Episode 40SN: Pressure Makes Diamonds: Dr. Crevecoeur’s Story

Today, we’re really lucky to interview Dr. Crevecoeur, who has an amazing story and many titles that I’m leaving off here by just referencing her background as a doctor as an OB, in fact. So Dr. Crevecoeur, thanks so much for coming to the show. And will you please give us a more extended sense of the things that you’ve been doing. 

 

Dr. Crevecoeur: Oh, well, thank you for having me. First of all, I really appreciate this opportunity to speak to your listeners. I’m a retired OB GYN and I stopped working maybe about 20 years ago, because I have five kids, and I stopped to homeschool them. The community that we lived in was not very conducive to learning. They really needed to be challenged. I stayed home and also because of the fact that my middle child was injured by the babysitter. We had no family in the area. So baby sitters was such so difficult for my husband and myself. We’re both physician and so we always had to compare our call schedule, application schedule. And then when the educational thing came in with my six year old, my five year old, then I figured, okay, you know what, this can’t go on like that. So then I took off my medical training hat that I worked so hard for, to put on my teacher homeschooling hat, which also was an amazing experience and I loved it. I I you know, looking back at it, my kids are adults now. Also beautiful, but of course, there was some difficult moments. Then I became an author I wrote about my experience, and my memoir, pressure makes diamond. And I talk about some of my war stories which I love your title of the podcast because people don’t understand that. Having a baby being pregnant, there is a lot of difficulty that occurs if there’s even tough that occurs with either my my two patients that I’m dealing with the unborn child and the mother and sometimes they’re in conflict of each other because the unborn child will try to do whatever they can to survive. 

 

P: It’s an amazing journey, and I think many of us can think relate more completely to the idea of homeschooling after the pandemic. And what an unbelievable undertaking that is. So I’m excited to hear this whole story. Let’s start from the early phase here. Do you have siblings? 

 

Dr. C: Yes I do. I have five siblings. I am kind of like the before the youngest on my little brothers. That is the youngest. I’m also an immigrant. I came to this country from Haiti. I left Haiti at the age of two, but I came to this country at the age of five because I traveled with my my parents. I was at that age where I wasn’t in school, like my oldest siblings, and I wasn’t a baby like my little brother, so I could travel with them and I kept my mom companion while my father pursued all these different avenues of where he would live with his kids. And so my father was an intellect a mathematician and a lawyer. And so he had a lot of offers at that time, especially in the late 60s With all of these social upheavals, civil rights movement and everything else. And they wanted a lot of black educators to come to this country and to other countries. So we lived in France for a year we lived in Africa for a year. Before we settle down in Brooklyn, New York. And then the rest of my family came and joined us. Yeah. And I love my siblings to death. They’re my best friend. And that was one of my main reason for wanting a large family. And when my husband and I got together when we were dating, I told him how important it was for me to have a large family. And he came also from a large family. So at the time, we thought it was perfect. We agreed. But once we had my girl and my boy, my oldest, my husband said we’re stopping at two and I said, No, you can’t renege on our promise. So then eventually, we settled for four, but I cheated because my last pregnancy with twins a girl and a boy. 

 

P: Well done. 

 

Dr. C: Thank you. Well, it was a touch and go pregnancy. That was my hardest pregnancy, actually. 

 

P: So let’s talk about the pregnancies. Were you already a doctor before you got pregnant? The first time?

 

Dr. C:  Yes. Yes, I was. 

 

P: So you unlike most of the people I talked to you probably stepped into pregnancy with a different set of expectations. And a different view about what it might be like so many people come on the show and say oh, you know I’d been on Instagram and I you know watched all the movies and I assumed pregnancy I’d be beautiful it would be fun and I could eat whatever I wanted. And it’s just a glowing aura around the idea of pregnancy that doesn’t necessarily match the experience. So I’m wondering what you were thinking about pregnancy before you got pregnant. 

 

Dr. C: Actually, I could say I was probably like he the other people you spoke to. I saw a lot of the mishaps in pregnancy, but I never expected it to be to me, you know,

P: yeah, that’s fair

 

Dr. C: I always felt that I ate right I exercise right.  So I knew what to do. I knew all the pre counseling that I gave my patients so I knew how to protect myself, my prenatal vitamins and everything else. I never expected to have twins that did not want to in my family. So that was a different aspect. I never tended to have preterm labor. I mean, how could you prepare for that? But I wasn’t treating labor and of course, the pain because of the fact that my husband’s anesthesiologists I wanted to feel that pain of pregnancy that my patient spoke about and I know some of it was was really hard but my husband told me Colleen and you’re sort of having these contraction now you become a moving target and if you decide to get epidural later on, it’s so much harder. Why don’t we just put in the catheter now and if you need to be topped off if you need medication, at least it’s already there. So I said fine. We’ll compromise oh my goodness, I have one I had one contraction that I could relate now with my other patients. after that. I told my my husband get me the anesthesia. 

 

P: You know pain is a hard thing to describe and to prepare for. It is it really feels like

 

Dr. C:  I felt like my back was going to break open. My oldest sister did not get an epidural and she went through the whole lamaze method. I didn’t go through that but because of everything she told me I figured that if she could do it, I could do it. And no after that first pain I said there is no reason for me to go through pain like this when I don’t have to. 

 

P: Yeah, 

 

Dr. C: so at least I know what that first pain felt like. And then I go maybe joyful. All of my kids. 

 

P:  feel like your husband will feel useful. 

 

Dr. C: Oh yeah, he used what he felt very. It’s not sensual. But I think it helps when a doctor could relate to what their patients are going through. And I’m saying that very cautiously because we know that we have a lot of male physicians that can’t go through that. So I’m not saying that women physician are necessarily better, but I just feel that when you been in that kind of situation. You could probably relate on that aspect better. 

