Episode 50SN: A Pregnancy that Outran Scary Predictions: Lisa’s Story

Today’s guest has an interesting spin on the difference between her expectations for the pregnancy and birth and her experience going into pregnancy. She had a number of health conditions that lead to a lot of cautionary talks about the many things that could go awry. And then when she actually was pregnant, she more or less skated through a problem free pregnancy. So she’s left with feeling grateful to have outruns so many serious issues and sad about the fact that she didn’t get to enjoy what was basically a straightforward pregnancy because she was constantly on alert.

You can find Lisa’s writing here

PCOS

https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
https://www.webmd.com/women/what-is-pcos
https://www.cdc.gov/diabetes/basics/pcos.html#:~:text=What%20is%20PCOS%3F,beyond%20the%20child%2Dbearing%20years.

Epilepsy
https://www.mayoclinic.org/diseases-conditions/epilepsy/symptoms-causes/syc-20350093

https://www.webmd.com/epilepsy/default.htm

Epilepsy and Pregnancy

https://www.cureepilepsy.org/webinars/epilepsy-pregnancy-contraception/
https://epilepsychicago.org/what-is-epilepsy/sudep/?gclid=Cj0KCQjwpcOTBhCZARIsAEAYLuU8fRCTSVMxWjho2b1pckFcUOEhXYtS6Nvros5kCvTJZgKhCcC3EUsaAncmEALw_wcB

Fetal Surgery for Spina Bifida

https://www.ucsfbenioffchildrens.org/clinics/fetal-treatment-center
https://www.ucsfbenioffchildrens.org/conditions/spina-bifida?campaignid=71700000085986996&adgroupid=58700007287088131&adgroup=FTC-NT+-+Conditions+-+Spina+Bifida&creative=537193062435&kwid=43700065426505077&matchtype=p&network=g&adposition=&target=&device=c&devicemodel=&feeditemid=&loc_physical_ms=9031971&loc_interest_ms=&targetid=kwd-803521056122&utm_source=GOOGLE&utm_medium=cpc&utm_campaign=FTC-NT+-+Conditions+All&utm_term=spina+bifida+fetus&&campaignid=14146813904&adgroupid=125672267659&adid=537193062435&gclid=Cj0KCQjwpcOTBhCZARIsAEAYLuVdDLyuSmXsok5GdMl3I_JALDEjLXlO00R2JNSHebSUzLG5DWzjA6QaAn3mEALw_wcB&gclsrc=aw.ds
https://www.chop.edu/treatments/fetal-surgery-spina-bifida/about

Pyloric Stenosis

https://my.clevelandclinic.org/health/diseases/4524-pyloric-stenosis-hps#:~:text=How%20common%20is%20pyloric%20stenosis,condition%20requiring%20surgery%20in%20infants.

Breastfeeding across the US

https://www.cdc.gov/breastfeeding/data/facts.html

Episode 29 SN: A Labor & Delivery in Two Acts, The Experience of an OB & a Midwife in one Birth: Janis

Everyone faces some kind of challenge in the process of becoming a parent. Today’s guest took an unanticipated tour of possible approaches to labor and delivery. Once contractions were confirmed she arrived at the hospital to find her midwife busy with another birthing mother. So in the first half of her birth she was attended to by an OB, and the second half was overseen by a midwife, with very different approaches to labor. And because she was a single parent, she braved postpartum without a partner, which turned out to be a real challenge when colic arrived.

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 a mother of two girls. Everyone faces some kind of challenge in the process of becoming a parent. Today’s guest took an unanticipated tour of possible approaches to labor and delivery. Once contractions were confirmed she arrived at the hospital to find her midwife busy with another birthing mother. So in the first half of her birth she was attended to by an OB, and the second half was overseen by a midwife, with very different approaches to labor. And because she was a single parent, she braved postpartum without a partner, which turned out to be a real challenge when colic arrived.

 I also had the chance to talk with a fantastic midwife who provides useful insights about the practice of midwifery

Let’s get to this inspiring story.

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

Janis: Yes, I am Janice Iseman and I live in Canada. 

P: Oh nice, lovely. So let’s talk about pregnancy, before you got pregnant. What did you think pregnancy would be like, what were you imagining.

J: I laughed because I nothing like what it actually was like, so I think when I saw photos of baby bumps It didn’t occur to me that that would have such a weight to it, that it would actually literally tip you forward. It just looked like this sort of beautiful air-filled. 

P: Yeah, 

J: ball on the front of the body, and I think that pregnant body is actually really beautiful, but I really didn’t understand what physical changes were actually happening inside the body. So I think that when I heard pregnant women talking about their different pregnancy issues, I didn’t get it. It didn’t make sense to me, it seems like not a big deal, like why are you complaining about having heartburn. You have this beautiful body. 

P: Yeah, yeah….So a light filled ball of air that is unrelated to physics, and is, it’s gonna make you get on your feet. 

J: Yeah,yeah, that’s not exactly what it felt like, obviously, but you know that’s definitely what I what I observed so it was, it was very shocking to me when that’s not what it felt like at all. 

P: Yeah, so, So let’s get Was it easy to get pregnant?

J: Yes, my planned pregnancy was actually unplanned, so that’s how easy it was, it was not on purpose. So I actually have a very fortunate story and that that was not something that I actually had to struggle for and strive for it totally happened and it happened, not on purpose.

P: Yeah, that’s what we’ll take the easy parts where we can get them right, so that’s great. And then you I’m assuming you found out with like a home kit. 

J: I did, 

P: yeah.

 

J: I found out in the way that many unplanned pregnancies are discovered because our periods are late, and I did have some other weird physical symptomology I was kind of feeling dizzy I was feeling claustrophobic, I am. According to the, to the personality tests and 87% extrovert, so that’s a lot of extrovert and I, and I very much live that way. And so I was really taken aback because I was out at a party and I felt like I wanted to go home. So it’s like a moment of introversion had stricken me, and I didn’t really know what was going on. And I also was dizzy a lot so that’s what took me to the store to get the home pregnancy test. 

P: Wow. And then what was the first trimester, like?

J: Well, I actually had been super athletic prior to getting pregnant, so I was, I was running six miles a day. and I had quite a lean bodyweight. So my first trimester was one of gaining a heck of a lot of weight. So by the end of the first trimester my midwife actually told me I was on track to gain 80 pounds, which I didn’t, but it was because I really dropped my activity, it didn’t feel good to me to run six miles a day. In fact, towards the end of that period it was just a bizarre experience because it had that sensation that I had only ever had when I consume too much water and I can kind of feel that sloshing around. 

P: Yeah,

J: so I just and I was tired a lot, and so I changed my eating habits I took my exercise habits and slashed them, and that would make anybody gain weight, even on a non pregnant body. 

P: Yeah, 

J: so my first trimester, was one of being exhausted, and really just falling into that pregnancy state of taking care of baby instead of running six miles a day.

P: I remember it being a different kind of exhaustion than any other kind of exhaustion

J: Oh yeah, yeah. Yes, I used to describe it as feeling like there was bowling balls on your head so I remember sitting in business meetings, And just feeling this kind of almost like I wanted to tip over. I’ve never had that before or after it’s different than sick, tired. It’s different Evening tired it’s just, yes bowling balls in your head, tired,

P: I remember being at my desk working away one minute, and the next minute I wake up with the imprint of the keyboard on my face seems 

J: that seems right. 

P: Where am I? How did that happen? Once you get to like 13 weeks does the fatigue abate, or how do you feel

J: it did actually end it was fairly instant, and that was a huge relief because I was not too sure how I was going to get through it, months of that. Yeah, because it really is. I mean, it’s not the entire first trimester that I was exhausted like that I don’t even know for six weeks, but that still that was, that was a really hard period, to try to adjust to because it was, I went from living this super high energy 87% extraversion lifestyle to, I just, I can barely function. 

P: And so how was the rest of the pregnancy you you’ve sailed into the second trimester, which is easier and then is there is the whole thing, easy up until the end, 

J: it actually was. Yeah, yeah, I think I would actually credit, a little bit the healthy lifestyle had coming into it. I think that I probably never been as fit or active before or after that little window right before, so I really did feel great and the pregnancy part was actually the easy part. 

P: Oh, good I guess. we’ll take that. And then, now take us to the day that you’re, it’s your son right. 

J: Yes, 

P: that your son is born, how do you know, today’s the day and what are what are you picturing 

like a waterbirth what’s on your mind?

J: Yeah what I pictured and what I what I had were two different things. Again, it was, it was different from the water filled belly to the heavy to the heavy real one, or the air filled belly I should say, 

P: yeah. 

J: So, what I pictured, because I always, and still am a Holistic Health person. My profession is one of being a movement specialist and, and nutrition coach so I’ve kind of got health and fitness wrapped up, and in a very holistic way. I wanted to be a woman who had this beautiful Hypno birthing experience. I read and listened to the Hypno birthing DVDs and the book, and felt like I probably could definitely do this in a way that the book suggested because it’s all about taking breaths, it’s all about your mindset, it’s all about this sense of calm like you would get it yoga. I had practiced Pilates for two decades, like I got this.

