Episode 86: Her C Section Recovery Led her to Holistic Healing: Kayshaun’s Story, Part II
Episode 58: The Power of Hormones, Hyperemesis & Postpartum Depression Visit a Pregnancy: Laura’s story
Episode 58 SN: The Power of Hormones, Hyperemesis & Postpartum Depression Visit a Pregnancy: Laura’s story
Today’s guest had a pregnancy marked by extremely easy things and significantly hard things. Getting pregnant was consistent with the kind of fertility you see in a romantic comedy instantaneous, but the first trimester morning sickness was more like a sci fi thriller, totally extreme and requiring all kinds of medical help. And after a pretty challenging pregnancy, she ran into postpartum depression after the birth but her’s is a story of overcoming. She found help and recovered and she’s deeply immersed in the joy only a five year old child can bring.
(image courtesy of https://www.girlsgonestrong.com/blog/articles/pregnancy-hormones/)
Links to some of Dr. Meltzer Brody‘s work
https://scholar.google.com/citations?user=6CCrvBEAAAAJ&hl=en
Audio Transcript
Paulette : Hi, welcome to war stories from the womb. I’m your host, Paulette kamenecka. I’m an economist and a writer and the mother of two girls. Today’s guest had a pregnancy marked by extremely easy things and significantly hard things. Getting pregnant was consistent with the kind of fertility you see in a romantic comedy instantaneous, but the first trimester morning sickness was more like a sci fi thriller, totally extreme and requiring all kinds of medical help. And after a pretty challenging pregnancy, she ran into postpartum depression after the birth but her’s is a story of overcoming. She found help and recovered and she’s deeply immersed in the joy only a five year old child can bring. After we spoke, I talked to a fantastic psychiatrist who’s done lots of research on postpartum depression, and gives us a sense of what the field might look like in the future. One more thing to add. My dogs were desperate to be a part of this episode. So you’ll hear their contributions at certain points, which in no way reflects the many efforts I made to keep them happy and quiet. Sorry about that.
Let’s get to this inspiring story.
P: Hi, thanks so much for coming to the show. Can you introduce yourself and tell us where you live?
Laura : Sure. Thanks so much for having me. My name is Laura Nelson. And I live in San Francisco, California.
P: Nice, lovely. And Laura, how many kids do you have?
L: I have one child and one husband.
P: well said and before you got pregnant, I’m sure you had an idea about what pregnancy would be like. What did you imagine it would be like?
Laura : Oh, well, I imagined I didn’t imagine it would be magical. I didn’t imagine it would be like a fairy tale. I think I took worst parts of pregnancy depicted on TV and media and went yeah, that’s probably what it’s gonna be like.
P: Well good. There’s only up from there. Right? That’s that’s a good way to start.
L: Yeah.
P: And did you get pregnant easily the first time?
Laura 2:09
Oh, yeah. First first try. We pulled the goalie pregnant.
P: Good lord. You’re the story we all hear. Everyone. Everyone thinks they’ll get pregnant as soon as they try. But it doesn’t happen all the time. Right? But this is the perfect example. That’s so good. I’m glad that was easy. And you found out with like a home pregnancy test.
L: I found out I was I was house sitting for my parents and their dog. And I went to I didn’t know I was pregnant, obviously. But I went to Long’s and I got I was like, I really needed some kulula And why not like a pregnancy test? So I had some grua and I took some more pregnancy tests and all of them are positive. And I was like, well yes, that’s that’s what it is. You know, truthfully, I was like, I was a smoker. And so I was like, I called my best friend and I was crying. So it’s just like such a shock. And I was smoking. I was like, it doesn’t count until the doctor says it right. And she’s like, you’re fine.
P: Yeah, that’s kind of a shock.
L: Yeah, but it was it was nice. It was good. And a good reason to quit smoking. So how about that?
P: And how was the pregnancy? How did it start off?
L: What was it like? Oh, the pregnancy was in a word traumatic. I think it started off with violence, never ending nausea and vomiting. So throughout the course of my pregnancy, I lost 30 pounds.
P: Wow
L: and then I think, so weeks, six through about 20 is going to the hospital three times a week for IV infusions, because I couldn’t even hold down ginger ale and crackers. I was just unable to eat food without taking. I ended up taking what was called Zofran. I took sublingually as well as intravenously. So if you are experiencing severe morning sickness and you’re worried about Zofran I took it pretty much the whole pregnancy and there were zero adverse side effects other than I could pull down food, which was nice.
P: so that seems like a violent entrance into a pregnancy like what it happened once and you thought, Oh, this is just once or like, did you react to a food or it was all food or how does it work?
L: It’s all food, all food and all smells and I was throwing up Bile or food. On a good day. 10 times I was throwing up.
P: Wow, that sounds unbelievably intense. So did it. It happened one day and you went to your doctor like how did it how did you kind of sort it out?
L: Oh, it happened in happened for a few days in it. I thought like, Oh, this is morning sickness. Right? Like This must be what everybody talks about. And then when I was showing signs of dehydration, and I like couldn’t actually function and was feeling very sick. I went to my OB and she said, Oh yeah, no, you need to hyperemesis Gavardiam you need to get fluids we need to give you medicines or you can eat and we need to give you something so you can not be nauseous all the time.
P: So they think like oh, maybe you have the flu or because it’s pretty distinct.
L: yup
P: So even though they gave you the medicine you lost all my weight.
L: Yeah. So I gained again Yeah, back towards months, eight and nine, nine and a half. Right. But But yeah, in the beginning, it was dramatic
P: That sounds super unpleasant. And where are you at? Were you working?
L: I was I was working. I was going into the office. I you know once I was able to announce my pregnancy, which I had to do earlier than I wanted, because I was so sick. You know, it would just be I’d be talking with people about plans and then I thought oh lord is gonna go vomit and I’m gonna throw up and then come back and keep working. But yeah, I was a very understanding very parent focused company. So I was very lucky that, you know, the CEO had kids and everyone I was working with was already a parent.
P: Yeah, that sounds intense. And so it sounds like it got a little less prominent later in the pregnancy.
L: So weeks 20 to about 32. I would say I was normal. So I was eating food walking around. I had a good normal pregnancy and then weeks 33 to 42. It came back and then
P: No, no, is that normal? Was that what they say?
L: Yeah, you’ll either have it just for the first semester or you’ll have it for the first semester and we’ve got like school for the first trimester or you’ll have it for first trimester in the second trimester and the third, so I was lucky that it got a little less severe. For the second semester, trimester. But It came back.
P: Oh my god, I’m so sorry to hear it. Good Lord. That must have been so disappointing the first time you threw up after you have the break.
L: for sure,
P: and so you get to 40 weeks and what happens?
L: I get 40 weeks and and nothing happens. You get to 41 weeks may be scraped the inside what’s it called an induction
P: Yeah. they strip the membranes or something or
L: yeah, they stripped the membranes and then they send you home so they gave me an induction I was induced. They said go home out should start happening. When it’s less than five minutes apart. Come back.
P: so this is this exciting. Because you’re done.