 

P: Yeah, experience is a real educator, especially in pregnancy where There’s so much going on. It’s really hard to describe in a way to make someone else which is why we walk in and think yeah, I won’t need the epidural. I remember when I had contractions and I didn’t even get that far. I felt like I must be doing it wrong because it hurts so much. there’s no reason it should it should be feeling like this but so I’m with you. Was it easy to get pregnant?

 

Dr. C:  It was very easy. 

 

P: Good. 

 

Dr. C: It was even too easy. And I could always find my pregnancy so we had let’s get pregnant here so we could have you know plan on vacation and it usually work. But you know what though? I felt guilty because I had Kate patients that were infertility treatment. I was there. We’re going through infertility treatment. And I was pregnant almost five years ago. So a period of time I have five on the five so and I wanted them that close because this is an eye with that close, 

 

P: Although I think it’s like it’s a beacon for the rest of us. Right I did not get pregnant easily but it’s a good story to have in the world and a good experience that’s hopefully someone’s getting pregnant easily. Right that that 

 

Dr. C: It is unless you’re dealing with your infertility patients or you’re dealing with patients that have previous miscarriages and I had a patient that you know, twice in a row she had her miscarriages when I was pregnant. 

 

P: That’s hard 

 

Dr. C:  so I saw her again and when they call to tell me Oh, that the critical we have a case you know, miss a bush, you know, I’m thinking who’s the patient and give me some history you know, I’m on my way. And when they would say the name I’m thinking oh my god not heard God you know, and I felt so awful. And here I am coming in with my pregnant belly. You know, she’s looking at me and I and as much condolences that I try to offer to her. She’s like, you don’t know what it feels like, you know, you’re pregnant every year. You know? Of course she doesn’t say that. But that’s how I could envision it. And I just felt guilty. I really did. 

 

P: Yeah, I can see what you’re saying is as someone who had trouble getting pregnant, whenever I went to my OB office and was surrounded by pregnant women, I was like okay, your’e make him look easy.

 

Dr. C: How was the first pregnancy? Well, my pregnancies I had hyperemesis I grew up throughout my whole pregnancy. When I would see patients I would say excuse me, I’ll be right back. I would go to the bathroom and I got to be really good at that. It wasn’t a big deal. But I was dehydrated. My husband being done anesthesiologists, he had to be in the office line by seven o’clock. He had to be in my nine. So he would hook me up to an IV and that’s how I would be hydrated. And in the evening he would hook me up again if I needed it. If I didn’t have him I know I would have been in the hospital a couple of times just getting IV fluid in and because that’s how bad things were. For me. So that helped a lot. But that happened throughout my whole entire pregnancy for all of my pregnancies that was something that I just had to get used to. 

 

P: Let’s talk about her emesis for a second. My understanding is that we think it’s driven by a hormonal issue. 

 

Dr. C: Yes, 

 

P: is there any more that we know about? hormones? 

 

Dr. C: not at the moment. Your body’s getting used to a lot of changes when you’re pregnant. And sometimes we see it happen with the first pregnancy and it doesn’t happen as much with the remaining pregnancies. And we see it mostly happening in the first trimester. And so as your body is getting used to it, you’re getting better handling it and then we see some pregnancies like myself but my own. It happened throughout the whole pregnancy was worse. I would say the first trimester then the remaining months, but it still was present different food elicited different reactions from us. That’s still the basis of it. Do we do give patients besides fluid we give them antiemetics or medication? I never really liked those so much. They didn’t seem to help me that much. 

 

P: So did you manage it with gingerale and saltines and the IVs or what was your approach?

 

Dr. C:  It was basically, um, ginger and fluids. Okay, that was my approach. And it was 

 

P: and is it does it run a family to any of your siblings have it? 

 

Dr. C: that’s a really good question. It really doesn’t matter and family and none of my two sisters ever complain? About so I was the only one. 

 

P: So that’s interesting. And hard. Good lord. Yeah. Especially since you had your pregnancies close to each other. It’s a long period of time to not enjoy food. I know right? 

 

Dr. C: You know, I enjoyed food is just I didn’t stay down. It didn’t enjoy me. As much. 

 

P: You only got to enjoy briefly. Okay. So with the first one, so we have hyperemesis and then someone is following you, I assume and and talk about the preterm labor. How did all that develop? 

 

Dr. C: Yeah, pre term labor and I don’t know, there’s a lot of theories about preterm. Labor. And now there’s also talking about vitamin D deficiency, and that’s something new that we never really associated with preterm labor, and of course, different infections could cause preterm labor. But for me, I was usually always healthy and exercising. I always tell my patients that if you’re healthy and exercising you shouldn’t stop doing that. And if you’re used to running marathons, or whatever your body’s used to, you should stop doing that. Well, I was very active, but I remember coming back from seeing my parents, my parents lived in Florida at the time and in Pennsylvania. Like I said, we didn’t really have any family members. And I was getting to this really depression like I miss my sister. I miss my mom, you know, my husband says you’re off next weekend. Why don’t you go take a trip and I was pregnant with my first child. I you know, if my mom was gonna fly in on time, I didn’t know my sisters. Were going to be there. So I went and I saw that my state as long as possible and when I was I laughed I was gonna miss the plane. So I was doing one of these running down that airlines getting down you know, the run, you know, like trying to catch my plane. And, and I was maybe around 20-24 weeks with my adult daughter. After that, I had the most severe pain. If I made the plane, I was in so much pain. Then I felt I was having these contractions these mild contractions I was so contacted my doctor right away. She hooked me up to the monitor, and she told me that I was contracting. She put me on medication and everything and I and it kind of stopped. Ever since then, all of my other kids. My contractions started earlier, and I was able to deliver my daughter at 37 weeks, but each child after that son was 36. My other son was 35. Then my twins were my earliest authority to 

 

P: talk about the first delivery because that that’s a must be a bit of a surprise. 

