, I also had a pleurisy let’s call it so I had this irritation in my lungs and it was very painful. And there was like 12 hours of just pain. And it was really bad.
P: And that sounds like a 17th century problem.
L: Yes. Like it does. it’s so weird. And I was at Northwestern. So I had all these residents that kept coming in because they were like, Oh, this is this is interesting. We don’t see this every day. And after 12 hours of that, like turned on my husband. I was like, You know what, I think I can give birth because like, that was awful. I survived it. And I just like had this weird change of heart in the hospital. I was like, You know what, I think I want to be a mother. I want to take a kid to Disneyland. I don’t know what it is and she was like, Okay, let’s give this a couple of years and figure this all out.
P: Yeah,
L: at that point, that’s when I started sort of maybe eating up a little bit more on pregnancy and then I saw a ton of doctors because obviously I just had this PE and we needed to see if I had some sort of blood clotting condition or if it was just provoked by Yaz. And then what we needed to do so then. Yeah, so then I went on sort of like a fertility journey, which was a fun time.
P: Yeah, I mean, this will be this will be interesting if you actually did have to go through the fertility gauntlet went because I too, went through the fertility gauntlet at Northwestern.
L: Oh, did you? Yes. Oh, we’ve probably crossed paths. Yeah. Because that was a couple of years of going to various doctors, lots of blood tests. I did find in OB that really specialized in this and he was very much of the mind that it was provoked and that I could have a normal pregnancy we would probably put me on a low dose blood thinner. And he said like no epidural. So that was kind of my plan.
P: Wow.
L: And then I had sort of a journey getting pregnant because it was not happening. It was just not happening right away.
P: Yep.yep.
L: And then I had some miscarriages as well, which then kind of triggered the doctors because they’re like, Well, maybe she does have a blood clotting issue. Maybe this is related. They really wanted to kind of tie it back to that PE so there was a couple of years of just trying to figure out why I couldn’t carry on a pregnancy what was going on,
P: let’s go a little slower here for one second. So first positive pregnancy tests you are pretty excited right my friend in a miscarriage also I guess people say oh, you’re not supposed to say okay, at least you can get pregnant, but I’ve been trying for a year and a half. So for me, right for me to get was actually a big deal to get pregnant at all. Up until then there was no evidence that I could, yeah, did you have that feeling as well? Or were you was it still just
L: totally very excited? Yeah. Really? Just like, Yes, this is this is it at that point, too. We had just purchased our house, and I just really felt like the timing was right. I felt like I was at a good place with work. Like it just felt like the stars were aligning.
P: Yeah, yeah
L: super happy about it. And I think and I lost that baby. I think I was I mean it was like 13 weeks.
P: Uugh..that’s late
L: So it was late. It was late. And it sucked because I did definitely I told my mother of course first. Like a weekend was very much like don’t tell anyone.
P: So that’s a weird cultural thing. Right? I talked to a therapist who wrote her dissertation on the idea that we all I mean, I feel like my doctors told me Don’t tell anyone. So after the first trimester is over, Oh, for sure. But the therapist was like That’s nuts because you’re going to need support
L: and like in 11 weeks, I was like, this is fine.
P: Yeah, yeah, totally
L: So my family was like super excited. I had not told work yet. That was the only thing I was really nervous about because I was nervous about what are the one of the repercussions of this honestly, yeah. What projects will I have taken away from me?
P: Yeah,
L: was really the thought but that kind of sucked because then I had my miscarriage. And I had it on my birthday too, which was insane.
P: The gods have their backs turned. That’s not fair. That’s not cool
L: It was crazy. Not cool. Then I just kind of like politely ducked out of work. And I think everyone thought I just was going to celebrate an early birthday and no one had any idea it was going on. And then I just didn’t want to tell them and it just was kind of a whole awful awkward situation.
P: Yeah.
L: I was like, I need a few days off. It’s personal. I don’t want to talk about it
P: Yeah. Did you have support when that happened?
L: Yeah. And I think I’m the kind of person to like, I want I want to take care of everything. So I think with that miscarriage I kind of almost just powered through my friends were great. My family, they were great. My husband was great, but I kind of was just like, well, we’re just gonna carry on. We’re gonna soldier through
P: Yeah, yeah.
L; And I was almost feeling part of me was feeling almost a little positive because I was like, Well, I know I can get pregnant. Okay, so that’s a good thing. So we know that but what’s going on? You know, I can’t carry on this pregnancy. So yeah, but then I got pregnant again, probably two or three months after that.
P: That’s awesome.
L: That was great. Yeah. And that that was Audrey. So that is yeah, my daughter, so
P: oh Wow, good,
L: okay, that worked.
P: And so are you again, are you nervous for the first trimester or do you handle it differently?
L: Totally. Totally. Like, won’t tell a soul completely terrified. Yeah. Yes, absolutely. I remember my husband’s a marathon runner.
P: Oh, wow.
L: And so I found out the day of the Chicago Marathon.
P: Oh, wow.
L: I woke up and was nauseous and felt like I had the flu. And it was like the first marathon I’d missed. Like, in 10…11 years. I was like, I can’t believe I can’t make it to your marathon today. And ended up being like his best time ever. And then he came back and I was like, I have not taken a pregnancy test. But I know that I’m pregnant. This is not the flu. And he was like, Okay, so let’s, yeah, we’re just gonna keep this one under wraps. But I went to the doctor immediately because of the the blood clotting issue. We knew that we had to we had to do a scan and we had to make sure that the you know, everything looked good. Because they were going to start me on a blood thinner pretty quickly. That was and that was, I think, yeah, maybe just a couple weeks after that. And then I was doing heparin shots twice daily.
P: Wow. So that sounds like they determine you did have a blood clotting issue.
L: This has been back and forth. This is the great mystery of me. Someday, someone will figure it out. But they were ruling that they didn’t think there was a blood clotting issue, but in case there was
P: okay,
L: we’re just gonna do it to be safe.
P: And for some reason because of this blood clotting issue and she you can’t have an epidural because your blood will pool while you’re laying there.
L: Yeah, so gosh, how did he describe it? So I will say this doctor who was like, Don’t do the epidural didn’t give me a ton of details. He was very much like, I remember him being very flippant. about it. He was like, Don’t do it. They don’t really work anyway. Just great for the hospital surveys. It was something along those lines. It was very flippant. He’s like don’t do it. It’s gonna mess everything up just as long as you don’t do the epidural, you’re fine. And then he had referred me to an OB who was a woman is great who’s still my OB. And I said, What do you think about this? And she’s like, actually, no, I’ve had women that have come in with the same thing. And her thought really was that you know, yaz, was the provoked the blood clots, and she’s like, honestly, we’re just doing this to be safe. I think you can still have the epidural. We’re going to you’re going to be on Heparin at that point in your pregnant pregnancy. And at that point, we will just time it out. We’ll try to time it out. So like you’re in between shots. Okay to give you the epidural
P: So, Quick question, Dr. Sur. Why are we concerned about the epidural if Lauren’s on Heparin?
Dr. Sur: It sounds like the issue there may have been because of the treatment, the way you treat blood clots circulating in the blood, especially if they’re enough to cause PE or pulmonary embolism. So a blood clot in the lung. So that’s treated with blood thinners. Or anticoagulation. So now the risk instead of clotting, the risk is then bleeding. And so it’s kind of weighing the risk of clotting versus bleeding. So so with an epidural, it’s essentially a spinal puncture so the risk is bleeding on anticoagulation
P: and then once you cross the first trimester, feeling better, how do we feel?
L: Feeling great, was traveling. I had some stuff going on for work. Still not telling anyone didn’t tell like partly what I told my best friend who was dabbling with but didn’t really tell a ton of people that I was pregnant until I started showing, honestly,
P: okay, that makes sense
L: Yeah. And then I was like, surprised.
P: And then how was the rest of the pregnancy?
L: Great, besides giving myself shots constantly, which was a pain in the butt, especially when I was traveling. Yeah. My pregnancy was fantastic. until like, the very end when I was just I was just sore all the time, obviously, like just normal stuff, but nothing. Nothing out of the ordinary. It was like very smooth sailing. I think that was one of the things that like, threw everyone off. Later on, because everything was so great blood pressure, great weight, great, like everything.
P: So how far did you make it? Did you make it to 40 weeks?
L: Yeah, so my daughter’s due date was June 11. And she was born on June 8.
P: Wow. So take us to the day like how do you know today’s the day what what happens to your house?
L: That Day was insane. There was recently an article about this, but I was actually that day on the phone between Northwestern and Blue Cross who was my insurer, because they were sort of arguing over the payment for a scan that I had when I was pregnant with the child that didn’t make it miscarriage. So they were like, Oh, we’re billing you full price because it ended in a miscarriage. And I was like, was pregnant when I had the scan.
P: That that’s nuts that insurance companies live in their own bizarre world. That could be a podcast itself, right.
L: it could be it absolutely could be. So I was going back and forth. And there was things that were coded incorrectly and and I was like, Can we code it correctly? Yeah. So it was back and forth with them for a really long time. And at one point, I had to leave the video conference and go to the bathroom and I just felt really weird. And I came back to the video conference, and I just was like, have you guys worked it out yet? And they were like, we’re still talking about the codes and bla bla and I sat down and my water just burst.
P: Oh, wow.
L: Like comedically, like like it was in a movie. And I said, Well, I have to go because my water has broken and I’m going to have a baby. So I really hope we can work this out at some point. And that was about four o’clock on a I think that was a Friday. And I was like, oh my god, I can’t believe this baby is coming like at rush hour or Yeah. And it’s so Adri now that I know her. I’m like, Yeah, you would do that.
P: That’s very funny. I hope we live close to Northwestern at this point
L: seven miles.
P: oh….that’s not close in Chicago
L: In Chicago traffic that is not close. And I was waiting I waited for my husband to come home. So he got on the metro and he was home pretty quickly gets home by five and we right at five like we get on the highway to go to Northwestern and we are just sitting in traffic for a while. Yeah, we got to the hospital around like 615 ish. Yeah, I want to say and everything was calm, like everything was just chill. It was very fun. It was fine.
P: were you having contractions?
L: they were far apart. Okay. But I had called my OB and I was on the phone with her nurse and she was like, why don’t you to come in right away? Because we need to get blood tests going and stuff like that. Yeah. And I was like, all right. I feel great. I feel fine. I’m just like in the car. Listening to music. I’m like, strolling into the hospital. Everything’s fine. I think until like seven 730 And that’s when the action just like hit me like a train.