L: Oh, I am ready to not be pregnant. Yeah. Yeah. So I go home as they’re happening and laboring, and it never retiming them. It never gets closer than five minutes eight eighths and spicy food. And it still stayed farther apart than 4-5 minutes. So I called and they said no, if you if you came in, we wouldn’t be able to admit you. I said okay. So 41 weeks, 2 days, I go back. We’re doing health checks. They’re doing the screens. They induced me again, go home labor. bounce on a ball. again It doesn’t stay closer than five minutes. So finally at 41 and five, said okay, well it’s time to come in. so We went down. We checked into hospital it was so I think the one of the nicest and most surreal things about going to the hospital knowing that you’re going to have the baby is you have this like brand new car seat. That you take with you. And you’re like, Okay, we’re taking carseat with us and like we’re leaving, we’re entering the hospital as just us and we’re gonna leave as a family like that. That’s just like it’s definitely a beautiful moment. So
P: let’s talk about your labor for a second. Were you like imagining a natural labor or I want to be in a bathtub or what was your you’re already shaking your head? What were you hoping for?
L: No, I took some birthing class classes with liars. They all said they wanted natural childbirth with flowers, and I said, my vision was epidurals just all of the like as many natural drugs as you can give me. Yeah. Was my natural birth vision. Plan.
P: good, I feel like you’re moving in the right direction then.
L: Yeah. So we go I’m in. I’m induced, they give me they give me Pitocin. I labor for about 12 hours. So that’s fine. We’re just me and my husband all night or just watching 30 Rock and I’m like, a little bit of pain, but not too bad. Then the doctor comes in and checks on me and she says, All right, you’ve been laboring for 12 hours and you’re not even one centimeter. And at this point, I was like, No, like really? Are you kidding? And so she said very plainly. She was a wonderful, wonderful doctor. She said, we think your baby’s really big. Can you either labor naturally over the weekend, and if things get bad, we’re going to have to do an emergency C section. Or we can get this baby out of you in the next two hours
P: oh wow
L: and do a C section right now.
P: yeah, I’ll take the door marked baby now.
L: I said yeah, let’s get this baby out. Like right now. And so the so it just went from a having a baby in two hours. So anesthesiologist came in and the anesthesiologist assistant who looks like Jessica Alba it might have been the drugs I was on but I swear I still tell my husband I’m like man do you remember that anesthesiologist. She was just she delivered kisses from angels with the epidural and she’s out of this world attractive. So anyway, I had the epidural. Seeing your partner scrubbed up in scrubs is just like, interesting.
P: I sort of felt like it you felt like you want to do an SNL skit
L: a little bit
P: come in with all the blue scrubs in that and hair cover and stuff. It’s so weird.
L: Yeah, just like Alright, we’re gonna go have a baby and then I didn’t expect can’t have your husband in when they give you the epidural. So you’re on your own and they’re having you bend over. You’re like gigantic pregnant belly. Yeah, this point I’m like basically 42 Weeks Pregnant I would say again to our baby and me. As the room is so cold, and you’re naked, your butts expose. Just jabbing you with a needle
P: It’s glamorous.
L: Yeah, then I had what’s known as a gentle C section. So I was able to listen to music which was nice we put on Lyle Lovett and put on allow love it playlist. So I was now they put up the curtain and they tested they said let us know if you feel this and just looked at my husband and said it’d be funny if I said it out. And he’s like, No, it would not be funny if you sat down. So we listened to music. Baby came out beautifully and immediately instead of wiping her off or when her they just immediately her on my chest and I was able to breastfeed her while they sewed me up.
P: Oh, wow. That’s amazing.
L: So that was really beautiful. And then they weighed her. And, you know, whisked us off to the recovery room. Once everything was all done. It was life changing in a lot of ways but I think having that gentle entrance into the world surrounded by so much chaos was just very nice bookend and blessing.
P: I was thinking gentle C section was marketing, but that sounds like a gentle C section. That sounds really nice.
L: Yeah,they just give you the baby right away.
P: That’s awesome.
L: Being able to breastfeed even though like I couldn’t feel my arms was nice.
P: Maybe the best way to do it. So you up, you’re in recovery. And then how long do you stay in
the hospital?
L: I was in the hospital. She was born on the 10th and went home on the 13th.
P: All right. And how do you feel when you go home?
L: Oh, I was loopy for sure. I think one thing that I was grateful for from just another friend who was a mother was I was taking the stronger pain medicine. It wasn’t Vicodin. I think it was Percocet and was actually causing like panic and me taking such a strong as soon as my friends had stopped taking Percocet, only take Motrin and so I switched to Motrin, and immediately the panic went away.
P: Oh good. I’ve never heard of that. That’s interesting to know that. It’s like well known enough that someone could give you a nice,
L: yeah, it was very good advice. Yeah, went home. tried to figure out how to be parents, and it was it was nice, but it was also very hard because I had a C section and I was on the I lived on the third floor walk up. And so the doctor says don’t do don’t take any stairs or I live on a third floor walk up. You know in retrospect, they after the kid is born, they have you come back or the next day or two days later for a sort of wellness check to weigh them and make sure they’re eating and maybe even get another shot. In retrospect I should not have gotten to that appointment into that with my husband. And if I had to do it again. I would say I’m gonna lie down. You can take the baby to go get a check up
P: because it was painful to manage the stairs and all that.
L: Yeah, the stairs were just brutal. I ended up popping a stitch.
P: Oh No. Oh my god.
L: but, that’s okay. I mean, the grand scheme of things. It was worth it.
P: What’s it like in the fourth trimester when you’re home?
L: Oh, yeah. So the fourth trimester be brutal for me, who loved my daughter? I think know that I had a lot of unhealed trauma from both the pregnancy and the birth that I didn’t address and being isolated in apartment–not that I couldn’t go outside but that going outside meant downstairs and eventually you know popping a stitch and hurting myself. A lot my husband took two weeks of paternity leave and to care for me and and us and the first day he went back he was let go.
P: Oh, my God that is crazy. Yeah.
L: So I had, I’m a mom, and I’m the sole breadwinner and I feel literally trapped in my apartment. So I should have seen The chips stacking up earlier than I did. But it wasn’t until it was about six or seven months old. I realized I was not well, I had severe postpartum depression. And I just had a breakdown one day where I just could not stop crying and it wasn’t that I didn’t love my child because I did I loved her so much was that and I thought of postpartum depression. The only things I thought of were very black and white. It was you had it or you didn’t. There was no gray area of you have it a little bit and then drawing on media and growing up. The only postpartum depression that I’ve ever seen talked about was that woman who drowned her kids in the bathtub.
P: Oh, wow. Yeah.
L: And I thought well, I don’t want to drown my kidney bathtub. So I obviously don’t have it
P: I brought the topic of postpartum depression to an expert. Today, we’re lucky to have Dr. Samantha Meltzer Brody, a psychiatrist who’s the director of the UNC Center for Women’s mood disorder, and the author of many, many scientific papers on the topic of perinatal, and postpartum depression. Thanks so much for coming on the show Dr. Meltzer-Brody.
Dr. Meltzer-Brody: Thanks for having me.
P: Harming your children is one small one small aspect that might present but there are probably many ways many things that postpartum depression can look like. So maybe you can define it for us.