 

Dr. C: So my first delivery besides the preterm labor and the hyperemesis and once I got my epidural, it was uneventful. So my doctor and I, we both decided that, you know, I could get off the video, gentlemen, the lung, my baby’s lungs should be mature because that’s the main thing that we worry about with preterm deliveries is the lung majority because babies are not breathing in utero for good reason. The mom is doing it for them. The lungs are not functioning and when they take their first breath, that’s when the lung starts functioning. So we know we don’t have any basis of knowing when the lung maturity is going to occur. And we think that by term, it should be fine. So preemies we do worry about the lung maturity they can’t read. And you know, and this is why we have so fast and now which helps the alveoli in the lungs to keep it open so it doesn’t collapse. 

 

P: Okay, so quick note about surfactant factor is a liquid made by the lungs that keep the air sacs or alveoli open. This liquid prevents the air sex from sticking together with a baby exhales making breathing possible after birth. A fetus starts making surfactant at about 26 weeks and the baby’s born before 37 weeks. There’s a concern that not enough of this liquid has been made and the baby may have breathing problems. When it’s born. The whole issue of surfactant was first identified in 1929 by a scientist in Switzerland. And it wasn’t until the 1980s that researchers were testing various animal surfactants and manufactured surfactants on preemies. 

 

Dr. C: That was what my research has a residency. That was what I did. My husband had helped me and that’s when we work together. And I was looking to see how so fat that really work. And could Is there any basis of putting it in the amniotic fluid because we do, although babies don’t really breathe. We do know that there are some instances and so I wanted to try to see if we could help these preterm babies earlier than wait until they are born to give them that dose of a surfactant in their lungs to help keep the alveoli open. So I understood all that and I was always 

 

P: wait that sounds like very cool research. Did you find out that if you inject surfactant in same fluid, it has an effect or 

 

Dr. C: it wasn’t statistically significant. And so that’s why we don’t do it. How was it when you took the first one home? Was it what you expected because you came from a big family or your siblings had kids or 

 

Dr. C: It was in November and we had a lot of snow we were in central Pennsylvania and that first three months or so I think my family did come but they didn’t stay too long they came to and we had snowstorm so it was really hard to get to us. And I stayed home with my oldest for six months before I went back to work. My husband was busy working and felt I was going crazy. As a mom just being with my daughter and not really having anyone to talk to. I felt totally isolated. I had all these plans to do things with her. But she was just a baby. And so it was difficult. You know now that you’re making me reflect on this. If you know you really hit a really great question. It was difficult those first three months I really wanted to do things for her. We were stuck in there was a big snowstorm. Remember, I couldn’t even go out. I couldn’t even drive around places would have my husband was always on call and we had no family in the area. So it was a very lonely period with her. I talked to her constantly and this is why she’s so smart, you know, until I have the other kids until my family came but that was a good question. It was different from what I expected. 

 

P: The kind of all demanding quality of a newborn is the another thing that’s sort of hard to translate or prepare for. 

 

Dr. C: Right as much as I tell my patients about breastfeeding and everything else. I wasn’t sure if I was gonna breastfeed to be honest. But I did my daughter just latched on before I even had a choice in the matter, which was so interesting. But that’s another thing with the breastfeeding. I liked it and I was thinking I would breastfeed, you know, for three months or something. And I was only able to breastfeed for six weeks because of what I did it for all my other kids six weeks after that my breast milk just dried up. So that was also something that I didn’t know if I was doing wrong and it’s so funny when the lactation nurse came in and say Oh, Dr. Crevecoeur, you know, I’m gonna teach you this but you’re a pro at this. I’m thinking No, I’m not a pro at this. I’ve never done this before. Don’t assume anything. Just make sure you’re talking to another patient you know, because you’re adopted they just assume you know all this my don’t so 

 

P: that’s amazing. Also, your body has its own limits, right. It’s you’re gonna have hyperemesis whether you want it or not and it sounds like your milk production is there for six weeks. So enjoy. Yeah, yeah, it’s over. I’m guessing that with your other pregnancies between your daughter and the twins, and it was pretty easy to get pregnant. Right? And then you have the hyperemesis. But was it a little bit better each time or was it equally bad? 

 

Dr. C: It was equally bad. I think I got better at it. I got it better. What’s your anticipate? And so but I think it was equally bad. 

 

P: Do you need the IV support at home for each one? Oh, wow. I did. 

 

Dr. C: I don’t know if you want to go to the incompetent cervix because I also had that. 

P: Sure. I mean, whatever you want to tell us about did that happen for the second one or happen for the second one and all of the remaining ones? I had traction throughout all my pregnancies and I was on medication for that. And I was on bed rest take it easy, Carlene and all these other things that I try to do and

 

P: Can I ask  a question. What is the medicine do how does that worked? 

 

Dr. C: The whole thing of how the ritigin works? 

 

P: Yeah, 

 

Dr. C: it’s supposed to uterine relaxation basically, supposed to counter the contractions 

 

P: it sounds like it more or less worked for you. 

 

Dr. C: It did. It did till until it didn’t until the baby’s like I’m coming out regardless of what you do. We move we stayed in Pennsylvania, but we moved maybe 30 minutes away from where we were living to a bigger house because now we were going to have two kids. Basically, we had our house a month before we actually moved in so that it wouldn’t be too crazy things would be put away. I remember that day. I called my husband I said, you know, I’ve been contracting throughout the day and I don’t think this medication is working. And my contractions weren’t anything severe but it was just, you know, I felt them. And he told me Well, Carlene, I’m on call today. I said, you know, I think we should go to the doctor. I think we should go to the hospital because I’m a little concerned. It’s not stopping. And he says Well, I’m on call today. Could you hold it? I said okay, I’m gonna go with or without you because I’m concerned. 

 

P: Yeah, 

 

Dr.C: he  goes, Okay, I’ll find someone to cover me. I’ll go with you. We go to the hospital and I’m sitting in waiting for my doctor. And I’m just common anything and then he examines me and he says, Carlene your seven centimeters.