 

P: And so, so for people who aren’t familiar with it, this is an alternative to like an epidural right.

J: Well, yeah, I guess, I mean it’s a drug free, methodology, or making verbs comfortable, and it’s based on sort of the idea of a lot of breathwork and a lot of visualizations and a lot of self affirmations, and I think that there’s nothing wrong with any of those things but in retrospect I would say, for those of us who maybe want to live in that bubble. It’s a little bit more complex than that and I, and I really struggled because actually in a lot of ways I did not feel prepared for the volume of pain and the situation that actually did unfold. So, my sister came to visit, and we were shopping, and we went to Whole Foods in New York City and I suddenly had another moment where I felt the same thing that I did in my early pregnancy, there’s too many people in here, I really want to get out of here. And I went and sat outside on the sidewalk, and she finished up the shopping. I didn’t even actually know I was in labor, what I experienced was back pain. 

P: Yep, 

J: so that wasn’t what I was expecting, and so I didn’t turn to my sister and say I’m in labor, because I actually didn’t know I was, I just can’t go away from the people. And I knew my back hurt. And so we walked home, and at some point, my sister has a child that’s two years older, and she realized that I probably was in labor. So then we started enacting the labor plan, but in the meantime we were out at whole foods because we hadn’t eaten for the day. So she was in my kitchen cooking food and I was in the bathtub trying to figure out how far apart my contractions were and they were a minute apart, so basically from the time we were in the store until we got home 15 minutes later I was at a minute apart. 

P: Wow, pause this right here for a second. This is something that you’re doing without a partner. 

J: I was doing this without a partner, yes, 

P: explain a little bit about that is that, does that make you feel empowered, does that make you feel nervous. What, how are you feeling about that.

J: It just was what it was I didn’t actually particularly have feelings, so my sister came to visit because I was doing this without a partner. And so she was helpful because we already had somebody in the room to this

P:  totally. 

J: And I had doulas. Well we’re incredible. Yeah. To this day I keep in touch with one of the doulas and she’s amazing, and I am sure that I knew this at the time but we were actually her first doula client, but I loved having a doula because she was basically a professional husband.

P: Yeah, yeah, Yeah, well, way better than a professional husband because she’s seen a bunch of births Right,

J: exactly, exactly. So she helped me prior to the day of labor and delivery, she helped me come up with a plan, we made sure we went through the checklist, and I remember her telling me those one of the most prepared people she’d ever seen because six weeks prior to my due date I had the hospital bag packed, and I was because I was just nervous that actually I was nervous that this was going to happen and I wasn’t going to notice it was happening or that I wasn’t going to know, and I didn’t want to be caught unaware. So because I didn’t have a partner I actually over planned I over prepared and I was really, really in a place where I knew that there wasn’t gonna be somebody to just run home and grab something or help me out in that way so my sister was one of my birth supports as my doula and then I had a couple of friends present as well.

 

P: Okay, this, this is sounding ideal more ideal by the moment right this is a good tribe to go to the hospital with right this

J:  is was a great tribe. Yeah, so that’s exactly what happened was my sister was cooking I called the midwife, we established I was a minute apart, and decided to go to the hospital and then I called my birth supports, and everybody sort of made a plan for whether they were meeting me at the hospital or meeting me at my house. So one of my friends came to my apartment we hailed the cab. I leaned against the tree and had contractions. And then the cab came and we sort of managed to get me into the cab where the cab driver was offering me advice on what was unfolding which was, we had the whole community involved in this, in this labor in the car.

P: Well you know it could go either way like once you said you got a cab, I was a little worried he’d be like no way you’re gonna have a baby in the backseat but it sounds like he’s like, Oh, let me tell you, let me tell you how to do it.

J: Absolutely, he was he was excited and I actually remember this, it was ridiculous. He’s like, you don’t look old enough to be a mother, I’m like dude, I’m not sure that this is the time.

P: That ship has sailed, my friend. Yes.

J: So, yeah, we, we had a great cab driver, and I remember him telling me to put my feet up on the on the seat so that I could actually feel more comfortable he was really, 

P: that’s awesome. 

J: Yeah, it was great.

P: And so, in New York City is there an issue of like I might get there and there might not be a room or, you know, that doesn’t happen. 

J: You know what,  I don’t know if it happens in other hospitals but I gave birth at the hospital where I had done all my prenatal care, and so their system, at least back in those days it might have changed subsequently but they had a couple of midwives, and that’s actually part of why I chose that particular hospital, they had doctors and midwives, and then when I would do my prenatal appointments, it would be this kind of cast of rotating midwives that would see me because whoever happened to be on shift when I checked in, I probably would have already met them and probably already would have done one of my prenatal appointments with them

P: and they are on board  for the Hypno birthing. 

J: Yes. 

P: Okay. good

J:  Yes, so they’re on board for all the hippy things that you want to do list of them so. And they knew that I was bringing the doula in and everything was sort of kosher, they were fully aware that that was all going to be happening. So when I checked into the hospital. This is actually one of my favorite things ever another client.. When I checked into the hospital, the midwife was busy, so she was attending to another client, and so they put me in a room to wait by myself, which was awful. That was definitely the worst part of the entire thing. And then because the midwife was busy I actually got paired with a doctor. So the first half of my birth experience was with a doctor, the second half was with midwife, so if anybody out there wants to know what the difference between a doctor and a midwife is, I can tell you because within the same birthing experience I had both and they were extremely different experiences in an American hospital, 

P: lay it out, I want to hear it out. 

J: Yeah, yeah. So, I had back labor, which is why my back hurt at the whole foods.

P: Today I’m lucky enough to interview a great nurse midwife. For those unfamiliar with this specialty certified nurse midwives are trained as registered nurses, and also earn a Master of Science in Nursing with a specialization in midwifery is particularly well suited for this episode, because she started her professional life in a setting in which physicians and midwives, had a strained relationship. And then she switched to a practice in which nurse midwives and OBs work collaboratively, which she felt will lead to the best outcomes for mothers and babies meaning Healthy Moms healthy babies and a very low C section rate. One thing to add, Anna sitting outside while we’re talking, I know hear the chatter and noise from people around her and cars, we’re just going to play through. 

Today we’re so lucky to talk to Ann Richards midwife in California, Anne  thanks so much for coming on the show.

Anne: I’m so excited to be here. I’m a huge birth podcast fan and I feel so honored to now be on one 

P: In Janis’ case she said, a baby is sitting in such a way that she has back labor.

Anne: Oh, and that’s a different beast. 

P: So, so let’s talk about a little bit about that. Back labor is reportedly exceedingly painful. 

Do we know why it’s more painful? 

Anne:  It used to be or even still sometimes now if a woman is reporting a lot of back labor, we kind of attribute it to the baby being in what we call an occipital posterior position, or you know a stargazing baby or quote unquote a sunny side up baby if people heard those phrases, not always, we know now that it can be a variety of things, but if we were to operate on that, that theory that it’s related to maybe fetal mal positioning where the baby not being perfectly aligned in the in the pelvis, not only head down but looking down at the ground so that when they come out of the birth canal, they’re, they’re looking at the floor as opposed to the ceiling. If it’s the other way around, or even if the baby’s just a little bit cockeyed in the pelvis, then you’re getting bone against bone, instead of squishy fetal face against maternal spine, and that bone against bone is just an incredibly intense, it’s just not how it’s supposed to be ideally in a perfectly a fetus perfectly aligned birth, and that bone against bone is just excruciating it’s just very intense. 

J: The closest thing that I have found to describing what that sensation feels like if you’ve ever been skating and you fall on your bum. Stand up fall on your bum stand up fall on your bum stand up. Stand up fall on your bum and do that another, you know however many hours you’re in labor. I did have really strong sensations in the front they hooked me up to a monitor and because I was a Pilates instructor, I had off the charts strong abdominal contractions, but the pain of that back labor was so intense, I can feel any of those contractions in the front, so the plus side  to back labor is that the labor itself hurt so much that when you actually give birth, I’ve heard other women talk about the Ring of Fire, let me tell you that felt great. If was such a relief. Whatever happens for other people on the back labor just just erased all the rest of anything that would normally be experienced as pain, so I was laying in a room all by myself in this incredible back pain, and 

P: wait the breathing is not helping. Are you are you like into the Hypno birthing right there or

J:  I tried. Yeah, I tried. So, I’ll jump forward to the end of the story I actually got through the entire labor without any epidural without any medication of any kind, without any pain relief. I’m glad I did it because I only have one child, but it would be a very difficult thing to convince me to do again and the Hypno birthing was only of some benefit because at the end of it with that level of excruciating pain. It takes all of your energy, everything in your soul just to breathe, basically.

