Month: October 2022

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Episode 70SN: Losing your Identity in Motherhood: Marnie’s story

Today’s guest had a number of challenges with the physical aspects of pregnancy–she and her partner had trouble getting pregnant initially, and her third child was born in June of 2020, very much in the heart of covid, which invited it’s own challenges; but what really surprised her was the loss of the person she used to be.  She found motherhood to be both beautiful and completely overwhelming and had to work hard to reestablish her boundaries and her life after kids.  Her experience becomes the motivation for a new company in an effort to help other mom’s navigate this enormous transition a little easier.

To find Marnie’s company Rumbly, click here

Audio Transcript

Paulette: Hi welcome to war stories from the womb

I’m your host paulette kamenecka. I’m a writer and an economist and the mother of two girls

Today’s guest had a number of challenges with the physical aspects of pregnancy–she and her partner had trouble getting pregnant initially, and her third child was born in June of 2020, very much in the heart of covid, which invited it’s own challenges; but what really surprised her was the loss of the person she used to be.  She found motherhood to be both beautiful and completely overwhelming and had to work hard to reestablish her boundaries and her life after kids.  Her experience becomes the motivation for a new company in an effort to help other mom’s navigate this enormous transition a little easier. Let’s get to her inspiring story.

Paulette: All right, thanks so much for coming on the show. Can you tell us your name and where you’re from?

Marnie: Yeah. My name is Marnie. I am from Toronto, Canada.

P: Oh, thank you. I was a Greek city right I love Toronto.

M: You know, I I had grown to love it. After I’d gone off to for university and came back I started to really appreciate it. I think I just saw it as an adult and I started it in a different light than I did growing up. So now now I get here.

P: Excellent. That’s a well chosen. Order. And everything. So morning we’re gonna talk about we’re gonna talk about your business which is related to your birth experience. So we’ll get to that and I’m gonna go further back and ask a question about the family team from imagining that influenced kind of what you thought you wanted going into creating a family did you grew up with siblings?

M: I did. I have three sisters. So I’m one of one of four, one of four girls.

P: That’s pretty lucky. And are you all close in age?

M: We are all about three years apart. So fairly close. So we’re similar life stages, I guess growing up.

P: Nice. Where are you? In the lineup?

M: I remember three, oh, and middle child and a lot, a lot of personality traits of that stereotype.

P: I’m also the third of four so i 

M: Oh, wow. That’s amazing. 

P: So growing up, did you think I want kids? I will want kids

M: Yes. 100%. I always wanted kids but it wasn’t my lifelong mission. I just knew when I was ready, it would come so I wasn’t like I had some friends who was just we’re trying to go through the process of going to school and getting there just so they could finding a partner just so they could have children. And for me it was it was a very more selfish journey, I guess of achieving what I wanted to achieve personally before kids came into it but knowing that family is something that I absolutely, absolutely want. Absolutely.

P: Okay, so when you when you were going to get pregnant, what did you think pregnancy would be like?

M: Like Emily’s? I Anna and I have to say that I didn’t. I’m someone who doesn’t really think about much. I kind of just go for it. But I thought I was just something I wanted so badly. I never thought much about it. I just thought it’s gonna be great. It’s just I want the end result. So I think I was just very focused on whatever it is to get me to that point. So I’m gonna get pregnant. I’m gonna grow belly and I’m gonna push baby. And that was kind of all I thought I really think much else about it. But knowing that I’d have this fries at the end, which would be my future children.

P: Yeah, that’s kind of a having talked to many people is kind of a smart way to go into it without very many details already worked out in your head of what it’s going to look like. So was it easy to get pregnant?

M: No, it wasn’t. It was very stressful. But we did and I cannot feel more thankful lucky, fortunate. Happy to have three children.

P: So for the first one, walk us through that one because usually there’s a lot learned on the first one.

M: So I actually had incredibly wood to get pregnant or

P: just the whole walkthrough that one slowly and then you can pick and choose about the other two.

M: It just timing perspective. It just to each one took I would say like a year or two longer than I would have liked. So it was it was a waiting game and of course, the longer you wait, the more frustrating it gets and, you know starts to the process of impacting your relationships, whether it be with your partner, or a lot for me, my friends who were able to get pregnant really easily are starting to build their families out and then that jealousy which again, I never had, because I was never in like a rush to do it. That that really creeped up on me. And then that started impacting I think a lot of my relationships with my friends. Yeah, it’s hard. It’s hard

P : to look around you it looks so easy, right? Yeah,

M : it’s it’s so easy in it and again, it brings out these these these these character these characteristics in you that you didn’t notice as I was never jealous person, but as I noticed everyone around me and I felt like getting pregnant like this this jealousy type of rage inside me with just kept growing and that was that was really hard and I didn’t like it. It was something I battled but I don’t think it wasn’t something that I could really quiet at the same time. But needless to say we did eventually get pregnant and like I said, I’m so fortunate to have free beautiful, healthy, amazing children today.

P: So let’s let’s talk about getting pregnant the first time did you find out with a home kit? Are you involved with doctors or how does that all go?

M: Yeah, so we took pregnancy tests with all them confirmed it with doctors kind of a very, I guess, linear path after that.

P :But so exciting to get the positive pregnancy test?

M: Oh, like I couldn’t control myself love like tears and joy and my heart racing. I did my chest in with all of them with all of them. It was it. Each one was truly an equal blessing that I felt.

P: And did you guys end up going through? Did you think there was something wrong in that it took that long or were doctors like no, this is what it takes?

M: Yes, but it wasn’t equipped with the education I think to know to really question that. I think today’s Today’s a very different environment. And I think I would have seeked help earlier on. In my process hadn’t had I known that was an option or to actually question these things rather than just kind of internalizing it and keeping it between me and my partner.

P: So it sounds like in part because you’re surrounded by people who are getting pregnant easily. It’s not obvious to you that that this is a medical issue and maybe you should go and talk to a doctor

M: right and you know, and social media wasn’t as strong then and there wasn’t as many conversations around fertility which there’s an infertility which there’s there’s so many more conversations and and companies and and ambassadors and people now speaking out on it. So I think you know, for for kids today or even just generations younger than me, they’re becoming their awareness of of fertility and the entire process and the education behind it is a lot stronger than it was even just for myself about just under a decade ago.

P: Okay, that makes sense. It that is frustrating though, and it is hard if you’re I mean not that it would have been a snap if he’d gone to medical people but that is that’s its own separate ride but it is I can imagine very frustrating if it’s just you and your partner and we can’t figure out what’s going on.

M : Absolutely. You know, and then it’s it’s, it’s always you feel like it’s you would always feel it’s the woman who’s who’s who’s the problem and you know your partner feel would or maybe not always but at least in my situation, I think we both kind of felt like oh, something’s wrong with me because I’m not the one getting pregnant. Right? Versus what we’re starting to learn now is you know, it really does take two people to make a baby and, and nothing that it was or wasn’t but you know, it just, it put a lot of the heavy emotions I think on me throughout that whole process, where a partner just made it more of like an impatient waiting game.

P: Yeah. You know, I interviewed a reproductive endocrinologist and she herself use IVF. And we were talking about if you go the IVF route, which I have no personal experience of so she’s educating me on it. They can look at the embryo immediately and look at it. As it grows from one cell, the T cells to three cells or whatever. And I was saying to her, Do you think there’s going to be a time where we can examine that embryo so meticulously that we can say, Yep, this is going to work. This embryo was perfect. And she said, No, because she’s an even if you know that you still have the uterus, you still have all the moms chemistry. There’s so complicated and there’s so many things going on, which is one thing that makes it hard to identify what’s wrong if something’s wrong, and hard to get pregnant, because it’s just there’s so many variables none of what you control.

M: Yeah. It’s so amazing. It’s so amazing how complex it is. And, you know, this is something from the dawn of time that that humans have done you know, it’s so it’s just amazing to hear all that you know, and how far even just the sciences and that we can’t still predict that kind of like we have a success, right?

P: There’s just so much we don’t know, right in this in this realm that it’s, you know, I don’t know what to somebody agree, I would think it’d be much easier if we could say, oh, it’s Bernie’s fault. Okay, I have no idea right? It’s, anyway, so you get pregnant and the first pregnancy. What’s that one? Like?

M: Amazing, honestly, like, it was, it was just, it was I wanted it in my head perfect. It was. At first the only thing I struggled with was that you know, I couldn’t vote because I’ve wanted it so badly for so long. That I didn’t believe it was real. And then I got incredibly incredibly nauseous in my first trimester. 24/7 and I was like, You know what, this is it. This is great. This is like my, my son and I embrace this because this is telling me that okay, I’m actually pregnant and now as I did that, it was really like textbook. Easy, simple. I felt great the entire time. My water broke two weeks early. I had a vaginal birth and and everything was really it was really great. It was a really easy good pregnancy.

P: That’s awesome. And the one thing I will say about the first trimester is there is this weird dissonance where you’re like so much has changed. And it’s there’s no physical evidence that you can see, unless you’re really sick, in which case you you know, it’s like a confirmation to yourself that something’s

M: happening. It seems like a it’s a very strange, you know, it’s a very strange symptom that like, you don’t want it. But in my case, I really wanted it because I Yeah,

P: yeah. I can totally relate to that. I can totally relate to it after the fact why you would have wanted it but I’m sure when you’re in it. It’s like a little bit miserable. No, I

M: honestly like I was but I was like no, this is good. This is good. I needed it. I needed it because I needed to. I needed to start to feel it. I needed after like that wanting it for so long. I actually did it as strange as that sounds and that was the same and that carried for for my other two following that I would almost wait for and I’m like, please, please bring on that now as you know that like it’s this is real. And it’s you know, because you can’t just look at it test. So but so my first pregnancy it was really it was really great. So, you know, I came into it that this is something I want more than anything and I had a great pregnancy and our family plan like we really wanted three children and you know after one I couldn’t be couldn’t be more love couldn’t couldn’t be more in love. I had a boy and he he was just teaching transform my insurance for my life. And after that my second pregnancy was it was health wise. There were some little like scares but everything turned out okay in the end, so I would say it was a pretty good pregnancy otherwise, my hormones were the only thing that were awful. I truly, I truly had no control over my hormones, which is something I didn’t experience my first pregnancy and like I really didn’t like myself that way

P:. How was that? How did you experience that? Was that when your hormones were right. I was so short tempered.

M: I was yelling all the time. And I was rude. I was I was like the worst version of myself.

P  It sounds like There’s like there were like mood effects.

M : Yeah, yeah, all mood and I really I didn’t feel like myself. Like when I spoke when I talked and how I acted to people acted around people and treated people. And I couldn’t I couldn’t find it. I couldn’t find it. You know, it was one of those that you lie in bed after and you’re just like, who am I? Who am I? But I had no clue what was going on. I didn’t even know pregnancy could call this like I had no previous education that like, I mean, I knew something’s gonna happen, but I didn’t know I didn’t read I didn’t know anything that pregnancy could cause such a shift and change, like my hormones to to, you know, cause these sorts of reactions for me all I knew is that I really for the 910 months or whatever it was really didn’t like myself at all.