 

P:  Oh my god. 

 

Dr C.: Seven that day two was an ice storm. And so while we were driving to the hospital, I wait for my husband got home. He was sliding. I could have had that. baby at home easily. Because if we waited until I was pushing, you know, 

 

P: what are you 36 weeks at this point? 

 

Dr. C: I was 36 weeks. 

 

P: So let’s agree that we need a different term other than incompetent cervix. I don’t love as a trainer. I have to figure out something else for that. I agree. But essentially, your cervix is opening because the uterus is contracting. Is that as it should? 

 

Dr. C: Yes. And I not really feeling that pain, because it’s kind of floppy. So So yeah, that’s basically what it is. It’s not holding tight. And what’s so remarkable about the organs in our body. Now cervix when we have pap smears and you have an abnormal pap smear and the doctor says, Oh, we could freeze it. We could do cryotherapy or we could take a piece of it. uncomfortable but it’s not painful. You know, if you’re doing a freezing technique and you’re telling your patient how are you doing? Are you okay? And they say yeah, I’m fine. We don’t have nerve endings for that in our cervix, 

 

P: okay, 

 

Dr. C: because I’ll start with never felt like they will be in a situation they will be frozen or they would be taking bites off. So there was no reason to put nerve endings there like we do enough skin. But we do have nerve endings for dilitation. And so when you’re dilating, you feel that pain, because your body’s telling you your cervix is opening up, you’re getting ready to deliver a child and you should know this other than that we don’t have nerve endings for anything else. It’s just like your bowel too we have no nerve endings for distension but if I take a piece of your bowel, my bone it you probably won’t feel that or at least you won’t feel it that way you’ll feel it on your skin. So when you have a quote incompetent cervix, your dilating, without me knowing you’re doing this on your own, which is dangerous, because then I could go to the hospital, or I, you know, I don’t know if I’m fully dilated. 

 

P: So so that’s really interesting because as you’re talking your cervix should be dilating when your uterus is contracting. That’s how the whole thing works. But for this condition, you don’t feel it the way you would at a normal time of labor. 

 

Dr. C: Exactly. 

 

P: Okay. If you’re seven centimeters, there’s no going back. 

 

Dr. C: There’s no going back. I guess I was contracting so continuously that the doctor felt that the long maturity of my my son would be fine. So as soon as he just broke the water, yeah,the amniotic  fluid I delivered. I delivered in like less than an hour. 

 

P: Wow. 

 

Dr. C: Yeah, I deliver very fast at that time. It would have been at home and if I didn’t go to the hospital when I did. 

 

P: I don’t know if it was your doctor training. Or your own intuition. But how smart to leave. Oh, no, thank god. Wow.

 

Dr. C: Yeah. And you know, and it was just continuous in the medication that seemed like it was helping, and it wasn’t painful, but it was not stopping. So with my history, I just want and then I think I heard that there was going to be an ice storm. And I knew that it was bad. So at least I wanted to be in a hospital in case anything had to be done. You know, even if they sent me home, no Carlene you okay, you will give me some fluid and send y’all you lose nothing. 

 

P: So the contractions feel like cramping. Is that what they feel like? 

 

Dr. C: Yes, they felt like cramping. Okay. Because when I have patient my time to seven centimeter you’re screaming your screen, I give me an OB doorwall Why did you do this to me? And so the fact that I was seven centimeter and it was just some mouth and traction that, you know, was dangerous. 

 

P: That’s a little scary. So it sounds like you and your husband took a little pause for a second to work out. How many kids are we going to have between the second and the third? 

 

Dr. C: Right a year

 

P: and and then you came around good work. And then do they put a stitch in your cervix immediately or how is our that usually work? 

 

Dr. C: that usually goes after the first trimester? That makes sense? 

 

P: Yeah. 

 

Dr. C: Because if you’re gonna have a miscarriage for whatever reason, then you don’t want to put a stitch there. But you want to definitely put it before the pregnancy gets much heavy and before you start dilating. 

 

P: So that’s enough to that first of all, the stitch Can you feel it or no because again, you said like that, that part of the cervix has not innovated. They had an epidural for that. 

 

Dr. C: Okay, you had an epidural and they took me to the O R, and they put the

stitch in 

 

P: and is it literally one stitch? That’s enough to keep your cervix closed?  

 

Dr. C: Yeah. Oh, yeah. It helps. 

 

P: So what happened with the third one because that one was even earlier? 

 

Dr. C: that one was at 35 weeks? I think I did have an amniocentesis for that where they take out the fluid to see the level to see the ratio of the lungs maturity. 

 

P: ok What you’re hearing is an edited version of my conversation with Dr. Quebecor, because we’re going to talk about prematurity. We talked briefly about the lab test to measure the lung maturity of a preemie. As she suggests it’s an amnio that examines the ratio of two I think their fats in the amniotic fluid. It’s called the LS ratio, and it provides a way to estimate lung maturity, given that lungs are the last organ to develop in utero. breathing problems are a big issue for preemies. In a 2014 article in a journal called Future medicine, the author suggests that this kind of testing doesn’t improve neonatal outcomes. So it’s becoming a less common way to manage premature babies, but I did it with my firstborn and it sounds like Dr. Crevecoeur did it with her third baby. 

 

Dr. C: So because my my child’s lung was mature, my doctor said, okay 35 weeks we’re gonna go and we’re gonna cut you a stage off and so by then I knew that I would probably go into labor. I did rounds that day. I told my patients that it I’m checking out it won’t see until six weeks later and everything because I’m probably going to go into labor. And my husband came with me afterwards they cut the stitch, So I started going into labor, and they just kept me broke my order and I delivered, but I remember going in the morning seeing my patients setting somehow. And so I think that one was more plan because my oldest son that was like rushing and everything else so this one was better. Plan as far as my schedule, my husband’s schedule. 