P: Yeah 

J: so, and because the Hypno birthing process and program had, it was my take on it so I don’t blame them, but it made it sound like it was all about my mindset and I simply stayed calm and took in these breaths that my vagina would open and I would have this almost orgasmic experience that is not at all what it felt like. So, I felt really like I was not prepared because I, my body skill set. If it was yoga class. Yeah, I’m in. but we’re talking about really escalated levels of pain, to the point where after I gave birth the nurse said, it’s like not even 10% of women make it through back labor without, without some sort of pharmaceutical intervention so I had an extreme scenario so I don’t want to say all the hypnobirthing is bad. 

P: Yeah, 

J: but it just was something that I think some row halfway through I was like, forget that like, that’s not a thing. This is unrealistic, and I just need to kind of get through it without, without dying. I kind of felt like

P: yeah, I mean I can’t imagine you practicing in your, in your apartment, or you’re not feeling anything. And then it seems like obvious and intuitive and powerful, then. But when someone has a sledgehammer to your back, less easy to use those mechanisms right, 

P: So I took my questions about hypnobirthing to Anne. can you tell us a little bit about hypnobirthing? 

Anne: Sure so Hypno birthing is very, you know, mindfulness based and really trying to train yourself in the pregnancy, they really recommend women start quote unquote training for this five of 20 weeks. And so it’s all about being able to sort of disconnect your brain from your body during birth and really working on reframing how we think about pain and contractions and oftentimes using different words like surges, because contractions for a lot of women can have a negative connotation, you know, really listening to these mantras throughout pregnancy that allow you to train to disconnect and so that when you start having surges or contractions in labor, you’re able to listen to these mantras and come and go somewhere else, like you’re not as focused on the physical work that your body is doing… it doesn’t work for everyone, you know that that method of training for women for whom it works, it just be mind blowing to watch them go through birth using just that, when it doesn’t work as well as maybe women and families hope or based on all the training done. I think it’s because it’s such a specific set of tools for the birth that once it doesn’t work it can feel very overwhelming. 

J: And this isn’t an experience I’ve ever had in my life before so I think that that’s also. When we only have one practice it’s something anything it doesn’t even matter what it is, it’s not going to go according to the plan that you imagined in your head. 

P: Yeah, yeah. 

J: So, birth is a very natural process. We also don’t really know what to expect until we’ve gone through the process because I also think everybody’s body is different, likely if I had another baby, that experience would even be different but I didn’t really know what it would feel like. And I did try to avoid a lot of the material that explained what it was like But then that also led to a scenario where I didn’t I underestimated how much pain I was actually going to be in.

P: Well that’s kind of a tricky thing right I think language fails us in terms of getting you to really have any sense of what it will actually feel like because it’s not like anything else, so there’s no analogy that you could even the falling on your, on your ass for ice skating like right that’s probably like a fraction of the real pain right but it’s as close as you can get so even if someone had told you that you wouldn’t have been scared of that and you would have said oh I can breathe through that.

 

JYes, and I would have said, Okay, I’ve gone skating and I’ve gone away but yeah, it’ll be okay. 

P: Yeah, Yeah,

J:  I think that one of the interesting things for me about the experience of having an unmedicated birth. 

P: Yeah, 

J: was an awareness that my body was kicking off natural drugs. So when I checked into the hospital, the maternity ward was in the very back of the hospital so the cab dropped me off at the front, which is like, literally, a New York city block away. Yeah. During the hospital. And as I was walking down the hallway, I recognized, and remember being actively aware at that point that I actually was stoned. So, the body will kick off, natural pain medication.

P: Janis brings up another cool topic, what your body does to help you manage the pain and I brought this question to Anne: What chemistry accompanies labor to make it easier on the mother.

Anne: So, you know, I call it labor lands when women really enter the active phase of labor. So, when families come into the hospital and maybe they’re going to go home because it’s an early labor and partners will say to me how will I know that it’s time to come back and I’ll say you’ll know, just watch her in between contractions, because not only will she be working hard through contractions but in between the contractions they in the act of basically where they enter the zone where women just told most women don’t want to talk, they don’t want to move, they don’t want any extra stimulation, because they’re so focused not only on the work they’ve done, but the work that’s to come because of that natural cascade of hormones it allows her to have the most intense physical discomfort probably for life. And then it allows her to relax enough to maybe do it again and again and again and again, it’s it’s sort of this seamless production of oxytocin then has work benefits and its relaxation benefit, 

J: which is really cool. Yeah so that was one thing I thought that it was a really interesting process to go through and feel everything that was happening in my body. Do I recommend it. Yeah, I mean if you have an interest in feeling it absolutely but I’m not sure that today that I would hold quite as fast to experiencing all of that pain as I did, but I did, I was I was adamant that, particularly because I had gone through the pregnancy alone, I wasn’t sure if I was going to have more children, so I wanted to really experience the sensations in my body. And I did.

P: And how long you were saying the contractions were one minute apart and then you got to the hospital. How long is this whole period, how long do you labor.

J: Well from Whole Foods to baby in arms, it was somewhere between 10 and 12 hours. There is a really fun photo of me laying in the hallway of my apartment building. That’s time stamped and there’s another really fun photo, exactly 12 hours later, with my baby. 

P; Wow 

J:  and we would have taken those photos prior to her a little excursion shopping, so my sister looked at me and she said, I think we should take some photos today because your body’s never going to look this way again and your, your belly has dropped. So we went and we did this whole photo shoot, so I know that I would always say that my labor was 10 hours, but for sure, I have to timestamp photos 12 hours apart between laying in the hallway and so. So it wasn’t it wasn’t too bad. All in. But at the time, it’s a long 10 hours,

P:  it seems, unbelievably hard, And the only lucky thing there is that I’ve talked to a bunch of women who say, 36 hours in, I was not fully dilated right and there’s so many other things competing for your resources that it’s hard to, it’s hard to manage that so I’m glad that yours went relatively quickly,

J:  it was, yes, I was under the average time for first birth, because, you know, there’s a whole lot of stuff that has to happen on that first birth, and that’s what sort of slows it down. So my contractions were pumping along like I had given birth before. Yeah, but that dilation and efffacing had to happen

P: yeah so that’s awesome and I accidentally stepped on the line that you were trading about Doctor versus midwife. So why don’t you tell us about that.

J: So, checking in with the doctor meant that I was put in the more traditional medical system, and then halfway through the midwife, had completed her other birth and came into the room. And then the second half of my active labor experience was with the midwife. The difference between those two is that the doctor version takes the mother’s comfort, and the mother’s body into very minimal consideration. So the fact that I had back pain was a little bit of an inconvenience because we were looking at time contractions we were looking at measurements we were looking into baby’s heart rate. We were looking to speed the process up. Which–that part was good, but there was a lot of discomfort, because the baby’s umbilical cord was actually wrapped around his neck, so they had monitored me, and they were trying to get that sorted out. And I had back labor and the nurse wanted to put my bed down, and she wanted to have specific moments when she changed the bedsheets so that we could, you know, keep the area free of the fluid that leaks out. 

P: Yeah. 

J: And that was done on kind of a bit of a schedule it wasn’t really done around my body. So what I remember is that the second that that midwife walked in she said she’s already told you she doesn’t want the bed flat, she has back labor, we’re moving that bed up and that changed instantly. And I felt like I was then part of the process where my needs, my comfort and my desires were actually going to be heard. So, when the nurse was there with the doctor. We had some natural birthing techniques. I wanted to drink some water. And they told me no, I wanted to have some essential oils to sort of smell, they told me no, they were concerned about me consuming anything they were concerned about any other, you know, foreign substances being in the room. I was really really hot, I was getting hot flashes. This is my favorite. So, my sister said Take off your robe, and the nurse told me put it back on, and I remember asking why and she said well, because a man may walk in the room and see your breasts, and I literally I was middle of labor and it was so painful, but I was like, a man is gonna walk in here and see my vagina that’s hanging out. He sees my breasts. So my experience,

P: and who’s walking in, like what three doctors or something right now,

J:  I know 

P: Is there are tour coming through what, that’s weird.

J: There is multiple things there, and I also was like, I am pretty sure that even if a man walked in, he’s not gonna be like ooh breasts. You know, like that’s that’s not what’s happening at all. But, so there is, there were moments in the in the traditional medicalized birth that really jumped forward at me in that hospital in that particular experience that just felt…. They’re very memorable, and they jumped forward as it didn’t matter what I wanted it didn’t matter what my comfort was it didn’t matter. And it did feel like there was kind of a subtle push towards just get a damn epidural, and then that way you won’t be hot. That way you won’t be feeling like you need the bed down that way. I remember her, the nurse, asking me to lift my bum so that she could change the bedsheets. When I was literally in the middle of an active contraction and I turned to her and said, Just give me literally less than 60 seconds this and that. And also, more stuff is gonna come out of me and then we’re gonna have to do this again. 

P: Yeah, yeah, yeah, yeah. 

J: So then when the midwife came in, all of that change I was allowed to, you know, have some water I was allowed to do whatever I wanted with my robe I was allowed to have the bed in a more comfortable position.