P: Did you talk to your doctor about that? Or like, oh, wow, we know how do we know now that it was hormones? Like we’re

M: because there’s there’s higher education? No, I know. I know. I know. I wish I did. I didn’t I It never occurred to me to talk to my doctor. And you know, one of the reasons which we’ll get into later is that it my dad tried to harass me I was I never knew anything was about me. It was all about the baby. So it had nothing to do with how I was doing. It was just weak. I’d go to my go to chat with my doctor and it’s How’s baby how’s the growth and development of baby? I am that’s all it’s nothing more than that. So it was it didn’t I was never asked and I never thought that I should be asking or seeking support or it kind of just like was the way it was in my head. Okay,

P: so let me ask a question about that. So so the context explaining like, what the relationship was with your doctor makes total sense. Now I can understand why you didn’t bring it to your doctor. But you clearly because you’re lying in bed questioning like what’s going on? I don’t feel like myself. You notice that something was different. You just thought I’m different now or like what did you think at the time? 

M : I just kind of bucket it in like well, just the way it is like this is pregnancy like, you know, like, I don’t know, like I’m just like, I don’t know, I really I I don’t have I don’t have a an answer that that I can really like put my finger on it. Like I just I just didn’t I just kind of sucked it up. Like for whatever it didn’t question myself. If that makes sense. I just It just happened. Like I question myself. Until after.

P: Yeah. Because Because after a breaks right, it goes away.

M : Yeah. And you know, I started to feel myself again, you know, it’s like I went through this like really dark hole and a new was happening, but I couldn’t I wasn’t conscious enough to question even myself and to seek help. Or ask if this is normal, or even among friends or anything. I never I never I never got to the point. I just kind of live with it

P : Well, and to be fair to you, you have a toddler and you’re pregnant. So you’re busy, right? You’re focused on other things. Yeah. So do you feel better at the birth or months later or

M: at the birth? Yeah, it was right after the birth. I started Yeah, I just myself, like not not fooling myself. But I think I had more. I should say not myself, but I had more control over the things I said and the way I reacted to things and how I treated people

P : do you reflect on that now and think that was some kind of Peri Partum Depression?

M: I don’t know how to. It was something I don’t intend to put that title like towards it. It was absolutely something. I don’t know what.

P: Yeah, yeah, you’re right. I mean, it sounds it just sounds pretty distinct. Especially since you know, it’s easier to reflect on that where you’re out of it. So I’m glad you got out of it. And how far apart are your kids?

M  Do you say? They’re two years apart? Two years Exactly. Two years and two days.

P  Oh wow…So birthdays in the same season? It sounds like two days apart to the third pregnancy offers something different entirely or

M : their pregnancy was in an exact reflection like first. Okay. Easy, simple, beautiful. I felt amazing. The whole time just kind of went through the process. And it was it was it was great. I had my daughter in June of 2020. So right after the onset of COVID Wow. And that that made it for a little bit. Interesting experience, of course, being that my partner couldn’t be there for he was there for the birth but immediately kicked out of the hospital. Right after I got off that birthing table. And that that was interesting for me because I was really okay with it before. It’s like, you know what, we, this is our third you’ve been there before. I know what it’s like I know it. I know what I’m going into. My pregnancy has been really easy up to this point. And you know, it’s for me to stay in the hospital for 24 hours. You know, I don’t need you I’ll be okay. And when they kicked him out, essentially before moving me to the maternity floor, I the pain me I can cry to this day thinking about it. That separation was horrible. It was horrible. It’s like a very strange, I don’t know, feeling similar to like, loneliness but he is telling it’s just like ripped away from you. And you just you just birth the child together and to not have them be in there, though that was only hard, challenging part of it. But the rest of the pregnancy itself was again it was very lucky that it was very similar to my first and really easy and I was really happy throughout the whole time.

P: That’s great. Wow, that sounds like outside of the birth experience that sounds like you know, the best possible the best possible experience you could have especially given COVID

M: Yeah, it was it was and it’s really interesting like why I’m here today and like what my like new mission in life is and it’s all it’s all a really, I think, like larger reflection on the whole process of everything that was going to while I say I had beautiful pregnancies, there was so much going on, but I’m I’m still struggling to get through that I didn’t realize while I was in it, even even though things were so, so great. And I really felt so great. But there’s there’s a lot that I’m still dealing with now that really started from from my first pregnancy.

P : So let’s talk about that. It sounds it sounds a little bit like what you’re saying is that motherhood is not what you thought it would be.

M: It motherhood. Motherhood is incredible. I absolutely adore my children. I absolutely adore being a mother. What’s hard is is losing yourself in the process. So I knew identify in to most of society, my friends, my family, I identify as mother, but not but not Marnie. So while I gained this absolutely beautiful life, I lost myself. And that’s where I didn’t realize why that was happening until very recently. So my youngest is almost two and it took like, till she was about a year for me to realize this. So this is about six years, six, seven years in this process where I feel like Hey, I I’m I’m not me, I’m I’m just a mom. Like I’m that that’s that’s that’s when people see me that’s how I see myself that’s, you know, how my partner sees me my colleagues, but there’s no money in that. And that that’s, that’s been a big focus of mine, I would say in the past. In the past year and a half to understand that and to change that.

P: So let’s talk about the you before the kid that was a person who was focused on career it sounds like yeah, it’s very clear.

M: Very, so. Very, yeah, just very, I think like, focus all around like very, very self identify, like totally new, but I was really glad to I was I had lots of interesting hobbies. I was definitely very, very career focused, but also very socially focused.

P: And motherhood displaced them both. Absolutely. So what what you’re struggling with is the loss of this former self and trying to figure out how to regain it or how to reshape it or

M: Yeah, I think it’s how to, we don’t need to be just one. I don’t need to be just a mom. I can still be I can identify I can have a lot of identities, you know, and being a mother is one of them. You know, being being a wife as well and a sister as one a friend is one a colleague is one, you know, so I think that people can have multiple identities, but oftentimes what happens is when you become a mom that almost becomes your leading identity. And what you need is to keep your core identity and realize that that is one part and it can be strong and amazing. And it can mean the absolute absolute world to you. But not at the sacrifice of losing like who you are. You as like the person.

P: Yeah, totally agreed. So So where are you on this journey?

M: So you know The first is like, the first step was, I think, just understanding it and and kind of going back in time and where we’re lost myself and trying to re identify who I was and what was important to me and what was I really passionate about enjoyed doing in thinking and, and where I am today is I feel like I’m in a I’m in a good place. I mean, I don’t know how to describe it otherwise, but I’m very conscious of not letting myself or others like my identity as a mother kind of take over everything else. And trying to like when my friends call me like they’re like Hey Mama, and I’m like, no, no, my name is Marni like I really just like the the mama culture. You know people who wear this like and I’m this is just me and I think it’s great for other people but because they’re so proud and they shouldn’t be proud to be mothers but for me, it’s pushing people around me to be like, okay, me first like I am person outside, outside of my children. You know, if you’re gonna give me a gift for my birthday, it doesn’t have to be like a necklace with all my children’s initials. Like, there’s something maybe for me too, as like a small example.

P: So why don’t you tell us about the company that you started?

M : Yeah, so the company’s rumbly and rumley started on this notion that women are not the priority in pregnancy. And they’re seen and treated through culture and our medical system as as merely vessels and the the market is saturated with maternal and baby products and nothing is really focused on the woman and the emotional journey that she’s on. You know, fertility has changed and postpartum has changed yet pregnancy has remained the same. So rumbly is is a brand that is to prioritize women’s health and experience and support them on this emotional journey, not just the physical journey. And it’s really to set them up for better outcomes after baby after baby arrives. At launch from these going to launch with a pregnancy subscription box, where half the items in every box are for the woman you are and the other half are for the mom you’re becoming and there’s three core goals with the subscription box and that’s just spoil and shower mom with gifts and that’s really to help celebrate every month every month is a milestone and and the reason to, to celebrate with items that are focused just on her. It’s also there to help prioritize herself again in pregnancy to help her not lose herself in the process, and then make the transition to motherhood a little less overwhelming because it’s extremely overwhelming. But also a little bit more fun. And again with the ultimate goal of setting her up for a better outcome and the end. So as a brand that I hope that women do see rumbly is more than a subscription box. It’s just a it’s a new way to experience pregnancy and to treat it really it’s as it’s a tool to help her in that journey. And the goal is to share more realness, more love support throughout the entire journeys. That’s when that positive test and then eventually going into her experience after delivery. And the aim to be a source of more truth and emotional support and ultimately women’s biggest cheerleaders

P: That sounds awesome like give us a sense of like what’s in the first month box

M: because women Some women find out a very different times when they’re actually pregnant. Instead of doing monthly the first box is is covers the first trimester. So months 123 in there I have a couple of branded items. So one of them I have a I have a calendar, a custom calendar flip calendar that we created every week it has either prompts or some insights into things that are going on some things to make you smile to make you laugh different things for the week. It’s kind of like a rumbly take on you know any of the apps you get like with the fruits like babies the size of this, it goes a little deeper in that but again like weekly kind of what’s going on and it’s a flip chart and it’s beautifully branded as something that you put on your desk to keep track of it. Of your pregnancy. Another item in there is a AEV have a felt folder and it’s your go to pregnancy organizer I found when I was pregnancy I got tons of papers and products and ultrasound pictures and it’s kind of one folder that you can keep everything in. I was kind of putting things all over the place. There’s a bracelet it’s a gold bangle that has two parts and it’s a beautiful piece of jewelry and it’s to help women just feel good. You know jewelry puts for many women a smile on their face and feel nice and the double hearts very symbolic of you know, you know, have another heart beating inside you so you kind of have two hearts at once. There’s a water bottle to encourage obviously hydration drink a lot. There’s a lip balm, there’s some vegan organic mint gum, there’s a a felt letter board where you can put like for pregnancy announcements or you can track your growth or whatever you want any input some personal like self love or any kind of your own custom messages on the board. And that that rocks up everything in that first box. So there’s seven items in there. And those again, are really kind of being in thought of what’s going on for you just in that first trimester. while also being a little bit more general to women’s experience. During that time. Of course everyone will have a very different first trimester but initially at launch, we’re trying to to appeal to the most common experiences that women have during that time.

P: This is cool, and it’s such a cool idea. It’s interesting to me that that is your experience in Canada because, you know, as someone who lives in the US, I think of Canada as our more rational cousin. So I would have imagined that the experience of being pregnant there would be different and somewhat better. If you’re being you’re in Toronto, like you’re in one of the major cities. So that’s your best shot and having experience with with the medical team where it’s more holistic.

M: Yeah, it’s, you know, it’s it’s very not the case and I think maybe it’s because of our healthcare system. we get to get two ultrasounds, Three reasons It’s a very process. One of the biggest things that every box is so their products and those products to support you in your journey.

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Episode 69SN: One Woman’s Experience with Recurrent Miscarriage: Eileen’s story, Part II

Today we hear the second half of Eileen’s story about her experience with pregnancy. Last week we heard about some of the challenges associated with her miscarriages. But when we left Eileen, she was about to deliver her first baby, having christened the hospital elevator when her water broke on the way up to a birthing room. we’ll pick up her story on the way to the hospital.

You can hear Naomi’s story here

alpha fetoprotein

https://www.stanfordchildrens.org/en/topic/default?id=alpha-fetoprotein-afp-90-P02426

https://americanpregnancy.org/prenatal-testing/alpha-fetoprotein-test/

Audio transcipt

Paulette: Hi, welcome to war stories from the womb. I’m your host, Paulette Kamenecka. I’m a writer and an economist and a mother of two girls. Today we hear the second half of Eileen story about her experience with pregnancy. Last week we heard about some of the challenges associated with her miscarriages. But when we left Eileen, she’s about to deliver her first baby, having just christened to the hospital elevator, when her water broke on the way up to a birthing Room. We’ll pick up her story on the way to the hospital.

Eileen: So I’m in the backseat of the car and on the other floors and I’m just like, moaning you know, and just like it was really kind of fun, you know? Like it was just like really letting it all hang out. You know,

P: wait, how long a drive is, this?