P: uh Oh,
L: that’s when they were like, oh yeah, this birth is happening. Like very quickly. So I remember I was in sort of, you know, they bring you in that like first room, I guess. It’s like the triage. Like, yeah, at Northwestern, and then it’s just chill. And then it was around 730 I was like, oh contractions big time. Everything’s happening. And they’re like, Okay, let’s take you upstairs. To the mainstage with all the lights.
P: Yeah, yeah.
L: Yeah. And then contractions were coming very hard and very fast. And they had taken my blood as soon as I got in there because they wanted to know, you know, when was my last heparin shot?
P: Yeah.
L: The blood results were taking forever. I think they even took a second set of bloods at one point. We just weren’t getting the results inside. It just felt like it felt like forever. Yeah, just waiting and waiting and waiting. And I don’t know what time it was, but I was just like, can I have an epidural? Because this is happening. I thought, I’m going to give birth like soon and the OB wasn’t there yet. Because they’re like, It’s first time waiting on bloods like, just, you know, we’re just going to work through the pain and I was like, No, I think this baby’s like, coming tonight. And everyone thought I was crazy. But then I remember at one point a resident came in and she was like, it’s coming fast. Like this is actually quite fast like we do. We actually do need the doctor here very soon.
P: So that means you’re pretty dilated.
L: I was pretty dilated. I think I was about I was like like maybe 8 when results came back by then they just ran in the anesthesiologist. And at that point, I was having some pretty hardcore contractions. That is when I had my epidural, which kind of set off the chain of events that were not so great. So
P: yeah, I mean, that alone is pretty tricky, right? Because you’re you’re supposed to bend over and be still which is not relaxing. Right?
L: I could not be still at that point. Yeah. So I yeah, I remember sitting up on the bed. Really. It was, it was hard. And he’s doing the epidural and suddenly my right leg just like shot out. I said Starburst. Everyone was like what? And the anesthesiologist was not super kind. He came around and he said, Well, you should have told me that you had scoliosis. I was like, I don’t have scoliosis, to my knowledge. And he was like, Well, I think you do. And he’s like there’s a puncture. And you might have a spinal headache. Or you might not might be fine who knows? And then he just kind of left
P: Good Lord.
L: I was like, what happened there? And I felt really strange because obviously, the epidural didn’t take. I was leaking spinal fluid. Oh, so yeah, so it was dizzy. And I was still feeling everything. Yeah. Still just yeah, basically just gave natural childbirth. So yeah, I remember saying to the nurse, I don’t think that worked. And she was like, Oh, what happened there what was going on? Because he didn’t really communicate with anyone else in the room as far as like what had just happened. And so you know, she had to kind of go after him and was like, what, what’s going on? And, you know, we need to talk to the OB who still was not there at that point.
P: Yikes.
L: So it was kind of like loose chaos. Yeah, I was in a lot of pain. And I know they gave me something but I’m not sure what it was. At one point. And then, very soon after, it was just like, it was just time it was just time to give birth because it was just happening. Like, it was just like a freight train. It was crazy. So I gave birth at 2am. So you know how so? Yeah, it happened to start at like 730
P: that is fast…thats 10 hours…
L: Yeah, it was really, really fast. I remember to at one point, I looked at B nurse and I said, How many babies do you think you’ve delivered? And she was like, Oh, I just I couldn’t even I couldn’t even begin to tell you and I was like, Okay, we’re gonna do this because I’ve got to push. I’ve got to do it. And she was like, No, can you wait like 20 minutes? I was like, I absolutely cannot wait 20 minutes and she was like, okay, so then we just did it. And I didn’t push for very long. I pushed maybe maybe for an hour. I remember Audrey was actually on her way out like she was it was the last push. And the doctor came into the room and she goes, Oh, we have a baby.
P: Wow
L: We do. So yeah, so that was Santa to ham. All good. I felt very dizzy or really
P: are we doing anything. For the leaking spinal fluid, or do they patch you up or something?
L: I think at that point that OB had, did not know or was not briefed just yet as to what was going on. So we were just kind of carrying on as normal pretty much and then it wasn’t until they got me down into the room. I think it was like the head of anesthesiology came in and he was assessing me and he was like How are you feeling? I heard about what happened like what’s going on? And I was like, I just feel really dizzy. And he’s like, okay, he’s like no headache. No like no stiffness in your neck. No, like, no. I mean, I’m just completely out of it. I don’t know. I just had a baby. This might be normal.
P: yeah, Yeah.
L: And he was like, Okay, so we’re gonna continue to monitor you. And then I kind of knew it was serious, maybe like an hour or two later because I kept getting visits from like, anesthesiologists. I guess they kept coming in.
P: Yeah, that’s unnerving.
L: Yeah. And I was like, oh, something’s wrong, because I didn’t really know what a Dural puncture was right. I was like, I don’t know what went wrong like some spinal fluid leak. Does that mean it sounds bad? But yeah, no one’s freaking out. So yeah, it seems like this might resolve itself. And also when he left the room, he was so casual like, well, you might have a headache. So
P: okay, so what’s a dural puncture and how does it cause a headache?
Dr. Sur: So the way that an epidural is done they use a spinal needle so long needle and the needle is placed in between the vertebral bodies which are the you know, the bones that make up the spine. And in between the vertebral bodies you have a disc you pass the needle through this disc and through the spinal ligaments and into what’s called the epidural space. So this is outside of the dura, which is the membrane that covers the spinal cord. The idea is to not touch the dura, it’s to land the needle just before the dura and allow the medication to pass into the epidural space. The anesthesia numbs the pelvic area so that you don’t feel the pain of the delivery of the labor. It’s a very small space. And one of the risks is that the needle has passed too far and hits the actual dura. Then you’re in the compartment of fluid that bathes the spinal cord and bathes the spinal nerves with a Dural puncture. This is commonly done when patients have what’s called a lumbar puncture or a spinal tap. So the needle is intentionally passed through the dura to collect the cerebrospinal fluid or if that’s not the objective in an epidural anaesthetic, the CSF or cerebrospinal fluid leaks and that will change the pressure is dynamic around the spinal cord and within the skull, and that can cause a headache that low pressure can cause a headache.
L: I mean, I guess I’ll have a headache.
P: spinal fluids is one of those things that sounds like it needs to be on the inside. Yeah, any on the outside.
L: It seems it seems like a serious situation. But I just was like maybe this is okay, because everyone’s acting very calm about it until they were Yeah, yeah. Until about 5am. Yeah,
P: you’re dizzy laying down.
L: Yeah, and I tried. I was trying to explain it at one point like, like an old tube TV like when it sort of like blinks?
P: Yeah,
L: was kind of like what my vision was like, like it was like I couldn’t settle. Just kind of couldn’t focus on one thing. It was kind of like I was like blinking out a little bit. So that was an even lying down. So yeah, that was what I was experiencing at that moment. I told someone that I was like, I can’t really like, focus on you. Everything’s kind of going hazy. I felt like a plane that had been depressurized, I guess in a way just sort of like waving in the wind and weird that point they were like Okay, so we’re gonna try a couple of things. And this was also very complicated because I’m back on Heparin, now back on a blood thinner. And they’re like, Okay, we’ve got a timeout a couple of different treatments for you. So one was a sort of like hormonal therapy that I didn’t quite understand to hopefully patch up this leak, and the other was a blood patch. Which would they would take some of my blood and that they would create a clot. Yeah, and actually patch up the look. So I said okay, so we kind of had a time that out between heparin doses. Yeah. So they get me down there. And doing a blood patch with residents. My mom worked at a teaching hospital for years. My whole family is like in the medical profession like…love teaching hospitals. But here’s where one of the issues I had was like, I think we need to get someone really experienced in here. Yeah, this already went wrong sort of in the epidural stage, but they brought in a resident and they brought in a nurse and neither of them had done a blood patch before. So that was really tough. And also I was just super dehydrated. Getting blood from me, it was like impossible.
P: So your your veins were like collapsed.
L: Yeah,
P: yeah.
L: So I’m in there. And they’re even just trying to get a line in for this like hormonal therapy that they’re going to do and they couldn’t do it and I feel like this whole process should have been think they were like, Oh, it’ll be like an hour because we were also trying to time it out because they’re like, Well, you’ve got to feed the baby. So to feed the baby gotta get your blood shots. It’s a whole thing. But I think I was down there for about three or four hours.
P: Oh, wow.
L: It was them trying to get blood out. of me trying to get a vein and then the blood patch went wrong.
P: Well, I can imagine if you’re taking blood from someone with heparin, right, they’re putting out your clotting factors. So how’s that gonna work?
L: Yeah, yeah, it was all very tricky and like it just it was not going to work that time and they also just couldn’t even get enough blood from me at for that blood patch,
P: are all these attempts painful because your body has already been through the Marathon of getting birth. So
L: yeah, that was one of the worst things that’s ever happened to me, but that three or four hours I was down there because I was in a lot of pain. It’s basically another epidural is them going into your back with needles. So I had to be very still. Yeah, I just remember like everything in My body hurt and then I was also very, very dizzy and I just felt like I was going to pass out. And at the end of it when they were like, Well, we think we may have gotten it.
Because that was the other thing. They’re like, Okay, can you feel it here? Is it here or here? And I’m like, I can’t. I’m about to pass out. I don’t know what Yeah, I don’t know what’s left or what’s right at this point. But I remember at the end of that, just kind of like looking back in the room as they were wheeling me out and there was blood everywhere. Just everywhere. And I was like I feel like I was just butchered. I was completely butchered and I have no idea what happened in that room. I was trying to communicate with people to as far as like, what are we doing and what’s happening and what went wrong. And but I know at that point, I was not getting my words out very well.
P: I took this question about blood patches to Dr. Sur: In a perfect world. How does the blood patch work and how long do you think it would take?
Dr. Sur: So in a perfect world it shouldn’t take very long. What you do in a blood patch is that you you draw blood from the actual patient and then you insert the blood back into the epidural space with the idea that the clotting factors in the blood will patch up the leak, and so this is something that’s done it when a patient is suspected of having a low pressure headache from a CSF leak, typically after like a spinal tap, and when other conservative measures have been exhausted with really no improvement on the patient side then blood patches is considered
P: And your husband’s not allowed to be in there for this.
L: No, and he was with our daughter at the time. And also he I mean, he did leave for the epidural as well. And he didn’t know if he could handle it. And I was like if you can’t handle it, it’s cool. Just go at that point. I did want him to stay with our daughter. And yeah, I was like I don’t know if I’ll be able to come back and feed her because Yeah, who knows what’s gonna happen down there. And so I got back up to the room. And I just remember the nurse saying to me, Well, you took too long so we had to bottle feeder. I was like I didn’t take too long.
P: Yeah, no kidding, good lord.
L: So she was very disappointed that Audrey was not breastfed at that point. But it was what it was.