P: I asked Anne to talk about the differences, she might just pay between a birth guided by OBs and birth guided by midwives, I have to paraphrase the first part of Anne’s answer, because the sounds of a garbage truck drown out her voice. She said the physicians have very little if any training and unmedicated labor and birth. They’re trained to look at all the factors around birth because their expertise is in high risk situations, and they’re trained to surgeons, and this is what else she said,

Anne: they’re focusing on usually everything. What’s the mom working through contractions you know are contractions efficient is the baby’s heart rate okay. And I think physicians, and a lot of nurses too who don’t have a lot of experience and unmedicated labor and birth pain is very uncomfortable to witness and so you know it’s oftentimes they want to make that pain go away, where as midwives we’re trained in this is not an broke my leg pain and emergency pain, This is a physiologic pain a physiologic discomfort, and so it makes us less uncomfortable because our training is so much in normal physiologic birth, but I think for a lot of birth workers, they just don’t have experience in it and so the idea of an epidural makes them feel more comfortable, it’s not to say that there aren’t obstetricians out there who are fabulous attending an unmedicated labor, reverse there and just watching birth and letting physiological happen, but it’s definitely not the norm because it’s just not their training, 

J: we took into account what was happening with the umbilical cord in fact the midwife came in and we got his cord unwrapped. 

P: Oh, Wow, 

J: let me turn in different ways and unwrap it. So we went from this scenario where they were saying, you might have to get a C section and I actually remember crying and saying that I couldn’t remove my, my robe and that I couldn’t have ice cubes or any water even if I was hot and you’re nauseous, we’ll here have a have a Pepto Bismol so that you don’t feel bad too. Okay, we’re going to regulate your body temperature, we’re going to do it with. In this calm way. If you want to take your robe off we’re not concerned about turning into a strip joint. And so I was put into the process in my body and my needs were respected along with keeping the baby in a in a safe, comfortable happy environment, and my labor actually sped up. At that point, because I went from being actually distressed to. Okay, I can actually relax a little bit, and it’s feels less scary.

P: That’s awesome. It’s awesome also that the midwives have those kind of tricks to help with the umbilical cord that’s super cool it does, and you can imagine has a long history and you feel like you’re capable hands and she knows what she’s doing.

J: Absolutely. So I’m not having had that experience I’m not against doctors and nurses, but I do feel quite strongly that if you are somebody like me that wants to have non medicated birth, that it is going to be strongly in your best interest to have a support team, that’s specific for an unmedicated birth, and that likely means a doula and a midwife. And even if you can’t have the doula. It’s probably almost definitely needs a midwife because that midwife is going to take your comfort into account

P:  So Janis brings up another good point here: go into labor and delivery with the right team. Anne and I had a longer conversation about the different incentives that shape the way hospitals, practices and providers manage labor and birth…she had some words of wisdom about important choices women are making for their labor and deliveries…this is what she said…

Anne: if you have, you know, private insurance and you can choose if you are  somewhere where you can choose between a variety of different practices, especially do your research, you know, what is that practices without providers C section rate what’s the hospital C section rate if you have settings to choose from. If you’re choosing an out of hospital setting, what’s their transfer rates you know how until until what gestation, can you be pregnant or when would encourage induction What’s your hospital providers induction rate. You know what, just need to leave, you know, most people do a lot of research on the Crib they’re going to buy or the carseat they’re going to buy, but I’m just like, oh this is who I was assigned to for prenatal care and just follow suit and the way your labor, pregnancy, labor end up being who’s there to help you along the way and who’s guiding you as your provider.

P: And then, what, how long do you stay in the hospital and what’s the fourth trimester, like,

J: I stayed in the hospital, I gave birth at around four in the morning, so I actually was lucky enough to get to stay. And I was lucky enough to actually get to stay, not just that quote unquote night, I mean that night was over because it was, it was six by the time I actually got to the room, but I got to stay the next night as well. And the baby actually was born with a huge bruise on his head because of his fun back labor experience. So he had jaundice, and he wasn’t discharged with me so unfortunately we did spend one of those early nights apart which I didn’t really love, but my stay was pretty short, I didn’t have any side effects, particularly from the birth.

Nothing ripped or tore so I was a pretty clean case of. Get in, get out. 

And the fourth trimester for me. It was kind of exhausting. I had a baby that had acid reflux and colic, and he cried. He cried and he cried and he cried and he cried, and breastfeeding was hard because he basically just wanted to breastfeed 24 hours a day. So, it was, it was a huge adjustment for me and because I was on my own. I really didn’t get enough sleep. and there wasn’t anybody to help me out. My parents came to visit each for two weeks so I did get some very early support, but then everything fell to me and to my community of friends and I did have some very helpful friends, but at the end of it, every diaper change was me every pickup the baby was me every meal was me and it was, it was a lot I mean I didn’t know anything different, To this day, when somebody I know has a baby. I sort of look at my proverbial watch and I’m like, Oh, I’m going to get that note in about three months and that note always has, I don’t know how you did this by yourself. 

P: Yeah, yeah. 

J: But it was just one of those things where, just like my birth, I didn’t have anything to compare it to. So, when I look back on that, that’s just what having a baby was, and you know I had a baby that was on the more difficult end because he didn’t sleep all day he cried all day, but it just was what happened, and so it wasn’t like he was my second child and suddenly I was thrust into something that I was unaware of really wasn’t like that first time. It just was what it was. Fortunately for me, I took a long maternity leave, and I also came into this situation. Really really healthy and vital with a lot of energy. So, I think that all things considered, I was lucky because I was able to take a lot of time off work, and I had come into it from a great pregnancy, super healthy lifestyle.

P: I am with you until you get to colic, because it you know, it’s hard enough to do the, the day to day tending to a very small baby and it sounds like you had a little bit of help around the edges but all those people who are gone wants to colic hit, I’m assuming, and that’s just a really challenging thing, it’s just a really challenging thing to live through, especially without someone else that you can give the baby to to say, I need to walk around the block. Right, I need to like do something.

J: Yeah, yeah, so I actually remember taking him in the baby carrier to the drugstore at four in the morning or three in the morning because he was just crying and crying, crying and literally taking him for a walk was the only thing that made it stop, and I mean, my dad was like oh that’s a great way to lose the baby weight and I’m like, Dad, I just want to sleep. Yeah, I mean he wasn’t wrong way to look at the positive dad but it was, it was exhausting. There were days when he literally cried 10 hours a day, and I do remember calling my sister, throwing the phone into the middle of the room, putting it on speakerphone and literally just shouting into the phone like she was, she was like, What are you yelling about I’m like I just can’t stand it anymore, it’s just, it’s crazy. Because a colicky baby is one that there’s no particular reason that they’re crying, they just spend their whole time crying, 

P: and, and there’s the feeling that there’s the feeling that you should be able to soothe them. Right. And you just there’s nothing you can do right it seems like it is just a, like a developmental thing right for them to go through art, you know the book The happiest baby on the block, you know, a book so maybe you studied that book, but I heard Harvey Karp say, I haven’t been able to verify this, but I’ve heard him say that in Navy SEAL training. They play the sounds of crying babies all the time because it breaks people down, like it is like a physiological response. So, congratulations your navy seal, I don’t know. 

J: Thank you. I did realize during that period, that when babies cry, it is meant to be annoying, because at a certain point, I was exhausted enough that I remembered dreaming, and in my dreams. The baby was crying but I realized it was real and it was right beside me. 

P: Yeah, 

J: or it wasn’t, but a lot of times, that level of exhaustion actually required him crying to wake me up and get my attention and that’s ultimately what it’s for, I mean, yeah, babies need attuned parenting, yeah need somebody to hold them and they need somebody to feed them and they need somebody to care for them or they die. 

P: Yeah, 

J: and the only way that they’re going to get a tired parent to do that is going to be through being annoying. So I really, I really learned that one. Because if that was a pleasant sound to the human ears, especially because babies are cute, we would just put them in the corner and it would be like a puppy, where we interact with them, we have a good time but we leave it, we leave them alone. Right. So I believe that that’s a really interesting story with the Navy SEALs,

P: yeah so once I bet it was like dreamlike once he got over the colic,

J:  it was, it was. I laugh because I never really knew what an old soul was until I had a baby, and then all of a sudden I’m like, I don’t even know what that is but I think he’s got an old soul so every time he went through a developmental phase, he would get happier and happier and he’s a, he’s a super happy smiley kid. But when he was three months old he was sitting in one of those little bumbo chairs right beside me and I was reading a baby book that said, Oh, your baby’s personality must be coming out by now and he sat there when he wasn’t crying, he would sit there and make this noise, like oh my god, I have given birth to a curmudgeon. 

P: Bad news, bad news Janis

J: Yes. This isn’t going very well. And so I actually feel like he was just a child that it was almost like some sort of locked in syndrome where every phase, where he got to eat it made him happier when he got to walk it made him happier when he got to stand it made him happier. So that was a huge relief was that he actually did turn into a very happy smiley little kid instead of this crying curmudgeon.

P: What’s he into now What’s it, what it was he like at ten?

