Episode 73SN: A Birth Visited by Too Many Medical Interventions: Nicole’s story, Part I

 

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

 

Nicole: Sure. My name is Nicole. I hail from the Midwest, Indiana. I’m halfway between Chicago and Indianapolis. 

 

P: Okay, so let’s talk pregnancy. You have three kids? 

 

N: Three. Yep, that’s right. 

 

P: And what’s the one of the ages?

 

N: three alive? I’ve three alive. Yep. So my kids are 420 

 

P: Wow, nice. That’s well spaced. Well done. 

 

N: I couldn’t have done it better if I planned it. 

 

P: Yeah. Yeah, totally. I agree. So before you got pregnant, what did you think pregnancy would be like? What were you imagining?

 

N: Uh, well, uh, so it all kind of happened kind of fast for me. My husband and I have been married now I think for seven years but we have been together for about 20 years.

And yeah, you know, when we were kids, we knew we knew we were gonna have kids, when we were kids, and that was something we always talked about when we grow up when we get married when we have kids. So we always had this, like far off distant idea. of in the future we will have children, but being unmarried teenagers, you know, we’re like avoiding that like the plague. 

 

P: yeah

 

N: We don’t want to be pregnant. We don’t you know, we don’t want that. You all have that. So we got married, and month and a half later, we were pregnant. It wasn’t quite the honeymoon baby. But we didn’t plan that we weren’t trying it wasn’t intended was not intended, but we were very surprised by it. And so my experience with it was going practically my whole life avoiding pregnancy. 

 

P: Yeah, 

 

N: to now being pregnant and it being socially acceptable, where like, so I didn’t have that time for my mind to shift from avoiding it to desiring it. So that was what what really struck me about my first pregnancy easy Yeah, that emotional trip into dealing with what what was happening? 

P: Well, good to good you know, struggle with the front end. Did you find out with like a home kid or how did you how did you find out you’re pregnant? 

 

N: I had an inkling who and I took a test and it was positive. And I, at that time, didn’t think you know, anything could happen. If the home pregnancy test says it’s positive than it’s positive and we just went with it. You know, we, you know, immediately called the doctor because that’s what you do when you’re pregnant, right? You go to the doctor, so we call the doctor we make the appointment we waited the traditional three months to tell everybody you know, in case something bad happened. We did all of those things like the way the cultural norm is so we went we went through all of that and that was all I mean, it’s still like deer in the headlights. You know, I just went from avoiding this to now everybody’s excited about it. 

 

P: That’s kind of amazing. I wonder where the three month rule. I feel like my doctor told me that although I did not follow it at all and had a miscarriage and just had to tell everyone but I think it’s I think it’s from I think my doctor said you might want to wait, but I can’t remember where it comes from. Anyway, 

 

N: I think that’s an old rule when I don’t know when doctors first started playing a big important role in pregnancy and they just advised you know, you want to save face. If you do have a miscarriage. You don’t want to have to go around telling everybody your business that you had a miscarriage and, you know, we thought we thought that that must be important. So that’s what we did. 

 

P: Yeah, yeah. So it was the first trimester easy. 

 

N: The whole pregnancy was pretty easy. Really. I didn’t have a lot of morning sickness. I craved pickles. I was working in a factory at the time. I was on my feet a lot time and that was the big joke like crazy pregnant lady drinking pickle juice. And I did I am but I had heartburn in my third trimester and that was really the hardest thing. You know, everybody has the discomfort and the tiredness and that part of it. But looking back on it, it was pretty easy. I know though that there were days when I was like, Oh my gosh, I can’t do this anymore. Like in the moment you deal with that, but But when it’s not extreme, and there’s not medical conditions and things like that, you just say Oh, this must be what everybody does. This is 

 

P: we just sort of accept it because it’s because how else is it gonna go right? That’s what you’re told. Yeah. So take us to the day of the birth. How do we know today’s today? And then let’s walk slowly through that day. 

