Episode 91: A Postpartum that Inspired a Novel: Julia’s Story, Part I
Episode 91SN: A Postpartum that inspired a Novel: Julia’s story, Part I
“Need is an albatross. To be needed is to wear the weight of stones across your chest . To be wanted. That is different. To be wanted by a child is the cleanest of desires. To still be wanted once the child is fed and rested; once the diapers are fresh and the snot has been siphoned from the nostril and the gas has passed through. To be recognized not just as a body, but a person, a comfort to be loved.”
That’s a brief snippet from the novel The Upstairs House by Julia Fine, my guest today on war stories from the womb.
In today’s episode the author Julia Fine talks about how her experience with the significant challenges of the postpartum period inspired her novel, what she’s learned about the experience now that’s its in the past, and how she hopes it will foster a more realistic public discussion of the challenging months that most mothers encounter in the weeks just after birth. I also include the insights of a former OB who has become a postpartum coach about signs of PPD and her advice to help women manage this often stressful, exhausting, lonely period.
Here is a link to The Upstairs House, Julia’s book about the Postpartum period, and to Julia’s other work
You can can find Dr. Geetika Patel‘s workshops, newsletter, Birthing Mamas group, and postpartum coaching here. Feel free to contact her through my website.
Audio Transcript
Paulette 0:07
My guest today on war stories from the womb. This is a show that shares true experiences of getting pregnant, being pregnant and giving birth to help shift the common cultural narrative away from the glossy depictions this enormous transition you can find out all kinds of media to a more realistic one. It also celebrates the incredible resilience and strain it takes to create another person inside your body and release that new person into the world. I’m your host, Paulette Kamenecka, I’m a writer and an economist and a mother of two girls. And I struggled with just about every aspect of this process.
In today’s episode, the author Julia fine talks about how her experience with the significant challenges of the postpartum period, inspire her novel, The upstairs house, what she’s learned about the experience now that it’s in the past and how she hopes it will foster a more realistic and honest public discussion of what it’s like for most mothers in the weeks just after birth. I also include the insights from a former OB who’s become a postpartum coach about signs of postpartum depression as opposed to baby blues. And her advice to help women manage this often stressful, exhausting, lonely period. What follows is the first part of my conversation with both of these women.
Hi, thanks so much for coming on the show today. We are lucky and excited to have author Julia fine on the show. And we’re going to talk about many things, one of which is her recent book, I think 2021 2021 Yeah, called the upstairs house and I want to describe it and you can correct me. Okay. So generally speaking, I’d say it’s a book about the challenges of the postpartum period. One of the themes is how cultural expectations about love and relationships can profoundly shape our actual experience of them. And what I’d say about the book is it follows two threads. One is the story of the main character in the present day, whose name is Megan, who’s working on her I’m guessing English dissertation,
Julia 2:40
right? Yeah, it’s a history, but it’s sort of some overlap. Yeah.
Paulette 2:43
And she has her first baby and is stepping into the postpartum period. And another thread starts off as a story of two women who are featured in Megan’s dissertation and progress and talks about their intimate relationship in the 30s and 40s. And one of the women featured in the dissertation is what I would call shadow famous, which is that we all know Margaret Wise Brown because every parent has read Goodnight Moon 4000 times, but we don’t know her know her which is coming through in the dissertation. And these two threads get tangled when Megan returns from the hospital with her firstborn and starts hallucinating that the women from her dissertation have moved in above her flat, there is no apartment above her flat. So that’s one of the signals that there’s this isn’t necessarily really what’s happening. And Megan is negotiating the intense challenges of this period of isolation, the exhaustion, the emotional flux, while her dissertation characters have invaded her home and in her mind are sort of stirring up trouble.
Julia 3:41
Yeah, that sounds about right to me. Okay, excellent.
Paulette 3:43
So I in some ways, on your perfect reader, because I did my dissertation at University of Chicago. I lived in Chicago was pregnant for that. I felt every single thing I lived in a walk up. All that stuff felt so real and familiar to me. I love this book. I thought it was really powerful. And for me, one of the marks of a good book is does it make you feel something and I felt panicked. I 100% I 100% felt it and I and I it is one of those books that you can’t put down so congratulations on this amazing work. And I know that you talk about in the book how you want to bring attention to the postpartum period. So we’re going to talk about that because I want to hear about your experience. How old is your
Julia 4:26
i So My oldest is he’ll be six at the end of April. which just sounds nuts to say but it’s true. And then I also have a two and a half year old.
Paulette 4:34
Okay, so you’ve been through this today. So let’s talk first about your experience. And then we’ll talk about this book and the one that you have coming out in June. Yeah, for sure. Yeah. So with most people we talk about is how the family that you create is in some ways linked to the family that you came from, in terms of your ideas about what you want a future and what you think it’s going to look like. So did you grow up with siblings?
Julia 4:56
Yeah, I have. So this actually is very, very apt because I’m the oldest of three I have two younger brothers, one of whom is three years younger than me, and it felt like everyone we knew the sibling, my age, and then there was younger. So when it came time to have a second kid, I was very much like, I want it to be three years younger, which I think ultimately means nothing, but to me felt very, very important. And it was funny too, because in order to have my kids three years apart, and one of them had to be born in June of 2020, which is like a terrible time to be giving birth. So if I had, if I had not felt so strongly, perhaps it would be different, but it definitely impacted you know, wanting my kid to have a sibling. I’m not sure that it would have been as important to me who I not grown up with siblings and sort of felt the value of that
Paulette 5:41
Okay, so now let’s fast forward to your children. When you go to get pregnant, is it easy?