J: he loves Lego, he loves books he actually is super into food. He loves cooking and fun trying new foods from around the world. He loves video games and YouTube videos, and anything that you can build or construct or create, he’s really into that. He recently started working with horses and loves horses. 

P: Oh wow, 

J: skating, and so he’s got a got a range of interests.

P: That sounds awesome, very exciting. Yeah, if you could go back and give advice to your younger self, what do you think you would tell her.

J: There is a certain naivete before you have a baby. And I think, I didn’t. I had no idea how much energy it all was going to take and how much of a marathon, it is. And so a lot of times in those early days I was trying to sprint through. 

P: Yeah, 

J: I would tell my earlier self to sleep as much as I could during pregnancy because afterwards you’re just not going to sleep again for like, I don’t know how many years but he’s 10 and he wasn’t feeling well last night so at midnight he came in, turn the light on and, yeah, yeah, I think it’s never the same ever again. Um, and I didn’t really recognize, I’m, I’m a bit of an energizer bunny. I am always high energy, I feel like I always have something that I’m ambitious about and wanting to do so even as a high energy person I did not realize it was going to drop me into my ass. So the demands of parenting are a lot higher than what I really had ever estimated what anybody talks about when anybody tells you, because when I see little kids. My brother has a four year old and in short spurts, it’s very manageable. 

P:Yeah, 

J: it’s the 24 seven this of it, that really wears you out because you don’t get a chance to really get those long breaks or the period of real recovery. So when you’re working on less sleep and constant activity, and you still have to maintain the rest of your life, your career, keeping the house clean doing all the adult things. It just is a huge drain, and that’s such a negative word but you know you’re adding this 20 to 60 hour responsibility to your to week and it didn’t really occur to me that something else was going to have to get pulled out of my schedule and out of my life. To the extent that it really did.

P: Yeah, yeah parenting is harder than it looks for sure. 

J: Yeah, way harder than it looks. 

P: Yeah, well you made it through though so far. It sounds like he’s ready to go, he can cook. What else does anybody know, right, laundry, we got to work on the laundry. I will ask you to close your very close. Janis thanks so much for coming on and sharing your story,

J: thanks for having me

P: Thanks again to Janis for sharing her story with us and thanks also to Anne for sharing her experience as a certified nurse midwife and for helping us to understand the different perspectives on labor and delivery between OBs and midwives. As always, thank you for listening. Feel free to like and subscribe to the podcast, and leave a review if you can. You can find shownotes and other information on our website, warstoriesfromthewomb.com. We’ll be back soon with another story of overcoming.

Episode 10 SN: Just When You Thought You Crossed the Finish Line, Colic: Clarissa

Some women waltz easily into pregnancy and motherhood, at least in the Hollywood version of the story.  This was not the version today’s guest experienced. Getting pregnant and being pregnant was not as straightforward as she was led to believe. Recovering from her first trimester loss was challenging, but my guest and her partner persevered and her subsequent pregnancy went swimmingly. The next challenge: birth–which was physically and emotionally daunting. And as she recovered from the birth, she was introduced to the relentless press of colic. Slowly, slowly the colic subsided and now the greatest challenge is planning weekend adventures with an entertaining and talkative toddler. 

D&C

https://www.mayoclinic.org/tests-procedures/dilation-and-curettage/about/pac-20384910

Pessary

https://www.mtw.nhs.uk/service/maternity-old/your-labour-and-birth/induction-of-labour/#:~:text=The%20pessary%2C%20which%20is%20inserted,your%20baby%20during%20this%20time.

Pitocin and contractions

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595289/#:~:text=Pitocin%20causes%20contractions%20that%20both,the%20uterus%20and%20the%20baby.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7406087/

Book mentioned by Dr. Chamberlain:

Happiest Baby on the Block

Audio transcript

Paulette: Hi Welcome to War Stories from the womb

I’m your host Paulette Kamenecka


Some women waltz easily into pregnancy and motherhood, at least in the Hollywood version of the story.  This was not the way today’s guest experienced that transition. Getting pregnant and being pregnant was not as straightforward as she was led to believe.


Neither was the fourth trimester. She and her husband were forced to surrender to the absolute lack of control that new parents have with a baby, thanks to their reckoning with the dreaded colic.


After our conversation I went back into the interview and included some details about medical issues that came up. I also included a conversation with a fantastic pediatrician.


One other issue to note: the sound quality on this recording has more texture than usual…Clarissa’s cat has a walk on role–literally; you can periodically hear her cat walking on paper on her desk while we’re talking, and in other places the internet squashes Clarissa’s voice a little bit …I apologize for that…and we’ll do our best.

Let’s get to the interview.

P: Hi, welcome to the show. Can you introduce yourself and tell us where you are?

Clarissa: Yes, Thank you for inviting me. My name is Clarissa. I’m from the UK. But I live in Madrid in Spain. And I’ve lived here for almost seven years now.

P: Oh, wow.

C:  Yeah, love it was supposed to be 18 months. My husband I love with it. And stayed.

P: So are you fluent in Spanish at this point?

C: No. embarrassingly awful at Spanish. When I first moved here I taught English I never, never practiced. And the more I didn’t practice, the more I get embarrassed about practicing. So it’s a vicious cycle of not practicing being by the Spanish. There’s a lot of Spanglish. So with my sort of Spanish and everyone else’s sort of English, yeah, I can get by again, another reason why I have not got fluent because I can survive with my intermediate level. Yes.

P: Excellent. How many kids you have?

C: just have one, one little boy who’s just turned one.

P: Oh, lovely.

C: Just  a couple of months ago.

P: Before you got pregnant with him, you must have had some ideas about what pregnancy would be like, what did you imagine that experience would be like?

C: I thought it would be very easy to become pregnant. And turned out it wasn’t. And yes, what I just thought, you know, in a couple of months I’ll be the pregnant everything will be fine and I’ll have a baby at the end of it. Because that’s what happens in the films and most of my friends thank goodness for them. And, and my mother as well, whose a very powerful and strong influence in my life. So yeah, that’s what I thought it would be.

P: And so when you started trying to do it, Was it easy? or What was your experience?

C: Well, The trying, the trying was fun, but after many, many months of many, many negative tests or you know, starting my cycle and disappointment it did become a little bit of a chore I think, a bit not soul destroying that’s too strong but every every month when there was another negative another No, it was hard to continue hard to keep going and keep motivated. And I think this is quite a common experience. I think it was almost coming up to a year of trying and I went to the doctor here to have a few tests to start the initial process of what is what is the process of not being able to conceive and what’s the next steps and the month after that I fell pregnant actually

P: Oh, wow

C: I think a friend of mine told me it happened to her I think when he started like again it’s not in my hands anymore I’m seeing a specialist things are gonna happen and then maybe your body relaxes and things as naturally as it did for me. I know, not always but it happened for us, which  was good.

P: Yeah, that is good. That’s nice to short circuit that trip down the fertility path which is you know, not not a not a fun

C: is not a fun I know that a couple of my friends have been through it and it’s not fun. It’s very testing and trying. So I’m very thankful that even though it took a year I’m thankful that it happened naturally in the end.

P: And what happened with the pregnancy?

C: and so that one very sadly, we lost that pregnancy as a as a as a missed miscarriage. I’d gone to my gynecologist, sort of just to meet her and start the process again, being British in in Spain. I wasn’t 100% Sure of how things worked here. And so I met my gynecologist quite early on in the pregnancy just to sort of find out the process. And she did a quick scan. And everything was fine. I mean, early, early early, but she said it look good. And booked me in for the next sort of proper, more official scan, in a few a few weeks time my husband came along to that was about nine weeks into the pregnancy, that scan. And that’s when she told me that there’s no heartbeat, nothing had grown, it was the same size as it had been previously. And we did to have her manage this carriage or something, I’ll come into how she described it, but had to go home and take some medication to remove the effects of pregnancy she phrased it as.. to it as remove the effects of pregnancy or something like that.

P: I feel like that strange wording is meant to be delicate, although it’s a little bit off putting right it’s weird not to kind of call it what it is.

C: I kind of I Yeah, probably it was supposed to be  a way to help me disassociate from it? I don’t know. But I found it really harsh. Actually, I found this process very difficult and quite hard on me. I didn’t know whether again It was difficult, or this particular doctor, but I found her very cold and very strange Matter of fact, and I’m someone who would need a little bit more comfort and being told it was a baby and all these things things. But yes, I found that quite difficult.

P: Yeah, I’m sorry, that sounds hard. I think that absence of suggesting there’s grief involved here is a weird way to handle it. I guess it’s more like medical than emotional or something like that. And that’s it

C:. Yes, it was very medical. Now, with with the benefit of hindsight, the benefit of distance. You know, I can see from her point of view, she would probably early miscarriages, I as we know are very common. Now. She probably sees them weekly, if not daily, it was the end of the day for her. It was the end of her shift. I don’t know what she had been put in it. But it was the some of the reasons that she might have been a bit cold. Still, I do feel like I was a bit of a number and Yes,

P: yeah, so that sounds like also surprising when you and your husband are going to the office for this exciting thing to have to have it sort of develope in that way. Right.