 

N: Yeah, sure. So. So looking back on everything that happened where my expectations didn’t really match up to what was happening was like with the birth part of it, and, and that was where, like, the experience just hit me like a Mack truck. So I grew up on a farm. You know, I assumed pigs and cows and horses. You know everything goats, sheep, I’ve seen everything be born. I know like, I knew when I was a kid like population how that happens. So I’ve always known this and I’ve been around forever. And when I got pregnant, my mom’s advice to me was, you know how this works. Don’t read the literature that they give you. It will scare you to death. You know how birth works. You’ve seen it done. Trust your body and it will happen. And my mom, in my mind was a warrior. She had four kids and the first three were born in a hospital completely naturally. The fourth one was a C section. You know, and there’s, you know, the story around you know, how the baby wouldn’t come down to the birth canal and that’s just how it was and whatever. But, you know, I had this wonderful example in my life of how birth was supposed to work. So I thought, okay, I don’t need to read anything. I don’t need to prepare my body knows what to do. I’ve seen it done. It’s going to happen. So I didn’t read anything, not What to Expect When You’re Expecting I didn’t watch videos. I didn’t blogs, nothing. 

 

And my husband says he knew that I was going to go into labor because I came home and I was like, our yard is a mess. I hate it. We’re going to clean it. All up like the baby is coming. I don’t want to have to come home and deal with a messy yard. We’re going to mow it and we’re going to weed it and we’re going to pull all the shrubs out of the flower bed. And you know, I just had all this energy and he said, you know, he reminds me of sitting on the couch after doing all of that work. I was just sitting there saying, I don’t know why everybody says pregnancy is so tiring. And I don’t know why the third trimester is supposed to be so bad because I just have all this energy and I feel so great. He’s like, uh huh, he knew what was coming.

 

So that night after doing all of this yard work and just feeling so amazing. I got up to go pee at midnight. And as I was sitting on the toilet, I heard like an audible pop.

 

P: Oh wow

 

N: That is a gush of water. You know like the things that doesn’t happen to everybody but that’s what it was. And it was read amniotic fluid and I like immediately just began shaking with fear like head to toe overcome with fear, like my whole body to the core was shaking. So I had to wait for this session to stop I had to go wake my husband up in the middle of the night. I have to say you know it’s time we have to no it didn’t take long once he heard me say it’s time like he was immediately awake and alert and up and out of bed and I had a bag packed and you know I am prepared that much at least we did not have a car seat. It was not in our car, but we’re like that’s the least of our worries. We’ll figure it out later. So we grab our bag and we go to the hospital and I didn’t think you know amniotic fluid was gonna leak I had no idea so I just put on jeans and you know I’m still leaking in the car. we didn’t have a trash bag. I made a mess of the car. I walked into the emergency room entrance of the hospital just like water still pouring down my legs and my husband got me a wheelchair and the people are like looking at me like what are you doing here? And I’m like, my water broke and they were like, oh, and then it became an emergency to get me checked in a wheelchair and to the labor and delivery. And so, all of this time though I’m still shaking with fear. We get to labor and delivery and we have this whole big rig mo row. Are you really in labor? Are you feeling contractions? Is this really your water breaking? And, you know, then the they had to do an amniotic test where they had to like swab me to determine that the fluid that was coming out really buzzed amniotic fluid. When it came back positive then they decided that I must really be in labor and I will be allowed to stay because they were so busy that night. 

 

P: That is like a little circus environment there. Although I think most people don’t experience the kind of dramatic and obvious water breaking that you did. So So I think some people are really unsure themselves like oh my Warbreaker broke or not although it seems like yours is pretty clear.

 

N: absolutely it was

 

P: And so at this point you’re not feeling contractions are you are 

 

N: i i probably had some pain in my back but I wasn’t feeling like miserable countable contractions I just my water had broken, but I’m also still shivering with fear. And, you know, in the birth that I’ve had since then, when looking back at that situation, I know that that fear response in my body was stopping any contractions that would have happened with that. So like this fear, this flight response that I was having definitely shut down. Anything that was happening. 

 

P: Yeah, there’s a lot of chemistry involved in that in that response. Right. So you can imagine it is telling your body like not now. 

 

N: Oh, well yeah, I mean, an animal’s in labor and there’s an ear Okay. Body says don’t be born because you’ll be taking your days and that’s, that’s what my body was going through. Because even though I like mentally knew that my body was capable of giving birth, I didn’t believe in my body like in my subconscious mind, you know, like, my body was fat and ugly. I hated it. I was constantly putting it on diets and berating it and saying, you know, I hate you all of these cultural stories that we have about women’s bodies. And and that was what was putting me into this fear like this mental juxtaposition of I know I can do this as opposed to the true like deep down beliefs that I have that my body was a piece of garbage like a piece of garbage can’t do something amazing. And and that’s that what, what, threw my first birth off the rails for sure. 