Dr MB: Absolutely. So postpartum depression is a mood disorder that occurs in the postpartum period. However, it comes with often many co occurring symptoms, including anxiety, also, according to the DSM can start during pregnancy. So oftentimes, hear the word Peri, partum, or perinatal, used to define symptoms of anxiety and depression. That occur either over the course of pregnancy or postpartum. If we’re talking specifically about postpartum depression exclusively, oftentimes, you’re not seeing symptoms creep in until late pregnancy or they start in the postpartum period. They can have a range from very mild to very severe with everything in between. So if someone is having the most severe symptoms, they may have suicidal ideation and tenor plan. Most rarely, you have co occurring psychotic symptoms that can be associated with postpartum psychosis which is not postpartum depression. It’s a severe postpartum psychiatric disorder that is thankfully because it’s so devastating, more rare and can be associated with thoughts of harm to the baby. But then can have a range of symptoms that can include anxiety, worrying, or being able to sleep even when the baby’s sleeping because of worrying about the baby not being able to enjoy the baby feeling keyed up on edge, feeling overly tearful, feeling completely overwhelmed having difficulty concentrating. Again this can be on the more mild side to the to the severe side but in general, they are going to last more than two weeks it is not the baby blues, so most women immediately upon giving birth are going to feel more emotionally exhausted because birthing is very powerful, profound time. Most moms will get their sea legs if you will, but for the one in eight women that continue to have clinically significant symptoms or up to 15% of women postpartum. It’s much more complicated. So what you will hear the terms, perinatal or postpartum mood and anxiety disorders. You’ll hear the term maternal sort of mental health, maternal mood and anxiety disorders to sort of be more broadly inclusive. So we’re not having any one woman gets stuck on one particular symptom as you stated that doesn’t resonate with her
L: but I did and I think that there’s so many different layers of postpartum depression that people don’t talk about. People don’t understand there wasn’t even you know, the right level of support even now, looking back that I was able to get, you know, I broke down i i called my doctor and I said, I’d like a really need help. And so I did three months of intensive outpatient therapy. So I was going in three days a week to the hospital to get talk therapy and medication and art therapy and group classes and group therapy and it really just only let me heal and focus but just realize that I wasn’t alone and that there’s nothing wrong with me as mom. There’s nothing wrong with what I was doing as a parent or how I was loving or how I was living. It was literally a cat, something’s wrong with your brain and you just have to fix it or work on it. So eventually, I found the right mix of medicine
P: One tricky issue with postpartum depression is it seems like it might be hard to identify in yourself or to rely on someone else to identify for you. I’m wondering if something like biomarkers might help here
Dr MB: well the use of a biomarker is, you know, variable depending on what biomarker you’re talking about. But for example, ideally there’d be a biomarker that would show women who are either at risk or to have someone start treatment in a preventative way or start path that would prevent symptoms from happening. Or biomarkers can be used to track response to different treatment or you know, indicate that someone’s going to be differentially responsive to a certain antidepressant or whatever it may be. So they can be used in lots of different ways at this point We do not have a reliable biomarker that’s ready for primetime. And so that’s an interesting area of investigation, both looking at genetic signature, but then looking at other types of biomarkers that can either help with diagnosis or help dictate treatment to be most targeted and effective. And that’s often when we think of precision medicine, or precision psychiatry, rather than saying, you have postpartum depression and we don’t know what treatments going to be most effective for you. So we’re going to, if we say pick an antidepressant that may or may not work for you, biomarkers when they are more sophisticated, can really help guide a specific line of treatment to be most effective.
L: I’m A huge fan of Lexapro I’m like a lexa pro cheerleader. But yeah, the days are brighter and heart is healed and I’m just so full of love and of being a parent, but I think one thing I would say to everyone who’s either expecting to have a child or just had a child and it’s in the fourth trimester is there’s absolutely nothing wrong with you. If you are feeling a little sad if you are feeling like you can’t make it if you’re feeling like things just aren’t adding up to help because it’s really easy and there’s nothing wrong with you. You’re doing a great job.
P: I think that’s a great message and I’m impressed that you were able to see it in yourself. And I’ve talked to a lot of women who have talked about postpartum depression and a lot of them don’t recognize it or think this is just what motherhood is, or I’m just a bad mom, or some version of that.
P: I talked with Dr. Meltzer Brody about some of the challenges inherent in identifying PPD: I’m imagining we don’t have a biomarker and we don’t know which medication would help you if you require medication because postpartum depression is really a constellation of things. And there are many, many roads lead to postpartum depression. So it’s not this this one thing. In the same way you’re describing all these different symptoms that could be sort of a postpartum depression diagnosis. Because there are many ways to get there. Is that Is that accurate?
Dr. MB: I think that there’s not going to be any one reason a woman would have postpartum depression. So in the same way, that there’s not any one type of breast cancer either, so I think one of the things we’ve seen as we get much more sophisticated in other fields of medicine in terms of precision medicine, as we get very tailored and targeted on the specific treatment, that’s going to lead to the best outcome. So 25 years ago, most women with breast cancer you may have gotten the same treatment. It turned out that didn’t work very well at all. And we now are much more specific and targeted based on you know, receptor type and hormonal responsiveness and any number of things where I hope we can get to with postpartum depression and all forms of depression is similarly so that there’s not one form of depression and that people are going to become depressed for any number of reasons and that there’s going to be obviously the psychological psychosocial factors that render someone more vulnerable, but ultimately, it’s going to be the biologic processes, right? So is it immunologic in origin? Is it inflammatory markers in origin? Is it genetic in origin? Is it epigenetic, you know, or dysregulation of the HPA axis or dysregulation of a specific neurotransmitter system? So all of these are hypotheses. It’s very likely going to be an interaction of those but also that some people differentially are going to have a specific sort of past that’s driving there’s for which a specific treatment may be most effective. Now, we are not there yet at all, but I think the hope will be that we can be looking forward to that in the next I would, I would like to say aspirationally decade,
P: generally speaking, it seems like postpartum depression is thought to arise from hormone shifts, during or after pregnancy, in particular, a big drop in progesterone but it sounds like all these other bodily systems are affected immune system HPA access other systems. So it does that contribute to why it is tricky to establish a link between hormone drops and postpartum depression.
Dr. MB: So I think that we know that all women who give birth have rising and then falling levels of estrogen and progesterone, female ganando hormones, that’s a normal part of physiology. They rise dramatically during pregnancy and they fall at the time of delivery and that is part of physiology and so there’s no difference in the rise and fall in any particular way that’s been studied for someone that has postpartum depression or not, what the current theories are, and you’ll hear the the expression, differential sensitivity meaning a woman who gets postpartum depression may be differentially sensitive to the rising and falling the normal, rising and falling in a way that someone else is not. Now, we haven’t necessarily gotten able to refine that exactly, not even close. And it’s very likely that some women are differentially sensitive to the rising, falling and they have postpartum depression for that. rising, falling and they have postpartum depression for that reason, it’s also very likely that other women have postpartum depression because of a different trigger. So, the dysregulated system is not necessarily going to be hormonally based it may be something else and so this is an active area of investigation is understanding what are all the different factors and how they interact and what may be driving that for any you know, individual person
P: In Laura’s experience she have really significant hyperemesis I’m wondering if someone like Laura, who is presenting with evidence of a sensitivity that’s really strong to changes in hormones is more likely to get something like postpartum depression because obviously her system is sensitive to these fluctuations.