 

P: so that one sounds a little less stressful because you’re taking all the information you learned from what exactly to this. 

 

Dr. C: Yeah, exactly. And just when you think you learned everything, you get a curveball with twins. 

 

P: So let’s talk about that. Obviously, you know, by eight weeks or how long does it take, can you use HCG to say this is off the charts? It might be more than one? 

 

Dr. C: No, no, I did not expect it to be more than one. I knew that I was pregnant, and I expected it to be one I was hoping forI was hoping for a little girl because I had already two boys and one girl and my sisters are my best friend. So I really was hoping for the girl and I already agreed with my husband had a big fight. And he said one more we’re going to have four and if it’s a girl or not with stopping and I had said, Okay, fine. So because he gave in I figured, you know, I’ll choose my battle. 

 

P; Yes. 

 

Dr. C: So he was in the hospital, and I was with my three it was in the evening I come home from work, and I was in the kitchen, washing some things or getting water or whatever. And I felt a pain searing across my pelvis. And it was extremely painful. It was spontaneous one minute I was fine. The next minute I was bent over in pain 

 

P: how far along are you at this point? 

Dr. C:  eight weeks 

 

P: Okay, 

 

Dr. C: I just limped over to that family room. And I told my oldest who was one five years old so at the time to take the kids upstairs and put them to bed and she was like so mature and she was my strength. I counted on a whole lot of things. So she put them to bed. You read them a story she was reading by then. She was so proud of her older sister, you know, role that she played. And I called my husband and I told him, I’m having a lot of pain. And I think I’m having a miscarriage. And he says, Okay, I’ll find someone to cover me I’ll come home. And I said, Sweetheart, this is eight weeks. There’s nothing you could do for me to just hold my hand. I said, I’m not bleeding yet. But I’ve never felt such bad pain in my life. And, and so for you to come home and hold my hands. It’s not gonna help. I just need to let this play out. He said are you sure and I said, Of course. I’m sure then he stayed. And I went over to the couch. And I started crying because eight weeks is nothing you’re going to do you know, the next day, I felt great. And I looked and I was in bleeding and I’m thinking what just happened here? And so I took the kids to preschool and daycare and everything else. I went to the ultrasound. I told my friend who was really my good friend could you scan to see what’s going on. I’m pregnant, but I thought I was having a miscarriage. It was so painful last night. When she did the ultrasound. sHe found out that I was having twins, but that’s not what caused my pain. My corpus luteum the dominant follicle that releases the egg becomes the corpus luteum that supports your pregnancy before the placenta could take over with progesterone 

 

P: In case you are like me and didn’t entirely follow along on the brief bio of the corpus luteum here’s a refresher. As a woman you are born with all the eggs you will ever have something on the order of 2 million by the time puberty hits about 400,000 eggs. Between 405 100 of these eggs will mature during your reproductive years. All the immature eggs are enclosed in a single layer of cells known as a follicle that supports the egg. Each cycle hormones encourage follicles to grow and release a mature egg. Sometimes too, but usually only one mature egg is released during ovulation from this dominant follicle. The empty follicle seals itself off and becomes the corpus luteum which produces progesterone and estrogen to prepare the lining of the uterus for potential pregnancy the role of hormone production is taken over by the placenta between 10 and 12 weeks if you become pregnant, 

 

Dr. C: that ruptured, there was fluid, right? You could see fluid behind my uterus. You could see that accumulating. And what’s so interesting about it is that could kind of see it and as it’s a carving in a way, a lot of times you assume that’s what happens to patients because of what how they describe it. But by the time you do an ultrasound allow that fluid has been resolved. And so you don’t see that so this was like it was happening to me but it was also so interesting, because I was able to see and I was new was happening. I did not expect that.

 

P: for the civilians in the room. Is this supposed to happen or it’s not supposed to happen? 

 

Dr. C: Oh, no, it’s not supposed to happen. We don’t want the copy studio to rupture before it’s ready. And in some patients that does what we do is we give them suggestions, depositories. And the reasons because of the corpus luteum is gone. It’s not doing the job. And the placenta is not yet developed enough to take over because at one point the placenta will take over. So and we think that this is why some patients have miscarriages. And so sometimes when the patients describe what I was describing, I would just give them suggestions repository to see if we could maintain that pregnancy

 

P: and that sends a signal to uterus to do what

 

Dr. C:  to basically protect the developing fertilized egg. It helps the villa the finger like projection of the placenta to embed itself. In the end, it helps develop that also kind of wrote out the description to myself, and I did it you know, and I did it right away and that saved my pregnancy. So after my first trimester, 

 

P: Good Lord, okay, so you’re the doctor, you’re the patient. You’re the saving the kids hear this a lot going on here. So how long do you have to take the suppositories for 

 

Dr. C: about the first trimester because by then you believe that the placenta will take over? 

 

P: Are you ultrasounding all the time now or how do you manage this? 

 

Dr. C: Well, I wasn’t ultrasounding all the time. That we saw to gestational sac to little tiny fetuses starting to develop. So one of them look the normal size, it’s going it’s symmetrical, and we’d like to see that the other sack was kind of irregular. That scares us. Because then we think that either that first sack absorb the irregular sack, which happens in two entitlements to choose and syndrome and all these other stuff that we know about twins. And we could still have a Miscavige because the bigger twin for whatever projection was left remaining. Maybe that twin was able to develop better and faster than that other point that we don’t have enough for. And so that irregular sack look like I could have lost if not both of the pregnancies, at least one of the pregnancy that was very concerning. So at 12 weeks, though, so once we knew that the pregnancy was viable that’s when you would put this a collage and I think get us a collage. 