Julia 5:48
Yeah, so my first is a surprise baby. I mean, we knew that we wanted kids, you know, within sort of like a three year window, but when I got pregnant, I it was not planned. And we were sort of like what now what do we do? And it sort of goes back to the book too, because I had just written but not yet sold. My first novel, you just signed with a literary agent. And I felt like I want to have a career before. I have kids because I had seen my own mother. How difficult that was. My mom had been a lawyer to work for the Justice Department and she had a career and took some time off to raise her kids and then tried to go back to it and it was so difficult. So I could only imagine how hard it would be if I had not yet really established myself because I was hoping to establish a career as a writer, which sounds nuts in any regard, especially nuts with a small baby. But we were sort of back and forth about like, is it the right time for us? And then ultimately, I think I felt like okay, well what if, you know, we decided it’s not the right time now. And then it’s hard to pregnant later or what if I regret it and so that was enough. For me to be like, This isn’t my timeline necessarily. We’re like two years off, but it’s gonna make sense for us. But what it meant was that in my circles, at least, I was the only one really having a kid I was 29 when he was born, I have just turned 29 which I know you know, in certain places is like, Oh, my goodness, why don’t you have five kids already? Among my friends and family. I was the first one and that made it, I think, more difficult because there wasn’t really I didn’t really know anyone who I could meet up with. afterwards. I didn’t know anyone who could sort of like explain pregnancy to me or sort of reassured me about things like I found myself in the role sense and but at this point in my life, like a lot of my friends have kids, but I found myself like as my college and high school friends were having kids. I was the one who’s like, Oh, this is normal. Oh, don’t worry about that. Oh, that’s weird. Maybe you should call somebody you know. It’s just nice to have that person. So I think that despite the fact that I had a very supportive family and very good friends who you know were there and what ever aspects they could be I found pregnancy and postpartum periods specifically to be very lonely. And I think that is what led me then to write a book about a very lonely woman who does not have the support that I had. And it also sort of led me to look into like, wait a minute, why is this the case? Like why as a country are we so obsessed with making women give birth and then giving them no resources? No preparation, I felt just like totally sort of thrown in the deep end. Because you read all the books, you know, like, you know, in six months of pregnancy, this is what your baby’s doing, and here’s how you should feel but then the baby comes out and it felt to me at least, like there were no real resources. There was a lot of like your baby should be eating and peeing this many times. But there wasn’t anything like for me necessarily. It felt it felt very isolated, very lonely. I felt like I was doing something wrong. And it took me probably like eight months to make friends who also had kids, and we were all like, oh, I felt that way too. And hence sort of feeling like Alright, there’s room to write more about what it feels like to become a new parent. Like, what it actually feels like.
Paulette 9:08
Yeah, so I’m picking up two things from what you said. The first is this attempts to mesh a family life with a career as I said, I missed my grad school graduation because I gave birth and then I was racing to recover because I had to start a job within three months. And this that, you know, the the career system is not set up for birthing people in any way. And I am sort of hoping that since COVID, kind of grasp the work environment and shook it hard, that we’ll get different ways to progress in a work context because it doesn’t make any sense and like you, I want it to be established before I had kids and and that’s just those are too many things to juggle and balance and the current system we have does not actually strike the word balance because that’s a silly word that doesn’t really apply to this experience. If you’re lucky enough to get to control your fertility. It’s hard to know what to do with that. There’s no There’s no good time. There’s no right time to do it. And the second thing that you mentioned was that there is no emotional investigation of what it is to be a mother when you give birth to a baby now, two things are being born the baby and a mother. Absolutely. And those things are both brand spanking new. And I feel like the books that are out there that describe it are a little bit more medical or clinical then is useful.
Julia 10:34
Yeah, I think so. And it’s cut off at the Automate because I’m not the type of person who sits and reads parenting books as much as I would love to. I sort of feel even today. All right, well, I spend all day doing it. I’m not going to read about it, which is probably to my disadvantage, because I’m sure I would learn things from read articles. I don’t you know, there there definitely are things out there too. Because when I started to dig in to do research for the upstairs has to I found into Memoirs of women and birthing people who’ve written about their postpartum depression. or psychosis or just sort of ambivalent or whatever else it was. And it’s funny too, because as I was working on the novel, I felt like there weren’t very many novels about what it was like or a bit sort of included. That part of random and even since 2021. If you think about sort of the lifecycle of a book I think I sold the book in 2019, early 2019, and it came out in 2021. And in that time, there have been a lot more books that I think interrogate society’s idea of the new mother and if what to me feels like a more accurate depiction of what it feels like and people who are not afraid to be talking about breastfeeding, you know, for like 50 pages in a row because that is what absorbs you. And for such a long time. I think we thought oh, one it only is relevant to new moms, which I think is absolutely ridiculous. I think in the same way that we would need to learn about other people’s experiences, the experience of a new mom is equally valid, as you know, a world war two pilot that you’re reading about. They’re just different people, different minds. And also this idea that the things that women do in the domestic sphere is aren’t all literary, I think has also been sort of a pervading myth. In the past, however, many more probably from the very beginning of sort of like modern fiction, and I think that’s something that a lot of people are pushing to change that, you know, we could read about a man’s midlife crisis and be like Pulitzer Prize winning literature, but for a woman it just nobody, no one would want to quote unquote, buy it. And I think that is something that I was really, really pushing back against, because it sort of invalidates the experience. There’s nothing more nuanced, I think, than those first few early days of parenthood in terms of just your the way that your emotions are so mixed, and the highs are so high and the lows can be so low, and it’s so new, and it’s a reinvention and the idea that that would not be literary enough or that there wouldn’t be interest in that just struck me as so ridiculous that I felt like how can I write this as a book that sucks people in and forces them to acknowledge when it’s valid to feel however you feel about new parenthood and to, you know, this experience is just as deserving of literary treatment as anything else.
Paulette 13:25
This issue of our cultural view of postpartum to an expert today we have Dr. Kate Tikka Patel on the show. She’s an OB by training, who saw and experienced some of the significant gaps in medical care for mothers who’ve given birth and is now focused full time on helping women manage the postpartum period. Dr. Patel, thanks so much for coming on.
Julia 13:45
Thank you very much. Thanks for having me.
Paulette 13:48
So I think part of Julie’s mission with this book is to normalize the experience of how difficult it is this early postpartum period. What are your thoughts about that, in your opinion? How does our current medical system handle this and what could it do better?