Dr. MB: So there’s there’s some data and we actually looked at this in the Danish registries and published out there is data showing that women that have hyperemesis gravidarum are at higher risk of having perinatal mood and anxiety complications than women that do not have it for an individual person who experiences hyperemesis gravidarum. It’s an extremely miserable experience, and I think it is just psychologically miserable. The second thing though, it also makes sense that whatever is happening in that individual person that makes them more sensitive to have the severity of symptoms in that way. There may be something happening in their body that works differently, that may make them more susceptible to other things. So I think it makes sense in a number of different ways. But we don’t understand deeply and at the biological level, exactly what’s going on. And I think that that’s what’s exciting right now is trying to get much more precise and dive deeper into the underlying pathophysiologic processes. So if I looked back over the last number of decades in our field, it it took decades in this country for even routine screening to take place and for us to move towards seeing this as a one of the greatest complications of pregnancy. And the postpartum period to do routine screening and all pregnant and postpartum women, to have it become part of public awareness to you know, work to decrease stigma so that people could talk about it. So we could get more women screened and more women into care and over what we’ve seen in the last 20 years is pretty remarkable in terms of a positive sea change in that direction. So where we need to go next is taking our understanding of what’s driving it, what’s the underlying pathophysiology, what are continued to be novel ways of diagnosing and treating, how can we be more precise and targeted and doing that and there’s a lot of work being done, which makes me encouraged on what may come next.
P: I have spoken to a couple of people at UCSF I don’t know if that’s where you were but they were saying that they are making an effort to have way more postpartum visits that aren’t normally scheduled because it is pretty spare.
L: Once you have a baby, it’s all about the baby and then six weeks, six week checkup, they’re like, Okay, hey, mom. You know,
P: and it does seem like it’s almost entirely physical. Have your wounds healed, and then we’ll send you on your way.
L: Yup
P: You know, having been through it, which seems bizarre.
L: Great. Yeah. UCSF has they have a really good postpartum depression group. I wasn’t able to join it. But I would have if I could have,
P: Yeah I’m guessing where and from whom you get care may make a difference because there’s a lot going on in the field of postpartum depression.
The future of postpartum care may not look much like the past I asked Dr. Meltzer, Brody about new medications. One thing she talks about is GABA, which if you’re not familiar with it is a chemical messenger in your brain that has a calming effect.
It looks like in 2019, the first drug was approved specifically for postpartum depression. Is that right?
Dr. MB: Yes. So in 2019, the drug Brexanalone was approved for postpartum depression. It was the first FDA approval for a drug specifically for postpartum depression. And it’s a novel drug it’s a neuroactive steroid. So it works on GABA, which is different than other drugs. And it’s actually a proprietary formulation of allopregnanolone, which is the neuro active metabolite of progesterone. So you have levels of allo that normally rise very high during pregnancy, just like progesterone does, because it’s a metabolite of it and then fall rapidly. Postpartum. And so we were able to do the first open label study and then proceed through the double blind placebo controlled studies of using brexanolone for treating postpartum depression at at the University of North Carolina at Chapel Hill. It’s an IV drug. It’s a 60 hour infusion. It’s powerful. And you see this rapid onset of action within the first day and so we continue to have a robust clinical program. We’re continuing clinical trials and then there’s also an oral being drug being developed by Sage therapeutics, which is the pharmaceutical company that’s developed brexanolone And now is arann. Alone. Saran alone is also a neuroactive steroid, but it’s different. It is not an oral form of bricks and alone. It’s not an oral form of allopregnanolone it’s a bit of a different interactive stereo. And there’s been multiple positive studies showing its effectiveness after a two week course for postpartum depression, that that could be a new tool in the toolbox available in a year plus.
P: Well, that’s super exciting.
Dr. MB: it is a really nice example of using pathophysiology to develop treatments leading to new treatments and a new tool for postpartum depression. And I think that approach hopefully, can be used in lots of different ways. Who’s going to be most responsive? For whom is this drug going to be the best fit? Or drugs like this and as we get much more refined understanding what treatments are going to be best for an individual patient that will lead to the best outcomes and brexanolone works fast and it works really fast. And so that’s so important in the perinatal period in the postpartum period, and having a rapid acting antidepressant that can work within a day is powerful and unlike most things on the market, a number of current therapies that we have take time. take days to weeks to months or longer, and then we unfortunately have people who don’t respond to the current therapies. So having new tools and new treatments that can act quickly and more quickly than what we’ve previously had, and then can increase effectiveness or be more effective to peep for people that haven’t responded to other treatments is really important.
P: How old is your daughter now?
L: She’s five and a half.
P: That’s so fun. That’s a great age what she into.
L: So if you ask her what she wants to be when she grows up, she will tell you she wants to be a mom, doctor, astronaut scientist. So she’ll go to space, but she’ll still be able to drive her gets to school.
P: well that’s the dream isn’t it? Seems like the right ambition. She sounds busy. is very busy.
L: She’s very smart. She’s I think she’s smarter than me. She’s five and a half and I’m pretty sure she’s smarter than me. She’ll be like, Mom, do you know what the biggest magnet on Earth is and no one should be like it’s Earth. Like okay
P: I feel like she needs a YouTube channel. These are just some real nuggets.
L: We’re not gonna stage mom her yet. We’re gonna try to keep childhood in its little bubble
P: is she goes to kindergarten or is it high?
L: So we did distance learning we did like a week of online kindergarten, because we live a half a block away from our public school. We found out very quickly that Zoom learning is not the way to go. It’s just not she hates it. enforcing it was not worth it. So we are in another year of transitional kindergarten, which is private and falls under the preschool rule so it can be in person rich, she’s thriving. And moms are think of
P: I think of kindergarteners socializing. And so that’s a hard, hard thing to do. So I’m glad that you guys have worked it out so that she can be out.
L: Even in the core things to work on like she’s an only child so sharing can’t can’t even do that in person preschool now because they all have their own pieces of art supplies and paper so they don’t contaminate.
P: Hopefully next year,
L: fingers crossed back to normal.
P: So if you could give advice to your younger self about this process what do you think you would tell her?
L: Oh, I would say two things. One, I would say Laura depressed get help. So okay. Yeah, because if I got help sooner, I just think it wouldn’t have been as bad as it was. The other thing I would say is, you’re going to be a great mom, don’t worry about messing her up. In 2020 it’ll all make sense. Because I feel like everything I could have done and did do like once we had to just pause and have her home and be a family and just sort of figure it out like it’s really mattered, you know?
P: Yeah, it is nice to have her home at this age. Right because five is so fun. I remember my when my oldest was five or went to kindergarten, I missed her so much.
L: uh huh
P: And she got she had walking pneumonia for like a week and a half and it wasn’t like that was technically the diagnosis but she didn’t seem very sick. And I was like, walking around with my arms in the air like this is the best week ever to get her back. So it’s kind of nice.
L: It was sad to knock at the end of preschool when she was turned five during this when she was four and a half. And we were lucky to be like Okay, let’s see, like there’s no, there’s no school. You’re gonna stay home with mom and dad. And she’s like, great. No school home. I get to stay home with you and dad. Cool.
P: that’s Awesome. Well Laura, thanks so much for coming on and sharing your story today. I really appreciate it.
L: Yeah, thank you so much for having me.
P: Thanks again to Laura for sharing some of the challenges in her pregnancy and the really really about her experience in the postpartum period, her recovery and her ultimate joy. And a big thank you to dr. meltzer brody for sharing her insights on the current state of PPD and what the future may look like. I’ll link to some of Dr. Meltzer Brody’s work in the show notes if you want to read more about these new medications for PPD.
Thank you for listening.