P: That’s another hobbyhorse I have about the pressure to breastfeed when other things are going on. Right right. We’re doing our best lady
L: I was like I’m trying I have no idea what’s happening.
P: I’m apparently donating all my blood out my back. So I don’t have time to Yeah, it’s not it’s kind of a bummer because you’re also emotionally fragile after all that right you are just given birth and you do have hormones swirling everywhere. And like be nice
L: I haven’t slept I have. Yeah, yeah. Been just freaked out as far as what’s going on. And I remember like they had Audrey at that point and I kind of went to lay down and I had a feeling that nothing worked. anesthesiologists had come in and they said, well, let’s see how that took. You know, let’s give it you know, a few hours. See how you feel. Hopefully, you know, you’ll feel better soon. I texted my best friend. I was like, Dude, I just want to let you know like things did not go well. I just I love you and I don’t know. I’m gonna make it out of here. It was like it was pretty like it was pretty dark at that point.
P: That’s really intense. Now, did they tell you like there’s a risk that that you’ll die from this or like, what why do you feel this way?
L: I think it was just everything that went down in that room like I’m trying so hard. I knew they didn’t get enough blood. I knew that it probably didn’t work. I felt like I hadn’t held up my end because when we were doing the blood patch they were very much like okay, we need you to communicate with us and tell us is it here is it here? Is it here is it here and I was like I just guys I don’t know. I don’t know where you should put the needle? I don’t know. And so
P: I don’t know if I could do that today. On coffee Right? Right even not even counting all the things that you went through. Like it’s just not that easy.
L: So I just felt like I had failed. That point. And I didn’t feel well. And I just was like this is not this is not good. Just so you know.
P: Yeah.
L: But then I went to sleep for like a minute. And I woke up and I was able to stand up and like walk around. Everyone was like really happy like I could see like OB was just like everyone looks so relieved. Like she’s walking. It’s okay. Looks like everything’s maybe going the way we want it to go. I did feel like pretty decent overnight. And so I was like okay, well maybe maybe I’m all right.
P: So less dizzy.
L: Less Dizzy was walking around, was talking fine. Like everything seemed okay. So they let me go home the next morning.
P: aaaahhh
L: So they said yep, we think you’re good. Go home. And it was crazy because it was like as soon as I got home as soon as I walked in the door. I was like, oh, no, something’s wrong. And I just again like the dizziness came back. I couldn’t focus I couldn’t see. I was very, very weak. And I just immediately had to go to bed and couldn’t move. The anesthesiologists. They wanted me to call like every couple hours, to sort of update them my condition. So that was kind of what the next I think the next 24 hours where I was calling them and I was like, I can’t get out of bed like I can’t move. I don’t know what’s going on. My neck was so stiff. Just I could I couldn’t turn my head.
P: Is this ringing a bell because the the senior anesthesiologist had said Do you have a stiff neck?
L: I know right. And I kept telling them that as like I have a stiff neck. What does that mean? Because I remember he said something about it.
P: So the anesthesiology team keeps asking Lauren about neck stiffness after the dural puncture were they looking for where’s that mean?
Dr. Sur: So that’s associated with infections of the meninges again, the infection of the dura for example, or the membrane that covers the brain and spinal cord. And there can be stiffness in something like meningitis.
L: And one guy I remember that I kept calling That night. he was like he was the guy manning the phones, I guess. he was like, well, I don’t know. I mean, you just gave birth.
And you gave birth pretty quick. It’s gotta be he probably just pulled a muscle. so that’s he’s like, that’s normal. it’s very normal. and I was like, well, I’m really weak. like I can’t make it to the bathroom like my husband was having to get me, you know, to the bathroom, which is like four feet out of our bedroom. And he was like well you just gave birth you lost a lot of God, I don’t know like just lay down and I don’t know.
I started having these insane like very intense headaches. I kept calling them back and I was like, my head is bursting. I don’t know what to do I seen lights like things are not going well. And they’re like, Okay, well you need caffeine. So we’re going to get you some caffeine, like some pills. Just drink soda, drink anything coffee, just get your your caffeine levels up. So that was like the start of the caffeine rush, which I think lasted for a long time.
And I was just and I was just high on caffeine.
P: This seems very bad because you haven’t slept. You’ve been through this ruinous thing.
Now they’re saying chug Mountain Dew. This feels wrong.
L: Yeah, yeah, it was It was wild. Yeah, it was wild. So yeah, so I’m caffeine. Still could barely move. My head was not right. My mom who thankfully at one point was a neuro nurse.
P: Wow.
L: She was ER for career but she also didn neuro as well. She was just like, This isn’t right. She’s like you got to stop calling These anesthesiologists we need to call just other doctors. And I literally was just like calling random doctors at Northwestern trying to get my you know my doctor my my OB like just anyone I could be just anyone I could and just sort of get them on the phone and explain to them like what was going on. So I think it was my primary care physician who was just like, okay, because this was like an info dump for her.
P: Yeah, yeah,
L: no idea what’s going on. And she was like, I want you to go to the Pain Center at Northwestern because maybe, like maybe something went wrong with this. And we just got to get you in there. Right away. And that was a whole situation of trying to get me scheduled to go into there and
P: but you can’t just show up right?
L: You can’t just show up, right. You can’t just show up. They have wait months for days. And yeah, I remember initially like we called and they were like, well we can get you in and you know, I’m like three weeks and they’re like no, she needs someone right now right now. So they were like okay, can you get here in like 20 minutes and we’re like, no, but we’ll try. Yeah. So I showed up and I probably got there 45 minutes later because of traffic.
P: Yeah,
L: this poor girl who was working the front desk. I think this was like her first day and I show up, I can barely move. And I’m like, I have this appointment. And she’s like, Oh, I’m so sorry. Like you missed it. And I think we can reschedule for like a few weeks and I’m sorry and she just like didn’t know what to do. And again I’m very much a person that doesn’t like, I don’t want to make a scene, but I just couldn’t like I couldn’t stop crying. And I don’t know why at that point. I just want to walk across the street and go to the ER but I was just like, I’m in so much pain. I don’t think anyone’s taking it seriously. I don’t know what to do.
And I was sobbing. And this woman who was in the waiting room goes, I don’t know what that woman has been through, but she can have my appointment, because this is wrong. Yeah,
P: that’s nice.
L: It was nice. So she was like she can have my appointment right now. Just get her to see a doctor right now. And the girl at the desk ran and grabbed a doctor and they brought me in and we did some X rays. We of course establish that the blood patch did not work. And so they said we’re going to do another blood patch, this time under X ray. So they did that and they’re like, You should feel like in an hour after we do this blood patch like you should feel relief. Like okay, so they do the blood patch it takes 15 minutes really, really quick. Yeah, 15 minutes tops. They put me in a room. Lay me down. And I felt like pretty decent when I was laying down at that point, and then they were like, Okay, we’ll give it an hour and then we’ll lift you up and we’ll see how you feel. gave it an hour. I get up and I’m just like, no. Still feel bad. So my neck hurts. I can’t, something’s wrong. They were just like, well, go home.
P: NOOO
L: Take some pills. Lay down. And again, this one doctor said, you know, you’ve just given birth. It’s a lot probably just stressed. I was at the point crying. I couldn’t really communicate very well. He was like, You’re just I mean, it basically was like you’re just hysterical. You’re hysterical woman. Who’s probably hurt her neck and childbirth. And yeah, there’s nothing we can do. Like we did the blood patch. It’s great. You’re gonna be fine. Just give it some time.
So I go home. And again, in terrible, terrible pain and I just start this round of phone calling again. Just calling people like something’s wrong. And I get on the phone with my OB nurse. I’m just explaining everything that happened to her and she was like, This is not right. Like none of this is right. And she’s like you need to go to the ER right now. And before before I had talked to her actually, what was something that was really crazy. There was another doctor I was talking to who had access the records from the Pain Center. Because he was like, Well, let me see what they said. Let me see. You know what the notes are and in the notes, the doctor who basically told me to just go home and lay down had said, You know what, her brain should be scanned for clots. That was not communicated to anyone that was not communicated to my primary care physician. It was not communicated to me it was not communicated to my OB we don’t
P: I don’t understand how it made it in the notes but not to anyone’s notice why it made no I didn’t he order things and if that’s what thought
L: unclear, that’s like a big question that I have big question. And I actually even called up the Pain Center and I mean I at this point was just like, just nuts. I just losing my mind and I said, you know, this is what this anesthesiologist told me. This isn’t the notes Was anyone going to tell me Was anyone going to tell me are you gonna call me and they were like, oh, yeah, we were, you know, he went he went out. He left he went to lunch. He hasn’t come back yet. But yeah, there’s an order here for you to go to the ER.
P: Oh my god. was we were telepathically sending you like yeah sending you
L: Yeah. And just it just was not communicated. So I was like, Okay, well, I’m going to the ER please send that order to the ER. FYI. Yeah. Um, and they were Yeah, and they were like, Okay, we’ll send it right now. cuz then I get to be er, and they’re like, We don’t have an order here. But thankfully, I had everything on my phone and they were like, Okay. And then a nurse came over the nurse that was assigned to me and she was about eight months pregnant. And at that point, I could barely move. I was just crying. I just handed her my phone. I was like, just read anything on here. I don’t I don’t know what to say. And I just remember like, she started to cry. She was like, she couldn’t hold it together. And I was like, Well, this is bad. I don’t know what what happened here, but this is all bad. And like, she brought me back she brought me back, you know, they were taking my blood pressure and doing all that stuff. And she just was like, disturbed as sort of my husband was kind of telling her what went down. And then they took me into another room and a doctor came in and we kind of went over everything but at that point, I was in so much pain. I was just gripping the hospital bed. And I was just my jaw was just like grind grinding, I couldn’t talk and my husband was doing all the talking for me. And the doctor was very straightforward. He’s like, Oh, yeah, she’s had a stroke. Yeah. What? He was like, Yeah, this is the stroke patient right here. No one knew that. I knew like he knew immediately. It was like two minutes in.
P: Good lord. Yeah.
L: And he was like all the signs were there. He was like, Oh yeah, the the weakness and she’s like weak on her left side and it’s yeah, the blinding headaches where she’s seeing lights and all of the things that you described. Yeah, she’s had a stroke.
P: can you tell us what happens in a stroke and why women are at higher risk during pregnancy and after delivery?
L: So a stroke is essentially a sudden, acute neurological deficit. One type of stroke is a clot in the venous system of the brain. So ischemic stroke is typically thought of a clot in the arterial system in the arteries of the brain. And then there’s the hemorrhagic types of stroke which is rupture of the arteries typically, and then there can be clotting within the veins of the brain that can also contribute to stroke the risk of that is higher. So in pregnant women, the risk of stroke is actually three times greater than in non pregnant women. of the same age. The risk is essentially in the peri partum period, and in the postpartum period of just up to six weeks after after the delivery. So she kind of was in that very high risk period of developing a stroke. In the peri partum and postpartum period,
P: because we have so much more blood volume or because of the estrogen, there’s a lot of clotting factors running around. why are we at higher risk?