 

P: Yeah, that sounds like a really hard thing to work through in the moment. And did you have 

 

N: I was not aware of it in the moment. took several years afterwards to come to that. 

 

P: Well, you probably knew you were fearful. Right? 

 

N: Yeah, I definitely knew I was afraid and that but you know, I just thought, you know, my, I’m afraid but my body’s gonna do it. And when it happens, I’ll just go along with it. Yeah, okay. 

 

P: And so, since you’re waiting for and stopping contractions at the same time, how does that progress? 

 

N: Yeah, it doesn’t.

It doesn’t progress at all. So after it was about six hours, they have me hooked up to machines and they were measuring my contractions and I was kind of sleeping off and on but I wasn’t feeling the pain and I felt poorly, but I wasn’t feeling regular measurable contractions. So they

Come in and they hook up an idea that kind of, I think it was they started hanging Pitocin at that time. And looking back on it. I see you know, the audacity that they had to come in and talk to my husband about this. They didn’t talk to me about any of it. I didn’t give my consent. Obviously, I wasn’t going to disagree with them at that time. But it was not me giving consent.

 

P: why aren’t they talking to you? 

 

N: I was tired. I was sleepy and he was awake. So rather than, you know, trying to rouse me and have a conversation with me, they just went right to my husband and talked with him. Because like yep, if that’s what we need to do, then that’s what we need to do. And over the next six hours, they have three bags of Pitocin 

 

P; oh Wow. 

 

N: Which was causing back labor. So by noon, 12 hours after I had been admitted. To the hospital by noon, I was ready for pain medication. 

 

P: Yeah, no kidding

 

N:  They hung up a pain medication. And still they were measuring contractions and saying you know, we see you’re having contractions, you’re in labor. They were checking my dilation constantly which you know, that’s a whole another story of invasion of self being uncomfortable and just adding to those to those hormones that are slowing down labor. But so yeah, by noon then 12 hours later, I was on Pitocin and pain meds

 

P: man, this is this is hard. 

 

N: So what not what I expected when I went to the hospital, that’s for sure. 

 

P: Did you think it would be fast like what what was the image in your mind? Yeah, 

 

N: so So in my mind, I thought you know, this is gonna be quick and easy. I’m just gonna lay there and my body will take over and do what it’s supposed to do. And eventually a baby will pop out. And I will have this baby in my arms. And that’s, that’s all the thought. That’s all the space. I allowed this event to have in my mind.

 

P:  Yeah, that makes sense. I think people are fuzzy in describing birth, right? They kind of walk fast by that part. And I think it’s hard to find the right vocabulary to make you viscerally appreciate the pain 

 

N: for the first two births. For me that was true by my third birth that wasn’t so true anymore. 

 

P:Interesting. Well, I’m interested to hear how we get there. 

 

N: Yeah. 

 

P: So how do we progress like how do we 

 

N: Yeah, so noon, they start giving me pain medication and then from noon to six, my temperature starts to increase which they attributed to possible infection because my water has broke and that’s the risk of having your why you have to go to the hospital when your water breaks, is because of that risk of infection.

They don’t talk about how the pain medication that they were hanging, for me causes your body temperature to rise.

 

P: Okay, so Nicole mentions of the pain medications in labor may have caused her fever. So this turns out is not entirely straightforward. Like many things about birth. There are some studies that suggest that an epidural can be associated with a non infectious rise in temperature, but there are many other factors that can contribute to fever, including things like a long duration of labor, and a long time separating ruptured membranes from delivery. I put some links in the show notes on this topic. If you’re interested in the details.

 

N: so my temperature is rising possible infections still not feeling contractions, six o’clock comes and the on call doctor for the evening comes on to the ward and there’s lots of other women in birth the whole word of school they have women in other rooms of the hospital who are in labor, but can’t come into this labor and delivery and it’s a pretty small rural hospital, really, it was a private kind of thing. It wasn’t part of a huge network. So it’s not a huge fancy place. So the hospital is dealing with their own constraints besides me. Taking up this room, progressing really slowly. Around 6pm They say you know your fever is starting to go up. We need to start doing fetal heart monitoring to make sure that the baby is safe while your body temperature is increasing. You know, we went to to walk we want you to do things to try and move things along. Because if you don’t, and that’s what they started telling me around six o’clock that evening, so 18 hours after I got to the hospital. If you don’t, then we will do a C section. So that kind of also starts weighing on my mind like oh my god, am I not capable of giving birth? Am I going to have to have a C section?