Julia 14:01
There really is not a lot of reliable consistent guidance for women in the postpartum period. So I think it is really important to get the word out about the lack of care I mean, the current medical system is basically absent from this time period. And it leaves women adrift and looking for answers on their own. And unfortunately, I think in previous generations, that support may have come from expertise within the family or community but the way our culture is now we’ve kind of lost that. And early postpartum is full of changes and struggles and whether it was generational support community, they would provide the extra hands, they would provide the expertise, and they would provide the companionship, which which many women are lacking in the postpartum period.
Paulette 15:02
So I totally agree with you and I think it should be a day Lodz. And just if we’re talking about statistics, let’s imagine it’s only women who care about it. 86% of women at some point in their life give birth. So that’s nearly half the population surely that’s enough. At the risk of suggesting this blaspheme. I think this is a movie. I think it’s a beautiful book. And one thing I like about it is I’m a little bit of a little bit of a snob for pretty prose, and it’s but but I think it is, this is a large story. This is a real story. You know, this woman in the book has postpartum psychosis. I think my legs say that. Yeah, yeah, it’s
Julia 15:41
I mean, it’s sort of unclear throughout the book, if it’s like she’s, it’s an actual ghost or postpartum psychosis and that it sort of comes down like the medical establishment comes down on the side of postpartum psychosis, but I sort of hoped that the reader could interpret it, you know, however you wanted to, but definitely the sort of realistic way to interpret it is like she’s having a psychotic break.
Paulette 16:01
This kind of psychosis is pretty rare. But, but, you know, I was looking at statistics for it. Let’s say there’s about 4 million births a year 350 to 9400 9400 is a lot of people. If you would think these sorts of things. It’s a small fraction, but there’s enough there are enough births, that it’s that is significant, but postpartum depression is like a half a million with women a year. Like that’s just a huge number of people who I’m sure can see their own experiences in this because this postpartum period is such a fun house. It’s just it’s such a weird transition and your view of reality gets so exactly warped by exhaustion and I totally agree with the isolation which I had no, I did not give birth during COVID at all, and and it was totally isolating in a way that I had was not prepared for
Julia 16:50
how I Yeah, so it was funny because the isolation of becoming a new parent. So my son was born in 2017. And my daughter was born in June 2020. And it should have been so much harder to give birth and COVID We had no outside help. We were all crammed into this small condo couldn’t go anywhere. No one could come to the hospital with me, you know, and she was early there were all these complications. And it was still harder for me the first time around with all of the social support and trends like not in a pandemic just because that transition is so hard.
Paulette 17:23
Yeah, it is. Can you speak specifically to the issue of isolations? Like what suggestions do you give to others to help us adjust to the dramatic shift in priorities when the social structure doesn’t shift with it?
Julia 17:37
Yes, so this is so important. I can’t even emphasize it enough. And I think that the first step is awareness that we have to talk about this it has to be more normalized and understood, not just among women who are getting pregnant or had been pregnant, but also their partners and the entire community in general. We have to talk about it. And because it happens so often in our culture, and if you think about why it’s happening, it makes perfect sense, right? We’re going from these social beings completely in control of our schedules and activities. In our lives. We are going to work or you know, hanging out with friends. And then suddenly we’re new moms, and we are constantly have a little helpless infant who can’t survive without us. We can’t sleep when we want. We can eat when we want. We can even use the bathroom without being interrupted. Much less go out, go to work, hang out with friends or have a normal phone conversation. Right? So so there’s none of that interaction that we get before having the baby and so it’s it’s only natural that it would lead to isolation. The partner may also feel the same isolation. If you know, the mom and the dad or mom and partner are both just taking care of baby on their own and they’re again neither one is getting out for a while or whatever. So they may feel it as well. And they also may not be aware that mom is feeling it if they’re going to work all the time and they don’t feel it at all right. So the partner is an important person ought to also be aware, along with extended family and friends. But once there is awareness, I think the other thing to emphasize to Mom is that this is a change that is not going to go go back to what you believe is normal anytime soon. So a good idea is to accept it to accept that these are changes that have to happen right now because this little one can’t survive without you. But you can also figure out ways to reduce the isolation. You can try to get support. You can join support groups, you can share your experiences with other new moms that are going through the same thing. You can ask for someone to come and help and maybe take baby for a little while so you can spend some time doing things that you want to do. I think it’s natural for us to try to fight it right to be like, Well, no, I’m supposed to be happy. I’m supposed to be joyful. I’m supposed to be fine with this and and everything will just be fine. And but I think that fighting and that sort of negative outlook on it doesn’t help either. We have to just say okay, this is what it is. And it’s really hard but let me see what I can do to alleviate it.
Paulette 20:30
So let’s get your son’s story so you get pregnant easily on and I you know thank goodness for that story because that’s the story we all have in our head. The first time I connected sex I was like I’m pregnant. Thank you very much pregnant, which was not how it works for a lot of people so I’m glad for that. And and it is hard to be the first in your friend group to be pregnant. So what is your pregnancy look like?
Julia 20:53
Oh, it was fairly easy. I had a decent amount of nausea, especially when I compare it to doing it a second time around with a three year old versus doing it just Oh, I could just lie in bed and watch movies and I was working as an adjunct professor so I had a lot of downtime. Where I didn’t need to be in an office. I only had to be on campus three days a week. So I literally was just eating grilled cheese and watching romantic comedies in bed thinking this is so hard and retrospectively I wish I could go back there. But yeah, no, it was a fairly uncomplicated, pretty easy, you know, up until like even even labor and delivery was pretty easy like I pushed for a very long time but that’s normal for you.
Paulette 21:36
But let’s go a little bit slower. So even the nausea would you want me to walk past that and be like oh so easy. I was throwing up every day. Like it is. It is I’m it’s Yeah, it is normal, but it is your first kind of wake up call that you are renting out your body and you are no longer the owner, the owner, the only owner. And it’s a little bit shocking. I mean, I was in grad school. So I also had a lot of flexibility. But I remember falling asleep on my keyboard. Like I think of it as like natural chloroform. Like you just all of a sudden you just can’t you just can’t write which is not what I expected. The overwhelming fatigue and the and the nausea of I again I was lucky in the in the scheme of things because I only threw up in the morning. It wasn’t like all day nausea. Yeah, but but that’s still a pretty big thing to undertake.