E:  is are we in for like 20 minutes? No one is it it’s it’s what time is is like 10 or 11 at night in the city. So what was it it was Thanksgiving night so there was like no traffic. So I’m more than we’re going to Lakeshore drive my husband just like flooring it, you know? And then we get to Northwestern and I’m just like, You know what I loved about it was like NUMA to see I was just like, I don’t care, moaning I don’t care, like whatever. So we get to triage and they’re like, You’re nine centimeters.

P: Oh my god. Oh my God.

E: So They put me on the gurney or whatever. We wheel into the elevator.

P: Wait a second only ask the question here. Are you Are you sensing that the waves are getting higher or whatever the whatever the image is,

E: I don’t know what the heck, you know what I mean? Like I don’t know what I was. I was just like, I was like very mammalian. Let’s just say I was very, I was totally my animal body. So then they really into the elevator and my water breaks

and that was kind of like take that!  Myt husband was like: it was like it was a hazmat situation. I was like I don’t care, you know. So like we put me into labor and delivery. And now I’m 10 centimeters. Oh, I saw my shoes on and you know, I’m just like, yeah, the doctor comes in. I mean, she’s like, has a sandwich in her hand. She’s like, Oh my god. They called her down from the  cafeteria and I’m wearing these like silver gym shoes and leg warmers. And she just like, can

we take your shoes off? And I like, I don’t care, you know, like, well, I believe he wanted to deliver cowboy boots last week. So I got

P: that’s so funny.

E: So then I’m pushing, you know, and I’m thinking like, I’m pushing and pushing. And then my jeweler turned to me she goes, I hate to tell you. But you have to push harder. And I was like, oh, okay, you know, because it’s weird. You know, you’re like you think you’re pushing but you’re again, like you’re I was holding back to get to kind of a comfort zone. 

P: Yeah. 

E: So I’ve never given birth before. So what do I know about how hard to push? So then I pushed and pushed in? Yeah, I think I was in there about an hour. I don’t know. It’s all that part’s kind of a blur. But

P: God, talk about waiting at home until the last minute, because well done. That’s extremely German engineering. That’s hard to top that. So when the baby is born, do you know are you hoping they don’t cut the cord and they put the baby on your chest? Or do you have any?

E: they did cut the cord? The cord and then yes, she came right on my chest and we didn’t know the sex either. So we really were expecting a boy and it was a girl. I mean, who cares? Right because I have a baby finally. 

P: Yeah, 

E: like a frickin miracle. Like I finally I get one finally you know so and then she nursed straightaway and all that went pretty easily for me too. And kind of like I had like the hell of getting pregnant and then like, like the reward of a good birth and easy pregnancy and

all that. So 

P: yeah. That is amazing. And it sounds like maybe the fourth trimester was not too trying, because you would have you’d seen it before you had experience. She could breastfeed pretty

well. 

E: You know, my mother said to me, nothing can prepare you for the first six weeks. And I think that was a really wonderful thing to say. And I always say to new moms too, because there does come this shift after six weeks. 

P: Yeah, 

E: you know, absolutely. Like, I don’t think I was more prepared than anybody else other than knowing like this entity will end but

P: but also that freeze gives you some sense that words can’t capture the difficulty or the hardship or the pain or the lack of sleep or the combination of all those things what that will feel like

E: Right. I mean, and I think that was really like liberating. You know, my mom just say like, nothing can prepare you so like, whatever there’s it’s not your fault, or there’s nothing you can do. Yeah, you can set up the crib and you can have the changing table and all of that stuff. You can prepare that way but emotionally and mentally can’t be prepared for that how absorbing and how exhausting and 24/7 It is.

P: Yeah, yeah. Well, good. So that is an amazing story of triumph. The girls are a couple years apart. It sounds like

E: oh, they’re three years apart. Yeah. So then my second daughter, yeah, again, it was never never trying. Right. It was like we never tried we just had sex and kind of let it go. So yeah, that was a huge surprise. I was 44 

P: Yeah. So you were you imagining to have another one or you were just Well, 

E: I was just it was funny because like to my closest friends in the neighborhood. Had we all had kids the same year or first were the same age. And then they were both pregnant. You know, 

P: wow. 

E: Yeah, with their second third like that one’s six years younger was 10 years younger. So they were younger, you know, than I am everybody. So everybody’s younger. With kids this age, but so I just was starting to kind of feel sorry for myself. Like I knew was I felt like it was too much to ask for but I did you know, want a second, of course just for her to have a sibling. But again, it was like a huge surprise a big surprise that I got pregnant with Alice and you know, happy surprise, but that pregnancy was not as easy.

P: So that one you find out because you miss your period. And that’s happy news  when you get the result.

E: Yeah, yeah. Surprising. 

P: And then what happens? 

E: So my first trimester is fine, kind of like the first one not a lot of morning sickness. And so we’re so in the midst of all and I’m thinking about I was listening to Naomi’s your Interview with Neil before. And so she went through that whole situation where her son was born and then her mother father died. Yeah.

P: Okay, so here Eileen is referencing Naomi’s story. That’s episode 51. And she’s talking about how her father died not long after the birth of her son, and its dramatic impact on her.

E: So my husband and I had been through that so like when this like first was born. In November of 06 and then in 08, ah, my mother in law died. So we spent like the first year of Lucille is like my husband’s French, like going back and forth to France, and he’s an only child. So so she died in 08 and then right after that. My father died. My father got sick and died in 09. Yeah, so it was like three months after my father passed away, I found out I was pregnant. So that was kind of cool. You know, like sad. too, because like in the process, we lost two of our 

P: Yeah. 

E: grandparents. So. So we had to go back to France that summer, because my husband was settling his mother’s state. So okay, so you know, I You heard how I had a miscarriage in Ireland. So when I got pregnant with my first, I’m not traveling anywhere when I’m pregnant. Totally staying put. I’m not going anyplace.

P: To give a little context to Eileen is talking about here her miscarriage in Ireland. I’m going to read another short section from her piece on fertility that she published in Toast at this point, she’s 33. And in her first trimester, she’s in Ireland, and her husband is back in the States. She miscarries in the shared bathroom of her b&b In the very early morning. There’s a lot of blood she’s just alerted her parents to the drama unfolding in the bathroom, she writes:  

I heard the paramedic stomp up the stairs. They lifted me off the floor. They swaddled me in maxi pads stacked one on top of the other shiniest move. I had an iPhone that I could unapologetically bleed into this Barbie sized mattress. As they helped me down the stairs the owner of the b&b lent me like gave me a cracker. The paramedics strapped on a gurney and bullied me into the ambulance. My mother jumped in the doors slammed and I watched my father grim faced as we pulled away in that rain speckled square window. I watched him shake his head light sharp in the lenses of his glasses. He ran a hand through his strict with grey black hair was still in his pajamas, flannel pants, leather jacket, overweight T. Then he grew smaller and smaller as the siren began as odd wailing. 

I was so relieved to be lying flat. And yet as I watched those green Irish Hills roll by, I felt again like a failure. My great grandmother in Bandon had birthed 10 children. My grandmother emigrated to Chicago and had 10 children. My mother had nine children, it seemed like to not manage one. The Moody gray clouds, the rocky walls, the abandoned castles, the herds of cows grazing and the lurid grass I watched all of it to the oblong window, I felt an elemental kinship with the landscape. The souls of the famine dead haunting the ditches, the fertile Irish landscape that was keenly linked to starvation, to death, and to ludicrously high birth rates. 

We’ll get back to the second pregnancy now you can find a link to this piece in the show notes.

E: Because Alice was such a surprise we had booked a trip to France for July. Okay, way before I even knew I was pregnant. 

P: Yeah. 

E: So we went to France. worked a lot on getting this state settled. I have a two year old and I’m pregnant. And I’m 44. So toward the end of the trip, all of a sudden, I could not urinate. I couldn’t I wake up the morning and I wouldn’t have to go pee and I was like, well, that’s kind of weird. And then it got worse and worse. And then I couldn’t pee at all. And so like we’re leaving for we’re leaving France and okay so my mother in law had a house on this little island in France. Okay, so this little island off the coast of Brittany is quite idyllic is blah, blah, blah, but healthcare wise, it’s kind of a nightmare. 

P: Yeah. 

E: So we go see this doctor. And this kind of, you know, he’s like, my husband’s like, my wife is in pain. You know, she has my stomach is starting to get big because my bladders full. I’m thinking I’m like, Oh, I’m really gonna show him you know, it’s actually not my uterus is my bladder. And every time like driving the car, everything hurts like nothing hurts like what this hurts. So the doctor is like, oh, mais bien sur, you know, she’s in pain or like, and he pulls out this PDR physicians desk reference from like, at that point, 2009 This is like the 1999 version and he prescribes, so yeah, describes this antibiotic for me. We run it we get it filled in, in France. It’s like a powder that you put in water. 

P; Okay. 

E: Well, that thing made me so sick and leave the next day and I was like, vomiting the whole way home. So I’m not pregnant. I got a two year old to get on. A boat and to get on three trains and then I fly back to Chicago. And I’m sick, and I’m puking and I can’t pee. Release me can pee this may be TMI is when I puke. So anyway, we get back to Chicago and I’m scheduled for my ultrasound. So you know I have to full bladder. 

P: Yeah. yeah, Done. 

E: They’re like your bladder is too full. We can’t see your uterus at all. So they should have like, sent me to the ER and catheterized me right. But they did it another day or two went on. I can like I can’t even tell you like seriously I’d rather go through labor than that pain. So finally we go to er they catheterized me dream you know an ungodly amount for my bladder and then and then we can figure it out. So so like the ER Doc’s are med students and they’re kind of like we think maybe, you know, you’re you’ve got a tipped uterus and that’s blocking your urethra or it’s this or that, you know, and, and then like three days later, I’m back in the ER because I still wasn’t getting another one, you know, so at that point, they put me on a Foley and I’m catherized for now this is what’s weird is unlike safely into my second trimester trimester, but I like you know, I’ve got a fully strapped on my leg. 

P: Yeah, 

E: actually, I’d rather have that than the pain so that goes on for a couple of weeks. But then they’re like can only have a fully in for so long. It’s because of the risk of infection and Eileen, you have to learn to catherize yourself. 

P: Are you kidding? 

E: So my husband and I go to a urologist in here, so learn how to do it. And we’re both you know, it’s just it’s just like a nightmare like it is the hardest thing for a woman to do to herself. Or, you know, if you’re a man, it’s not so hard, but for women, it’s very difficult. So I kind of give up on this whole thing. And so my sister, my older sister, who’s a nurse, we just cannot figure this out. We cannot figure out how to get there. And she said, well just start measuring your pee. Just Just see how much comes out. And if a little bit more comes out every time. You know, that’s a good sign. So I just started measuring it, measuring it measuring and eventually I’m just like back to normal. I don’t know why. They don’t know why. Nobody knows what happened. But I so I go back to the neurologists, like two weeks later and they’re like, how’s it catherizeing going? Like, I kind of stopped you know, and I don’t know if this is another example of that mind over matter kind of thing where I can’t go through this process like or maybe like the uterus

grew. 

P: Yeah. And shifted. Yeah, yeah.

E: In the urethra, whatever. The plumbing. You know, worked itself out. So but Oh, and also what was tough about that pregnancy was you know, I went in for all the alpha feta protein tests and everything and I got irregular results. And so then you wait what to 20 to 22 weeks before they can actually see if there’s anything wrong. 

P: Yeah. 