C: Yeah. Yeah. And it was, you know, it was his his first time any experience of any of any kind of that kind of office. And yeah, as I will know, his face will always stay in my memory. The memory of that is this kind of complete shock of what’s going on what’s happening as well, but he was amazingly supportive to me and his focus was definitely on right. Let’s keep clarissa happy, make sure she’s safe. Make sure she’s okay. He was wonderful. And I have to say in the end, again, I went home and took the medication that she gave me that day. Unfortunately, it didn’t work. Two weeks later, I went back to get another scan. And still she still does the same words of materails of pregnancy or remains of pregnancy or something that essence that is still there, so I had to have a DNC operation.

P: Clarissa mentioned a DNC which stands for dilation and coverage. It’s a surgical procedure. Once the cervix is dilated, so the uterine lining can be scraped with a spoon shaped instrument called the caret to remove abnormal tissues. It’s used to diagnose and treat certain uterine conditions, or to clear the uterine lining after a miscarriage.

C: And I have to say, Actually, she did that. And she did it. Her after care with that was wonderful. She quite nervous I had to go into the hospital, my own, my husband had to go to work. We just come to me up that after the operation, she came in for the aftercare talk and it was very caring, and about the grief that I will experience and to allow myself to feel this grief. And don’t let anyone tell me that just because it’s an early loss. It’s not a loss. And so she redeemed herself a lot after that aftercare, actually. I ended up with quite a positive feeling.

P: Good, good

C: It Took a strange way to get there.

P: Yeah, yeah….Well, I’m sorry to hear all that. That does sound hard.and the DNC is not pleasant. No matter what So I assume you took time after that to….

C: Yeah. Well, she, as part of the aftercare, she said wait until you’ve had one cycle before trying again. You’re right. I kind of because she said, Oh, you know, you’ll be in and out operation. They, you know, about the same day I went and didn’t think ever take anything calm. I feel fine. Yes. All right. It was quite um, it took my body a long time to get back to feeling okay and everything. And because of that, even though my cycle came, okay, my husband, I said, Let the beginning of a new year, it was January. Let’s give it some time. We’re not in a rush anymore. A bit of a cliche, but we we know we can get pregnant. So let’s just relax. We’re given a holiday, a family holiday, and we went skiing in January and didn’t think about it. Then I missed my second cycle, my second period. Take a test. And it’s very, very positive. So surprise, we were a bit shocked and not sure we’re ready. My husband especially I think he was particularly that I’m not sure I’m ready. This thing, but nature has it’s own way of doing things

P: That’s what the nine ones are for…It’s an acclimation period, right?

C: We used those fully. Yeah.

P: So how was this pregnancy?

C: And this pregnancy was great. I felt really, really well,  for the first few months, a little bit of sickness and a little bit of tiredness. But overall, I felt fantastic. I used to use them. Every time I went for a scan, every time I had an appointment, I changed doctors actually, in the end, just to be more local to my house, but also to not have the same feelings of being in that waiting room. And having sort of negative feelings about that negative feelings about that  waiting room. So I changed doctor and she was fantastic. I still get walking towards her office, I’d still get Oh, gosh, what is going to happen again? What’s going to happen again? And even every time every time I went to the bathroom, and is there going to be blood on the tissue? Is there going to be any I think every time you’ve had a loss, even if you feel very confident and happy.  it’s always in the back of your mind?

P: totally, I think one thing that’s kind of prominent about that experience is that it makes it clear that you have no control. Like this is a process going on in your body. And while it is internal to you, that’s about the limit of your control. So that you know you’re always nervous, right? Because it happened last time and you didn’t do anything to make it happen, right? You have no control either way.

C: Yes. Which is a great thing about living in Spain, actually, they they every pregnancy loss, they test, the test and to see maybe why, why it happened, which is actually really reassuring because it confirmed that nothing I did, that baby was never going to be viable. And there was my body’s way of telling me that So yeah, that’s a positive thing. But I wouldn’t have got that back at home in the UK. So that’s a positive thing about living in Spain. And again, a little bit more confidence with this one because there’s nothing I did and yeah, I didn’t let go and hope for the best. But yeah, this pregnancy was better I had that’s what I do. last few weeks of it. My husband and I went out a lot in the evenings take advantage of it just being us two the last few times. And yes, I sort of got that burst of energy towards the end, which is nice.

P: That sounds lovely and and how was the birth?

C: Long

P: So let’s walk slowly through this one. Tell us you know what happened that day that you started to have contractions or whatever it started for you?

C: Well, a few weeks before my doctor was a little bit worried about my blood pressure. It was a little I mean not extraordinarily high. It was a little bit high. So I had to go and check every day at the pharmacist pharmacy. Keep checking. So that was in the back of my mind a little bit of a worry. And she was talking about not letting me go over too much and things like that. I was due the 13th of October and it was my birthday on the eighth of October and I woke up on the eighth on my birthday with sort of a gentle water leaking I’m sure I think nothing dramatic like the films or like that, just all day until leaking of water and my I am a midwife. I have done a an antenatal course with my the speaking with her and she said you know don’t have any contractions or anything. Just keep the endorphins flowing, keep happy hormones going. I had planned to go out Milk with my birthday said yet keep doing that, you know no need to rush to hospital or anything like this. So we have a lovely evening celebrating my birthday on the way back from that we did pop in to the hospital just to check everything was okay. And they said they will it was the doctor duty on it was midnight, the doctor on call had said no, we don’t think this is waters breaking go home. I had a routine appointment the next day anyway, due to my blood pressure. Come back with that, which I did. I had a lovely night’s sleep and had my appointment in the morning. My weekly appointment to check my blood pressure. And it was it wasn’t quite a lot. And obviously I was to my doctor, I think my waters are going and I came in last night and they said no. And she did a quick scan. And then I think they are your there’s not much water around the a baby, your blood pressure’s high. I think it’s enough. I’d like you to stay in and start the induction. And one thing I have to say about my doctor here, I was told that is quite old fashioned compared to us, the US, UK and other doctors in charge and they don’t talk to you about things. And it’s never my natural birth and all this but my doctor was very considerate of me considerate of my opinions. We always talked about decision before we made it together. And so I felt very happy with her, and her  decision to suggest staying in. And yes, so that was Wednesday, the ninth. I started the induction process that day. And nothing really got going. It was just an

P: Does induction process mean Pitocin? Is that what that means?

C: Not at this stage. I don’t think It was just a pessary just to see if my cervix would open a little bit more.

P: What’s a pessary. It’s something used to help thin and soften the cervix getting it ready for labor. The pessary looks like a very small tampon that’s inserted into the vagina. It contains prostaglandins, which are hormone like substances that are released slowly over 24 hours in an effort to ripen your cervix.

C: And sort of start things a little bit without drugs and drips to stay in. But nothing Nothing happened. we stayed in hospital all afternoon like playing games and facetiming people and bouncing on my Pilates ball. But nothing got going so they took the pessary out three hours at about 7pm and told us to get another good night’s sleep and they will start the drip drip in the morning 7am. So that’s what happened. Had another very good night’s sleep. quite excited about we knew it as a boy. We knew he was going to be called Charlie. Getting quite excited about meeting him. And yes, seven o’clock in the morning. tHey started me on the drip things. Again, that felt quite slow it was. I sort of lost track of time. This point I think, remember at about midday. A lot of breathing through the pain, the pain was just getting really intense. And the midwives are coming in saying you wanted to wait for an epidural until you seven centimeters or six centimeters that isn’t a natural birth.the medication is making your contractions much more intense than it would be without them.

P: oxytocin is the hormone that helps encourage contractions during labor. pitocin, which is synthetic oxytocin can have similar effects. But in your body, oxytocin is released impulses both into the bloodstream and simultaneously into the brain for labouring women and the brain it positively affects mood and bonding behavior. Pitocin however, doesn’t cross the blood brain barrier. So if it’s being given to a woman in labor through an IV, it’s not creating the same emotional effects. And in part because it’s not being released impulses in the body. It can lead to contractions that are stronger and more frequent than naturally occurring contractions.