Dr. Sur: So what it’s all related to the kind of physiological changes that happen during the delivery and so right after the delivery, essentially, the body is going into kind of clotting mode, because all of the blood vessels and all of the vasculature that fed the fetus is no longer necessary, and to prevent essentially postpartum hemorrhage or bleeding out from those vessels. They all have to kind of clot off and that’s why the uterus also contracts a lot immediately after the the delivery to try and then close off the vasculature to the uterus, which is no longer necessary once the fetus has been delivered. So you’re essentially in this pro thrombotic state where clotting factors are elevated and and so it’s, that’s why it’s a high risk period.
L: part of me was almost relieved, in a sense, because I was like, one believes that something’s wrong.
P: Yeah. Yeah, that was like that nurse was the first person to have a human reaction. To everything you’ve been going through, right?
L: Yes, absolutely. I think everyone else was very much like, she’s a problem. She keeps calling like, we just need to shuffle her off. And yeah, so he’s like, Yeah, we need to get her CAT scan, He’s like, Yeah, let’s get her in there. And see what’s going on. And so this was kind of almost funny. I mean, my husband and I laugh about it now, but I was like, I don’t know if I can go in there because I was in so much pain and I just needed something to like, hold on to
P: Yeah.
L: And so they’re like, Okay, we’re gonna give you something to calm you down. They were just like, is there any chance you could be pregnant? But absolutely.
P: good news…Yeah.
L: And they’re like, Are you sure? And I was like, I just had a baby like two days. ago. Yeah. And they’re like, Well, yeah, you know, sometimes people. I was like, they do not, they do not. I was like, I promise you. There is absolutely no way I’m pregnant. I said it maybe 15 times. They’re like alright, okay. So then they give me the Dilaudid and do the scan. And then after the scan, the next thing I remember as I was in the ICU, and I was hooked up to many machines, and there were lots of residents and we were talking about the stroke and how it had affected my right side. My right side was very weak. And my speech at that point was not good. And my neck was very stiff, and I couldn’t I couldn’t really move bad scene. And then I think it was like Audrey’s first appointment with a pediatrician. I can’t remember what time this was. I feel like it was like maybe two in the morning or something. And John was like, I’ve got to go take her to the pediatrician at 8am. And I was like, Okay, I was like, just go like, You should go.
He was a mess. So I was in the ICU for quite a while. Which is a weird thing I remember. Maybe it was the next day or the day after. They have an occupational therapist come in and they’re like, Okay, today we’re going to work on putting on socks and maybe taking a walk up and down the hall. Do you think about that and you’re like, wow, I have a little baby at home who I never seen. How am I gonna change a diaper?
P: Yeah,
L: you know how to put on my socks. So yeah, so that was a thing and I was just trying to push through and I was I was in there as like you know what, I’m gonna just I’m gonna beat it. I’m gonna put on my socks. I’m gonna like run around in the hallways. I’m gonna show them that I’m like, I’m fine. But it was very much not fine. So then finally I get to a step down, ICU. And just so many tests, so many things. are going on. So many people are talking around me, including all of the residents of the neuro like it’s, but no one’s talking to me.
P: Yeah,
L: essentially, which I think, say the first five days in the hospital. That was pretty much the case. I was in a lot of pain. And I didn’t know what the source of the pain was. And again, I kept talking to them like, Oh, my, it really hurts at the epidural site, like it’s I’m really, like really sore, and they’re like, Yeah, you’re gonna be sore. And I’m like, I still can’t move my neck like what’s going on with my neck? And they’re like, oh, you know, the patch is sealed. Like we’re getting your blood under control. Like, let’s, we’ll see it just like no answers. And I remember I hadn’t slept for days. It was again middle of the night. And this nurse comes in and I just was like I said before you do anything, like we need to have talk as like, I just need I need someone on my side. And I don’t know what’s wrong with me. I don’t know if this is normal. Do you know if it’s normal, but I’m in so much pain, and I just feel like I just I’ve just I feel like I’m gonna die tonight. Like, this is really bad. And she was like, okay, she’s like, first of all, let’s get a scan because they wanted to make sure I didn’t have a bleed and my brain scan comes out like normal. You know, there’s clots in your brain. But nothing’s bleeding.
So, blah, you’re fine. She comes back. And she’s like, well, you know, do you feel better? What do you think what, you know, this is what happened. They said, You know, it’s the same. I’m like, something is wrong. Like, I can’t I can’t move. And she was like, well, has anyone given you like Gabapentin and I’m like, no, like, I’m just on like, Tylenol.
P: Oh my god.
L: And she was like, Okay. And so she like, grabs a doctor and she’s having this conversation with him. And I hear them get into an argument in the hallway where she’s like, just try it. Like it’s not gonna hurt her. Why can’t we just try it? She’s in a lot of pain. She can’t move. She can barely talk to us. This is insane. And he’s like, Fine, whatever. And he approves it. And I felt like the Gabapentin had saved my life. Like as soon as I started it, I felt like I was just a stone, just like a statue before it was so everything was so tight. I couldn’t move anything. And then as I was taking gabapentin, as I was sort of like ramped up on it, it suddenly like move again. And I could talk and suddenly I was like myself and I told that to one of the doctors. And he was like, oh, you know what, now that we think about it. So where the blood clots were in my brain, it was sort of blocking the blood flow from like, just guess exiting your brain and that pressure was building up and it was putting pressure on my nerves. So that’s why I couldn’t couldn’t move my neck. So it was all that pressure. And he’s like, yeah, he’s like, I guess that would be painful.
P: Oh, my God. Now that we think of it, yeah, what were we doing last few days?
L: What were we doing? What were we doing? And I know I’ve read all of my my notes, which I requested from Northwestern and I had hundreds of pages of them. And it’s marked in the chart like the difference there like oh, one day she was just gripping, but could not get up, gripping the side of the hospital bed, would not move and would barely communicate. And literally the next day was standing up and was talking to us like okay, what’s going on guys? What’s happening?
So yeah, it’s like in the charts and it was just wild. And then the hospital experience was very different after the Gabapentin I was like, I’m taking control of this situation. Yeah, I was quite motivated. I had a lot of adrenaline in a sense, like, especially after that Gabapentin. It was like, Yeah, after that change. I was just like, Oh, I’m taking control of this whole situation, and I’m going to be fine. And you guys need to all tell me like how I need to get there. Yeah, one of the things I need to do I need to lift weights do I need to get on the treadmill every day for 30? Like I was just like, we’re gonna do this because I couldn’t figure out how life was gonna be with my daughter especially in those first six months. Or even the first three months when I had my new those clots were still in my brain. And what if a clot moves? Or what if my brain started bleeding? Yeah, I think that was really scary to me. I was really scared to be alone with my daughter for a really long time.
P: Yeah, that sounds super scary. And they just resolve on their own. Is that how we let that
L: be to the to us you’re Yeah, and you’re on the blood thinner until they resolve and mine did resolve this all went down in June. I believe I had my MRI, it was like late September. And they’re like, Okay, great. They’re gone. And I remember seeing my neurologist after that, and she was like, you’re really lucky that all just took away. It’s like they were never there. And I was like, Okay,
P: wow, that is amazing.
L: Yeah.
P: Ultimately, it was the epidural. That was the problem. Right.
L: And yeah, ultimately, what we found out was the epidural, of course, like set off that chain of events, so it was botched and then the blood patch. At one that was like a three hour blood. Yeah, ouch. Yeah. That was the one that sent those clots actually up into my brain. Wow. So instead of actually feeling that Leah, that’s where they went. And then the second blood patch is the one that finally patched it and sealed it, but at that point, stroke time.
P: good Lord, so it’s like all those compounding things. Right.
L: And it’s, it’s a wild situation, right? Like none of this is typical, but it was pretty crazy. I think. Also, it was really hard for like a lot of the anesthesiologists who were also residents that I was like calling and dealing with, was that the spinal headache symptoms are, I mean, they’re kind of similar to a stroke. And so they kept going to the spinal headache thing saying like, well, I don’t know the headache. Yeah. And she’s weak. She just gave birth. So they just kept deferring to that it never occurred to them, that there had been a stroke. I mean, I guess it It occurred to the guy at the Pain Center, but he didn’t say anything. But when I went to the ER and that doctor was just like, oh, yeah, she’s had a stroke. Like, guys, come on.
P: Yeah. Yeah. Because you passed through many hands before you got there.
L: Yeah, they didn’t realize that was the thing.
P: Let’s now reflect on the things that we have learned from this unbelievably traumatic experience. Yeah. If you could go back. What would you tell younger you and what do you take from this experience?
L: Well, I think it’s been more of an advocate for myself in those situations, which is hard. It’s really hard with a doctor because they’re the expert, right? They went to school for so long. They’ve been doing this forever. They’ve seen so many people, but I do think, especially in this case, a lot of people were very disconnected from me as a person. And they didn’t see me as a person. They saw me as problem. And remember, even we’ll say I was about seven months pregnant somewhere around there. Saw that Serena Williams Vogue story about her childbirth experience.
P: In case you missed it, Serena Williams gave birth and 2018. The day after the birth she became short of breath, and she worried that it was a clotting issue, given that she had a serious blood clot in her lungs in 2011 that required emergency care. The shortness of breath she felt after the birth very much reminded her of that earlier experience. When she tried to get help for it. She was dismissed numerous times by medical people around her. Ultimately, they found that she did in fact have a blood clot in her lungs
L: and I remember taking that into my doctor’s office, because I was terrified when I read that story. And I was like, Oh God, what if this happens to me, I’ve had this you know, clotting issue like this could easily happen to me and still get in there. And like how do we make this not happen? Like have you read this and I will say that I was easily dismissed was like, ah, that won’t happen to you. This is not the same blah, blah, blah just kind of brushed it off.
P: How can it not be the same? I mean, I I definitely had a fear of God reaction to that in that Williams is beloved famous, wealthy. You know, right, powerful. If she can’t make it happen. How’s anyone else gonna make it happen?
L; I know. No. And I just was like, how do we like I just was like, how do we learn from this? I learned from this Yeah. And I remember everyone be like, It’s fine. Don’t worry about it. Just just, you know, just trust us is basically what was the message? And I think in all of that, and especially in those two days, when I was just calling people and I wanted to believe those anesthesiologists who were saying, like, just lay down, like, just lay down. You know, you’re gonna feel great after hours asleep, like taking ibuprofen, like it’d be fine. And I really wanted to believe that but I knew something was wrong. And I think I should have been in that moment, a stronger advocate for myself, I should have just gone immediately to the ER and been like something is wrong. I really should have listened to that inner voice because it was right. Yeah, essentially.