Julia 22:28
Oh, it was a lot and I think I just mentally when I think back to pregnancy, the first time around. I just knew it was so new. And again, I didn’t have any close friends who had been through it. And so every little thing. It’s like oh my boobs hurt is that normal? Oh I’m you know bleeding. Is that normal? Is this normal? Should I be throwing up this offense? You know, I was on the What to Expect When You’re Expecting message boards where you just ask every single question it’s everybody’s asking all these questions like Is this a normal thing does this look at this like does that and I feel like it says something culturally, we’re gonna get 10 xiety inducing just carrying a child is but also like how unprepared we are because we don’t really talk about it in any circles other than that particular circle. Imagine if growing up, I had talked to people all the time who were pregnant about the specifics of pregnancy, I feel like it would have been a very different experience.
Paulette 23:27
Totally, totally. And so it sounds like the pregnancy went along pretty normally. And then before we get to the birth, did you have an idea of what you hoped it would be like or how
Julia 23:37
so I am such a baby when it comes to pain. I was like I want the epidural. As soon as possible. I knew I wanted to be in a hospital where I could be as zonked out as possible from it. I’m trying to remember if I had a playlist I might have had. I might have made a playlist, but it was not very precious at all about what I thought would happen. I just wanted to help the baby and I wanted to feel the least amount of pain that I could possibly feel.
Paulette 24:05
Okay, totally fair. So take us through the day. How do you know Today’s a day?
Julia 24:10
Oh man, so I my son was born on his due date. So it was I had gone in for all of the checks where they’ll what do they call it where they write down your cervix or whatever they do? Or they stick their finger up there, you know? And I kept thinking, oh my god, I was so I was so uncomfortable. Everybody is in those final days and weeks of pregnancy that I was just like, come on, come on, come on out. And I can remember I eat spicy food and had sex took a walk and did all the things and then it was 9pm the night before my due date and all of a sudden I started having contractions, and I was there. I’m in general, a fairly prompt person. I like to be like Okay, now it’s time to do this. Now it’s time to do that. So it’s like now it’s time to the hospital. And they’re like, No, it’s not you know, you stayed stayed home for a while to remember I finished the book I was reading. And it was a 200 pages of a book that I read between 830 and I sent my husband as you go to sleep because you’re going to need you know, I can’t sleep right now and one of us should be well rested. And I remember I woke him up probably at like 2am to be like this really really hard. And when made called they say the thing of you know wait for the contractions are five minutes apart and lasting however long and when a time that it wasn’t quite so we tried to put something on TV and it’s like I can’t even sit here and watch us we have to just go. So we got super lucky because we live in we’re in Chicago and really in the middle of the city and our hospital was downtown. And I had been like oh my gosh this traffic What will we do but it was 3am so it hurt it was terrible like every pothole felt like I was gonna die. But there was no traffic so we got there really quickly. But when you get to the hospital at 3am There’s just not as much good they cannot move quite as quickly. So we were in triage for three or four hours or Wow by which point because i They admitted me at first and they were like you’re not dilated enough. And I said how is that possible? And they sent me to walk around in the halls for a while. So I did and then I came back I was like, please check me there’s no way and then they checked in like oh wow, you’re now which sounds like is that fair? Like? But then yeah, I just remember being in triage. We got to the hospital around three and I was admitted around 7am or 730. At which point I was like it felt like heaven to be moved from the tiny little triage room with the blurry TV and you know, there’s no space at all into the big birthing room. And then I got asked for the epidural on the way up for you guys like I’m ready for it now and then it was great both times I had I’ve had the epidural and has worked. So it’s not even true with my daughter. They couldn’t find the nerve for it. So that part was awful. But for my son, they found it right away. The epidural kicked in. It was great. I was great. I was calling my mom texting my friends. You know, so ready, maybe napped a little bit. Although I do remember my husband was like, I’m gonna go get something to eat and I’m like, don’t leave you might miss the baby and the nurses were like, go get by. Yeah, so I it was a nurse that I liked. I remember I was chatting with the nurse. I started All right yeah They’re like two hours into pushing. Maybe we’re all of a sudden it’s like a switch flipped and all of a sudden is like, this is actually terrible. I’m in so much pain. It’s really bad. And it went from being like if he had just come come right on out, it would have been such a pleasant experience. But then I think he was crowding for 45 minutes. And wow. It was awful. They had to bring in the mirror, which I think I have in the book, too. They brought in a mirror because they were like, look, look at him. He is progressing, but I just use the big headed kid. And it wasn’t my OB either because it was so early in the morning, I guess or I’m not sure exactly what it was, but that would be there. I’d been seeing it was somebody else too, which felt very weird. But yeah, it just took it took a while but then he was out and it was fairly uncomplicated after that no carrying no bleeding. So in retrospect, I got very, very lucky but it was at last hour and a half of pushing. It’s all Oh, I’m actually
Paulette 28:23
there’s no fear.
Julia 28:24
Oh, I was really scared. I think that
Paulette 28:29
I accelerated Prentice
Julia 28:30
Women’s Hospital which is just I felt very I have a few friends who work there, which I think helped. But I also felt very I just felt very secure very safe very much if something goes wrong. That’s why I’m in a hospital which in a way, I was so nonchalant about the birthing process that then when I had a baby to take care of I was like, Whoa, this is the end result of this, you know, but yeah, when I hear other people’s stories, I’m like, Oh my gosh, I maybe should have been more afraid. And my mother actually when I asked her what her labor with me was like she’s like I’m not even going to tell you so bad. I’m not going to get it in your head. I still don’t even really know that story. But for my son it was. Yeah, especially then when I think my second time around was much more complicated. And so it was just sort of your textbook, labor and delivery.