E: And so my doctor was like, Look, you’re because of your age, your results are skewing against you so don’t take it too hard. You know, just see what happens. So we go for the ultrasound. And my daughter, Allison, she’s just all curled up. She will not and the whole thing that they’re checking for at that point is her chamber formation. And you can see that all four chambers of the harder developing properly, and if they aren’t, then it’s I think they were thinking it was Trisomy 18. 

P: Okay. 

E: And so she just would not show her heart. She was just like this in the in the ultrasound technicians taking longer and longer and longer and I’m getting more and more freaked out, and we’re waiting and they can’t get a read. And so, you know, imagine, you know how the heart your pumping heart gets registered on the ultrasound mines like thump, thump, thump, right? I was just like, oh God, and so then they brought in. Finally the doctor came in. And he was just super chill, very relaxed, kind of nerdy guy and he just was like, she just like it was like a magic wand. Like he just did this thing with the ultrasound and then Alice just opened up and showed her heart and it looks perfect

P: That’s exciting.

E: So that was great, you know, and then after that, it was fine. The pregnancy was fine. But it was it was a rough second trimester. 

E: Yeah, that sounds rough. Good Lord. That does sound like a movie script. You wouldn’t believe right? If you read it, you’d be like, come on. The French doctor. Come on. 

E: The French doctor mais bien sur…, you know, he’s so arrogant. Oh my god. And then you know, this this hot. I mean, it was like I never wanted to like I just wanted to get to a major medical facility. Yeah, yeah, I was so terrified. Well, once we made it to Paris, and I called my doctor at Northwestern, I said, I’m scared I can’t keep any food down. You know, I couldn’t eat anything. And I’m really afraid for the baby. And the doctor was so sweet. She’s just like babies getting exactly what she needs. She’s taken that all from you. 

P: yeah, yeah, Yeah, 

E: it will be the baby will be fine. You’re the one that’s suffering, but the babies know how to get what they need. Out of the mother. So and then I said, Well, how am I gonna get on this eight hour flight without throwing up and she said tiny slips of paper without dehydrating. 

P: yeah, yeah

E: And she’s a tiny sips of water every 10 minutes. And that’s what I did. I could keep that much down, you know, and I just kept doing tiny sips of water and that’s, that’s up the nausea and that can be hydrate, you know, so just like those little, those little nuggets of advice are so precious, you know, like, really helps. So yeah, so the pregnancy got better. 

P: And what was the birth redo of the first one?

E: Even faster. 

P: Wow. 

E: Yeah. So what was weird about Ellis is Selena was born my first was born on her due date. So you know, you think your second birth is gonna be your second is going to be exactly like the first well this reconciling in your mind that like, it’s not. So I my water broke at night, a week before Alex was due and I was like, well, that is so weird. That’s not how it works usually explode in the elevator, you know? So, and again, that was mostly at 1030. At night. I call my Doula we leave her for a few hours labor totally stops. We go about our day. My sister came in took my oldest overnight, you know, because we thought it was so that was like 10 on a Saturday night and then Alice was born at 10 on a Sunday night. It was Super Bowl Sunday. So again, nothing had walked around, spent the day kind of walking, eating napping, and then labor kicked in and around eight at night. And so same time, we might actually know that you’re saying that. And so my Doula had left. She had come and  she had left. And then it was like eight and I said and of course because I’m thinking this is gonna be exactly the same as my first baby. So I called her and I said, and she was she had no car she was she writes bike everywhere. So she was in she was half hour away. And I said, don’t rush. It’s fine. It’s early, you know? Like, don’t don’t, don’t worry about it. And so then the contractions start coming. So my husband starts giving me massages between the contractions, right? This is also like, really a true story. And so he has this drum. So he started kind of drumbing for me. And it was like, it was like the drum and the contraction. All of a sudden, I just had this huge contraction, and I was like, Oh my God, right? Like I’m about to have this baby like, I was like, I’m gonna have a baby. So we were like, I can, I can feel this thing coming, you know? And so, and I have, like, if I honestly call it I was like, if I squat and make is so, so we call the doula and we’re like, Oh, I think she’s actually coming. So she’s like, I’ll meet you at the hospital. Right? So, again, we jump in the car. And we’re going we’re going down Wilson Avenue, my husband is speeding, and I’m like, now at this point, I’m crossing my legs. together to keep from giving birth like I’m holding this baby in we’re like going down Wilson and he’s he’s driving super fast and super bowl sunday is at night not too many people on the road. 

P: Yeah. 

E: And this he started speeding up and then someone starts drag racing with us and we’re like, inching down. It’s a two lanes and we’re not there to guard side by side. Finally, I look at them and I go, I’m about to have a baby, right. Oh, you can pass. So then he’s doing like 65 and a 45. We pull up the like to the to the hospital in the wrong the wrong way on a one way street. I go in there. And they’re like triage and I’m like, um, um…do like you need to go the bathroom. I’m gonna have this baby in the toilet. And sure enough, some find that get in there. And I’m 10 centimeters. 

P: wow

E: I’m 10 centimeters in the oven. This another doctor comes in. She goes, Well, I mean, this is how you’re gonna do it. This is how you got to do it, you know? So then Alice was born pretty quickly. And interestingly, her birth story was she she had her little hand on her cheek put her umbilical cord was wrapped around her neck and her wrist. And so thankfully, because of her fist on her cheek, she didn’t get strangled by the umbilical cord. So that was another piece of luck, right? 

P: Yes. 

E: And all these things.

P: I mean, there’s a lot of lucky things in that both of your kids have picked like national holidays so that you don’t have to like you don’t have to mess with the traffic getting to the hospital.

E: I mean, I probably could have had a home birth with the second you know, but I was too nervous to do that. I’d had some friends who’d had some pretty rough experiences with home births. And given my own history, I just wonder is that 

P: so that’s amazing. Yeah, so that’s easy, too. And that fourth trimester was probably a little easier because you knew what to expect.

E: Yeah, especially the birds do like I totally knew what to expect. So yeah, so that was good. You know, it all worked out. But it was a long journey, right.

P: It was a long journey. And it sounds like you’re did you write the essay and toast before you had the kids or where does that fall in line? 

E: So after? Yeah, so like I wrote it? I don’t know. I think it was published in 2015 or 16 and Alice’s point in 2010. So

P: so you had more time to process that from a different perspective.

E: Right. Yeah, exactly. Yeah. Yeah. It’s weird because I feel like birth stories and fertility stories and pregnancy stories. You know, there’s so many different iterations of how it goes you know, there’s you got those women who get pregnant right away. Super easy, and they’re like, it’s like, their lives change so fast. 

P: Yeah. Yeah. 

E: You know, they were the kinds of people that I envy back in the day, you know, but at the same time, it’s like, they didn’t really like there. They didn’t have time to, you know, really get how precious it is, in a sense, like, what a privilege. 

P: Yeah,

E:  motherhood is.

P: Yeah, if it comes easily, right, that lesson is not as obvious.

E: Yeah, and I think I think it’s you know, I think once you go through all everything that I went through, then like, even when it’s really tough being a mother, you’re I was always so like, oh my god, I can’t believe I get to be one. 

P: Yeah, yeah. Yeah, that totally makes sense. I have a similar I have a similar awe about it. And I also have an awe of about the whole process. Just because it’s so many things have to fall in place. It’s just the right time and there’s got to be luck. There’s got to be all kinds of things, none of which you control everything which you imagine you control. Right. There’s just a lot. A lot going on that if you are in a position where things don’t come easily, you can see all those thresholds.

E: And the weird thing about pregnancy and motherhood in miscarriage is you hear it all the time. It’s it’s such a common thing, right? We all have these experiences in our lives like you, you know, you went to graduate school, the University of Chicago like that is not common, right. But becoming a mother’s is really common. Like so many people go through that. And yet it’s so extraordinary. 

P: Yeah, yeah. Yeah, I do think I was terrified. of birth. And I kept telling myself, you know, how many hundreds of millions of people have done this, right? This is a doable thing. But in your own, on your own journey in your own life in your own experience. It just it takes on something different, right. It is a totally different animal.

E: Right, right. And and, you know, that’s why like, there were a lot of things for me that I really, when it came to birth, you know, I was reading a lot about Ina May Garter, you know, like, it’s like, this is a natural process that women have been doing forever and I really did not want to turn it over. You know, the power of that over in a way but we haven’t jokes to my family because like certain of us have very high thresholds for pain and other people in my family has super low press thresholds. I happen to be a high threshold person. So like, I really, yeah, yeah, I mean, like, I know that I could impose because my experience of miscarriage too, I was just like, okay, I can I can deal with this pain. I can manage this pain, but I know that that’s not the same for every woman, right? I mean, like, many women are just like, give me that epidural, you know, bring on the drugs. But yeah,

I don’t blame that. You know. It’s fine. Like, I don’t want to be like, you have to do it my way, kind of mother, because that’s a trap that women get into against each other, right? Yeah, the kids are how you get pregnant or how you give birth or is it a season like all of those judgment things, and ranking of what’s most superior is really toxic. 

P: Yeah, I totally agree. In fact, I saw some maybe it was a New York Times headline this morning about the baby food shortage which you know, my husband and I discussed like, oh my god, it’s so scary. What would you do a week I breastfeed at all so we that definitely would have been us. And you know, the New York Times article said something like people are telling them to just breastfeed

E:  it’s too late. 

P: Like you have no people can’t force feed like it just there’s a million things that go into that. Right. So to suggest just breastfeed is doesn’t make any sense, right? There’s no I mean, in

a lot of women, like my niece has had a six month old Well, she can’t suddenly start breastfeeding months in late, you know, like, so that I know it’s so frightening for those women I feel really bad about that must be

so scary. 

E: Yeah, is I’m feeling scared. And I my youngest ones 18. So I can only imagine. I can only imagine what they’re going through. I’m stressed on their behalf. 

P: Well, thank you so much for coming and sharing your story. It’s an amazing story and I will link to your essay. Thank you toast and if there’s anything else you want to join to them and your website or anything else.

E: I do have a website, eileenfavorite.com I mean favorite.com It’s got other content. I have a novel called the heroines that came out when I was actually so when I was pregnant with my first which is kind of cool. Wow. And yes, so I’m a professor and there’s all kinds of things on that website. They’re not necessarily about parenting, but other creative things I do.

P: That sounds awesome. All right. Well, I’ll link that. 

E: Thank you. Thanks for

giving me the opportunity to speak with you. It was really fun time.

P: Thanks again to Eileen for sharing her story. I think reflecting on everything that’s happened over the course of the 10 years. She and her partner were interested and are ultimately not directly interested in having kids. It’s a very unique personal set of experiences. And as she said last week, each person processes miscarriage differently. And we as a culture should make space for all these differences and hold them gently. Thanks for listening. We’ll be back next week with another inspiring story.

Posted on

Episode 68SN: One Woman’s Experience with Recurrent Miscarriage: Eileen’s Story, Part I

 In today’s episode, my guests challenge is with miscarriage. She has two miscarriages both at the end of the first trimester, and then uses IVF (despite the fact that getting pregnant isn’t the issue)…and get’s pregnant, and has a miscarriage….eventually she becomes the mother of two girls, but that’s later in the story. She is a writer, and in one of her pieces about this topic  called On Fertility in Toast magazine she writes: When you give birth, you do it with others. When you miscarry, you do it alone. Even if doctors and nurses are present, numbing you, holding your hand, giving gentle instructions, they’re not with you, because what’s happening is both too awful, and too common, to be shared. Nobody wants co-ownership of the failed human. Many don’t even consider it human.