 

P: What’s your emotional state between eight weeks and 12 weeks? I think I would be ultrasounding every day just to be like, Okay, we’ve still got it

 

Dr. C: I don’t know if itwould have helped me to know that. I was just saying that. Just gonna do a projection this is going to work out because again, you’re not going to do a C section at eight weeks to protect the baby. So it’s either it does or it doesn’t work. And so because of the fact I was still working and because of the fact I still had my little ones at home, I needed to get my mind off that and just carry myself to To 12 weeks. We’ll know what we have to do that I saved the pregnancy. How am I going to get us a car do I move on? 

 

P: That seems like a lot. It was it was like to some degree thank God for all the stuff he had going on so that you can focus on other things. 

 

Dr. C: That’s true that does help after when the doctor puts into succotash and says Coleen, you have a history of preterm labor. With twins, it’s even more just because of the whole pressure and everything else that we really need to be careful with you. I want you to go on bed rest very early in your pregnancy. So I said okay, so you told me Don’t go crazy. Don’t do anything abnormal or anything too strenuous because of my history. And because now I was having twins at 24 weeks. My ceclage ripped open. 

 

P: Oh wow

 

Dr. C: Yeah, yeah. We were in, in North Carolina at a family reunion of my husbands. And during that time, again, I felt contractions in the religion, the medications that are we’re on, we’re really not helping, and it wasn’t bad contractions but with my history, I said to my husband you know, let’s go to a local hospital. Let’s just somebody checked my cervix because I don’t know if I’m dilating on her in that’s what he says Colleen, you have this a card. I said here but times you can break through this o’clock and open up the cordless. And so he really didn’t want to leave. He says, Okay, we’ll call tomorrow, you know, and then it was a death of his family. And so this family reunion. We all were having a wonderful time in North Carolina had to be cut short. So everybody had to leave as soon as we got home. I caught one of my nurses who was really in I’m one of my OB nurse and I told her, you know, I’ve been having contractions throughout the whole trip, and I really think I’m dilating. Would you mind coming to my house and checking me out and she was so wonderful. She says that the critical I’ll be right there. She comes over and she says you’re four centimeters.

 

At 24 weeks I was four centimeters. 

 

P: yeah, that’s too soon

 

Dr. C:  that’s way too soon. And I always tell my mother in law she recently passed away that it was her father passed away. The kids grandfather, he saved my kids because my husband did not want to leave. So we would have waited probably too long and I don’t know what would have happened. I had bulging membranes and I was four centimeters. So I get rushed to a tertiary care center in Johnstown. Which is like an hour away from us because my local hospital is not a tertiary care center. And if I delivered those kids, those preemies we wouldn’t have the facilities, the proper facilities to either 

 

P: you need like a NICU or something 

 

Dr. C: exactly. But NICU where we will so we drove over to the hospital that did have a NICU, they put me in Trendelenburg which is basically they turned my bed like almost upside down where my head would be down just so that the gravity and the pressure would be alleviated off my pelvis and, and they put me on IV medication and fluid, and even antibiotics because sometimes when you have contractions like that there as soon as could be an infection. And he told me Coleen, you have both your membranes we’re going to do our best but in putting that stitch in we could also ruptured your cervix because you’re already four centimeters. So we’re going to put another stitch in we’re going to try to stop your contractions but you have all people know this that involve, you may lose babies. 

 

P: Okay, three questions. Question number one at subsequent ultrasounds, Baby B looks fine. Doesn’t 

 

Dr C: Yes. 

 

P: Okay, good. 

 

Dr. C: Yes, baby. He looks fine. And Baby B was my daughter. And by that I knew that idea was a boy and a girl. So yes, so I was eight. I was telling my husband that after this pregnancy, hopefully everything’s fine. You could cut my tubes. You could burn my tubes you could do whatever you want with my tubes. I signed the consent form that said I was done. So I was going to get my little boy, my little girl afterwards. 

 

P: So second question is why do we think bedrest works? Do we still think progress works? 

 

Dr. C: I don’t think again, we have a lot of sense that we can, you know, so we hope that helps because you’re being less active. And like I said, when I was with my first pregnancy when I was running down the airport and everything else I had some bad pains and I think that started everything. So we don’t know how much it else but we know that it doesn’t hurt. And so when I told patients, I’m going to put you on bed rest because I just want you to take it easy. And they said how do I do that with three toddlers? How do I do that? And the reality is, it’s so hard. 

 

P: Why do we think if your resting will affect a delivery date? 

 

Dr. C: That’s a good question, but it’s also not actively because of gravity pounding on your cervix pounding on your uterus. 

 

P: Okay, so basically we’re just trying to alleviate the pressure of gravity. 

 

Dr. C: Yes. 

 

P: Okay. Tell me I was gonna ask Golgi membranes is that the amniotic fluid and 

 

Dr. C: that’s what we we say all the cervix is closed, you know, or the service is one centimeter. You know, you can move your membrane very well. But by the time the service is for 10 centimeters, you could kind of feel membrane, but when it’s bulging, you have fluid there and so it’s easy to rupture the membranes and the fluid comes out and then the head comes out. So when you have bolted membranes like that, you really want it to be pushed back. Up, especially if you’re going to be putting in a stitch. The last thing you want is to put a needle through that membrane. 

 

P: Yeah, 

 

Dr. C: you know, the uterus is pretty a sterile area. You don’t want to introduce infection there. And so once your water breaks, don’t really the patient on any kind of tocolytic medication to stop their contraction because now you’re increasing the risk of infection. 

 

P: So now we’re back with you and you’re kind of tilted in a way that does not seem comfortable to keep your cervix closed and they’re about to do another sir collage. Yes. Okay. So okay, sorry, play, okay. So,

 

Dr. C:  it doesn’t surprise that he tells me the risk 50 You know, that I could lose a baby and of course, I cry, but I understood it helped that I knew what could happen. You know, he didn’t have to go through all the information, although he did and I appreciate it that I go through it. It’s successful. My contractions kind of diminishes. And he tells me on strict bed rest for the remaining of the pregnancy. And this is where family comes in. My in laws came in for a weekend so my parents flew in from Florida, they stayed till 32 weeks when I went into labor again. 