Paulette 29:31
That’s great. That’s great. So they hold you for 24 hours after vaginal delivery.
Julia 29:36
I stayed for two days. I think I hadn’t started nights and I wasn’t checked in until I showed up at 3am. So do count as a night so I got an extra one.
Paulette 29:50
Okay. Okay. And then what’s it like when you go home?
Julia 29:53
Oh, gosh, that was hard. That was I mean, I that was almost directly what I what I wrote about where I remember I sat in the backseat with him. So terrified to have this child float. Drive slower. Oh my gosh, drive faster.
Julia 0:07
That was I mean I that was almost directly what I what I wrote about where I remember I sat in the backseat with him so terrified to have this child flow that drive slower oh my gosh drive faster you’re driving too slow cars gonna hit us it was just very very intense
Paulette 0:23
if it makes you feel any better when we came home from the hospital my husband dropped me off in front of our walk up and then crashed the car in the air. I’m tired. Like it’s so stressful. So drive your egg around, right it’s just it’s
Julia 0:40
yeah, no, I yeah, I remember we got in and this was good too, because this was not a COVID delivery. So my sister in law had come and I saw many of these details ended up in the upstairs house. She had come and she had cleaned up for us and she had put food in our fridge and made a little fine. And it was me she was so so sweet. And then I felt terrible because then when she had kids, I was like, I can come do this, but I’m dragging my one year old along so it’s not quite the same. But yeah, she had prepped everything. It was great. I had totally set and then I think it was that first night we’ve had actually I just remembering this now so he was circumcised at the hospital but you were supposed to wait after the circumcision. They want you to wait until he has a wet diaper. I think before you go home but because of insurance and timing and everything and the doctor’s schedule, they were like you can just go home but check for it. And I remember being so anxious. I mean, like I can’t tell heads up what’s happening. I’m calling I remember I called the doctor at 1am That first night and they were like well hold on hold on. I remember I was on the phone with a doctor. He looking straight up at me. You know, it’s like Oh, thank God, but it was Yeah. It was very surreal. And it I think I feel like it was like fun sort of at first because you’re still kind of loopy and then it very quickly. So my husband had at that point he had like 10 days of paternity I think good luck and enjoy your five minutes. So yeah, he had 10 days and so for those 10 days i do i very clearly remember my in laws coming over and I didn’t I just wanted to lie on the bed and cry. I was just like I retrospectively clearly this was not you know, I should have been talking to someone for this but at the time I think now I can look at it and be like yeah, I probably did have postpartum depression, but at the time I felt like well, it’s not that bad. And like baby blues suck it up. You know,
Paulette 2:29
first of all this term of baby blues, what can we change that? It’s silly. That feels patronizing.
Julia 2:35
Well, how much of how much of medical care is not paid for? But baby blues is I don’t even know who coined the term but it’s become a term that’s accepted and so changing it might be difficult, but I agree with you. I don’t I don’t love that term. I also feel like it doesn’t really describe what’s going on. So can
Paulette 2:53
you can you describe like what actually is happening that we’re labeling the baby blues? Yeah, so baby blues
Julia 2:59
can happen at 70 to 80% of births, which is a really large number, right? And the fact that people don’t talk about it, like as a routine thing is kind of crazy. But so the symptoms of baby blues are basically very similar to depression. You may experience sadness, sleepiness, irritability, insomnia, impatience, anxiety, fatigue, poor concentration, all the things that you associate with depression. It usually starts within the first few days after giving birth and lasts usually about up to two weeks, but it goes away on its own, and symptoms come and go. They’re intermittent. So you might be super weepy. And then 510 minutes later, an hour later, you’re feeling perfectly fine. So the symptoms usually lasts for a few minutes up to an hour or two. But usually not longer than that in one go. And we don’t know the exact cause of baby blues, but we believe it. It’s related to the large hormone fluctuations that come with delivery and also combined with the lack of sleep that mom is having at that point, the changes in her routines, a lack of control all the emotions from her childbirth, experience, all of those together can lead to baby blues.
Julia 4:23
But then when my husband went back to work, it was really really hard. Even with visitors adjusted you know, I had gone from having my own life and my own creative work and teaching to like, you know, the baby was my full time job and I wasn’t sleeping and my son still doesn’t sleep through the night. He’s almost six and is still awful and that has been like from day one to use a terrible sleeper. We didn’t even get those good. The first few newborn nights that people get with that fool you into thinking that oh, it’s not that bad. We didn’t even get those. It was just, it’s just exhausting.
Paulette 5:03
I’m going to end my conversation with Julia here. I’m grateful to her for both the beautiful novel she’s produced and for her willingness to share her own experience of this enormous transition. The suggestion that these early days weeks months of becoming a parent, especially from the mother’s point of view is not worthy of literary investigation. That’s something anyone wants to read. About. Sounds like a quote from a TV villain version of a publisher. Although I don’t doubt for one second that Julie is reading the landscape is accurate. It just feels very distant from reality. Hope her book sales bear that out. I also appreciate Dr. Patel’s work and her suggestions. Next Friday. I’ll share the second half of my conversation with both Trulia and Dr. Patel. You can find links to Julie’s work and Dr. Patel in the show notes available on the war stories website. Thanks for listening. If you liked the show, please share it with friends and subscribe. We’ll be back next week with the rest of Julia’s inspiring story.