Even if your father is driving you to the hospital in his buttery yellow Lincoln, or even if your mother is riding in the ambulance with you, or even if you husband and sister are outside the procedure room waiting, you’re still alone. There was a person/being/cluster of cells that was alive inside you, and now it’s not. Times three. It happened when I was 31, 33, and 38.

I’ll stop reading there and you can hear my guest describe her experience…our conversation is broken into two parts. In this first part I also spoke with a doctor whose specialty is recurrent miscarriage and he shares insights from his own research and experience.

To find Eileen’s writing in The Toast, go here

To find Dr. Kutteh’s paper on a new algorithm for recurrent miscarriage, go here

Audio Transcript

Paulette: Hi welcome to war stories from the womb. I’m your host Paulette kamenecka. Im an economist and a writer and the mother of two girls.  In today’s episode, my guests challenge is with miscarriage. She has two miscarriages both at the end of the first trimester, and then uses IVF (despite the fact that getting pregnant isn’t the issue)…and get’s pregnant, and has a miscarriage….eventually she becomes the mother of two girls, but that’s later in the story. She is a writer, and in one of her pieces about this topic called On Fertility in Toast magazine she writes: 

When you give birth, you do it with others. When you miscarry, you do it alone. Even if doctors and nurses are present, numbing you, holding your hand, giving gentle instructions, they’re not with you, because what’s happening is both too awful, and too common, to be shared. Nobody wants co-ownership of the failed human. Many don’t even consider it human.

Even if your father is driving you to the hospital in his buttery yellow Lincoln, or even if your mother is riding in the ambulance with you, or even if you husband and sister are outside the procedure room waiting, you’re still alone. There was a person/being/cluster of cells that was alive inside you, and now it’s not. Times three. It happened when I was 31, 33, and 38.

I’ll stop reading there and you can hear my guest describe her experience…our conversation is broken into two parts. In this first part I also spoke with a doctor whose specialty is recurrent miscarriage and he shares insights from his own research and experience.

Let’s get to this inspiring story…

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

Eileen: My name is Eileen favorite. And I’m from Chicago, Illinois.

P: Nice. Excellent. So Eileen, we’re going to talk about the family that you have created. But sometimes the family you’ve created is a reflection in some ways of the family you came from. So I’m just wondering, did you grow up with siblings? Did you know you wanted to have a family what what’s your background like in those in those respects?

E: I grew up with siblings. I grew up with eight siblings. Wow. I I’m the number eight of nine. So yes, I always anticipated that I would have children and I have two girls.

P: Wow, that’s amazing. eight of nine is amazing. So imagining you all are pretty close in age.

E: Yes. My mother had the first four in four years. And then I don’t know, after that every two years so there were nine of us born in 13 years. 

P: God that’s like an amazing accomplishment to be to be honest. Wow. So we all know that’s hard work.

E: Right. So she my mother was 24 when she had her first and 37 when she had her last.

P: Wow. Okay, so that led to you thinking you definitely wanted the family. Did you want a large family? 

E: No. 

P: Okay. Okay. Probably also related right to your experience

E: more just you know, the financial realities of a huge family definitely shifted over time. You know, it was much everything was a little bit cheaper when my parents were coming up right homeownership education, all that good stuff. So I knew that for me that would not be in the game in the cards.

P: So let’s talk about your family then. Before you got pregnant. What did you imagine that would be like?

E: Well, so I have five sisters. So I pretty much watched all my sisters have babies from the time I was 13. I had my first nephew Wow. So I was always around kids, little kids being kids, you know, always so I don’t feel like I had any kind of illusions about it. Having been an adult so young, and then having much my sisters have babies and see their struggles and see their happiness. 

P: And so you didn’t imagine that you weren’t necessarily walking into some easy process.

E: No, no. No, I knew what it was like my sister had her first baby when she was 21. So you know, she was young. She got married young, she was you know, I was so I was babysitting at 14, you know, and she and her husband wanted to go out and parties, you know, so like, I was watching pretty young babies from a young age.

P: Wow, that’s good training, actually. 

E: Yeah, 

P: so was it easy to get pregnant the first time well,

E: so you know, my story is that it took me 10 years of infertility and miscarriages before I had a baby. So my my first pregnancy was like, Hey, let’s try to get pregnant and yeah, we got pregnant right away, but then I miscarried. So that was when I was 31. And then it was two years before I got pregnant again, at 33. And then I miscarried again, and then I didn’t get it.

P: Wait, let me let me stop you right there for a second. So at this point, then now what’s our view? I have one miscarriage and for the next pregnancy, I was, you know, on DEF CON two for the whole thing. Yeah, I’m wondering if you took it the same way or you thought this is a process and this is how it works?

E: Oh, no, they were. They were devastating for me. The miscarriages were really hard and really unexpected too because as you can hear I come from this very fertile background. My mother had nine children. She was one of 10 herself. Wow. And my grandmother was an Irish immigrant. And she came from like a family of 10 in Ireland, you know, so like I come from this long line of hyper fertile women. Yeah, so I never expected it to be a problem for me.

P: I brought this question about genetics and fertility to an expert.Today, we’re lucky to have Dr. William Kutteh. On the show. He’s the director of fertility associates of Memphis and board certified and reproductive endocrinology and infertility. Thanks so much for coming on the show. 

Dr. Kutteh: Thank you. 

P: Before we get into the specifics, Eileen’s mother and grandmother are both from really large families like 10 kids. I mean, herself is one of eight kids. And she was saying that she expected because she comes from what she described as a hyper fertile line that she would have kids easily wondering, is is a hyper fertilized thing or is fertility has no basis in genetics or how do we think about that?

Dr. Kutteh: That’s an interesting that’s an interesting point. Many people think that what are super fertile meaning that their problem is not they can get pregnant if they can easily get pregnant.

Issues then the study is what to do different about her family, and in many cases was this concept of uterine receptivity, how receptive is the embryo and neuter and selectivity. So in a normal, fertile woman who’s not having miscarriages?  She has a selection mechanism. In the years that allows computers to discriminate between the normal embryos that may be genetically abnormal. And if the embryos genetically abnormal in individual, normal reproductive potential, like her mother, then in most cases, we believe that that abnormal embryo never attached. She would not get pregnant. And next month, maybe a good embryo come along, she would get pregnant. In case of some women, I don’t know about this. Because this is all research and there’s not a test. I can draw blood or do a sample or whatever. We think that something about that selective mechanism of the uterus to discriminate between an abnormal and a normal embryo is altered in a way that uterus no longer is capable of doing a good job of saying is this going to be a medically normal, or is this going to be an abnormal embryo? And it can’t discern. So, you know, reproduction is complicated. There’s a lot of waste along the way. There’s a lot of duplicity. There’s a lot of excess on your test sperm A man may have millions and millions of sperm. Thanks for one fertilized the same thing, women that have hundreds of 1000s of eggs at birth, and they may have two three or four children typically. So the selectivity years in this individual that male say it was super fertile. It can grab the embryo, its ability to select out that embryo that’s normal, abnormal, is weak or under functioning or not not working well. And therefore the uterus holds on the embryos that normally would never attached. There’s another screening mechanism in a woman’s reproductive system that looks at that India when it’s a quarter of an inch and a half an inch in size 6,7,8,9 weeks for most miscarriages curve, and somehow we don’t understand somehow says this one, there’s this genetic problem or that genetic problem. And therefore, we’re going to shut down all maternal support to this particular pregnancy and we call that a mystery. So this is an individual’s this may be what was going on. She’s still able to produce eggs, they’re still able to get pregnant they’re still able to get to the uterus and attach and start knowing that that selective mechanism, which embryo implants in which, somehow

  

Eileen: so yeah, so it was really tough after the first one, and then, you know, I kind of got into that, you know, I think women go through infertility, you go through this sort of like, let’s try to get pregnant and then all the kind of rigmarole of like sex on timing and temperatures and your legs up the wall and all of that stuff. And after a while, that would get really a strain, you know, on the marriage. So, I would we would sort of go through like, let’s just stop trying, you know, with scare quotes, stop trying, you know, because it was sort of like even a verb itself is an action, that it has an underlying sort of feeling of desperation about it. And so you kind of let it go and then I got pregnant again, in the middle of graduate school, but how, and then I miscarried again. So at that point, I was, yeah, I was 33. In the summer between my MFA. I’d gotten one year down and I was going into my second year, and then I miscarried over the summer and then it was really five years before I got pregnant again.

P: So after the second one, do doctors say okay, if you’ve had two miscarriages, we need to look at X, Y, and Z.

E: Nope. It’s all falls under that. This is so common, and it happens to lots of women and the percentages whatever I think the percentages are like 25% of pregnancies end in miscarriage. So and I didn’t have tests to see, you know, the chromosomal test. Well, that to say my second miscarriage happened in Ireland. So you know, it was I was on vacation, so like it really wasn’t even discussed the idea of like doing a chromosome test.

P: One thing about Eileen’s case is that after she experienced her second miscarriage, there weren’t any tests run to determine what was the issue, and she was basically told that it’s common to miscarry. What’s the standard of care for recurrent miscarriage now?

Dr. Kutteh: The last dozen years or so there’s been a emphasis particularly from arboreta knowledge, that when a woman has an experience, whether she passes, whether she has medically induced passes or that tissue surgically collected, that it should be sent for genetic testing and the reason is not necessarily that he’s going to change any medical treatment that we do. It changes the way we think about that history. And hopefully the way that that individual patient or her partner, think about that mystery,

P: It makes sense to get tested in one of your papers you described all the things that can contribute to miscarriage. Does the testing involve the genetic testing of the products of the miscarriage or it’s everything

Dr. Kutteh: no society has been recommending that I have heard that the American Society of Reproductive Medicine was revising their guidelines. And in medicine, as I said, it may take eight to 10 years before changes, impact appear. To be is reasonable care for patients, like one of the factors also showed a study that prospective study on your 100 patients where we did all the guideline test and we did the test on the miscarriage. We tried to figure out what’s the most cost effective and beneficial and what will be less than those to answer. And when you add that medic question on the miscarriage to the standard, recommended gobbling effect now, we can give an answer to about 90% of people. There’s no more so sorry that bad luck kind of thing. We don’t understand what’s going on. You can give them a pretty good idea of what’s happened. Then we always can fix it, but at least we can say what it is and what our chances are in the future.

Eileen: Then five years went by without getting pregnant again. And I decided to try fertility treatments. So I went through I went through a round of IVF I got pregnant and then I miscarried again.

P: So did the miscarriages happen at the same point?

E: Pretty much yeah, pretty much like around nine somewhere between the nine to 11 weeks. Point always in the first trimester, which tends to be a chromosomal issue, right? Okay. So on this, I’m the third one. I said, Look, I want to cry, I want to test you know, I want to see what went wrong. And so sure enough, there was it was Trisomy 16. So there was an extra chromosome or allele or whatever. So that was sort of comforting. Knowing that’s what it was because I think for a lot of women when you have this really, you know, there’s a lot of like self blame like what did I do wrong? Did I drink coffee? Did I you know, have too much stress did that you know like and then you realize like that really helped me realize like, the problem happened at conception. Really, really small kind of microscopic level when I have absolutely no control and and that that sort of really helped.

P: Yeah, I think the truth of it is, for the most part, we don’t have much control at all over any of the pregnancy. So the idea that it’s your fault, I think is based on this belief that I could have done something different because I control this process in my body when really you’re not controlling any of it.