C: please, please have an epidural and you know I thought Yes, yes, please. Yes. So the other day I was rolled off that it was absolute bliss, feeling I have ever had in my life. Having this epidural, I think I managed to get a quite a couple of hours sleep in the afternoon as well with that going on. And unfortunately, of course it it does slow down the process the contractions were getting slower. Charlie was taking longer to come down into position. I think it was about five or six o’clock in the afternoon evening. My doctor came and said right we need to try to turn you on to your front to try and encourage him into the into a better birthing position. He’s not coming down the birth canal. She’s a very traditional Spanish lovely lady trying to make me laugh. But she’d seen this on an episode of Call the Midwife, which is a very UK, BBC drama but I wasn’t really in the mood for Jokes at that point. So I couldn’t, I’d sort of clicking the epidural and it’s been getting stronger and stronger, I couldn’t feel my legs, I had to turn on my front into like a downward dog position was impossible, my husband would have between doctors and my husband trying to turn me over to the downward dog position. And that unfortunately, as well picked out half of the epidural. So I could start feeling the left hand side of my body,

P: oh, no,

C: for the pain, which was, which was intense, intense pain. I don’t know what it was hours or minutes. But it had me doing a few practice pushes. Once I was back on my back, I think now that was my transition. Because I I remember having a bit of a breakdown, screaming, I can’t do this, I just cannot do this. And I’m so thankful that I gave birth before the pandemic, because my husband was there with me. And there was loads of doctors telling me I can do this, but the only person I believed was him. You know, he took me in the eye and told me I could do it. And he just completely calmed me down. We got through it. Again, Charlie was still not coming down anywhere close to the birth canal. Again, the full discussion with me as much as she could in my in my state of my left side and agony of things going on. But she did say we’d agreed as well that we’ll do everything we can do a vaginal birth. And that things are looking good and closer to having to do a C section. The baby’s still absolutely fine. His heart rate is good but it’s  getting I think this is coming into sort of 8pm 9pm at night. And so we’re going to take you to theater, maybe prep everything for a C section, but we will we will really try to get him out naturally. And that sort of sped me on as I’m having done all this work to then

P: yeah.

C:  But we got into the theater just in case James is outside having to put all the scrubs on and everything. I remember at this stage I was completely naked, I lost all kind of sense of propriety, or any kind of sense of this is not normal, but it was a student hospital. So a few student doctors, they’ve got some pediatrics in as well just in case Johnny hadn’t wasn’t doing very well. I know the doctors there for me and my niece the test and I just have my legs up on the stirrups, the very sort of old fashioned traditional way of giving birth stirrups and something to hold. And my poor husband sort of walked into the scene. Again, I just always I do manage to remember his face look strange in his face. He said I don’t want to look at the business end. But he walked in straight directly looking at it bless him. The doctor said if you try and push and if you can push with all your might we can we can get him out and we did it definitely was a team effort. My anesthetist was helping me breathe and my doctor was again talking to me through everything she said, I’m going to have to cut you if you’re going down we can use the forceps to get him out and my dream had been natural birth no forceps, no episiotomy, but at this point I was like Yes, yes, everything just get him out, get him out. And yet and he came out beautifully, wonderfully. Lucky I luckily the epidural was had failed on my left side, but not I couldn’t feel her cut me or I couldn’t feel anything like that, which the anesthetist was telling me That’s the most important thing. So that’s good. He had the he had the cord wrapped around a few times around his neck, which was the reason struggling to come down. But he was fine. They took him away It felt like three seconds later, in a way to make sure he’s breathing. But then he was on my chest. And he had done it. So it was strange experience.

P: That sounds like a triumph.

C: Yeah, in the end, it feels like a triumph. Because even though it was nothing as I’d imagined, I didn’t want any intervention or to be cut or to have as many doctors in the room as there were. But because I think I had such a good dialogue with my main doctor. And such a good relationship with her. And she always asked me before she did anything she asked me my profession and explained everything. I felt like it was a time when I feel very positive about it.

P: Good.

C: Yes. Yeah, that’s good.

P: And so how long do you stay in the hospital after that?

C: It’s typical for Spain to stay three days. Yeah. So we stayed, there was a tiny bit of worry because I’d lost quite a lot of blood during that. But in the end, I got to the test. I didn’t need anything to do at home for a few days. I remember being my first shower getting really dizzy. And they said that’s normal with the blood loss. Have a cold shower. Not a hot shower. But yes, three days quite, although we did sneak out a bit early because he was born so late. I think he’s born at 10pm at night. So he stayed that night, the next night, and we went home about 9pm the next next evening. But yeah, it was, I was so glad to get home, although also nerve wracking, because at the hospital, everything’s done. You know, they come early. Oh, maybe you should feel the baby. Now. Maybe you should do that maybe should change my, you know, brain kind of suggestions. But all right. Okay. That’s what I need to take further home. It’s just you.

P: Yeah, yeah. It’s nice to have adult supervision in the beginning for sure.

C: Yeah. Yeah.

P: And how was it when you got home?

C: Yes, it was often the nerve racking, where were the adults were in charge. Now. It was another bit of a haze of just feeding and I had no expectations of myself to breastfeed or not, I hadn’t really thought about it. But he and I just happened to, to click and bond and that way, and he found it quite easy. And I found it quite easy as well, he did have a tongue tie, which made it a bit sore. But we got that sorted quite quickly with my midwife here. So I just it was a haze of breastfeeding and changing. And then my parents came to visit which was lovely to visit, which again, I found helpful more than hindering, especially because because we live abroad there back in the UK, they can only visit for a short amount of time. They’re not here all the time. So it was a lovely bit of help. And then back to being just a three again, it was sort of I think about four weeks old, he started with a colic, which I found extremely testing, extremely testing

P:  that’s so hard, but it didn’t happen like every night at six or like, was it regular? Or

C: it was my regular, yes, he wasn’t, he was always quite a clingy baby. I remember, when my husband went back to work, he went back to work after six weeks. So pretty much at the start of the joy.

P: Yeah,

C: he would only be in the daytime, he’d only be happy in the carrier. So even in the house, I would do some housework or some gentle things, but he had been the carrier. Next to me my heart. Now I consider the time I find it extremely suffocating. But now learning more about the fourth trimester. And things I can understand a little bit more. He just wanted to be close to me. But at about 5:30-6pm that wouldn’t do it and nothing would do it. He would just be screaming, screaming screaming to about 10pm at night. So but and it was always a time my husband got back from work. So I’d had quite a nice day with him. Sleeping, feeding, watching TV and going for a little walk. And then just my husband most of the day after work, screaming would start.

P: I took some questions about colic to a pediatrician. Hi, welcome to the show. Can you introduce yourself and tell us about your training?

Dr. Chamberlain: Absolutely. Thanks so much for having me. I’m Lisa Chamberlin. I’m a professor of pediatrics at the Stanford Department of Pediatrics and the School of Medicine here. And I work at the Stanford Children’s Hospital.

P: How long have you been a pediatrician?

Dr. Chamberlain: Oh, let’s see, forever 20 years.

P: Clarissa said it was you know, idyllic, she brought her new baby home. And then as soon as her husband’s paternity leave ran out, the crying started, let’s talk a little bit about colic how does a doctor define colic?

Dr. Chamberlain: Yeah. Great question. And I really feel for Clarissa it’s, it’s a hard thing to have to go through. So call it a few different definitions. But the one that a lot of us think of is crying, that is three hours or more a day, more than three times a week for infants less than three months old. So kind of the rules of three. If it’s less than three hours or less than three days a week or a child that’s over, you know, more like four or five months old, we would think less of colic. But if it meets those kind of rule of three criteria, and we think of it as colic,

P: do we know what the source of colic is why why babies develop it?

Dr. Chamberlain: We don’t know. So one of the first is a short answer, long answer. We have to make sure it’s not other things. So I need to make sure that there’s not any kind of neurological problems, rare things around the brain. Rare things with the heart there are Some heart conditions, and then things that have to do with the stomach places where like one of the valves, the pyloric valve is maybe a little tight that can cause stomach pain or more problems with formula or breast milk. So is there some sort of milk allergy? Is there some sort of intolerance to food? Because that can cause stomach pain, that last category that that intolerance to the food is the most common of those other things that I talked about? Once I’ve thought, you know what, I don’t think it’s any of these medical things. I really think what we’re talking about is colic, then we kind of go down that pathway. So what causes that? We’re not totally sure some people think that it has to do with a developing nervous system. And babies, I don’t know if it’s common to think about it this way. But some people talk about the fourth trimester, that those babies really maybe should stay in the womb until 12 months, but you know, blessedly on some levels, they come out at nine. So for the last three months, there’s a lot of neurological development. So it’s really kind of a normal developmental stage that they have to go through. And colic is just a manifestation of kind of a subset of kids who experienced that with more difficulty. So a normal process that on the bell shaped curve, they get too much stimulation and cry as a result.

C: So I think he found it quite hard to bond with him for that time. I did as well, I had, I had I heard about these initial when the first time you see his face, you’ll love him. 100% and I didn’t get that. I got a sense of I’ve always known him and I’ve he’s part of me, but I didn’t get that love feeling. So again, I think that was quite a testing time, especially for my husband. Only getting home and seeing him when he was a screaming angry ball of red flesh. But for me as well. We did we found that time very difficult as family.

P: yeah I think that’s pretty universal. It’s really stressful to have a baby You can’t calm down.