Episode 29: A Labor & Delivery in Two Acts, The Experience of an OB & a Midwife in one Birth: Janis
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 17 : On Both Sides of the Line, An OBs Story: Dr. Shieva Ghofrany
Episode 17 SN: On Both Sides of the Line, An OBs Story: Dr. Shieva Ghofrany
There are three reasons to tune into today’s episode: first, it is a chance to see pregnancy through the eyes of an OB who is both the emotional individual experiencing what we all experience when we try to grow our families, and someone endowed with much more experience and information than most of us. Second reason: when you hear the story of a fully trained OB, who has seen how pregnancies and births can progress in a multitude of ways, but still cannot control her own experience it’s a powerful reminder that (spoiler alert) no one can control this experience. And finally, three, Dr. Ghofrany has a significant following on instagram for a reason: she’s a great combination of articulate, charismatic and warm, and, it turns out, a particularly resilient person who shares her challenging, beautiful and inspiring birth story
Endometriosis
https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
https://www.womenshealth.gov/a-z-topics/endometriosis
Audio Transcript:
Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette kamenecka I’m an economist, a writer and a parent to two children who rigorously tested my ability to reproduce. Today I’m talking to an OB and a friend. Dr. Ghofrany’s best friend in high school was my college roommate, which is lucky for me because she is an amazing person and a force for good in gynecology. If that wasn’t reason enough, more reasons to tune into today’s episode. First, it’s a chance to see pregnancy through the eyes of an OB, who is both the emotional individual experiencing what we all experienced when we try to grow our families, and someone who dealt with much more information than most of us. Secondly, when you hear the story of a fully trained OB, who has seen how pregnancies and births can progress in a multitude of ways, but still cannot control her own experience. It’s a powerful reminder that, spoiler alert, no one can control this experience, and three, Dr Ghofrany has a significant following on Instagram for a reason. She’s a great combination of articulate charismatic and warm. And it turns out a particularly resilient person who shares her challenging, beautiful and inspiring birth story.
Let’s get to the interview.
Paulette: Hi, thanks so much for coming on the show, can you introduce yourself and tell us where you live.
Dr.Ghofrany: Yes, thank you for having me. I’m Shieva ghofrany I live in Connecticut, and I’m an OB GYN for 20 years,
P: amazing so that’s the also interesting facet of your story is that in some ways you know too much. Which will be interesting to hear. So before you got pregnant. I’m wondering what your ideas were about pregnancy, and how far you’re training you were or your experience.
Dr. G: Do you know how many times I’ve talked about this, no one’s actually ever asked me that question, kudos already i What were my thoughts about pregnancy well I had had endometriosis. That was diagnosed when I was 28, so I’d had a long history of really bad painful periods that literally led me to at age 27,28 I remember saying, in medical school. I’m never going to have a baby, because it sounds, it’s just so painful, I would like a hysterectomy because I was in so much pain from my endometriosis, so that was my like what were my thoughts about having a baby. That was my thought.
P: So what’s endometriosis. It’s a condition where the tissue that normally lines the inside of your uterus, the endometrium grows outside your uterus. Endometrial-like tissue outside the uterus, acts like it does inside the uterus. It thickens breaks down and bleeds with each menstrual cycle, but this tissue has no way to exit your body surrounding tissue can become irritated, eventually developing scar tissue and adhesions. The main symptom is painful periods, it may affect more than 11% of American women between the ages of 15 and 44. It’s especially found by women in their 30s and 40s, and may make it harder to get pregnant.
Dr. G: I always assumed I’d have children because I come from a more kind of traditional household, but my pain was so bad that if you asked me in the childbearing years when I was of age, I didn’t want to have babies because it was too painful. Then I did get married when I was 29, and started getting pregnant, and miscarrying when I was 32, and had my first child at 34, and I was a resident at the time.
P: Okay, so let’s go back over here. So, did you get pregnant easily.
Dr. G: So I was 32 went off the pill, I was a resident, didn’t want to necessarily get pregnant, because I thought let me just go off the pill, let my cycle get back to normal. We’ll try in a year got pregnant quickly. Oh, right, which was great, in retrospect because then I didn’t have to worry about it, except that that ended up being a miscarriage. It was what’s called a blighted ovum, which is where it’s a gestational sack meaning the sack was inside my uterus, but it was empty, so the egg and the sperm had gotten together created the pregnancy but that pregnancy never would have gone on to have a heartbeat or anything so it, so it didn’t.
P: It didn’t develop
Dr. G: it was an empty sack and it passed on its own, except that I had to have some of the SAC removed, like in a little office procedure because not everything came out on its own so I was a resident and bleeding and cramping and running out from like the hospital to the doctor’s office and back to the hospital. So that was my first experience with like women tough it out. We go through things, and we kind of compartmentalize, right,
P: that sounds really hard. Good Lord, I’m sorry to hear that you did you because you were a resident like you knew exactly what was going on and scientifically or
Dr.G: I knew exactly what was going on, scientifically, which made it easier and the good news was I could look at it kind of pragmatically as Oh well, at least I can get pregnant, and I’m still young enough at 32, and I didn’t start to kind of delve into the like, I was very overweight, I was very overworked, did that have an effect, you know, we were still in the mindset, this was back in 2002 of, well, people who are stressed and overweight get pregnant all the time so it can’t be any of that effect, and I would still say that’s somewhat true but it’s, you know, I think we know more nuances now. But yeah so that was the first miscarriage. And then pretty quickly. A couple months later I got pregnant, a second time and got a bit farther, and almost saw a heartbeat, that was kind of lagging in the measurements and had started bleeding pretty quickly after the positive pregnancy test, and that one miscarried. That one unfortunately miscarried didn’t go away altogether on its own meaning I didn’t pass all the tissue so I needed a D&C the dilation and curretage the procedure to remove everything. And because my uterus is tilted very kind of aggressively like at an acute angle. I had to go back a second time for a second DNC
P: Good Lord and are you as, kind of, are you as kind of pragmatic about the second miscarriage or this is upsetting
Dr. G: this time I’m upset because sort of upset because I didn’t even know if I wanted to be pregnant, you know, with my first pregnancy that quickly. But then, as you probably know like once you get pregnant once like your appetite you like your you get your appetite so you want to be pregnant again. So now I’m more upset, but I’m still telling myself, what we what we used to say clinically, you’re, we’re not worried until you’ve had three miscarriages in a row. Now we kind of actually have altered it to about two in a row if you haven’t had a child at the time was three. So I kept trying to be pragmatic and not let myself be too upset. And the truth is, you know, I’m a workhorse so I kept working. I did start to get really frustrated with my husband whose a wonderful soul, but just didn’t know how to deal with this, you know, the emotional toll of having a husband who is great, but has zero idea how to cope with pregnancy with miscarriage, and with a wife who happens to work a lot in the field so she’s somewhat obnoxious about like pushing you away as it is.