E: Right. Oh, you know, and it was really funny because when I got pregnant, again to talk a little bit about space between so I had I had another miscarriage I was 38 and I think by the time I turned 14, I was like ready to accept, like, I’m not going to be a mother. You know, like, this is not in the cards for me. I made my peace with that. And I think it’s really I want to be really careful when I talk about something like that because I feel like a lot of women who mystery get told you just need to relax. You just ate and then you get pregnant and again, this idea of control around but also like us sort of faulting the mother for being too anxious or something to get pregnant. You know, like

P: It’s you It’s your anxiety. That’s right. Yeah, yeah. 

E: So I really want to I really want to like express that like I did deep. But I don’t want to prescribe that path toward fertility. Because I think that’s really a dangerous thing to say to any woman. And like I don’t want anyone to like say that but I can say that, like in myself. I had reconciled it. You know, it was 10 years. Yeah, years of trying to get pregnant. I was like, I’m kind of done with this thing that’s just not working.

P: And in the end, the whole process is stressful. We had a lot of trouble getting pregnant and I remember like once the sex becomes work yeah, you’ve stripped away kind of the fun, and it’s now it’s just stressful. You’re in it for an outcome. And that’s, that kind of takes some of the joy out of it for sure.

E: Right. And so like I just, I’m a yogi, so I’ve been practicing yoga for a long time. And so like I really I really saw that like mind body connection. And I really believe in that mind body connection. At the same time. I don’t want to say that like it’s something you can just will yourself to have, like it has to be a deep conversion within the self. And no one should tell anybody else. Just that though, you know, but I will say that I did deeply let go when I turned 40 And I was just like, that’s okay, I’m gonna be able to do other things with my life, yada yada. And that’s when I got pregnant. What was really interesting was during that first trimester so I’m I’m a I’m a professor, so I was teaching one night. I was you know, very early in the pregnancy, maybe about 1011 weeks, and I went to the bathroom on the break, and I was bleeding. And I was like, Okay, I’ll tell you what’s also funny. At the same time, my sister was pregnant. My sister was two years older than I am. And so she was she was even older than I was. She was 42. I was 40. It was pretty much going through and she was six months pregnant. And when I told her that I was pregnant, I said okay, let’s just get ready because I’m gonna miscarry when you have your baby. So let’s just, let’s just get ready for that, you know? Like, let’s just, she was like, whatever you need to say, sister, you know, whatever. You know, whatever. Whatever makes you feel like yep. So let’s just say that’s going to happen. And so I called her that night and I said, I’m spotting. And she was like, okay, and I said, this is totally out of my hands. Either there’s the right number of chromosomes, or there is right yeah, 

P: yeah. 

E: And, and I really, I really believed that finally, you know, I really believe like, this is completely out of my hands. If this is going wrong. It’s nothing I did. It happened 11 weeks ago with sperm egg. And that’s all we have to do. So I went the next morning, I went to see my doctor, and we are going to start crying. And he gives me the old ultrasound wand, you know, because I’ve had been through so many, you know, three really horrible ultrasound, and he was like, we’ve got a heartbeat and I could not believe it. You know, I was like, and he goes if you’ve got a heartbeat that’s strong at this point. That’s probably going to work.

P: Wow. Oh my god. One thing I want to say about the miscarriages which are super painful, kind of amazing that your body can distinguish what’s going on chemistry is saying, Oh, this this sperm combination will not develop into a person. Yeah. And that in itself is like unbelievably cool wisdom that you can’t control.

E: No, you can’t control it. You know,

P: I mean, when I miscarried, I was doing a lot of computer programming at the time. And so that’s the way I thought of it is like, Oh, my body has figured out that this is not going to go to some endpoint. So it’s and that to me was a little bit comforting because I was doing this programming and you know, you get this error, you know, obnoxious beep and error message every time your code wasn’t working. I love it. And so, like that helped me get through to say, you know, this is kind of like

E: you’re articulating something. I think that’s really important for people to remember is that every room is going to encounter this experience in a different way. And they’re going to find comfort in all these different ways. And some people they might find it like, well, it was God’s will or it might be something else, you know, might be well, data error. Yeah, like not the right chromosome number, you know, whatever. But like we have to make space for like, all the different responses and like give voice to them. Yeah, because the culture hates to talk about miscarriage and, and people said the wrong thing to me because they didn’t know what to say. 

P: Yeah, yeah. I think people don’t know what to do with those sad feelings, right? Or how to talk about loss and for sure, I was upset and disappointed but in our you know, singular journey was a big deal to have gotten pregnant. And so we kind of held on to that.

E: Yeah, and I think for me, it was kind of weird to because I had didn’t have any problem getting pregnant. Pregnant, so I resisted, like fertility treatments for a long time because of that. And then when I turned 38 I was like, Alright, I better at least try this IVF because I don’t want to look back and regret it. Yeah. And then after I miscarried after one IVF round, which is horrible. I think I think that was worse, you know, and I mean, because you go through all the needles in the shots and that’s and all this stuff and like the fertility doctor was just like rooting for me, you know? And then, and then I went through another round, and I didn’t get pregnant. And I think that maybe contributed to just be like, okay, you know what I mean? Like, I think I in my head, I said, Look, I’d rather never be pregnant again. Then go through another miscarriage.

P: Yeah, it’s just it’s so much more complicated than we are willing to admit or thinking.

E: I was speaking with a friend of mine who just had a miscarriage a couple of months ago, and she was just like, it’s really hard to get pregnant. You know, she’s like, there’s only like this really small window every month. You know, the timing has to be just perfect. Yeah. Like, I know, it is really small when you start breaking it down and trying. 

P: Yeah, it’s just, it’s kind of a miracle that it even happens, you know, around 

E: Yep, I agree. Luck has such a huge it’s such a huge player in the whole process. Yeah, I feel Yeah, I mean, that was kind of what I came down to in the end. I just sort of went you know, I’ve just, I just had bad luck. Like, you know, like, up until that point, I was like, I’m just on the bad side of the of the odds. Yeah, yeah. Like bearing the brunt of the odds for all the women you know, like because I’m very you know, like, I’m, I’m like, oh, for three and, you know, that’s, I’m not gonna do the math right. But you’re, you know, I’m saying represent our miscarriages that I’m miscarrying more, carry my share. 

P: So how common would you say do we have real statistics on how common miscarriages

Dr. Kutteh: recurrent miscarriage?  Yes. So it’s a hard study to do because you need to, if you asked me how many patients every year we did a study when I was in Dallas at Parkland Hospital, it’s a non referred population. patient demographics are roughly a third Hispanic, Caucasian, a third African American, and at that time, there were 15 or 16,000 deliveries performed in that hospital every year. Now it’s and went through the database and found how many women had been diagnosed with recurrent miscarriage when I presented the hospital as about 1.5%. Now, that has to be an underestimate because everybody might not come back to that same facility for indigent patients that were saved for that hospital because as I say, less than baseline, if you look at all the other types of studies and literature is probably two three or 4% of all reproductive age couples will experience frequent mistakes your patient for example,  

her pregnancies and standard losses. This is the same with the same, some people said in a baby and we were supposed to see this and say this is normal. 

P: And you pass the 10 week mark in a heartbeat and then what’s our pregnancy like?

E: It was great. I had a really easy pregnancy. I don’t have any I mean, no, not really very little sickness. No, I never. I never had any sickness or nausea, fatigue, you know, no. Weight gain, no, nothing. It was perfect.

P: What were you imagining for the birth?

E: My second miscarriage was in Ireland. And so if you read the essay that I wrote about fertility, which was The Toast, it kind of goes into the blow by blow of that miscarriage but it was pretty traumatic. And I went into labor, basically a mini labor that’s what they call it in Ireland, mini labor, where I was just doing the abortion. It was it was brutal. I’m a writer. So like, as I was going through that, I told myself, I’m going to remember how steals and I remember that it was like, I’d have this like, pounding in my back and then just you know, a flood of tissue. And you know, and so, when I went into birth, right labor, so two things I went through initial childbirth classes and the regular childbirth class, and because I had to write so I gave birth at Northwestern British Women’s Hospital at Northwestern. And so before you could do natural childbirth class, you had to do traditional childbirth class. So I was in that and the whole traditional childbirth class was about epidurals. Yeah. And when you get home and wet, you know, and Pitocin and now it’s kind of like, okay, wait a second. You’re telling me that when I get an epidural, I can’t eat. I can’t walk around, and I won’t feel my leg. I’m thinking, how am I supposed to give birth if I can’t feel my legs? Yeah, I can’t feel my body below the waist. How do you possibly give birth so that was my logic. I know. And I know some women love epidurals so like No, no judgement, but like in my logical Virgo brain, I was like, that doesn’t make any sense. Right? So then I did the National Child Birth class. And they said, the best thing you can do is come to the hospital as late as possible. So and the other thing that I did through my yoga studio was I found an incredible doula. So when I went into labor, I called my Doula whose name is story. And, you know, she came to the house and she was also a massage therapist. So like for every contraction, I got a massage.

P: That’s awesome.

E: So it’s just like in what I was noticing it was that stab in the back feeling that I knew. Yeah. That I had already survived. Yeah. And in my brain, I’m thinking I can get that stab in the back and actually get a baby out of this. No problem. Yeah, you know, so I think like for me, compared to most women going into labor there was that pain fear factor was not as strong because I had been through that other experience with the kind of the catastrophic result of no baby. So I just really migraine I was just like, You know what I can I can take any of this if I get to be at the end. So story came and it was like, Okay, I think we’re, I’m writing down the, you know, the differences, the timing of the contractions, how many how many minutes? How many, you know, and I’m like, I think I’m ready to go to the hospital. I think I’m ready to go and she’s like we’re like up all night and she was ready to just go lie down on the bed for a little while. So she knew like because my my contractions were like kind of all over. They had hit a certain rapidity and so it’s now Thanksgiving morning, you know, Thursday morning at five. Dory and my husband I were off lying on the queen size bed and my labor completely stops, just stops. And so she’s like, okay, you know, I’m gonna go home call me if it starts up again. So she’s like, just walk around and just wait, you know, so I was ready to go the hospital around five in the morning on November 23. And then she talked me out of it. She really talked me out of it, which was great. And so then the whole rest of the next day, I just kind of hung out, walked around, but I didn’t want to go to Thanksgiving dinner. at my mom’s house. I just found had that whole like, feeling that 

P: Yeah, yeah. 

E: And then around eight o’clock that night, the contraction started again. You know, pretty rapid. I called Dory came and basically labored in my living room with her for, I don’t know, maybe three hours, so does your For, I don’t know, maybe three hours. 

P: So does your water break at this point or no water? 

E: Because that’s funny. So, so, so she’s giving me massages. And in she said to me this amazing thing she said, Okay, they know what he’s visualizing right now, like when you’re in when you’re when the contractions are coming in. So I used to live in Southern California, so I was like, Oh, I’m imagining like, you know, diving under the wave, right? You know, I like the waves coming in. So I’m like in my mind of a contraction, just dive in under the way and she said, I hate to tell you this. But in order for your labor to advance you have to stop diving under the wave. You have to let the wave come through you. And I was like, Oh, no. And so that whole idea of the mind body connection told me that like, I was actually keeping myself from progressing. Yeah, my brain was like, I was saving myself. I was keeping my cervix from opening through my own like Jedi mind tricks. So but the way she put it was like, it just I got it, you know, and so then the next contractions that came I didn’t die, you know, and I sort of like let that power come through, you know, and so what’s the what’s the visual now are you getting hit by the wave? Was really felt like the power went came up from below the earth and like, straight through me, like straight up my middle and like, open my cervix, you know, and she enjoys it. I’ve never seen anybody turn labor around that fast. It’s amazing. I know. It’s super amazing. So next thing, you know, and she’s like, Oh, we better get to the hospital right? Because like I

So, I’m in the backseat of the car and on all fours and I’m just like, moaning you know, just like it was really kind of fun. You know? Like, it was just like really letting it all hang out. You know how long a drive is, is are we in for like, 20 minutes? No one is it it’s in. It’s like 10 or 11 at night in the city. So it was Thanksgiving night, so there was like, no traffic. So I’m moaning. We’re going down Lakeshore drive my husband just like flooring it, and then we get to Northwestern. And I’m just like, You know what I loved about it was like, I had no modesty. I was just like, I don’t care moanin I don’t care like whatever. And so we get to triage and they’re like, You’re nine centimeters. 