We’ll be back soon with another story of overcoming
Episode 38: Many Challenges can Visit a Pregnancy and Birth (including Covid): Erin’s story
Episode 38 SN: Many Challenges can Visit a Pregnancy and Birth (including Covid): Erin’s story
Having spoken with a lot of women about their experiences with reproduction, many of them report having one or possibly two issues that visit their pregnancy or birth that alert them to the fact that they have very little control over the momentous task of creating another person in the confines of their body. Today’s guest was visited by many, many issues, including miscarriage, hyperemesis, gestational diabetes and the coup de gras, issues with breastfeeding, all of which happened (drumroll please) during Covid….so yeah, it was a lot. But now that she and her partner are on the other side of that experience, and getting to enjoy their beautiful six month old, she can appreciate how many of these challenges taught her valuable things about herself.
Japanese Art of Grieving a Misscarriage
http://deathtalkproject.com/on-the-japanese-art-of-grieving-a-miscarriage/
https://embryo.asu.edu/pages/mizuko-kuyo
Engagement
https://www.healthline.com/health/pregnancy/baby-engaged#engagement-explained
Audio Transcript
Paulette: Hi Welcome to War Stories from the Womb. I’m your host Paulette Kamenecka. I’m an economist and a writer, and the mother of two girls. Having spoken with a lot of women about their experiences with reproduction, many of them report having one or possibly two issues that visit their pregnancy or birth that alert them to the fact that they have very little control over the momentous task of creating another person in the confines of their body. Today’s guest was visited by many, many issues, including miscarriage, hyperemesis, gestational diabetes and the coup de gras, issues with breastfeeding, all of which happened (drumroll please) during Covid….so yeah, it was a lot. But now that she and her partner are on the other side of that experience, and getting to enjoy their beautiful six month old, she can appreciate how many of these challenges taught her valuable things about herself.
After we spoke I went back into our conversation and included some details about medical issues that came up, and also had the opportunity to speak to a fantastic midwife and listening to her empathic and intelligent answers to my questions, I can see that she also teaches all of us what we should all be looking for in a midwife.
Let’s get to this inspiring story.
Thanks so much for coming on the show. Can you tell us your name and where you’re from?
Erin: My name is Erin Donaghy, and I’m from Melbourne in Australia.
P: Oh, wow. Cool. I’m jealous. It’s beautiful right?
E: It is very beautiful. We were just in fall at the moment. So it’s gotten very cold all of a sudden but it is a wonderful place in the world. Yeah,
P: I don’t think I realized it ever got that cold…
E: Everyone thinks is always beautiful and sunny. There are some parts which are definitely much warmer. But yeah, we’re right down south. So it does get a bit cool.
P: So Erin, tell us a little bit about yourself. Do you have siblings?
E: I do. Yeah, I am one of three. I have a brother and a sister. So my sister is two years younger than me and my brother is eight years younger than me so he was a little bit of a surprise but a very welcome surprise to the family.
P: I’m the third of four and I have a sister who’s eight years younger than me and she’s like the best one. So thank God for surprises.
E: Thank goodness she came along.
P: Exactly. Did you imagine that you would have a family someday?
E: That’s I think, always probably did you know, my brother being eight years younger than me. I was always called his second mom, you know? So I think now to an eight year old and I’m not sure I would trust an eight year old with what I was trusting during that time. But you know, it was the 80s and maybe things were a little bit different, but I think I probably always did but then as I got into my 20s I became quite career focused and my mum is very maternal and was always has always been having you kids was the best thing ever. Having kids is the best thing you know, you’ll regret it if you don’t, and I was always a little bit different. You know, I was like, Look, I can imagine having a family but I think it’s also possible to that I may not have a family. So yeah. And then that sort of changed as I got into my Well, I suppose I was more towards my mid 30s where I started to think actually, yeah, this is something that I want. So I am an older mum. Just kind of how life has worked out. So
P: Erin and I are on zoom so I can see her and Aaron does not look like an older mom. So I feel skeptical. so before you got pregnant, what did you think pregnancy would evolve?
E: I think that because I am a little bit older. I’ve had lots of friends and you know my sister she has two beautiful boys and so she’d had kids as well. So I sort of I had an idea that could be tough. I didn’t have this vision of this. You know, I’d seen women that look beautiful and growing with a beautiful perfect bump. I didn’t necessarily expect that for me, but I think there’s nothing quite like a lived experience. Right? So no matter how much you can seek, you know, or you think you’ve seen from your friends or your family, nothing like living at yourself. So I think probably the main gap in my expectations was well pregnant during COVID So that was completely and and then I think probably how my birth kind of ended up but that’s a process. You know, it’s a process we go through when we go and so I have this tension. You know, I’m so happy to be here talking to you about this because I think it’s so important that we share our experiences in order to demystify, de stigmatize so many things. And also I understand that there’s nothing quite like doing it, to be able to know what it’s like so,
P: but it’s useful to hear many people’s stories about pregnancy, when very few of us have this Hollywood image of you know, it was easy, and I looked beautiful the whole time and i i loved it, every bit of it. So it’s interesting to hear people’s experience. So did you get pregnant easily?
E: I did. So as I said mid 30s and sort of early to mid 30s I decided something I wanted to do. I was married at the time, and we had started trying for family and then our relationship broke down. So I went through a whole process of grieving that thinking, Well really, maybe I won’t become a mom because I was in my mid 30s. And what did that actually mean? So I went through the whole process of wondering if it was something I wanted to do on my own, but decided that going through that grieving process was not the time to make that kind of decision. So I went through a complete life change left my corporate job, started up my own business, did lots of travel, and then met my now partner we talked for a long time before we actually met in person but I think things are often meant to be in the way that they turn out. So we were together for two months. When I found out I was unexpectedly pregnant, which was a wonderful, beautiful, happy surprise, completely overwhelming but you know, we both very much wanted it. It was earlier than we wanted. Unexpected, but that’s why it happened. But unfortunately that pregnancy ended in miscarriage quite early on around about seven week mark. I had some bleeding, which, you know, led to a prolonged period of bleeding, some scans that were inconclusive, so that I had to wait a couple of weeks and unfortunately the time my partner was overseas so I was dealing with that on my own in a very good health system in Australia, but not particularly empathetic. So I found the process to be quite I mean it was a difficult it’s difficult going through a miscarriage of course, but I think because it happens so early on and in the medical world they deal with it quite regularly. I don’t feel that I got a great amount of support.
P: Yeah, That’s really hard. I’m sorry, they didn’t find someone who had good hands for that job and hard that your partner was gone.
E: Yes, it was. It was a full time as I said it was very early on in our relationship and not at all expected. So yeah, it was one of those things and when I look when I think back now I think I don’t really remember that month post it. I think I was quite numb like I am quite a spiritual person. I’m quite an emotionally self aware person and I’ve learnt to the feelings as they arise but at that time Yeah, I think back to that month I you know, I came back to my business. I just kept going because I thought that was what I had to do. And you know, I think one of the things that again it’s lived experience because I think I probably haven’t been completely very empathetic in the past when it’s happened to people when I’ve known about it. It’s all the hopes and dreams that you attach to a pregnancy this little being that although just a little bean at the time, everything you imagined for that what that means for you your relationship for creating beautiful little life sort of disappears in a flash and I don’t think there’s a lot around to actually deal with that. And because we don’t talk about pregnancy till sort of the 13 week mark when it’s safer to do so I think it’s not until you actually start talking to people that you realize how common it is.
P: I feel like we need some kind of rituals around it to help to help us grieve and just something to help us get some sort of closure on it right because it feels so finished and unexpected and you have no control right one way or the other.