P: Yeah,
Dr. G: the extra layer of challenge there, you know.
P: Yeah, that sounds hard.
Dr. G: Yeah. So did you were you trying again or where are we and the luck was that despite me having endometriosis, that was bad enough that I had had surgery again back when I was 28 I got pregnant quickly, each time I’d get pregnant, so I got pregnant, and that one, I spotted and bled, but turned out to be a good pregnancy, meaning that is, who is now my almost 17 year old son.
P: Oh my god.
Dr. G: That said, that pregnancy was really fraught with challenges by that point I had gotten up to 250 pounds and I’m only five foot three so that’s not healthy anyway you cut it, I was mildly hypertensive so my blood pressure was always a little bit elevated, and from the beginning, the tests that we had done for him were during the pregnancy showed that his placenta probably wasn’t that healthy, meaning at the time the tests we did for Down syndrome. When they were abnormal, but didn’t show Down syndrome, really meant that there was probably something placental going on and in my case, what happened was throughout the pregnancy, his growth started to lag, the fluid around him was really low. And so we ended up having to induce me for growth restriction. And that was like a very challenging labor. In fact, your friend Sarah was at that delivery. It was a 30 hour labor with three hours of pushing and within eight hours after the delivery, he ended up having some seizures and went to the NICU where we found out he had had an intra uterine stroke in the previous week, At some point the MRI could time when the stroke occurred in a general scheme
P: let’s go slower here one second here, where are you in your pregnancy when you get induced
Dr. G: 39 weeks.
P: Okay so late
Dr. G: Yeah, working all the time, watch the baby, he’s starting to lag in his growth. Probably I should have agreed to be induced at 37 ish weeks but I was like, wait I’m working, I’m working. Finally,
P: do they give you a scale in terms of growth restriction like he’s, you know,
Dr. G: right, like he was when we worry about growth restriction we worry about two things really we worry about a deceleration and growth like where are the babies falling off their growth curve we call it, or once they get below 10th percentile, and he was falling off his growth curve sticking around 10th ish percentile with the fluid, being not as much as we’d like. And that’s a secondary part that we look at, Because if the fluid is less that really shows the placenta is not giving the baby all the nutrients, and then finally by 39 weeks he was like just below the 10th percentile. His head circumference was not growing, that’s something else we look at and his fluid was low, so I got induced.
P: And that sounds, the induction nobody talks about induction with like loving terms right.
Dr. G: Well, I mean, you know I have a catch 20 I will have a love hate for deductions on one hand deductions nowadays we realize that if you do, most women 39 weeks. This new trial that’s coming out called the ARRIVE trial really shows that you can have lower rates of really dramatically bad things that we don’t like like God forbid fetal death and higher rates of vaginal deliveries, but it does mean you’re there at the hospital for a longer period of time potentially if your body doesn’t want to go into labor, mine did not want to go into labor, nor was I in great shape from a stamina perspective like pushing was really challenging, but you know listen when he came out, I kind of naively was like, Finally he’s out. That’s it. Forgetting that things can happen afterwards. And the truth is, he is a very healthy, almost 17 year old now, with some learning disabilities and other, you know, side effects later but overall I’m, I feel very fortunate that it was not as bad as it could have been.
P: Yeah, no kidding. Wow, so was the labor what you thought it would be because you probably had seen Labor’s, are you.
Dr. G: Yeah, at that point. So at this point by the way I had finished residency I had found out I was pregnant with this pregnancy, right, right when I basically started my practice, so I joined my office at the time this is now 2003 I’m a new attending, I’m working crazy hours we delivered a lot of babies, it was three of us I was on call every third night. And so I ended up, then getting induced like close to the end of my first year of being in private practice and I’ve been a doctor for five years I’d seen, You know, 1000s of deliveries that point, and my delivery was kind of like what I expected it was long, it was challenging. I had an epidural early, you know, there was points throughout the entire labor were touch and go. Should we do a C section should we not the heart rate tracing which is what we look at as a reflection of oxygen status during labor was never terrible but never perfect, so it was kind of a challenge the entire time, and then the pushing was also three hours with my mother, my sister, my husband, my best friend who’s your friend in the room, three nurses, two doctors at time for the delivery, and like I said then eight hours later he was a little bit like pale and blue. And it turns out his oxygen level was dropping. And so we sent him to the nursery to get checked out, and they realized he was having seizures. So, that kind of turned into a 10 day, NICU stay, me trying to recover from three hours of pushing which is not pleasant or fun, and actually what’s interesting that I learned a lot about then was just that the whole notion that everyone should deliver vaginally, that’s when I really cemented my ideology that that is just not true. Some women deliver vaginally and it’s an amazing process and some women do not deliver vaginally, Nor should they and my delivery was really not a great delivery and it was no one’s fault. It wasn’t my doctor’s fault I trust him and he did everything that he can and should have done, but it made me realize that this push to really force women or shame women into thinking they should deliver vaginally is very damaging and I actually say this a lot. I think it’s, I think it happens at the hands of other women as well I think it’s very anti feminist, and it’s women who are perpetuating it in my case my catheter in my bladder stayed in for 48 hours after my delivery because I was so swollen from pushing, whereas after a C section it comes out after 12 hours right so again, I’ve really tried to encourage women to understand that when it’s a great delivery it’s great and when it’s a challenging delivery is challenging, regardless of whether it’s vaginal or C section. And the more we can really discuss that both deliveries can be wonderful in different ways, and each can be challenging in different ways. I think will really get parity and equity, with regard to respecting either delivery.
P: Do you think vaginal deliveries become not the right choice when there’s some physiological issue like you said your uterus is tilted in a certain way, like that.