C: Yeah,

P: And with colic, you just can’t

C: and, and actually, because I the mum guilt goes but the mum guilt got to me that why can’t I calm him ? He’s my baby, I should I be able to do this. Why can’t I do this? Don’t I love him enough and all these things. Plus the hormones. Yes, healing from quite a traumatic birth. So many things. I have to say my husband was amazing, just so he would just sit on the Pilates ball all evening with him. I could see in his face the frustration and the sort of shock of this thing happening to us on my husband’s face. But the calmness he would have while he was holding the baby was amazing to me to see because I just didn’t feel I’m sure he didn’t fit inside. But he looked so calm. And he definitely radiated calm to the baby. Every time is my turn to have a go holding the baby I just felt guilt and sadness and absolute sort of horror with what was going on? It was Yes, it was a difficult time

P: Yeah, that sounds I mean, it’s hard kind of no matter what, but also, if you have the expectation that you’ll you know, you’ll be the one with the magic touch that will soothe him that it’s even harder.

P: So Clarissa talks about feeling like a bad mother, because she can’t see her baby, which I’m sure is not unusual. What What would you say to a patient who brought that to you?

Dr. Chamberlain: Yeah. So that’s actually one of the main things I was I was thinking about, and it’s this feeling what I hear a lot of people say it’s a feeling of helplessness.

P: Yeah.

Dr. Chamberlain And we’re not used to. And so I think for a lot of mothers, new mothers, you know, we’ve come with a sense of efficacy, and we can solve problems, know what to do. And, and this is a really helpless thing, and that you feel like, you know, you’re worried I’m doing something wrong. I’m not bonding with my baby, things like this. And so one of the first things I do, when I when I hear the story of colic is I reassure the family, and the mom, usually the mums, a primary caretaker, you know, you’re not doing anything wrong. This is a normal process, and you’re doing great and, you know, just to reassure them about that, and then try to give them some tools that can give them some options and some places to go. When they are feeling this range of emotions. And for some people, it’s frustration, some people anger, experiencing frustration and anger is normal. You’re not a bad person. If you feel that caring a creature that you love, so much cry in this way for so long. is really hard. so just really wanting to reassure people, and then also the exhaustion. This is all happening at a time when people are physically exhausted, they’ve given birth they are nursing, and they’re not sleeping through the night. So it’s really kind of a perfect storm to feel bad about yourself and feel about about your parenting. So we just tried to reassure people that, you know, you take it day by day, they will outgrow this, this ends, I promise it will end. And so what are some tools we can convey to help them bridge to the other side of this? Which, which will happen? They will get through it?

P: And are the tools like walk around and try to shut down simulation? What can you do?

Dr. Chamberlain: That’s a great question. So there’s a book, it’s an older book, but it describes the five S’s and it’s the happiest baby on the block book. And, and I disclosure, no, no conflict of interest. I don’t know the author, I get nothing for this. But it’s a very simple book, and it conveys kind of the five S’s. So the five things you can do that basically recapitulate the environment of the womb, the first one is swaddling. swaddling is the way that you can have the burrito Baby, you wrap the baby super tight in a blanket. And so that, that hold that that puts the child in very tightly again, like womb, like, right, like it’s all tucked in. And, and, and really snuggled it in and the second one is a side or stomach position. So again, in the womb, that baby’s in these different positions, and they’re out and we just hold them up all the time. So it’s side position, stomach position, using some sounds, that shushing sounds. So that’s kind of mimicking the heart tones that they would hear in the womb, sh-sh-sh that this sort of thing. So that constant sound, and there are people talking about using hairdryers using these white noise machines. So other things that can create that noise, doing some small swinging or jiggling is something else that you can do that helps to soothe the baby and then suck. So the last S is a pacifier or a thumb, something that the baby can suck on. So with these five S’s, these are the different things parents can try. And it’s kind of a trial and error thing, find the one that works for your baby. But people describe it like a switch, like when they, you know, it’s a combination of a couple of them, or maybe three of the five for your baby. And that this this kind of combination seems to flip a switch and the child then calms down. So those are some things that have really no cost, no side effects, easy to try, and are have been found by many parents to be very helpful.

C: You don’t you don’t care. You will do you, you know, you throw money at you. Yeah. living through it. You will do anything. Anything? Yes.

P: So what happens when colic  eventually goes away? And do you know, Is it some kind of physiologic? Do we know what that is?

C: every time that I had my moment I would spend on the internet googling. And I never found an answer. We did used to feel in the evenings when it got peak screaming like you could feel the gas bubble in his tummy. And I mean, I spent a lot of time learning to massage and the leg thing just

P:  yeah,

C: ease and gases. But in reality, it’s just waiting, I think waiting for his digestive system to develop a bit better. And online is no three months, three months, the magic age and we got to three months. And it wasn’t the magic age. And my mother in law  and so I said no, no, it’s four months, four months is really the time and I reached that and things did start to really improve after four months. Plus that three months then there’s a lady in Madrid is quite well known with all the expat mothers about she’s a sleep. Sleep consultancy, gentle sleep consultants and I went to one of her to open evenings. And Charlie was just about three months and it was and again, sleep cycles of up to three months. There’s nothing you can do with a baby’s sleep I don’t know when they just want to be next to you all the time. But for three months, you can start implementing a routine and I did I got him that night, implemented the routine for him in in our bedroom, we used to let him sleep on the sofa all night until we went to bed but know his bedtime. He’s going into his bed with the monitor on and that was also a game changer. For us. I think he was relieved to have a routine at bedtime. We were relieved. And then at four months, it all started slotting in together a little bit better. his tummy got better his colic  was improving. We have the bedtime routine down. He was going on he was going on. Yeah things definitely.

P: That sounds awesome and what what uh what are his tricks at one? What is he into?

C: ah, he is. If he will eating. He will eat everything. Which means he’s become very good at. Like the fine details fine is is fine motor skills is fantastic. And he’s talking skills, also. Very good. He’s just started nursery, full time. Slowly he was part time status early but he’s now been at nursery full time. A couple of months. And he’s just started to, in the middle of life now isn’t such a good sleeper. I can’t criticize on the time but every single day we wake up about the morning just for chat. He didn’t need me, doesn’t want me to go in, he gets a bit annoyed if I go in, actually, but just have a little 20 minute chat. And then they go to sleep. And nursery they say the same. He wakes up from the siesta just to have a litte chat, and they like Charlie your friends and sleeping. Those chatty is not walking yet he’s focusing on the chatting in the eating.

P: You know, we have two kids and the first one walked at 17 months. And she like Charlie, like talks kind of early and so she could order us around. She could say, Go, Go get me that thing; why would I have to get over there  I have you

C: Yes, absolutely. That is exactly what he does. And because he’s my current only my best I, I would do anything for him so of course, yeah he tells me what he wants. I do it. Is it the trick. Right.

P: I think if you have a personal assistant, you don’t need to get there.

C: No, of course. Yeah, so making sense now. Right.

P: I hope you’re taping some of these conversations.

C: Oh, oh no, I’m not as your mind I remember taping a few nights of breastfeeding actually to have that kind of little snuffly  sound that they make when they breastfeed, which I’m so glad I did because he sort of stopped weaned himself, quite early on really so I’m glad I’ve got that but yes, that’s a good idea. I will do some taping, especially for the granparents.

P: Well I was gonna say need it for the wedding.

C: Yes. Definitely. Little cherub face with his chatting. Yeah,

P: if you could go back and give advice to your younger self. What do you think you would tell her?

C: I’ve been thinking about this recently. It’s  come up on a radio station I listen to here, and without a doubt it would be let go of your expectations. I definitely had high not high expectations. I just thought that I would love every minute of it. I thought it would be natural and I, when my baby cried I know exactly what he wanted because I’m his mother. And, yes, and then, the most important thing is that you don’t have to love every minute of it it’s okay to say, this is boring or This is hard.

P: Yeah,

C: or it’s not enjoyable.

P: Yeah.

C: And I think that’s positive because it makes the fun and the enjoyable. The lovely bits, even more special because there are so many lovely bits and enjoyable it’s and love them so much. And that is even more special to you if you acknowledge that. Some days are hard. Some days are boring, and I do miss my pre-Charlie life and I think that’s okay as well. I wouldn’t change anything I love my life I love having Charlie in my life but I have to accept that I, I’m not 25 I can’t go out to the clubs till 6am. I don’t want to.

P: Yeah,

C: but I’m also allowed to miss that I used to, I think, yeah,

would tell my younger self. Enjoy. I did enjoy my late 20s, that enjoying the 20s, and don’t have such high expectations of motherhood. It’s wonderful. And it’s not everything that I am. I’m also I’m still meet. Yeah,

P: that sounds wise lucky Charlie.

C: Hopefully, lucky charlie.

P: Yeah. Well thank you so much for talking to us today and for sharing your story.

C: Thank you. Thank you for inviting me it’s, it’s very important. Again, Wish I had listened to more stories when I was pregnant or when I was trying to get pregnant and it might have helped me realize, and not to be so scared about my emotions and my guilt, and the first few months, if I had listened to my story that so thank you for doing it.

P: Sure, absolutely. Thanks again to dr Chamberlain for the great advice about colic. And thanks to Clarissa for sharing her story. A link to the book dr Chamberlain suggested in the notes. If you like this episode, feel free to like and subscribe if you’d like to be a guest on the show, go over to the war stories website and sign up. We’ll be back soon with another episode of overcoming.