P: Oh my god. Oh my god. 

E: So they put me on the gurney or whatever. We really into the elevator. Wait, let me ask you a question here. Are you Are you sensing that the waves are getting higher or whatever the whatever the image is, I don’t know what the heck, you know what I mean? Like, I don’t know what it was. I was just like, I was like very mammalian. Let’s just say it was very. I was totally my animal body. So then they really into the elevator and my water breaks  all over, and I was like Take That!

P:  I’m going to end this episode right here, with Eileen very much in labor, with her husband newly surrounded by amniotic fluid. Next Friday the 21st we’ll air the rest of our conversation. 

It’s impossible to listen to Eileen’s story and Dr. Kutteh’s experience and not be awed by the complexity of the project of growing another person. One other statistic that I wanted to add from Dr. Kutteh’s 2020 paper in Current Opinion in Obstetrics and Gynecology that blew me away: and I quote It is appropriate to remember that human reproduc- tion is an extremely inefficient process. Approxi- mately 70% of human conceptions never achieve viability, and nearly 50% spontaneously fade before ever being noticed [21,22]. Spontaneous miscarriage is ultimately the most common complication of pregnancy.

thanks for listening

we’ll be back next week with the rest of Eileen’s story.

 

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Episode 67SN: The Power of Gut Instinct: Kristine’s Story, Part II

Today we hear the second half of my conversation with Justine. Last week we heard about her first pregnancy that ended in a stillbirth. She just started talking about her second pregnancy, which was looking and feeling too much like the first one for her comfort. And she’s gone into the hospital at 27 weeks to get checked out. Near the end of our conversation, when reflecting on her experiences with pregnancy and delivery, Kristine wonders again about the possible impact that trauma could have on her pregnancies. To give us a sense of prevalent issue.

I spoke with a clinical psychologist who studies trauma and pregnancy. Her conversation is included.

cover art care of: Maddison, owner of County Road Crochet, find her work here

To find Kristine’s writing, go here

Preemie weight

https://www.babycenter.com/pregnancy/your-body/growth-chart-fetal-length-and-weight-week-by-week_1290794

https://www.whattoexpect.com/first-year/ask-heidi/premature-baby-size.aspx

Retinopathy of Prematurity

https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity

Full Interview with Dr. Natalie Stevens:

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 girls. Today we hear the second half of my conversation with Justine. Last week we heard about her first pregnancy that ended in a stillbirth. She just started talking about her second pregnancy, which was looking and feeling too much like the first one for her comfort. And she’s gone into the hospital at 27 weeks to get checked out. Near the end of our conversation, when reflecting on her experiences with pregnancy and delivery, Kristine wonders again about the possible impact that trauma could have on her pregnancies. To give us a sense of prevalent issue.

I spoke with a clinical psychologist who studies trauma and pregnancy. Her conversation is included.

Let’s get back to Kristine’s story.

K: I got to the same gestational age or as became hyper concerned that something was wrong.

P: And that because you because you felt something different or just that I felt like

K: there was too much similarity. You know, gestational li small, not a ton of movements, you know nothing that should have really blossomed as a second pregnancy should you know once your body’s gone through that once but again, my first pregnancy being so a typical no one could really say well, maybe this is just what your body does. Or there’s you know, this is this wasn’t like that kind of thing, but I yeah, there just didn’t come a date in May 2008 Or I said I think there’s something wrong and going in kind of thing.

P: did you drive to the far hospital or you went to the near one?

K: Yeah, I by that time, we we’ve had a few emergency trips for various reasons. And it was very clear that if you’re, if there’s anything at all complicated about it, you’re gonna get transferred anyway, so you might as well just drive there. So we did and we were admitted. And that just started the whole process of figuring out how much of this is normal, you know, yes, your fetus is in distress you know, we don’t know but we don’t know. What’s what’s normal here. And

P: when they say the fetus was in distress because of a heart rate issue? Okay,

K: yeah, and and it became, you know, became our decision quite quickly, you know, within a matter of hours, you know, do you want to just wait this out and see what happens with this traumatic history, or do you want to start on I forget what it is. It’s a surfactant that they unstart to help the baby’s lungs in emergency situation.

P: So surfactant is a substance that makes the lungs more pliable. Premature babies can be born before enough surfactant has been made with the poor lung function

K: and or do you want to just deliver her early and take your chances on what she wants you can get from the NICU. And I don’t remember the pin drop of the decision. But I remember both of us being a man of our chances were better with her being delivered. 

P: Yeah. 

K: And it was not an easy decision. And it was not scary. But I did discover after the fact that the one thing that was right in that decision is that the NICU was very successful. They hadn’t lost a baby of any kind of distressing many years. 

P: Oh, that’s great. 

K: And the OB, I discovered after the fact is was a doctor that all the other nurses really wanted on their own case. 

P: That’s lucky. 

K: Yes. And so between the two of them, we had good feedback, but the OB was very much there’s something wrong my guess is that this is a dire situation. And the NICU, who’s a very cerebral research renowned, published researcher, was much more, you know, thoughtful, he’s like, Well, this could just be normal for your body, but that was came straight out of the confidence that whatever happened happened, and they would deal with it. 

P: yeah, Yeah. 

K; And, and we were lucky that those two things came together at the same time. So yeah, it was delivered in 27 weeks and five days.

P: What was that birth like?

K: Again, it wasn’t prepared for it. It wasn’t prepared for a cesarean. chose to be awake. Which for me is the cocktail of sedatives and and everything else that I am not familiar with. So when they say as they pull on plunger, this is going to give you a headache it Did you know immediately the headache what was cool about that the operating room. I learned after the fact again, that every single practitioner was a woman.

P:  Oh, that’s so cool.

K: the anesthesiologist, t the OB forming a surgery and everyone else attending so

P: that feels comfortable. I like that. 

K: Yeah. So they did an emergency C section as well. 

P: It sounds like yep.

K: An emergency and then I didn’t see her for a whole night. We didn’t she was going in the afternoon. You know, whisked away before I saw anything. And then a whole night I mean, we got reports, but at the same time, you know, in order to see her you have to get yourself physically out of bed after a C section. Get yourself down there. And that’s after they’d already been flying you to start pumping. You know, in the night I remember thinking whoa, but at the same time, yeah. You have to do the things that no one tells you that you need to be prepared for but you do and yeah, so we got we did that here.

P: let me ask a your question about the birth? Did you hear her cry?

 

K: No, she was way too small. They you know, if, if there was anything to be observed, I think they could tell me or it’s written somewhere in the record. You know that she’s super active. I think about premies that you don’t realize you’ve never watched one in the NICU is that they’re really mobile. But think about how mobile they are in the womb. Yeah, that’s how mobile they are outside the body too. 

P: Yeah. 

K: And so they are flip flopping like little fish in their isolettes because they don’t have the body weight to slow them down.

P: Yeah, that’s interesting. Yeah.

K: So I think there was somewhere on our record saying that mobile you know, it moving the clincher that we didn’t know learn until after the fact is that she did not receive she didn’t require intubation. She came out breathing, and stayed that way. 

P: Amazing. For 27 weeks. That’s amazing and stayed

K: that way for two full weeks.

P:I feel like you have an Olympian.

K: She does she does like to swim. She preferred to ride horses. And then when she did receive oxygen, this is jumping. headwind go back and get details. But it was supplemental, it was never intubated. And so the weaning process was was pretty easy. And I did meet other NICU families in that timeframe. Some of them are burdened by by oxygen for life. Yeah. And I remember thinking how much how cumbersome it was just to bring them home with a little aid, you know, an eight milliliters of oxygen,  which is barely, you know, barely the threshold to even have to monitor for anything, but many families don’t have that experience.

P: So let’s talk about the NICU. How long was she there for

 

K: a shockingly short amount of time for a smallest us she was born at one pound? 13 ounces. So you don’t realize how light they are? Because they are they look fully formed? Yes, but they fit in the palm of your hand. And she was there from May 22 Until honestly the middle of July. So probably just under two months. 

P: that Does seem really short. 

K: Yeah, she came home weighing four pounds

P: How did that go? That’s easily My mind was had all kinds of issues but she was like six pounds. I found that very stressful. Yeah.

K: Oh, there’s I mean, they come home with you know, the tiny micro diapers that they only issue to hospitals and the preemie clothes don’t fit and, you know this and that. Well, it was you know, it was a pretty steady progression. But of course we didn’t know what the progression was at the time, the whatever the developmental hole in their heart muscle that needs to close between the ventricles that closed on time. Even though she was outside the womb. She never had lung pulmonary issues. They were concerned at the time they released her about her vision and her hearing. Hearing is all resolved and vision did not she was she didn’t meet the threshold for retinopathy of prematurity. And that launched into an infant laser surgery when she was a little guy but

P: okay, so retinopathy of prematurity. ROP is an eye disease. That’s my current preemies form before 30 weeks are babies who weigh less than three pounds at birth. ROP happens when abnormal blood vessels grow in the retina which is the light sensitive layer of tissue in the back of your eye. Normally the blood vessels of the retina finish developing closer to the end of 40 weeks. So babies born very early, these blood vessels may stop developing normally, blood vessels can grow in the wrong direction. Blood vessels are attached to the retina. So if they go too far in the wrong direction, they can pull the retina up off the back of the eye. 

K: Anyway, coming home at four pounds. What was cumbersome to me was the fact that she did have that whiff of oxygen. And so then they come with a heart monitor. And so between those two things, you’ve got four wires tethering you to 10 feet of space and, and needing to change it a couple of times a day. 24 I can’t remember what that was. But anyway, it was a lot of stuff. And we had to we wanted to make sure we were at least responsible with it. So we had to stay overnight with her in the hospital under surveillance to make sure that you know we could monitor these systems.

P: And Did did you appreciate that adult supervision or did you think oh, we could definitely do this

K: at the time it was an all new parents stuff. I was like Okay, here we go. Because it just is what it is. And in the meantime, there had been this weird learning curve with pumping 

P: Yeah, 

K: because I you know, I’m felt strongly about it, but I had no idea of what kind of commitment pumping was when your intent wasn’t nursing at all. 

P: Yeah. 

K: And so I was pumping, freezing it in essentially, you know, those little two ounce urine cups that they issue from a hospital or they used to and happens to be the right size for feeding a NICU. Baby. 

P: Yeah. 

K: And so I had a stash of Lowe’s at the hospital to refer to it in that and then deliver it to the hospital, you know, every couple of days, but that regimen was working. And so they were very adamant about that. And so that’s what she started on and by the time she was able to take a bottle that she did and stayed on stage on a breast milk regimen. She had a few other supplemental weird things like liquid caffeine. couple little things that had to be added supplements to her milk. But the clincher there was a she refused to nurse and so even though she was home, the pumping continued. I realized many many women do that by choice. It’s their profession and they’re there. The rest of their life more, but at the time, it was still cumbersome. Maybe I just had old technology or bad bad attitude about it. I don’t know I did it. And I didn’t do it begrudgingly. But it was it was a lot.