 

So you know, I’ve got all of that going on. I do the walking they give me more pain meds, they increase I think probably the day to start working on the contractions and around nine o’clock. I went ahead and took the epidural, the first epidural

 

P: Oh wow, 

 

N: labor doesn’t progress. nothing’s really happening. Around 11 o’clock. They come in and say you’re going to push I think they weren’t declaring me to be around nine centimeters dilated, but by the measurements of the contractions I was having something should have been happening. They criticize the way I’m pushing and say you’re not doing it right. This is how you do it and 11 o’clock goes by and they keep making me push and I’m pushing according to readings on a machine. Not according to my body. Like I’m so out of my mind. I don’t really even know what’s going on. Like I’m I’m desperately afraid of what’s happening right now. And it came to like 1130 and the nurse went and got the doctor and said, You know she’s pushed, nothing’s happening. They decided your body temperature is too high. At 1130. They decided you’re going to have a C section so they started prepping that they started checking my epidural. I could feel where they were poking and all the tests that they were doing so I had another epidural and the anesthesiologist that came in and did it. He had to come in from home wherever he was at to do it. And he just said I’m going to give you two to make sure that you get through the next however long it’s going to take you because again the hospital has a lot of other constraints they were dealing with. He wanted to make sure he didn’t have to do it again right before they did the operation. 

 

It was between 1130 and 1145 or so they do the extra epidurals they have my husband and they put him in you know the full HEPA suit with his beard cover and all of that and 

 

P: wait How are you feeling? Are you are you upset or where are you? 

 

N: I’m drugged out of my mind at this point. I’m still shivering with fear but I just like so out of my body that I I’m I’m not capable of giving consent. I’m not capable of not giving consent. 

 

P: Yeah, 

 

N: I’m just I’m just going along with it. I’m desperately afraid of what’s happening. I’m in fear. I’m disappointed because, you know, I never thought that I would need the epidural. I never thought I would need the pain meds and I’ve taken all of that and now they’re telling me that my baby is in danger. Heart rate might be low that my body temperature is increasing, who’s going to be born with an infection? Just fear.

 

P: Okay, so this is the issue of fever if the epidural is a catalyst for a fever, but it’s a non infectious source, then we’re not worried that the baby will be born with an infection. Some theories suggest that the epidural along with other factors may induce an inflammatory response in the mother’s body. If this is the case, then it’s not likely that something is transmitted. To the baby and the baby doesn’t need antibiotics. So although we don’t have a definitive answer yet to this, this is an, important focus of study.

 

N: Yeah, everything was here. Everything was saved my life saved my babies life

 

P:  yeah, 

 

N: and they went we went into labor and delivery and the C section was fine and maybe boy was born. And they put me in a room and my in laws. Got to see my baby before I did. 

 

P: Wow. 

 

N: Yeah, yeah. And looking back that was one of the thing that was hardest for me, especially, you know, in the postpartum recovery was they put me up in the surgery board. They did the surgery. I saw that like they helped the baby’s butt up like you have a boy here he is. And they cleaned him up and took him away. And then they took me to a room to get cleaned up. And I don’t even know what happened what they were doing. You know what happened while they were cleaning me up but they gave me a picture. A photograph of this naked squirmy little thing that had salve in its eyes, you know had on its head and like, that’s how I got a picture. And, and that was like, again, like so surreal. So out of body. There’s not nobody nothing in my arms. My belly is soft and squishy. And I don’t have a baby. And, you know, we had we had called people before I went into surgery just because you know, again, kind of like the three months rule with announcing your pregnancy. It’s you call people because what if something happens while you’re in surgery? Which again shows how fearful we were? 

 

P: yeah

 

N: what if someone dies with this C section. So my in laws were at the hospital. My mom had come to the hospital and my husband followed the nurses with the baby to see them wash baby after he was born. And he has very fond memories of walking into the room and talking and, and my son like instantly looking for him recognizing His voice. So 

 

P: yeah, so that’s cool 

 

N: has fond memories. Yeah. But it was I don’t know, maybe an hour before I got to even see him. And then like, just the surreal moment of is this little thing. This score me a little baby my and having them that first hold your baby. 