So I took this question of rituals to a midwife. today. We’re really lucky to get to talk to a certified nurse midwife. Her name is Ann Richards Ann thanks so much for coming on the show.
Ann Richards: Thank you so much for having me. I am a birth podcast fanatic and listen to them all the time and I’m just giddy that I get to be here on one
P: Erin’s first pregnancy in a miscarriage and instead of about seven weeks, she said she didn’t really think it was dealt with very empathically I’m guessing that you see it often in your practice, and wondering how midwives are trained to deal with miscarriage and if there’s any effort afoot to develop rituals around this because it’s so common,
Ann: that’s interesting. So you know the training for it is very different. I think, depending on where your practices in school, we didn’t learn a whole lot about how to manage it. Oftentimes it’s well if it you know, a fetus in the uterus without a heartbeat, and obviously the body hasn’t passed that that non viable pregnancy then you’re usually just consulting and passing the patient off to an obstetrician who then is talking about management options. And so it’s kind of brushed over to be honest because we call that a missed AB or missed abortion slash missed miscarriage, meaning the body has not recognized that that the pregnancy is no longer viable and so you can kind of lay out how do we help the body to pass this non viable pregnancy? So it wasn’t until I was in my current practice where I worked collaboratively with obstetricians that I got to see those discussions regarding management. But whenever you diagnose someone with a miscarriage, you know, maybe they come in for that very first ultrasound, that very first prenatal appointment and there is no heartbeat. It’s devastating. It is for me personally, knowing that I have no idea how devastating it is for the patient. You know, it’s so hard to say you know, not knowing exactly how that was dealt with by the midwife she saw but I’m I’m just really sorry to hear that. You know, because it is that’s something every time I see a patient for her first visit, I have a huge lump in my throat until we see a viable pregnancy. And if we don’t, it is incredibly hard to navigate because I’m totally tearing up thinking about it. You can’t help but just feel helpless, you know, as a provider, and I can’t even imagine as the patient you know, wondering, why did I do something wrong? You know, which of course the patient hasn’t it’s such a difficult situation to navigate and there’s no right answer. There’s no easy answer in counseling someone but there’s of course, an empathetic way to approach it and recognizing that this for that that person in that family is is a lost life is a lost idea of life and at the last family pains, my midwife Heartseeker that she didn’t receive the compassion that that she needed and certainly deserved.
P: I feel like everyone I speak with agrees that we need some kind of ritual, kind of manage and move on. I don’t know where that’s going to come from. I don’t know if you think that it makes sense that it comes from medical practice or it will come from somewhere else.
Ann: I think it should originate with us. I mean something I actually recommend my patients now that it’s called the Japanese Art of miscarriage is a beautiful, just very raw approach to to miscarriage and helping families it’s from a patient’s perspective but I think it’s called the Japanese art of miscarriage and it’s what I personally use in counseling people if I think they’re ready for that.
P: So If you’re interested in exploring this, I put a link to it in the show notes. Feel free to check that out.
And so did you try to get pregnant immediately again or how’d you handle it?
E: Yeah, so we did to my plan is Filipino so he was in the Philippines when it happened. And so I went over, um, towards the end of his trip to visit him. We spent a bit of time there, recuperating. The advice from the hospital was to at least wait one full cycle, trying again so we started trying again after that. Our relationship went through a bit of a very rocky patch, but we then did become pregnant again. And we found out in February 2020s. So it was six months post. So I think in hindsight that six months felt very long at the time, you know, that every time you’re paying on the stage hoping and wishing and thinking and and you know, the I think you said before, you know, one of the things about pregnancy is that so much out of your control. And so yeah, thinking about the six months was not a long time to wait but it felt excruciatingly wrong at the time, but yeah, we got the wonderful news in February 2020 that we were expecting. And then months later, we went into lockdown. We actually took a holiday to Bali, and it was sort of an early babymoon and I’m so so glad we took it now. Time we were coming and going it was sort of on the precipice of things before they got really crazy. We knew that there was potentially a race I was quite seeking. They sickness but it felt like the right thing to do and it was we got back just in time before everything really kind of shut down.
P: Remind me how far is Bali for you guys not that far.
E: Not too far. So it’s a five and a half hour flight from Melbourne. Okay, so
P: not too bad.
E: Not too bad at all. No. And it was you know, it was lovely. It was a beautiful, beautiful time and as I said, potentially quite risky but it was very different over there at the time, you know wasn’t a lot of precautions happening. It was a little quieter but just not necessarily a great thing about the precautions but it was nice to escape it a little bit. Yeah. Before heading back into what was the year that has been so
P: god yeah, in hindsight, it’s genius. Well done.
E: It worked out beautifully. The universe was definitely protecting us. So then we came back and I ended up admitted to hospital because I was vomiting and I was diagnosed with hyper. Yeah, yes, very, very bad morning slash all day sickness.
P: Do we know what generates hyperemesis?
Ann: It’s very largely suspected to be related to pro pregnancy hormones that HCG are the hormone that is tested for via blood or urine when you do a pregnancy test and the higher that hormone, which tends to be much higher in multiple gestation pregnancies, the higher the nausea I really feel for patients who are going through that a lot of women are prepared to maybe not feel their best or not go well in the first trimester. But hyperemesis is just a different beast. It just lays you up and most women have a singleton Or one baby pregnancy and the gamut of what’s normal for how they feel in early pregnancy is so wide what woman you know, feel mildly nauseous or not nauseous at all and other women have hyperemesis or vomiting multiple times a day every day. It makes no sense. It’s just kind of mind boggling. It really attests to the fact that we know some about pregnancy and birth but we don’t know a lot more than we do know
E: I ended up medic medicated for that up until about 16-17 weeks, I think and that was sort of, I guess the beginning of the discomfort for me around wanting a more natural type of birth. I had a lot of fears around giving birth, but I was working through them. I really don’t like taking medication unless I have to you know, modern medicine is wonderful, but I try to avoid it as much as I can. Particularly when I was pregnant. You know, I didn’t know what these tablets were going to do. But I was just so sick. I couldn’t function without it. So I think that’s probably the first real step of letting go. That, you know, I have to be the best I can be in order to grow the baby the best I can so
P: yeah, not being able to eat is definitely a barrier you’re gonna have to cross right so yes,
E: yes, exactly.
P: So was the second trimester easier.
E: second trimester got better not immediately. You know, I was sort of hanging on to the 13 weeks thinking is going to get better. It’s going to get better. And it didn’t immediately but it did. It did go on to get better. I was in my second trimester and so I was diagnosed with gestational diabetes, which was also a pretty average experience because the reason I was sent for early testing was because of my BMI. I’m a size 16 Australian, which I think is like a 14 us sizes. You know so I’m a curvy girl, but I was made to feel bad, to be honest about my size. I understand why, you know, you’ve come up as a risk kind of factor. We flagged this but it was the way in which you know, I got an email from the midwife thing for the very procedurally does why and it’s because of your BMI. And that was kind of it. So that was a that was a tricky experience, too. Because then I went for the testing and the hospital told me I didn’t have it and then they called me back a different person told me I did have it. So I was very borderline. I think the cutoff for the sugar ratings of five or 5.1. And I was just over that, like 5.1 or 5.2. So that was difficult again, I felt like I failed. And it’s sort of ridiculous in hindsight, but I felt like I was being told that I put my baby in danger. You know, there was no sort of questions around how active I was, you know, whether I was healthy, whether I had health issues, it was all sort of based on these numbers that I have a bit of an issue.