P: Yeah.
L: So that has been what I’ve really taken into my healthcare practice today is Yeah, I do treat it almost like a business. I don’t feel like I should have to but when I do go to the doctor. I mean, I bring a notebook. They document a lot of things. Yeah. And I run it like a meeting. And I talk a lot. Yeah, and I ask people to clarify things and repeat things. Some doctors don’t care for it, but some are absolutely fine with it, especially once they have seen my medical history.
P: Yeah, yeah.
L: They actually are okay. And I feel like I’ve had a much different experience now. And I’ve even been really upfront with some doctors where I’d say like, listen, it feels like you’re sort of brushing me off right now and I have not had a great past. So can we go over this again? Or do you think maybe I would be a better fit with someone else? And some people are they really, you know, change after you are that direct? They really start to see this more as a partnership. Oh, that’s been really beneficial.
P: I’m gonna steal that language that that is a really good way to say it and to get their attention apparently, right.
L: Yes. Yeah. I mean, I get it too, especially now. I mean, with COVID Everyone’s stressed out. Everyone’s been working too much. Again, family, they’re all nurses. My some of my best friends. It’s a high pressure situation. So I have a lot of respect for them. But also, I’m just like, I’m gonna need you to give me time and your full time and attention right now.
P: Yeah. Yeah. Well, I’m glad that you’re back. Thank you. We’ve recovered everything that’s awesome. And inspiring. And what is your three year old into now?
L: Oh, gosh, DC Superhero Girls loves that. Yes. Loves the cape just runs around back and forth. Bubbles. Wow. Bubbles are a hit. But if you Yeah, she’s very cute. She’s very, very active. She’s always just yeah, she’s on time. She’s early. She’s ready to go up every day at seven o’clock. Just like what do we do and where are we going?
P: Very cute. that does sound like the baby who comes in 10 hours instead of 23.
L: Yeah, exactly.
P: Well, Lauren, thank you so much for coming on and sharing your story. And I think if I’m right when we talked in the very beginning of this, you’re a writer so you’re sharing stories all the time, right?
L: I am indeed. You know what’s insane is that when I was in the hospital, I had had this like book proposal that was just on my desktop at home and I got home I was like, I’m gonna send this off. And I wrote a very cocky proposal letter and I was like, You should publish this book because it’s great. And then the publisher responded like seven hours later and they said, Okay, we will. So yeah, that you know, near death, adrenaline that was going through me,
P: that’s awesome
L: But yeah, I have a podcast called bonnets of dawn, which is about 18th 19th and 20th century women writers. And then my book is called why she wrote and it is about 18th 19th and 20th century women writers.
P: That’s super cool. Awesome. Thank you so much. Thanks so much for sharing your story.
L: Yeah, thank you for having me.
P: So thanks again to Dr. Sur for sharing her medical insights…and thanks to Lauren for sharing what is a really important story. Likely we will never know the full picture of what happened; how did so many people fail to show a requisite amount of interest in her experience, how did so many lack real curiosity about her case…it’s hard to get your mind around.
It’s possible that when so many people brushed past her complaints about pain and told her to just go and lie down it’s a reflection of, among other things, a cultural view of women after birth, and in Lauren’s case, maybe also how the medical establishment views not just women but especially black women. There’s a fair amount of literature documenting the fact that black patient’s pain is often managed differently than pain for white patients . It feels wildly unfair that one of the take aways from Lauren’s experience is that after you’ve birthed a baby and your body is wrung out, you are responsible not only for this new human being’s survival, but also your own advocacy…please share this story with friends, because even though it feels like too much to ask, it’s where we are today.
Thanks for listening,
We’ll be back soon with another story of overcoming.
Episode 35: Vagonominal: A vaginal delivery and a cesarean visit the same birth: Kristy
Episode 35 SN: Vagonominal: A vaginal delivery and a cesarean visit the same birth: Kristy
Today we are lucky to get to talk to a midwife who shares her experience of a twin pregnancy. The process of getting pregnant and giving birth did not look at all as she had planned–and she had a lot of real information on which to base her prediction. Although she didn’t have the specific birth she originally envisioned, she successfully carried twins to term, and gained personal experience with more styles of delivery in one pregnancy than most mothers of twins–she delivered one twin vaginally and the other through cesarean section–which she described as a vaginominal, thus the title. Now she can bring her hard won knowledge to her midwifery work.
Relationship between sleep and birth outcomes
https://academic.oup.com/sleep/article/43/12/zsaa110/5851407?login=true
https://pubmed.ncbi.nlm.nih.gov/29103944/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836666/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2824023/
Preeclampsia
https://academic.oup.com/jn/article/133/5/1684S/4558569
https://www.uptodate.com/contents/preeclampsia-clinical-features-and-diagnosis
Maternity leave laws in US
https://worldpopulationreview.com/state-rankings/paid-maternity-leave-by-state
https://www.patriotsoftware.com/blog/payroll/states-with-paid-family-leave/
Audio Transcript
Paulette: Hi, Welcome to War Stories from the Womb. I’m your host, Paulette Kamenecka. I’m an economist and a writer, and the mother of two girls. My kids are in their late teens, and talking with todays guest, who has kids of the same vintage, its really interesting to acknowledge how much has changed in the world of pregnancy between the time we had our kids and now. And that comparison is made possible by the fact that today’s guest is a midwife.
The process of getting pregnant and giving birth did not look at all as she had planned–and she had a lot of real information on which to base her prediction. Although she didn’t have the specific birth she originally envisioned, she successfully carried twins to term, and gained personal experience with more styles of delivery in one pregnancy than most mothers of twins–she delivered one twin vaginally and the other through cesarean section–which she described as a vaginominal, thus the title. Now she can bring her hard won knowledge to her midwifery work.
Let’s get to her inspiring story.
P: Hi, thanks so much for coming on the show. Can you introduce yourself and tell us where you’re from?
Kristy: I’m Kristy Culp-Leonard and I’m from California.
P: Cool. Thanks for coming on the show Kristy. One thing I should bring up before we really get into it is that you are a midwife, which is super cool. So But before we talk about your kids, why don’t you tell us how you came to midwifery?
K: Oh, wow. Well, that’s a long journey ago. I’ve been a certified nurse midwife since 2002. I was my in my early years in college, I did public health work in Latin America, and was very much interested in Spanish speaking culture and then found myself to also be interested in public health and working with families and decided to go on to nursing school with the idea was going to be a nurse practitioner and work with women and families, and then learned about becoming a certified nurse midwife and being able to really care for women through their lifespan and work with them. Through labor and birth and empowerment and post birth. So that’s how I ended up being a certified nurse midwife.
P: That’s very cool. Where are you in Latin America, what countries.
K: I have an in Paraguay twice. Costa Rica. And Mexico twice.
P: I assume you’re fluent in Spanish. I’m totally jealous. Oh my god. That’s very cool. Did you become a nurse midwife before you had kids?
K: I’d graduated from the University of San Francisco with my bachelor’s in nursing. moved to Houston Texas. Wow get work experience knowing that I wanted to be a nurse midwife. So my app the time fiance but now husband, we just packed up and moved there and and I worked is an OB nurse in labor and delivery are about five years before I went to midwifery school at University of Texas in Galveston.
P: Okay, so you’re a midwife first. So how do you step into pregnancy? Many of us who you know we’re just civilians, we walk into pregnancy with this very idealized view of what it’s going to look like. But I wonder how people in the know might approach it.
K: so we were very plans. husband went to law school, some work experience. I was getting my graduate degree in midwifery getting all of our degrees out of the way. Kind of like a lot of Silicon Valley couples these days.
P: Yeah,
K: and work experience and then decided on having a family also decided to go back and get a master’s degree which kind of threw a wrench in it all. But that’s, that’s okay. I was a professional as an as a certified nurse midwife at the time, and then we encountered some trouble getting pregnant and had to seek out some assistance there. So that kind of threw us for a loop because I had at the time done a lot of internships in birthing centers and home birth and just really had this dream of a beautiful waterbirth with my colleague in her birthing center, and all of a sudden those dreams came to a halt because we had to work on getting pregnant, not the most traditional way at home. So but we were pregnant with our first try through assistance. Twins.
P: Wow. I remember when I was pregnant, and we got that first ultrasound, and they’re like, I see a heartbeat and I was like checking CVC and other one was keep looking around there. So that to me feels like a feels like a lottery win. When were you excited for twins?
K: I was not my husband was super stoked. He was like, oh two for the price of one. I immediately as a midwife, and having previously worked as a high risk OB nurse. I was stressed, worried about premature birth. Worried about being laid up at home in bed all the time during pregnancy. I was not excited at all. In fact, it probably wasn’t really embracing it until about halfway through the pregnancy.
P: So this is a difference between knowledge and no knowledge, which is you and me because I would have no idea what the risks are. So I like your husband will be like oh my god, this is so great. We only have to do this once.
K: Right? And I was not feeling that and you kind of at the beginning of pregnancy in general. You don’t feel that great or most people don’t feel that great with morning sickness and just feeling really tired. I think with twins, you have a much higher risk of morning sickness. So just knowing that in my mind, I kind of went full force with all of the natural remedies like taking vitamin B and trying all of the other natural remedies like ginger and just making myself eat a snack every two hours regardless of how I felt. So I think that kind of stuff was really important at first I was also extremely worried about the future, looking all the way forward to school days with twins and parenting twins. And is it right to have them in the same class or not? And so I’ve all of a sudden had to like start reading general lay persons literature about parenting twins and trying to not look at it from a clinical perspective.
P: yeah, yeah, You’re right that it does obviously bring up 100 different challenges for parenting that you may not have. It just does having twins mean you can’t do the waterbirth
K: correct
P: okay, so you also do that?
K: Yeah. Oh, yes. During our pregnancy, we went to a cloth diapering class at my friend’s birthing center. And it was it was the first time my husband had ever been there. But I had been there to seeing as a student nurse midwife, and assisting in birth, I said, Hey, let me show you this place and we walked around and he was like, Oh, my gosh, this is seems so awesome. Why can’t we have the babies here? And I was just like, Oh, you just like crushed my dreams.
P: Yeah I’m on a slower learning curve with your husband there. It was. It would have taken me going as well to be like, Oh, this idea. So how was the pregnancy?
K: Actually my pregnancy went pretty well. Probably around 12 weeks of pregnancy. I let most of my co workers know. I was pregnant and they were super kind and took me off of night calls. So I didn’t have to do night call in the hospital.