 

P: Oh, okay. So for those eight weeks, right, are you are you just lying flat? Are you inclined or

 

Dr. C: I am just up flat. Okay, the incline was more so they could put the stitch and move the membranes away. So by the time I get home, I’m just lying flat. 

 

P: And how do you feel?

 

Dr. C:  I feel okay, you know, the surgery was a success. I feel happy my family was able to come to help my babies were still doing okay and now I had to be on steroids injections. Because of the lung maturity. We knew that most likely they were going to be delivered early because of my history and because of pain points in general. But one thing about twins because of the fact that they are in a smaller space and a single tenant already fighting with each other for space. They’re very stressed. The cortisol level the stress level actually increases with the lung maturity. 

 

P: that’s interesting

 

Dr. C: So yeah, so that was good to know. Plus, because of that, I was also getting injections of steroids to help with their lung maturity and at 32 weeks, I was contracting again and I went to the tertiary hospital because that’s where I was going to go. Now when he examined me my first one which was turned out to be my boy was a footling breech 

 

P: uh oh

 

Dr. C: footling breech, the foot is coming out first and you don’t want to stress a premium out and you don’t want to deliver anybody. footling first, and I’ve had three successful vaginal deliveries. I left the hospital before 24 hours. I’ve never stayed after delivery. I’ve never stayed in the hospital for more than 24 hours. The reason was because not only did my husband Hurry up wanted me to come home, but my husband we are an interracial couple. He’s White, I’m black. And so a lot of the reasons why they want you to stay in the hospital rather than 24 hours because they’re learning all of these genetic tests on your baby to make sure that everything is fine before they send your baby home with your baby. And a lot of these test takes at least 24 hours for the results definitely for my case being black. They will get sickle cell they will look at anything that’s prevalent in the black community and for him and the white community would do that. And so we’re both physician and so I said, Sweetheart, we can’t leave now they’re running tests and you know, and he says Colleen, what is the likelihood we are both carrying a recessive gene. Our kids are going to be dominant on he says the things that’s gonna run in my family is not gonna win. In your family. And when he said that, I was like, Oh, and this is an aside but I feel that people go outside of their race or their ethnicity of the chances of us have having kids that are affected with genetic abnormalities is better. And at some point, I’m thinking, was that the reason for doing all these race, and we haven’t decided that when we all stay without own blue? We’re making things worse. 

 

P: Yep. 

 

Dr. C: And so because of how you see your god i This is not meant to be a religious discussion. But I think it’s ingenious. I think the more we realize that we need each other and that we’re better together and that we have less of a chance of these genetic abnormalities being predominant. I think the better it is 

 

P: totally agree with your larger point here, and then with respect to your smaller point, I think you’re going to stay longer than 24 hours because you have preemies, right?

 

Dr. C: because of the fact that they were pre knees because of the fact that one of them the first one was afoot language had to put a foot out there, and I was contracting. My doctor told me that he’s gonna do a C section. And before he did that, they did test the lung maturity of my babies. And they found that at 32 weeks, the lungs were mature. They said, Okay, we’re going to schedule you for a C section first thing in the morning, and they did

 

P: and how did you find that experience. 

 

Dr. C: Oh, boy. That was hard. Because again, like I said, I never had a C section with my other baby. And after having a vaginal deliveries, I was up and walking around. I felt great. It felt wonderful. And this is one of the reasons that I really tried hard not to give one of my patients C sections if they didn’t need it 

 

I was in pain after that C section. I’m thinking oh my god, is this what I do to my patients, you know, it’s painful. It really is. Also as doctors we have a habit of taking out the uterus, putting it kind of on the abdomen and sewing it right there and pushing it back in when we finished because you have a clear view of it. And I saw what people you know, when you keep the uterus inside and you sew it from there, it’s less trauma to the uterus. It’s less potential adhesions later on that you’re, you know you’re doing and so of course the patients only see the finished product and they’re always worried about the scar out of there Scott looks but there’s a lot of other things that you have to consider for your patients in their healing process. 

 

P: So are we trying to direct the show from the operating table? 

 

Dr. C: Oh, no that at all. I really liked my doctor and I was very confident that he was going to do everything he could to give me as minimal amount of pain as possible. And my husband he was the one that kept peeking over the to see what was doing and he goes oh my god call me the first boy he’s he’s five penalty so big. So my kids were five pounds and four pounds my daughter.

 

P: wow

 

Dr. C:  Yeah, they were in the NICU just observation, but they did well and in three days they were able to go home with me. 

 

P: So they would have been giants, if you kept them in are much longer. 

 

Dr. C: I know I know. My second pregnancy my son, Michael, he was my biggest pregnancy at like seven pounds, you know, just barely seven pounds all my others were like six and I told them if you’re bigger than seven pounds, you’re staying in there. I’m not pushing out a bowling ball. 

 

P: No kidding. Wow. And only NICU for a day is kind of awesome for 32 weeks, right? 

 

Dr. C: Yeah. But like they did the preliminaries. They did the lung maturity I was getting you know test the amniocentesis, I was getting steroids, you know, so all of that. 

 

P: That’s amazing. So how many days do you have to stay in the hospital with the C section 

 

Dr. C: C section is normally three days and I was so distended afterwards because they heard bowel sounds. You’re not supposed to eat anything. You know, we tell patients until we have bowel sounds. But my husband listen, then he goes, Oh, I could hear bounce. I’m so hungry. I’m starving. Well, I think he got food for me or the nurse. Somebody did I wasn’t supposed to eat and I did eat and my bowl once you maneuver the bow it stops working for a while and 

 

P: yeah, 

 

Dr. C: just stay there. Well, I didn’t take that advice. I was so distended afterwards, I was in pain. And my parents were with me for how long like six, eight weeks. They were excited and they came to see the babies but after that, I think my dad booked a ticket at one way back. They gave up a lot and you know, as soon as I heard they were leaving. I had five little ones now. Yeah, I had a C section. I was so shocked that okay, Colleen, you’re fine. You’re doing well. We’re leaving. I was like, How could you do that? But I could say that I couldn’t be you know, just to give myself but I was a little sad that they would choose to leave me like this. My husband did have a week off. I think he had like the following or, but he didn’t have that time off. And it’s not like we had this paternity leave at the time at all. No one was doing that. 