P: Of course, we’re in the US and Erin’s in Australia. So other things may be different but in general is BMI, the only marker for screening for gestational diabetes.
Ann: All women, all pregnant women get get screened for gestational diabetes, regardless of their BMI. And that tends to be between 24 and 28 weeks of pregnancy because that’s when the way the body metabolizes carbohydrates in pregnancy and how sugar crosses the placenta to the fetus is really affected and late second early third trimester, but there are risk factors for developing gestational diabetes being over the age of 35. The Grand Old Age of 35 is is the primary risk factor. And then having a pre pregnancy BMI of 30 or greater. We do encourage women with higher BMI entering pregnancy to get screened a little bit earlier. And so it sounds like what happened in her case, and
P: is there at all genetic components gestational diabetes.
Ann: If you have immediate family members, one or more with non pregnancy, diabetes, non gestational diabetes, that automatically puts you at increased risk. It’s not just BMI like there is definitely a family link.
P: And this is totally speculative. But in the course of four or five months and gets both hyperemesis and gestational diabetes, do you think anything’s going on there?
Ann: It’s really interesting. You wonder if she says really sensitive to pregnancy hormones, including the hormones that affect glucose metabolism. So that could be it.
E: And when I got to the endocrinologist, the specialist specializing National Diabetes, she said that to me, she said no because what he said I was pretty I was a bit of a wreck, to be honest. She said to me, Look, BMI is one of the indicators but she said it’s probably most likely getting your mum may have had it, it’s most likely passed on in that way. And she said the more and more research that I do the less and less I believe it’s related to that. So that helped at the time. I don’t know, she was just trying to appease me, but you know, again, it’s one of those things that I just got to the point where, after a very emotional and rocky time, just got to the point where I accepted that I was going to get extra help through my pregnancy because of this condition and that whatever was good for the baby I needed to do. So again, I was quite resistant to wanting to go on insulin. I was like I can manage this by diet and exercise. And I did for the most part but my sugars overnight, were not well managed, for whatever reason and again, there was absolutely nothing I could do about it. So I ended up on very low doses of insulin, you know, to the point that by the time I got to the end, a lot of the risk factors that were associated early with the gestational diabetes didn’t end up sort of being there. So they started to somewhat treat me like a more normal pregnancy as opposed to this higher risk pregnancy.
P: Well this doesn’t sound like an easy trip. Good Lord.
E: I know. But they will say how is the pregnancy like, oh, it was pretty good and there was nothing. There was nothing majorly, you know, big, big issues that happen but there was a lot of small issues. I think it was just kind of this ongoing pace of it felt like a lot of hurdles to jump through. And ironically, you know, where I was sort of sensitive about being an older mom, it never really came up as part of the conversation. You know, I never got called whatever the geriatric pregnancy is. Yeah, it was interesting. I think I was probably a little bit sensitive about that, but it didn’t end up being a thing at all.
P: And so when you get to the end of your pregnancy, it sounds like gestational diabetes is you just being monitored or how are we handling that?
E: Yes. So um, so one of the parts of one of the lots I guess, of being pregnant through COVID Was that access was quite limited to healthcare. So we had a very hard lockdown last year in Melbourne, which is paid benefits now, but we weren’t allowed five kilometers away from our home. And we were only allowed outside for one day of exercise and what that implication was in the medical side of things was that we had to attend appointments on our own. A lot of appointments were transitioned to telehealth, but because of the diabetes, I was able to continue seeing the team so my OB, the OB and the endocrinologist, in person weekly or fortnightly sort of as it went through and I also got extra scans. So I went through our public health system, meaning that I didn’t have a dedicated OB, and I think having had that experience again, taking away the positives from it. Had I been a regular pregnancy or not a high risk pregnancy or may have gotten very, very little care during that time or very, very little face to face care. So take it as that but it was fairly routine from them. The scans were going really well until we sort of got towards the end of the pregnancy and she was so we knew that having a baby girl. She was measuring bigger. So then the kind of alerts the medical kind of alerts go up and the red flags come up. And that was really stressful because again, I was quite conscious of everything that I was doing and what the impact that might have on her throughout the pregnancy and because everything had been going pretty well. You know, Mike was really well controlled small amounts of insulin. And then to get this kind of red flag around. She’s measuring large on the scan, which we think we all know well. I’ve learned that a so so unpredictable and so not accurate. So then the flag sort of went up again and then we were heading down the path of she was also she wasn’t in position. So she was great. So then we headed down the path of discussing C sections, which was not something that I wanted. So I think I mentioned before I had a fear around birth, but I had been working through it, you know, I’d been reading Hypno birthing books. I was really sort of working towards hoping to have as natural as possible birth but then there’s conversations kind of that say section induction and I wasn’t super keen on induction either. So that was quite stressful and my partner wasn’t able to be there. At these appointments, which wasn’t great. And I don’t think it’s great for the partners either. You know, I think sometimes, you know, obviously I used to have this impression that you know, the prime is not the one going through the pregnancy and so, you know, they’re not going through the pain and the carrying, but I think also on the flip side of that they don’t necessarily get that very early connection and the experience that comes through pregnancy. So yeah, that was difficult. I think it was difficult for me not having him there and I felt like it was difficult for him not being there as well. Yeah, I was relaying everything secondhand with all of my emotions and but the next scan I had, you know, sort of closer to the time again, she was measuring back normal again. So that kind of alert went down and it was all calm again. So I was really excited because I was getting to sort of the 36 week mark when that’s often when if you’ve got gestational diabetes, they’ll trying to induce your encourage you to have a C section and everything was going well and it was all fine. And then I went in to on the 37th week wanting to have a meeting with the induction midwife. As I said I wasn’t keen on induction and I was still in this very much in this mindset of if she’s not engaged. And my gestational diabetes is under control. Are we rushing her it was sort of this real challenge because of like, I’ve got these medical people who know what they’re doing and are the risks far more than I do versus the more sort of feminine spiritual side of me that’s really trying to connect with my baby and saying, but hang on, she’s not giving us signs that she’s ready. So it was really it was a tension and no my partner was he was worried he wanted to make sure that both of us were okay. And actually, like the doctors are telling you to do this. So you go in, you do it. So that was really challenging. So I went into the induction meeting and they said, Look, she’s not engaged. You’re almost at full term. We’re not going to induce her…that’s just not advise at this stage because she’s not engaged.
P: Okay, engagement refers to the position of the baby’s head relative to its mother’s pelvis as the pregnancy progresses, the ligaments around the pelvis loosen making space for the baby. This is good and important because to make it out of the mother’s body, the baby will have to travel through the pelvis. Once the widest part of the baby’s head has entered the pelvis, the baby is determined to be engaged. So if the baby’s not engaged, it’s not in a position that suggests that it’s ready to be born.
E: We’re really worried about the risk of if your waters break that her cord will come out first. And one thing I didn’t mention before so my mom had a stillborn baby before me. Who’s done his cord was wrapped around his neck. So in the late 70s It was a very different proposition to things how things are now, they didn’t know that at the time, but so that caused our um for us because this has been a very real experience in my family. So basically three days out. He went on the path of a Plan C section, and I still wasn’t convinced that it was the right thing to do. Had you date was the 18th of October. My 40th birthday was the 14th of October, and the C section was then scheduled for the 15th of October. So which also happens to be my nephew’s birthday. So she shares a birthday with the cousin which is lovely. I went through the whole process of just assessing I guess and accepting the fact that my birth was not going to be I that I wanted it to be. I think it’s it’s that point of letting go of control as a parent you learn pretty quickly you have very little control.