 

P: It feels like you’ve been put through a very weird version of a birth in which you’re present but not entirely and they’re like not treating you like your president at any point. Right? It’s wacky to criticize you’re pushing Oh, you mean from the 1000s of times. I’ve done it before and you know, 

 

N: absolutely

 

P: the consent thing is weird and shuffling too often. You have the baby off to different rooms, like Okay, we’re done with her. Let’s just that’s just weird. 

 

N: Yeah. And you know, at the time, I don’t have the presence of mind or the perspective that I gained over the next few years to know to say something’s wrong with this. Yeah, yeah. You can’t say what you don’t know. And I absolutely did not know in that moment. 

 

P: But it sounds like it fell off. You have nothing to compare it to.

 

N:  Right. But it just has nothing to compare it to. Yeah, yeah. So you know, then I have the whole hospital stay and you know, people come to see the baby. And I was I was really dedicated to breastfeeding and that didn’t really work well, and baby was kind of grumpy. And it turned out that he had high bilirubin so he was orange and they wanted him to lay under this light. So not only do I have like the surreal meeting of my son, but now they say don’t hold him put him under this light. You know, don’t interact with him except to feed him you know in the hole coming in all the time to check your temperature so you never really get any sleep and just all of the things just was not a great bonding time. 

 

P: Yeah, 

 

N: my mom came to stay with me which really felt good, which was really good. Besides that, just the birth experience of not being considered an active participant in the birth to a person to whom it was happening, that they had to deal with in the process. 

 

P: Yeah, all that sounds really hard to manage emotionally. And certainly your experience didn’t match your expectation at all. What’s postpartum like? 

 

N: My dad came to stay with me after the birth, which was an incredibly generous gesture on behalf of my dad. But in hindsight, and even in the moment, like it was so awkward, like my parents were splitting up in the moment. My dad was like, one upping my mom by being able to be the one who was there. With me. He is not really a baby or a kid person. He was trying to like treat me like his kid. And at the same time, allow me space to be a mom. It was really uncomfortable. So I have these five days, you know where my husband is gone. He had to go back to work and I have to deal with this and driving back and forth to the doctor and baby not nursing and nobody. I had zero support of people saying yes you can rescue they were all saying Oh, baby’s not latching right give him formula. Like no person said, Oh, he’s not laughing. Let me help you. 

 

P: Yeah. 

 

N: And it was only my stubborn persistence that did that but he finally latched on to finally nurse and I finally did that and when that got easier, then I get this you know, whole emotional wave of you know how did that happen? And I think it was probably after my second child was born. But I look back on that time now and I say that that was trauma in my day.

 

P: Yup, yup

 

N: I knew that it wasn’t right that what happened wasn’t right and after baby was born, the next morning the surgeon had come in and you know, I expressed to him my disappointment in what had happened. And I said, is it going to be possible for me to have a vaginal birth in my next pregnancy? You know, I’m already planning my next one and I just got the first one in my arm. And he says, no, no, no, V backs are dangerous. You know, in the 90s. We pushed everybody to do it. It was this big thing and we damaged a lot of women, we damaged women in the V back process and we don’t do that anymore. So if you ever see sex and you always have a C section, and besides, your hips are too small, you’re really too small of a person to be giving birth anyway. And that was just that was his answer. And it kind of was weird in the moment when he said that because my mom might know again, my example in birth is smaller than me. And she had these three babies naturally and and she was fine. So how was that the case? And it was about 18 months. I finally am starting to heal. I say, you know, that was a really sucky experience. I never want to have that again. I know I’m going to have kids in the future. And I’m never doing that again. And you know, I start reading things on the internet. I start watching YouTube videos, and around the time that I’m thinking about all of this, we got pregnant again. Like we weren’t trying it. We weren’t not trying but it just happened. And it was good timing and it was right. And so I’m pregnant now. And I’m thinking about all of this, and that freaking doctor was absolutely wrong. I am capable of giving birth and I’m gonna prove it to him. 

 

P: Thanks again to Nicole for sharing her experience. With this first birth.

Her experience of the hospital has a steep learning curve that she uses in future births her attempt to get the birth she was hoping for.

Thanks again. Thanks again to Nicole for sharing her story. Her experience in the hospital has steep learning curve that she uses in future births and her attempt to get the birth she was hoping for. Unlike many women who go into birth with a fully formed birth plan, it calls hoping to avoid another experience. She feels like a disposable contributor to the whole event.