P: So it occurs to me that very few professions would be so understanding about pregnancy in terms of what your schedule was like, is there are they just being kind or is there clinical evidence to suggest you need to sleep or you shouldn’t have interrupted sleep or anything like that?
K; that’s a Good point. I think that we know being mindful and having less stress is really important for pregnancy. And however, there’s not a lot of great supports in the workplace for that. We experienced this with all kinds of professions I do when I’m caring for patients. And they happen to have the night shift whether they’re working at Home Depot stocking housekeeper for a hotel or a nurse in the hospital. Yeah, and there’s really not much as a professional that I that we can do except for just saying, you know, it’s really important to manage your life when you’re not at work. Make sure you’re getting adequate sleep for me because I’m a nurse midwife. We work in the office so we have daytime work hours as well as nighttime work hours, and you swap back and forth a lot. So I think if there was another person in my practice that had a singleton pregnancy, the group might not have been so supportive. But knowing that this was twins and I think some people knew that it was challenging for us to get pregnant. They were supportive
P: kudos, to practice for doing the right thing.
P: so I was impressed by the nurse midwives in Kristy’s practice before I did a lot of research but it turns out that researchers think there is a relationship between sleep and birth outcomes. There’s some studies in both humans and racks that suggest as you might expect, that sleep deprivation is associated with worse outcomes for mother and baby. It’s associated with higher rates of gestational diabetes in the mother, which is probably not super surprising. Since there’s a bunch of research about how sleep deprivation interferes with glucose metabolism in people who aren’t pregnant. But in pregnancy, this problem can be shared with the fetus and affect this development. One study found a higher rate of preterm births. Another found that sleep deprivation of the mothers was related to higher BMI. And higher risk for overweight or obesity in girl babies, but not boys. It’s nice to see a practice treating one of its own in a way that is consistent with good birth outcomes. Now we just need the rest of the workforce to follow suit and think more carefully about how pregnant women are treated since it fell in love who’s affected it’s also the baby which translates into public health.
K: I was still working a solid 40 to 50 hours a week. Yeah, it’s the removal of night call was extremely supportive and helpful. Yeah.
P: That’s awesome. So, so 12 weeks you tell everyone and you’re doing pretty well. And then for twin pregnancies, does it start imagining and starts to feel harder to carry the pregnancy just kind of physically earlier than it does for a single family? Is that your experience?
K: Yes. When I was 12 weeks pregnant, my tummy was probably more like 18 to 20 weeks sighs maybe still you can hide it and scrubs.
P: Yeah,
K: at work. Well, yeah. And then around 30 weeks, I looked like I was gonna deliver. Yeah, it’s just extra heavy weight and little ones growing in there.
P: Are there any recommendations for twin pregnancies like different levels of vitamins or something else you’re supposed to do?
K: Yeah, I did do some early reading in the pregnancy and what I was basing it off of was like a twin mom book that I had read about vitamins and protein being really important to try to prevent preeclampsia in pregnancy.
P: One thing that’s interesting about talking to Kristy is that she’s in the medical field so likely in touch with the most up to date information. And in the last 20 years since she’s had kids, information, ideas about preeclampsia have changed. So for example, around the time when her kids were born, doctors used to say that preeclampsia resolves with the delivery of the baby in the placenta. And now doctors think that preeclampsia is not a condition cured. By delivery. And long term women who experienced preeclampsia are an increased risk for heart and kidney issues. Researchers used to think that protein intake might be related to the incidence of preeclampsia, as well as calcium, sodium, iron and folate. But now more extensive studies suggest that we can’t link protein or these specific micronutrients to the development of preeclampsia. So medical community has known about preeclampsia for something like 2000 years, but we still don’t know what causes it. Having said that, you can’t really go wrong by pursuing a healthy diet. The only trick there is defining healthy
P: are you at higher risk with twins?
K: Yes.
P: Okay.
K: higher for gestational diabetes, preeclampsia. And so I just really managed my nutrition really well. And made sure my body was nurses like those cupcakes. Eating those I was like, I’m not doing it. I because I don’t have a lot of space, right?
P: Yeah, yeah.
K: So it has to be pure value if I was eating it.
P: That’s an impressive thing to follow. Because it takes a lot of willpower and you’re already tired with my first pregnancy. I was really careful about eating what I imagined in Olympian would eat. And with my second one, I was nauseous the whole time and only ate hotdogs and I’m a vegetarian. So it’s disgusting and under no circumstance should anyone consume that many hotdogs but I just I couldn’t I couldn’t hold anything else down so I’m impressed that you that you kind of traveled the straight and narrow….that’s a hard thing to do.
K: Well, interesting thing is, this was back so they were born in 2004. Yeah, so it was near the end of my pregnancy. I think I remember reading an article about professional article about mere mercury and fish and really the types of fish we should be limiting during pregnancy. Like all of that information started coming out. Yeah. One of the things was albacore tuna. Oh, my main sources of protein during my entire pregnancy was albacore tuna. So I stopped eating the albacore tuna probably about and went to chunk light tuna, probably only about a month before they were born. That was really science.
P: Totally, totally it you know, you’re you’re doing your best and you’re you’re better than Mrs. Hot dog. So that’s a we’ll take a week yet. So how far do you get to your in your pregnancy?
K: Well, that’s an interesting situation. They were born 39 weeks and four days. Wow. That’s 2004 Oh, so about I think it was about a year or two after that recommendation from maternal fetal medicine was that twins should be delivered by 38 weeks of pregnancy because of risks of the placenta, just aging and maturing a little bit faster and maybe not functioning as well. At the end of pregnancy, also risks of hypertension in the mom.
P; So did you make it to that late date intact? Is there any obvious cost to you for going longer?
K: But I worked all the way until 39 weeks? Oh, wow. I was living in Texas. We don’t have state disability there. So I had to work. And I actually I probably had preeclampsia in retrospect. And they were most likely some pretty solid signs of it starting around 37 weeks.
P: What so what happened that what happened that wasn’t caught by her practice?
K: well, I think there was this feeling of oh, she’s gonna be fine. When she lays down her blood pressure goes down. So a couple things we look at when there’s preeclampsia and pregnancy is maternal blood pressure. If it’s elevated, then that signs of at least hypertension, high blood pressure and pregnancy and then if there’s protein in your urine that’s a latter sign of eclampsia as well. So I had intermittently small amounts of protein in my urine, but when I would lay down my blood pressure wasn’t really elevated at all. So
P: are the guidelines for the blood pressure positional
K: not really like your body shouldn’t be shooting high blood pressures, intermittently like that?
P: Yeah.
K: I’m currently speaking about hypertension from my current knowledge and what the guidelines are currently. Yeah, this is back in 2004.
P: Yeah,
K: we weren’t as strict okay about hypertension in pregnancy. So I would go into the office and be checked and then I would take a couple breaths and my blood pressure would be fine. And then I would go home and I feel fine, no headache or anything like that. And then at 39 weeks, in a couple of days, I had an office appointment. And my blood pressure was sustaining of pretty high, pretty high numbers. In that practice. I was sent home to rest with a plan to be induced the next day, when a bed opened up. If I had at that time if I had seen a person in my practice with those blood pressures. He would have said Beeline it to the hospital right now. But I was in a different practice slightly different guidelines at that time. So I said, okay, I’m fine to go home because I’m in my heart. I didn’t want to be induced. But clinically, I knew it was right to be induced.
P: Well, that sounds like a tricky thing. And advances in medicine take a really long time. This doesn’t seem all that long, right? It’s like 17 years. Right? So it’s interesting how much we have learned about pregnancy in the since well, I have a 2004 birth also. So since those kids yeah, I feel like a lot has changed.
K: I’m going to rewind a little bit. So just share one of the things about twin pregnancies,
P: yeah.
K: And route of delivery though. So it’s in twin pregnancies. We have to be concerned about the two babies and the position that they are in the womb. So ideally, you have babies in the womb that are both head down. And we checked out at the end of pregnancy and if a person’s desiring a vaginal birth, and we move forward with plans for vaginal birth twins are both head down.
So in my pregnancy at around 28 weeks, first baby twin A is head down but Baby B was Baby B had prior to that then head down or vertex so he continues to be breach breach breach, and I started going bonkers thinking I’m not having a cesarean birth and talked to my OB was in support with my midwife and I said I know you have a lot of experience with a breech extraction. And we need to have an honest discussion about this because I really want to have a breech extraction with Baby B. And he kind of was not giving me like an absolute solid answer on that. Well Kristy, we’re just gonna kind of roll with it and see how it goes. And let’s just seeing it that baby turns. I start getting stressed about this and start at around
P: thats a stressful answer.
K: right? I think it’s yeah, it probably didn’t help that my husband is an attorney either. So we have a midwife patient and houses an attorney and honestly, so I enlisted some support of local pregnancy natural support people in Houston. First I went to my acupuncturist said we got to do something to help this baby turns her head down and they’re like, no, what we’ve got we we do have tricks for that, but not when there’s a twin pregnancy. You can do some acupuncture to help with relaxation. Oh, I did that. Then there’s a doula massage therapist in Houston at the time, who was known for pregnancy massage and helping open up the lower back and the mostly the lower back of, of the pregnant woman at her hips. In her massage techniques, and frequently breech babies would turn to head down. So I started seeing her like two to three times a week, around probably around 35 weeks of pregnancy. It wasn’t cheap. It was well worth it. Initially, I knew there was an OB physician in Houston. That’s known for his technique at doing vaginal breech births, which now is more of a lost art, especially for the first time mom and I had actually like looked into going to him to transfer care. It was like 37 weeks of pregnancy.
P: Yeah,
K: really late.
P: Yeah.
K: So if I did transfer care to him, though, it was going to be extremely tricky. It was going to definitely be induced labor because of his call schedule and where he worked. It was going to be a lot more medicalized than I was really desiring so I decided to stick with my team. I was super nervous about being in the hospital, even though I work in a hospital and literally went on two tours of the labor and delivery unit with my midwife. I was just like, oh, I have to see where I’m going to be. I have to see the operating room. I know I’m going to give birth in there so I’ve got to got to feel comfortable here. So fast forward to about that 39 week visit where my blood pressure is going up. We do an ultrasound and lo and behold, Baby B is head down as well.
P: Oh, Wow,
K: so I’ve got two babies that are heads down. And at this point, I was like, Okay, this is great. I’m totally on board with being induced. I know I have high blood pressure. This is a bummer but I can do this.
P: Is it riskier to be induced? What if you have high blood pressure?
K: not necessarily, I mean, it’s risky to stay pregnant,
P: okay.