 

I remember getting up out of bed taking care of my twins taking care of my three little ones in so much pain. One or two of my neighbors stopped by to pick up my daughter to take her to daycare or preschool. I remember them helping me. But other than that I was on my own was harder than when I had Danielle at first that we talked about walking around when you have just had your abdomen open up that was extremely painful. 

 

P: The whole thing is kind of nuts right that you’re sent home after major abdominal surgery to take twins no less and other kids. Yes. And even six weeks seems like a crime so that people go back to work after that. Yeah, it’s a lot is a lot.

 

Dr. C:  There’s a lot that was very painful. Not even having my husband to be able to take paternity leave. So I could have been home I had leave but being by myself and not having a supporting spouse to help you. It’s really hard. 

 

P: Yeah, seems unbelievably hard. Yeah. They’re all grown. 

 

Dr. C: Yeah, they all go. Remember I had when I stopped working for some reason. I guess I was telling my kids I used to be a doctor. You know, things like that. And I remember my daughter, my oldest thing that she wants to be an OBGYN. I don’t think she ever had a clue of what that is because she wanted to be like Mommy, and I was so touched by that and I’ve always wished that I was worthless. I could take her to my practice with me because I’ve done that with medical students. I’ve done that and high school students to let them assess. And so now that my daughter is in her second year, they did like a minor introduction to all the specialties and she was Oh Mom OB is so interesting. And I just like oh my god. Oh, that’s always nice when your kids want to follow in your footsteps.

 

P: That’s amazing. That’s awesome. Yeah. So wondering, other than these experiences helping you to connect with patients? Is there anything you learned yourself that you’d say Oh, if only I could speak to younger, Carlene, I would tell her.

 

Dr. C:  I think I try planning everything in my life from my medical school experience from working to put myself through medical school to college, and everything when I was going to have my babies and when I was going to take time off and planning everything, and plans don’t always work. It’s good to have plans though because it helps you have a goal. It helps you to be able to pivot but you always have to remember that ready to pivot. Because, plans do change everything is not set in stone. And I think when I saw my plans changing, I became so upset because how dare they change on me, you know, this is how it’s supposed to happen and life doesn’t happen like that. I didn’t think I was going to quit my job to homeschool my kids 

 

P: right

 

Dr. C: but the situation happened and I had to learn how to pivot. And so doing so causes anxiety, so I need to know or tell my younger self to relax. Because getting upset over things you can’t change doesn’t help you take a deep breath and you say, Okay, how do I pivot? 

 

How do I turn this into a positive and even with my own cancer diagnosis, which was a very depressing and low part of my life. I had to find a silver lining and that one of my silver lining that helped me move forward. Not only was I still homeschooling my kids, and I did that on my weeks that I wasn’t on chemo, but also when it came back and I was diagnosed with stage four. I said, You know what? I may die, but I’m not going to look at this like, by me God or like, why not me? I had a terrific life because of the fact that I was able to with my kids, and during that time was somewhat the part of my life. I enjoy that immensely.

 

 Life is gonna throw you a curveball all along. How you approach the curveball. How you try to enjoy your life helps you move forward and helps you to live. 

 

P: Yeah, that’s an amazing lesson to have pulled from that really only what we see really hard experiences. Yeah, it’s awesome. 

 

P: Tell us about the book where we can find it, what is called and a description of your book. Let’s talk about that. 

 

Dr. C: Oh, yeah. Right. Yeah, it is cool. Pressure makes diamonds. From homeschooling to the Ivy League. It’s a parenting story. And call the pressure makes diamond because of the fact that we put ourselves through a lot of pressure as wives as mothers as teachers has member of society. We place a lot of pressure on ourselves and sometimes I think we just need to stop. Take a deep breath, especially mothers, I think we try to be perfect. And everything our kids do or don’t do somehow it’s our fault. 

 

And we don’t have an algorithm to motherhood. We don’t have a previous book that we could describe the perfect mother or the perfect child. And I think it’s left up to us to make that definition for ourselves. And our family and not be pressured by why society thinks you should do. 

 

P: Well. It’s amazing advice and the book is called pressure makes diamonds. From homeschooling to the Ivy League a parenting story. I know we can find it on Amazon because I looked it up and you have a author website. 

 

Dr. C: Yes. And it’s my last name WWW dot Kolleen primer core.com. And when you go on that website, you kind of get an introduction to the family. You get in you get different places where you could purchase the book and yes, you could get it at Amazon but you can also get it at bookshop that org and then if you live locally, I have some local bookstores that are carrying my books and so it’s really nice. I like that. 

 

P: Dr. Crevecoeur thank you so much for sharing your story gratulations on your amazing kids and and on your recent election. Thank you. It’s been great talking to you and I so I’m looking forward to sharing this story. 

 

Dr. C: Thank you so much. I really appreciate talking to you

Thanks again to Dr. Crevecoeur.  I have links to her book up in the show notes which You can find that on the war stories from the womb website.  and thanks for listening. If you liked this show, feel free to like and subscribe, and share it with friends.

 

As the year closes We are going to take a little break on the podcast, to plan for next year’s shows. If your expectations of getting pregnant, being pregnant or giving birth didn’t match your experience and you’d like to share your story, contact me through the website. and we’ll be back with new episodes later in January.

 

Have a great holiday and a happy new year.