P: That sounds like a lot. It’s you know, bringing home an infant under perfect circumstances a lot. So in this case, it’s just when we were in the hospital, we have baby in the NICU. Also, I wanted to stay forever with like, you know all the nurses every day. How can you send us home to be on our own? We don’t know anything. So I’m amazed that you did all that on your own

K: well, it was a leap of faith, you know, at the time because I couldn’t afford care for her in order to keep working. So I had some back and forth with my employer at the time as to when exactly my maternity leave should start. Because I had been spending oodles of time in the NICU and it didn’t work out very well. So I ended up needing to maintain whatever my insurance margin was from my employer, but I needed to leave my work to be able to care for her time. And you know, there’s a little tiny baby who sleeps even more than a regular sized infant and you know, so there’s a lot of downtime, but it’s still care. You find the replays, especially in a rural setting. And so that’s what we did.

P: How old is she now?

K; She’s 13

P: Oh my god, that’s amazing. Wow.

 

K: And what was even more amazing. Besides the scent was written off to the approved maturity is that nothing else seemed to falter. By the time she was a year old. She was on the growth chart for her actual age, gestational age, and has since gotten way off. She’s 510 her feet are size 11 and a half. 

P: Wow. That’s amazing. 

K: Yeah. Her father is very tall. And so at the time I remember someone telling me well, you know, typical, you know, she gets her overall stature could be stunted by the time I joke, like, Well, I hope I hope so. And she No, I think he’s plateaued out now. She’s taller than I am. She takes very seriously.

P: I don’t know if he was very funny. My daughter does, too. I don’t know if you’re a Phineas and Ferb fan. Have you ever seen that show? Yeah. Well, five for 10 is a flawless girl.

K; I will tell her that. That’s funny.

P: Never less than five for 10 My girls say it all the time. None of us are five or 10. So we’re all yearning for that accomplishment.

K: Yeah. Yep. I have to I have learned field to be as tall as she is. And it’s such a it’s such a strange thing to be looking her in the eye that that she comments on it every time.

P: That is amazing. Wow. Yeah, that is some journey. So with, I wonder with her birth, you didn’t examine the placenta or anything like that after the delivery.

K:  I think there was so many things I didn’t know or think about there. She has that big fat medical record. Again, because her NICU primary was a researcher. I didn’t realize until after long months after maybe a year after when they were just codifying everything. That went into her care and everything they surveilled for a year or more that the surfactant they gave her at birth was some of the earliest they’d ever administered to a baby that small 

P: oh wow. 

K: And, you know, of course, I probably signed signing something that gave them permission to pursue that therapy. But at the time, I couldn’t No, probably couldn’t have lived with that information at the time. But you really

P: you wouldn’t have signed it. You wouldn’t have said yes to it. If you had known.

K: I don’t know if I wouldn’t have said yes, but I didn’t want to know about that risk. And I would have had an opinion about that risk at that time. But the way it worked out, you know, that’s what it is.

P: Yeah. In those emergency situations. It’s interesting to see what they would do. And it’s amazing that she spent such a short time in the NICU given how young she was. And it sounds like you didn’t get steroids before they delivered you to help with lung maturity.

K: Probably they probably did, but the window of time was too short. Yeah, yes. So the, you know, as you needed, what, eight hours, 12 hours, something like that, and the gap was only three hour. 

P: oh Wow, that that’s kind of amazing, right? The progress they’ve made in helping premies to breathe is is an amazing accomplishment. Yep. Yep,

K: I follow up on that was good again, or hearing if good or vision is not a you know, not great, but it’s not a documented you know, when people from getting a driver’s license or anything that is isn’t a hardship that they will have dealt with

P: But does that mean that she wears glasses or it’s something more expensive than that?

K: She had surgery when she was an infant infant, like babies basically at her term date. And what was interesting about that time was that she saw an ophthalmologist at Mayo in Rochester. And they had recently changed the threshold for qualification for surgery, and it’ll have lowered and so because she was one of the first babies to meet that threshold, the entire clinic was looking at her she was probably served by 12 different physicians just to make sure yes, definitively, this qualifies and we’re going to do XYZ. 

Some kids have that needs the same surgery and never need visual correction. In her case, by the time she was a year, maybe, you know, their eyes can still pass but by the time she was a year they were they were starting to look at lenses and then as soon as we could keep goggles on her head she started wearing lenses and then there was the biting your nails wait and see how long it takes for their eyes to fully adjust and settle and stop changing stop getting worse. So the first couple of years of her life and probably stabilized by the time she was around nine. But it is what it is. And I don’t think it necessarily gets worse. But the question then becomes what has their little infant brain done to account for the fact that their vision has always been lopsided, substantially lopsided, even with correction. 

P: does that mean one I worked for them the other way better?

K: Yep, revision even with glasses is probably 20/40. And without it I don’t know. And and that launches into my most recent chapters, which is you know, how to address education issues, and how much of them can be pegged to prematurity. So vision was a first thing developmental delays. And, you know, I’ve been the one along the way saying, you know, what, yeah, there’s this, this and this happening where there’s clearly delay, but I don’t see the gap necessarily getting bigger. I just see that it’s a delay that we’ve defined a little bit better with each passing year. You know, is it a year, two years, you know, what’s, what is it? And then you want to say that you just learned to compensate for all for all the things vision for academic things that are academically challenging things that are socially challenging. In her case, it helps a lot but she is so called because she was there. And people wouldn’t notice that she might have any kind of academic challenge unless she was around and asked to do something that’s difficult for her

P: that’s such an inspiring story. That she’s done. So well. If you are looking back on this experience. Now, is there any advice you would have given to your younger self?

 

K: I’m not sure. Honestly, I think I’m just that much older than people who would be experiencing or pursuing anything. Even like what I experienced because of the age of the internet that you can, you know, as scary as it is to research anything medical on the internet, you have such access to all the scenarios. And I think you could at least learn more about what could happen and be aware. So you know, my younger self, I think it’s all the same options. I’m still learning and I’m now divorced, still learning all the same license that when your gut tells you there’s something wrong or stressful or toxic in your life, your relationship. It’s not always wise to just bootstrap it. 

P: Yeah. 

K: That’s you, you really have to stop and get to the bottom of those things because you know, whatever you want to read about epigenetic trauma.

P: So this is an issue that Kristine has brought up a few times how trauma could have affected her pregnancy, and the development of her babies I took this question to Dr. Natalie Stevens. Today, we’re lucky to get a chance to talk with Dr. Natalie Stevens, a clinical psychologist and assistant professor at Rush Medical Center in Chicago. Thanks so much for coming on today. Doctor.

Dr. Stevens: Thank you for inviting me.

P: I wanted to talk with you because you study the importance of the impact of a history of trauma on pregnancy, and how trauma informed care can benefit patients. But rather than distill all your work and effectively capture the scope, why don’t you tell us a little bit about your work?

Dr. Stevens: Yes, absolutely. Well, prior to going to graduate school for clinical health psychology, I trained as a childbirth doula, and I was trying to see which path seemed to fit most whether I wanted to go a midwifery or medical school path or more psychological path and I knew that I needed to have some experiences from the setting in which I would be working and it turns out that I chose the health psychology path which doesn’t involve providing any medical care but rather depends on understanding from the patient’s perspective, what it is like being in a medical setting when you’re going through some kind of health related experience. And so my research and clinical focus has always been on the transitions. of care, through pregnancy and postpartum which also includes fertility and fertility loss, other topics like that. And when I started this over 10 years ago, it the concept of trauma really wasn’t considered a lot of the attention. Back then was mostly focused on depression, preventing and treating perinatal depression. So that area has come a long way.

Paulette kamenecka  23:17  

For sure. It’s kind of shocking that this is new, which given the pregnancy is not that new but so thank you for your work, because this seems vitally important. One thing that when we talk about trauma I think people can get confused by is, is what does that mean? Does that mean, you know, a child survivor of a war or, you know, what’s the scope of that? Can you maybe define for us what we’re looking at

Unknown Speaker  23:41  

Absolutely. And it depends on who you’re talking to. Because when I started my work early on, working pretty closely with obstetricians and the obstetric residency program at Rush, the word trauma in the medical setting means a physical trauma that requires even more clarification. So a psychological trauma is more often what we’re thinking about when we use the term trauma and it’s an event that is a stressor that is out of the ordinary beyond the the intensity or level of threat to a person’s health, life, safety, bodily integrity than what is typically experienced.

P:Today, we’re gonna talk about perceived concerns about how trauma may have affected the outcome of our pregnancies. Can trauma cause slower growth for the fetus in utero and trauma cause issues with the placenta? Do you think there’s any connection there? And and, you know, is it related to premature delivery?

Dr. Stevens: Yeah, that this is such a fascinating and complex question. But the short answer is, yes, there. There are physiological things, processes that have been sort of teased apart by various researchers and projects to try to see what the connection might be between both having a history of trauma, but not necessarily a diagnosis of PTSD having a history of PTSD that isn’t present during the pregnancy. Or having PTSD while you’re pregnant, that has been examined in relation to prematurity, low birth weights. And those are those are the two primary outcomes, but there are a number of complications and things that quote unquote, can go wrong. That I think feed into a lot of the anxiety that pregnant people feel. So there are other things going on here. Trauma doesn’t only lead to PTSD, there’s also the risk of depression, substance misuse and anxiety. So I was thinking about that and the story you described, that person doesn’t have to have all the full criteria for PTSD in order to have a lot of hyper vigilance in the subsequent pregnancy when all of these signals are coming up that remind them in parallel. What happened before. So then there are other studies that have looked at anxiety symptoms, not specifically traumatic stress symptoms, but anxiety symptoms, that have also shown an association with these outcomes. But I think the important thing to remember about all of that is that this is the larger scale epidemiological research and it’s really, really difficult to if not impossible, and as researchers and scientists we don’t we don’t do this to extrapolate from those findings to an individual case. So the other thing I think it’s important to mention, and there’s some really great, accessible information at the National Center for PTSD website that talks about different risk factors for PTSD and how women are more likely to develop it than men are. Part of that is greater exposure to trauma, greater exposure to things like sexual violence, which are more likely to lead to PTSD and that the key here is the idea of what what does the brain do, what does the person’s thinking do or how does their thinking change as a result of the trauma? And so there’s some evidence to suggest that women are more likely to blame themselves for things like sexual assault, but also the instance you’re describing something that happened to my pregnancy and that self blame coupled with the social support, not not having those supportive people around you, that you feel safe and and perhaps are helping you to challenge that narrative are really important process. So I’m speaking more to the psychosocial processes because that’s more my area, but there is absolutely some fascinating studies that I have read about the links between trauma and inflammation. The way that it affects the fetal placental unit, you know, this kind of unit where the pregnant person’s body and the fetal unit are coming together. And there are certainly many studies that have pointed to, although not completely described, or found, that there’s there are alterations when there’s a history of trauma, even even epigenetically even in previous generations. If I can repeat back what I think they’re saying is two things. Thing Number One is there’s definitely research on the fact that history of trauma and maybe trauma during the pregnancy can have physiological effects that might be correlated with low birth weight or prematurity that can’t explain one person’s experience. But he somewhat natural inclination we all have because the pregnancy is going on in our own body to claim responsibility for the outcome is not helpful and probably not right, given how complicated this

P; process is. Right? If you had that much control over your own pregnancy, everyone would be born with like an eight pound share. Right? Exactly