K: Depends on how high your blood pressure how high the person’s blood pressure is, and if we can control it, so sometimes there’s people depending on where they are in their pregnancy in the way the baby’s laying that do need a cesarean birth as a result of their high blood pressure, okay?
P: but You’re not that person. So, now I’m imagining your bag is packed and you go in for your induction.
K: Well, my bag is packed. And I go home and I from the office and I sleep right? And then we call the next morning. We’re ready. Like when should we go in and they’re like, You know what, we were really busy all night. We don’t have a bed. So,
P: wow.
K: So eventually that evening, have a bed for me. And so we go in to be induced
P: and how did that go?
K: We get there and one of the midwives from the group, probably I would say the people always have personality clicks, right. And so she’s like one of my favorite midwives in the group. She was on call that night. So she comes in and she checks my cervix. And I was thinking I was like, you know, maybe a half a centimeter dilated or one because my physician the day before checks me and she looks at me with all honesty and she said you know, Kristy, I think doctor was really generous. Yesterday, your cervix is rock solid.
P: Oh
K: hard and you are not dilated. So I’m just gonna start this induction
P: so you’re starting from ground zero
K: there is what I’m starting from ground zero and we started with Pitocin and my IV from ground zero.
P: Well, that doesn’t sound comfortable already.
K: Really, but here’s the thing. Things that happens when a woman has preeclampsia and I’ll be honest, I don’t truly understand the physiology of this but a true a person with true preeclampsia many times once their body is into labor, they just go and their bodies like we know we have to cure this by delivering the baby in my case babies and placenta so also as pretty. I feel like I’m fortunate my mom has really good birthing genes. She’s just kind of like that person that accepted labor contractions and just went with it and had a baby in a normal ish amount of time. So I just kept thinking about my mom during the labor and go and thinking like I’ve I’ve got my mom’s genes on my side, I can do this. My husband and I did have a doula with us. It was someone that I had worked with in the community, so I knew her do her techniques. I felt super comfortable with her.
So she was there for our labor. The beginning of the labor, we started with Pitocin it was a little rough. I had a newish nurse caring for me. So this was the hard part. Because remember, I had been a nurse before I was a midwife I have ideas and how a nurse should be
P: Yeah, yeah.
K: And I don’t think we were a good personality fit. That’s okay, but one of the things for me was don’t offer me pain medicine. I’m very much aware of what the options are. I’ll let you know if I want it. And the first couple hours all of a sudden into labor I just had some excruciating pain in like, of my lower quadrants on my abdomen and it would not let up at all. In retrospect I think it was probably one of the babies like just elbowing me and was just like, This is what I’ve got to do to come out so deal But The team was pretty like worry about my level of pain, because it wasn’t related to contractions. It was like this severe shooting pain and rare but we’re always concerned what if there’s a spontaneous uterine rupture like it’s thin and it ruptures or something we’re more concerned about that of course and someone that’s having a vaginal birth after cesarean but the twins do create an over distended uterus, so we turned off the Pitocin for a while. And the nurse of course offered me pain medicine.
And I was like, we’re not going there. My doula will be in in just a moment. And I think like at that point, I was probably only like, one and a half centimeter dilated or maybe even one. Like I knew this was gonna be a long night and a long next day, and I’m sure everyone in the background was like just shaking their head and rolling their eyes at the midwife laying in the bed in room, whatever. But my Doula Nadia came and when she was there, I just felt like super confident and comfortable. And something just changed. And I said, let’s start that Pitocin backup. Come on, like we’re not going to sit here all day.
P; Yeah,
K: or really. It was at night. And I think we started the Pitocin backup around midnight. And things just truly picked up at that point in they did not have any option for like cordless monitoring or anything like that and the bathroom was across the room from the fetal monitoring.
But I felt the best sitting on the toilets. So I had every like side effects like nausea, vomiting, and and I was like, Well, I’m gonna I’m gonna go to bathroom. I need to go to the bathroom. And I just kept getting off the monitor and going to the bathroom. And I begged my midwife please can we just like let me take five minutes shower. Like because I was trying so much just be in the shower because I knew that water is like what we call an agua dural. So water is super helpful for support but I couldn’t be in there. Because they had to monitor the high risk pregnancy. And keep in mind I had high blood pressure too. My midwife had to come in and give me a little lecture on how it was really important to be on the monitor. So we went back to the bedside, and I was on the monitor and then the nurse kept fiddling around with the monitors on my tummy which drove me crazy because the night before I got into so I broke out with a rash called pups, which is an itchy rash all over it was all over my lower abdomen and thighs.
And so I was extremely sensitive to fetal monitors. I was just getting annoyed with them adjusting them the whole time. So my bag of water had broken and my husband was super stoked and excited things are moving along. And Nadia and I just looked at each other and we’re like, we’re not gonna make a big deal out of this out the bag of water breaking and we just kind of just kept laboring because we felt like the more the nurse wasn’t in the room, the better it was for my mental state and progress, which absolutely was true. They should have changed I should have asked for a different nurse or they should have changed us or something. Bad personality fit but that’s okay.
At Some point my husband goes outside to get ice and water and he’s just so excited and he tells the nurses all we think her bag of water broke about an hour ago.
P: Oops.
K: Exactly. So Nadia and I when we heard that, that he did that we were just shaking our heads because we knew we were like doing this on the down low or not telling anyone because we knew the babies were fine like listening to their heartbeat. And we knew that they had central monitoring outside of our room and they could see their heartbeat tracings. So it was fine. So the nurse comes in, you know, we get scolded, how come you didn’t tell me? Because everything’s fine. That’s why we didn’t tell you I literally I had to calm her down. I said because everything’s fine. That’s why we didn’t tell you. And then she, she looks through the pads and she’s like, there’s Meconium in the amniotic fluid. I said yes, there is. It’s like meconium but everything is fine. So there’s nothing we’re going to change about this. We’re just going to keep supporting my labor. I mean, I’m having to labor support my nurse, literally so as much as possible that we could get her keep her out of the room. It was great.
At that point I said you know what, I’m I’m done with you pressing around on my tummy. Can we just put scalp clip on baby as head because it’s hard for you to monitor and I can’t I can’t handle you touching me all the time. And so we agreed to that. I was four to five centimeters already. I was probably like, at three in the morning. Literally. We started Pitocin around midnight, and that was probably around three or four in the morning.
P: That seems fast.
K: oh Yes. It was. And I was really like, don’t really want to be in my mind. I was like, I don’t want to be checks because in my mind I was thinking oh my word. I’m only going to be one centimeter and it’s going to be so depressing. I don’t want to know that I’m one centimeter but I’m bracing myself mentally. I can do this if I’m one centimeter right. And then she’s like, you’re like four to five. Okay, that’s pretty impressive. We put the scalp electrode on the baby and then probably about an hour and a half later I’m still standing at the bedside standing getting on my hands and knees just moaning with each contraction and just taking one at a time. No pain medicine at all. And then probably about an hour and a half later. Started like showing signs of transition shaking. Things were just getting really intense.
I think we had to check on one of the babies or something at that point. Or it could have been a time when Titi was telling me I needed to stay on the monitor again because I was sitting on the toilet a little too often. And so she checked me and I was already seven to eight centimeters.
P: Oh Wow.
K: It was really intense. Pretty sure she left the room and went and called the doc because he was probably at home I’m assuming to say hey, you’re not going to believe this or midwife twin patient is almost complete. And so about an hour, hour and a half after being seven centimeters I was fully dilated.
P: Wow.
K: Yeah. 10 centimeters and bearing down spontaneously.
P: Wow.
K: Yeah. Kind of how my mom’s? I think labor went like smooth that way. Like literally like I really only had like six hour labor though.
P: Wow. So is the delivery smooth now that we’ve gotten complete,
K: right? So my doctor, he comes in and he’s just like trying to you know, talk to me and I’m just having contractions back to back. And I’m on my hands and knees and I just keep looking at him going. This is so hard. This is the hardest work I’ve ever done. This is so hard. That was my mantra. I never said like, I can’t do this. How much longer nothing like that. I just kept acknowledging how challenging the situation was my doula and I didn’t really want to start pushing in the operating room. We really were hoping to like do some of the pushing in our delivery room but with twin deliveries, you need to go to the operating room for the just in case
P: Yeah,
K: there was a scenario and my midwife told me, Oh, Kristy, you’re doing great. You’re not going to push that long. Which I will never say that to a patient because that was the longest hour in my life. So we go to the operating room, and unfortunately in the operating room, you’re laying on a table meant for surgery. It was much different than my my ability to be free standing or on my hands and knees and moving around and squatting. And I was just laying there and with my over distended tummy it was plopping over to one side or the other was very challenging to get my pushing efforts together. There’s probably about like 10 or 15 people in the operating room, which I didn’t really feel or notice, because I think I was used to that.
P: Yeah,
K: but my husband was like, Oh my gosh, what’s going on here? So we just working on pushing a lot of like the nurses had to do a lot of coaching. Eventually, they pulled in this nurse who I had actually worked with when I was a labor and delivery nurse before I was a midwife, and I really admired her and thought she was a great nurse. She just got in my face and was really screaming at me like come on, you can do this. You’ve got this that’s exactly how to do it. And that is truly what got me to help birth my baby. Some people really want to have a calm pushing experience. But I needed somebody to be in my face, coached me through this to give me the feedback.
Additionally, I was like, Wait a minute. It was just running around in here and nobody’s helping me hold my tummy. I was lucky enough. They let my Doula go in. And I think that’s really because possibly my persistence and me being a midwife, and they knew that we had this really good teamwork bond going on.
P: Yeah.
K: And they also they they knew this doula really well. And so usually you can only bring one person into the OR with you but husband and doula both gotta go. And Nadia knew her place and she sat there and she just like worked with me and helps me. She helped hold my tummy in place. And then I was like, Don’t you know, have a mirror in here so I can see what I’m doing. They got that mirror in there and the nurse was super helpful was coaching me then we had baby A. so Baby A was born and was handed to the pediatric team I barely got to see are our babies were our their genders were surprised. So that was exciting.
P: that is exciting
K: it was a little girl. And I totally didn’t believe my husband when he announced it. That was one of the like the the most important thing I had a birth plan. The most important thing to me on it was nobody announced the gender of our children let my husband look and say it’s everything out like if I got an epidural or something like that, I’d be okay with it. That was the most important thing. So he told me and I was like you got to be like, I don’t believe this. I said, Okay. And then I just remember looking up at him and going, Oh, my God, I got to do this again for the next one. So at that point, there’s in a twin delivery there’s a lot of poking and prodding and everything into the vagina and feeling the cervix and breaking the bag of water and think, you know, ultrasound on your tummy to check the position of baby B and that was that was pretty stressful. So we confirmed Baby B was head down. they broke the bag of water which Ideally,
bring the baby’s head down to the cervix and then you just push the baby out. That’s not what happened in my case.