P: Yeah.
E: And I, you know, might have a tendency to like to control things in my life, but that’s one thing that you know, the pregnancy, being quite sick and not having the same amount of energy that I had then COVID and not being able to do what I would normally do. I think probably prepared me beautifully. As tough as it was for how much you need to let go of control as parents so
P: that is a useful lesson. So did you have any contractions when you went in or felt like a business meeting?
E: No. So I did beautifully driving into the hospital. I started having contractions.
P: Oh, wow.
E: So I’ve got goose bumps now so that that made me feel happier. You know, it made me feel like although I know that those early contractions were nothing like what they would have ended up being it made me feel like she was ready to come and it gave me a little bit of a so I’ve been getting Braxton Hicks for quite a while. And so I knew that this felt different you know, that kind of rising up kind of feeling was how I described it and now we’re coming quite close together. So that was nice, but it was very strange kind of waking up in the morning, packing our bags and going we’re going into have a baby today.
P: Yes.
E: But you know, with all of the stress that had come the challenges, I think there was something nice about not having that chaotic rush to the hospital. Oh my gosh, what’s happening? My waters are broken. We need to urgently get there. There was something very nice about the calm way in which we did it. So we popped on in I was very lucky that my partner was able to be there because they were early stages during COVID where Partners weren’t able to be there. It did feel a little bit clinical, you know, you walk into a theater but the anesthetist was wonderful. She talked me through everything. was as I said it was quite calm. You know, I didn’t I couldn’t get my you know, my own burning all my music going or any of that sort of stuff that I didn’t visit envisaged in this beautiful hypnobirth that I wanted, but at the end of the day, we were there together and I held her up over the curtain. That feeling itself was amazing. And whether I went through natural birth or a C section. It was at that point in time that I just realized She’s here and she’s safe. And that is the most important thing. So yes, that magical moment when they’re then passed sort of back to you for that first skin to skin and just the three of us there. Although we were in this surgery theater, just everyone else really disappeared, I guess. Yeah. So that was just beautiful and she’s a beautiful, healthy seven pound nine. So three and a half kilos, good size, you know, good size baby. The babies in my family are nine pounders. So. She was much smaller than I expected. Yeah, just beautiful. Beautiful that that moment. It was a little bit strange because then my partner took went with her as they you know stitch me up and and those sorts of things. So being away from her and feeling a bit groggy and weird and but I knew that she was with her dad, so I was okay. Yeah. And then we headed down to recovery. I heard a baby cry and I’m like, oh, that that might be mine. wasn’t mine. She was so chilled, very, very chilled baby. And they put her on to me to latch and we did a bit of a feed there which seems to go really well. Again, I was fortunate because I’d had the C section. I’ve got a private room so my partner was able to stay again during COVID It was amazing and I don’t know how I would have done it without him you know that first night especially with you know, still not being able to really move a lot. I don’t know how I would have done it. I suppose I would have just had to call the midwives but I mean being that was absolutely amazing. You know,
E: From but it was sort of around the time where the gestational diabetes would happen. And I’d been dealing with so many different people that I felt like bringing another person into my care was would have been difficult. And also I didn’t know if she would be able to be present at the birth because of the COVID restriction. So I decided not to, again, because I was focused so much on the lead up to the birth and the birth itself. I didn’t really appreciate what that support would have been like for us post.
P: yeah, that sounds that sounds smart. I think a doula or other living or some other support system for sure in the US that postpartum care is really, really thin. You don’t see your gynecologist again for six weeks, which is six weeks. Time, right? Yeah, so maybe that’s something we all need to put a little attention on to figure out how that can be. Improved.
E: So we had the midwives visit from the hospital but that was again limited somewhat because of COVID. And we have a maternal child health nurse system here where but that’s really about the baby. That’s about making sure the baby’s okay. I think the six week or eight week mark, they ask you the questions the standard questions about postnatal depression but my nurse as lovely as she was, she was sitting at a computer facing away from me asking this question and sort of a tick box activity. I’m not sure that they’re skilled up to really deal with the gravity of those types of situations and I did not have postnatal depression. I don’t believe there were things in our house that we’re taught, you know, there were we’re dealing with this whole changing dynamic, you know, and I think having a child brings up stuff from your own childhood, whether consciously or unconsciously, so, yeah, so 100% agree with you, I think much more care and particularly focusing on the emotional side of things post birth is something that we could all benefit from.
P: It is a little too medical. I totally agree with that. So how old is your daughter now?
E: She’s six months old Isabella? And she is a delight. She has a beautiful girl she is as I said she came at a very chilled baby. And she is for the most part very chilled, but she sort of goes from zero to 100 She’s also very cheeky and she’s starting to realize that when she does things she gets certain reactions. So she she like this morning she woke up singing now she’s found her voice and she just wakes up smiling every day. So bless her as I said, she’s a very, very good sleeper, which has been wonderful. So we’ve just removed the dream feed. So she’s sleeping from 730 ish to 630 so
P: wow.
E: Yeah, yeah, that definitely definitely helps.
P: That’s awesome. How fun. So you’re so close to this experience. I’m going to ask you this anyway. Is there any advice you would have given to your to your pre pregnant self?
E: Yeah, I think the one around the doula engage a doula. That’s kind of a very practical piece of advice. I think. From a bigger picture perspective. Advice I would give is, don’t be afraid to speak up. I’m not generally a person that’s afraid to speak up but something happens to me when I walk into a hospital. I think hospitals don’t realize how hierarchical and overwhelming they are, you know, the medical side of things is something they do every day, but it’s very new to us. So don’t ever feel bad for asking questions. Don’t ever feel bad for saying that doesn’t feel right to me. I need to think about it. And don’t be afraid to ask for extra help both physical and emotional I think you know, it’s okay to say I’m struggling a little bit with this got to the point where you know, people wouldn’t be offering food and I would normally say no, we are okay because my partner’s a chef by trade. So where I kind of got that covered and I actually got to the point of just saying, actually, that will be lovely. Thank you so much. Because even though you might be okay one day, something might happen that you’re just you know, something might not happen you might just wake up feeling not so great. Yeah. Except the help you know, it is a particularly vulnerable time. I thought I gave myself time to recover despite the fact that we returned to work early. I really was very conscious of being present when I was with her and still am, but your body has been through an amazing and massive thing and we are emotional, spiritual. I went through a big transition when I was pregnant. I knew my life would change when she arrived. But I had underestimated how it would change as soon as I was pregnant. So she kind to yourself, trust your intuition and let go of control, I guess.
P: Yeah, that’s a good that’s a good lesson that you will learn quickly as a parent, right. So
E: absolutely. I was grateful to learn it earlier on. So she, she teaches me every day. Cue reminds me every day but yeah, it is you know, there it’s it’s now much less about any of that than it has been before.
P: It’s such a great story. Thank you so much for coming out and sharing your story. I totally
E: appreciate it. It’s my pleasure. Thank you for allowing me to tell my story.
P: Thanks again to Erin for sharing her story, and to Isabella for doing her part to ease her parents into family life. Thanks also to Ann Richards for her insights about a wide range of issues from miscarriage to breastfeeding–I appreciate your time, expertise and empathy. Thank you for listening. If you liked this episode feel free to share it with friends. We’ll be back soon with another inspiring story.