So my cervix moved back to be about eight centimeters dilated
P: No,
K: yes. But I didn’t know that. And baby’s heart rate started having these huge dips, which I was not aware of because part of me trying to be mindful and in the moment of labor and birth was I absolutely didn’t follow. I didn’t look at the fetal monitoring or anything like that. I was not interpreting anything that was going on. I just said, You know what, I’m just going to take care of each contraction at a time, push the babies out. You’re my clinical people. Trust that you’re monitoring the monitors. Right?
P: Yeah,
K: It’s not my job. My job is to go through labor. Not a midwife today. Oh, I didn’t know his heart rate was doing all these changes. Everyone in the room starts to get a little worried. Doc was in there and you could see the look on his face like oh, he’s like, listen, we have to have a true discussion here. Baby B’s having a lot of decelerations on the monitor. This doesn’t look good. I’d really like to deliver baby soon. But we can go through a few more contractions and see how it is a baby will tolerate it. So we go through a few more contractions and at this point, they turn the volume up on the monitor so everyone knows what’s going on. And then I hear it and I can just hear the dunk. Which is a very slow rate, right? Oh, yeah. And I was just like, Oh no, this isn’t good. I practically sat up on the operating table and I was like, I give you permissions. Put a vacuum or forceps on baby B right now. Let’s just do it and he looks at me and says, You know what? I can’t do it. You’re only eight centimeters.
P: Are you surprised by that? Is it normal for the cervix to close? Well, there’s another baby in there.
K: I mean, it could but it’s not that like usually in all of my experience. Between deliveries. You break the bag of water. The baby mom bears down the cervix stays dilated.
P: Yeah,
K: you have the next baby. There’s usually like a, like a 10 minute difference in their age or something like that.
P: Yeah.
K: No. And so we try a bunch of position changes to alleviate heart rate changes, and that didn’t work. So I decided that I needed a cesarean birth for the Cesarean birth though I remember I don’t have any pain medicine.
P: Oh, yeah.
K: So I just started to mentally prepare myself that I was going to have to have general anesthesia be put to sleep
P: because that’s faster acting than a seat get an epidural. Right?
K: Yeah, I started to get like a little teary eyed and freaked out but I was like, I can’t do that. Because if I’m freaking out, going under, I’m going to be freaking out coming out. Need to just calm down. And I remember the anesthesiologist, just saying in his like lovely think it was a British accent. Listen Kristy just roll over to your side and push your back out and let me see if I think I can get a spinal anesthesia in you really fast. And I was probably the most compliant person ever.
I rolled over. I was laying there for probably like two minutes, maybe three, pushing my back out towards him. Watching the fetal monitor and watching that baby’s heart rate go super low. And then he’s like I got it in control over now. Oh, who’s like the most grateful person ever? Because that is not very common.
P: Yeah,
K: it was literally like three minutes. I rolled over. I looked at the team and I said because you have to have a Foley catheter in your bladder before surgery to keep your bladder empty. And I was like, alright, team, let’s put in that catheter and let’s go then I was kind of a midwife telling them what to do. Then they started the Cesarean birth, and I looked up at my husband and that was really scary. I looked at him knowing what I saw on the fetal monitor and I said this might not be good. It might not come out screaming and crying right away. That’s why we have this neonatal team in here. We’re just gonna like, be calm right now, but this might not be good. And that was sTinker came out. screaming and crying.
P: Awesome. Well done.
K: Yeah, I joke now that it was a vaginal birth. One vagina, one abdominal.
P: I feel like you’ve coined a useful phrase here.
K: Yeah. I’m like super grateful for the anesthesia team for their skills. Getting that spinal anesthesia in me. I’m super grateful because like, literally that was about three minutes. And they’re under some stress.
P: yeah, Yeah,
K: trying to feel through this and also thinking like, I’m not gonna mess this one up. Yeah. You any wasted three minutes.
P: Yep. Yep.
K: So I’m very grateful for that. Then my husband was like, Oh, we have a boy. So we had a we have a girl and a boy. And I was like, that’s great. Make sure he’s tagged and there there was a nursery and I was like, I need to recover. I’m extremely nauseous and vomiting right now. I can’t enjoy these babies. Send them to the nursery.
P: Yeah, that’s probably smart though,. Right? That that is again, like I think evidence of what real knowledge is helpful for?
K: I think, yes. So for me, I needed to take care of myself so that I could start parenting them better. Yeah, and a couple of hours. I really had to get past the nausea and vomiting because that was horrible. And then I was confident about, you know, the security and the nursery. So going into pregnancy, I thought I was going to have this like singleton waterbirth at my friend’s birthing center, and waddle back to a queen sized bed and have that bonding golden hour after birth with a baby on my chest. But I didn’t I got to see them about two hours after birth. And they were on my chest for months and months after that.
P: Yeah, no, honestly. It Sounds like because you know so much you kind of expected from challenges in your pregnancy and that went pretty well. I mean, that went shockingly well, to make it so late.
K: Yeah. I just had to like mostly let go a couple times. I called my Doula one time when I was at work, and I was like, I think I’m having contractions. This is so stressful. I put myself on the monitor and she’s like, Kristy, you gotta take your clinical mind out of this. Go with what how your body’s feeling. I want you to lay down right now and be patient and her support in that sense was super helpful. I wasn’t that person that went home. And listened to the baby’s heartbeats with a Doppler all the time. I have my own Doppler. I could do that.
P: yeah, Yeah,
K: I only did ultrasounds during pregnancy when I needed them. I didn’t I never did them for fun at work. Because I was worried not even to check position.
P: yeah.
K; So I’m, I mean, I’m grateful for my ability to be able to do that. Well, and the support of my Doula friend.
P: that seems amazing. Since your kids have been born. Have you seen any other twin births like yours?
K: I have not. I don’t think so. Something I’ve been present. Of course, there have been people in our practice that have had vaginal and unnecessary and but most of the time, I have not either somebody chooses to have an elective Cesarean birth for twins, or they have successful vaginal birth times two
P: that is totally interesting.
K: Yeah, one of my best friends who is a labor and delivery nurse, I would have wanted her to be with me if she could have been with me, but she was living in a different state at the time. But she hears my story and she’s sometimes a little bit more on the high risk end and I’m on the low risk end of like, how things go and how we approach and and she’s like, wow, that’s a bummer. Wouldn’t you have just rather just had a cesarean birth to begin with and I was like, No, I got to experience labor and birth
P: yeah, Yeah.
K: And even if I had gotten an epidural, I still would have experienced labor in my mind, but I am happy that I truly experienced a full labor and vaginal birth without an epidural.
P: My guess is it’s a boon to your patients. That You have this pretty wide experience in one pregnancy,
K: I could have a better idea of how they feel.
P: Yeah,
K: you know, actually on that note, like it’s, it’s definitely helped me coach people and be genuinely honest with them before having a cesarean birth and what their recovery will look like. Because we talked to people about to cesarean birth, and we’re just really, oh, these are the risks, you know, infection and bleeding and da da da, but we don’t really talk to them much about the sensations, yeah, of recovery. Say a little bit about like, what you might feel during the actual birth, but not all of the recovery, but definitely has helped me change the way I speak to people before Cesarean birth, how their recovery is going to be and also just being supportive with them, even a year after their Cesarean birth if I just meet them for the first time talking to them about the sensations they have, because there’s a lot of things that go on with when your nerves start waking up and the sensations like on your skin level. The tingling and the itching and pulling in the corners of your scar and how weird it is.
P: Yeah,
K: and that’s ignored.
P: Yeah, I mean, that falls into the giant, bottomless postpartum bucket in which wrecks many things are shoved right without examination. How was your postpartum with twins?
P: There wasn’t much sleep. I forced myself to take a nap every single day. The whole time. I was on maternity leave, which was only 11 weeks so
P: oh, Wow, good lord.
Let’s talk real briefly about maternity leave while we’re on the topic. The US currently ranks 36 Rock Bottom among OECD countries for the carrot provides new parents for maternity leave. Probably everyone listening heard that the attempt to pass a paid leave bill is precarious right now in Congress. current federal law requires 12 weeks of unpaid leave for companies with at least 50 employees. Basically, this leads to about 12% of Americans getting paid leave for 12 weeks. States have passed their own paid leave bills in 2018 and 2019. And these states are basically on the east or west coasts, and they vary in their generosity.
K: I was in Texas and I didn’t have a lot of benefits and I guess it was just all I got was my FMLA. That’s it.
P: here FMLA is money from the Family Medical Leave Act.
K: So it was 11 weeks and the whole time I was on maternity leave for 11 weeks. I made sure I took a nap every single day I was scared to death of getting postpartum depression because I had the blues that was definitely apparent and I probably had some depression but just kind of worked my way through it, keeping my chin up and acknowledging it and taking naps and then once I went back to work, I only went back to work part time which I’m super grateful for my employer, allowing me to change my status. I only worked in the office, so I stopped doing call in the hospital, but every single day I was off. I still took a nap. So we were woken up frequently for a very long time. In fact, our children didn’t really ever sleep through the night until probably about three or four years old. And I nursed 100% A little over a year.
P: Good lord. Wow. that’s a lot of work…
K: I had helped a lot of people with breastfeeding and nursing and the minute they came out of the nursery, I was like alright, we got to nurse these little babies and did send them to the nursery. Again to try to get like a three, three or four hour solid nap in because I was like this was like maybe day two postbirth is one of my midwives from the practice came in to round on me and I got an earful in a lecture from her about how silly it was to send those babies to the nursery. They needed to be with me mammals are never left by their left by their mom, almost pulling their baby cubs every two hours to offer them milk to keep them alive. They need it for survival. I loved Theodora she was also one of my other favorite midwives in the group for background was breastfeeding support and also doula support. The babies had already been latching and stuffing perfectly so I was feeling like pretty overly confident. That’s why I sent him to the nursery but she she must yourself into that nursery brought those two babies back and was like, alright, what is it then you need to nurse them for survival. And honestly with that little pep talk and lecture. I didn’t have any issues with milk supply. I mean, I had to work hard when I got back to work and I was pumping and all of that would pump in my car on the way to work and do crazy things like that, but I never had to purchase formula.
P: and Now there have one foot out the door for college right?
K: Mm hmm.
P: Amazing.
K: Yep.
P: Thank you so much for sharing your story.
K: Thank you
P: Thanks so much to Kristy for sharing her story and her insights about pregnancy in general and twin pregnancy, given her professional life as a midwife. And thank you for listening. We’ll be back soon with another inspiring story.