Dr. G: Yeah I mean I think that it depends on so many different factors right the patient the her, her anatomy, her emotions, the baby’s position everything and I don’t think her emotions should be discounted and I think they are, in my case the baby was sunny side up. Have you heard that term where we’re what we call occiput posterior it’s actually very common. If you have friends who are like I pushed for three hours and the baby came out with a cone head and I had back labor. Those were all whether or not the patient knows it their baby was most likely what we call sunny side up, meaning the head is down where it should be. But instead of the face looking towards mom’s spine, the face is turned up, looking towards the front, and that means that the diameter of the head that’s trying to come out of the pelvis is a bigger diameter than if the head was the other way. And so my six pound baby. We three hours to push him out and came out with the craziest conehead. And so my sacrum I had like my, my cocksix was fractured so my sacrum really hurt
P: Oh my God.
Dr. G: I was so swollen from again pushing for three hours that my bladder needed the catheter in for 48 hours, so I think no one could have predicted that and I have other women who were also 250 pounds and small babies and they come out easily, or skinny with big babies who come out easily, so that I think that the really important thing is that every patient, every situation and every baby is so different in the OB world we call it power passenger pelvis. So the power being how big your how good your contractions are the passenger being the baby and the baby’s position and your pelvis, meaning what shape is your pelvis and your uterus and are those going to allow the baby to be in the right position to come out and any of those varying factors can alter how easy or how difficult it is for the baby to come out. And I think unfortunately what we see nowadays is this big push, no pun intended for women to deliver vaginally, and because of women’s backlash at wanting to deliver vaginally to take back. You know what they deem is something natural from the medical community, the medical community’s response has been to say okay well we’ll look at things and you’re right we can we can allow you to push even longer than we thought and we will get more vaginal deliveries out of this and that will be satisfactory for moms because moms want vaginal deliveries, they get more epigenetic changes and all these things that are evidence based, but in reality I think what we’re ignoring is the physical physiologic and psychological toll on those very difficult deliveries that either don’t end up bad you know and have harder C sections or do end up vaginal and have really challenging recoveries, or, you know, babies that end up not being as healthy as they could be. So I think there’s a lot of aspects with that are really complicated and it’s become oversimplified into vaginal delivery good section is like, you know, we just, you know, step cousin, kind of thing
P: can you use those three metrics that you talked about the power the psychology and I forgot what the third one was
Dr. G: power,passenger pelvis,
P: can you use those three to predict, like who will have a good birth and who won’t to to say to them ahead of time, it’s likely that you’ll do X or Y, right…
Dr. G: Yes to a degree right like if you’ve been doing this long enough, just like any field, you’ve seen enough to know like when I’ve seen, you know this mom with this psyche, with this pelvis, with this passenger in this position, blah blah blah. Here’s what I think. Now, even the best of doctors who’ve done this for a long time we’ll be wrong sometimes. Not a lot. In other words, when I if I think before at the beginning of every delivery or even a week before the delivery, what do I think is going to happen. I’m not always right for sure I’ve been wrong sometimes. But I’m often right. And the hard part is that sometimes, if you know the answer is the doctor is not an easy thing to inform the patient of right like let’s say I knew the baby is sunny side up at 39 weeks when I’m going to induce you. But if I say to you, Paulette you know baby sunny side up so I think this is what’s going to happen anyway. It sounds good, like you as a rational, reasonable person sound like you might be like well I wish you would have told me because then I would have done things differently, But it’s not that easy because you have had not only nine months of your pregnancy 10 months really of your pregnancy of reading things and researching, but then also being told that the medical community just wants to induce babies or just wants to do C sections because they get paid more, which by the way is not true, or that they just want to be home by five o’clock, which is a joke is never true like no OB is home by five o’clock, or that like, of course you have to deliver vaginally because it’s natural and because it is better for the epigenetic changes so you can’t hear that information and really digest it that
way, some women can but many women don’t want to hear it.
P: Yeah, yeah
Dr. G: and it sounds negative to them and they’d rather just kind of go into it in a more positive way which I actually love manifesting and I love positivity, but I think it has to be metered with some realism in order to actually achieve better outcomes and I, I’ve said, frequently, patients who come into it realistically but optimistically saying, I’m gonna try this gradually. I hope that’s what it is, I fully realized that I might need a C section and that’s okay too. They do great meaning anecdotally, they have a higher rate of vaginal deliveries, I think, and those who end up needing a C section, have had a very good experience and felt very validated and felt very heard by their doctor. And so either way it’s a win win, whereas those go into a dogmatically saying it has to be this way, has to be vaginal, with no epidural or whatever it is that they think it has to be, then no matter what happens, they’re really, they’re unhappy, and sometimes maybe even have more complications because they are trying to control a not controllable situation that we can respond well to, if we have a partner in it who kind of has faith and trust in what we’re doing.
P: Yeah, this is an important narrative to publicize because this is contra to the cultural pressure to do otherwise right and this is, I’ve already talked to so many women who said I had to be natural I you know I had pictures in my head and have to look exactly this way, and that’s, I think our diet of what birth looks like is so unrealistic and so thin and so like it’s in the movies or whatever
Dr. G: and honestly it’s, it’s not just in the fiction movies, it’s in the very present population of documentaries and things that are, and I listen I did an integrative health and healing, fellowship, right, like a Masters of sorts, so I love things that are Eastern an alternative, but the unfortunately the Eastern alternative or even just like Instagram world of things should be natural, really glorify the ability of nature to always do the right thing. The irony being and I say this a lot when people say things like the women have been delivering bad generally in nature for millennia, women have been dying,
P: I was just gonna say what’s the death rate right now
Dr. G: currently die in other countries. Right, yeah, or have other side effects so which I say to patients like if you are willing to accept those consequences that I’m, God bless you. That’s okay. I don’t mind. But to go against nature by women being older than we used to be heavier than we used to be, reproductive techniques like IVF been in or, you know, women who are having, having babies through IVF with a donor sperm donor egg with their female partner, all things that I support, as I always joke like we have not set the table for nature, and then we expect nature to show up to our party ready and willing to like do the right thing, and it’s obscene and absurd and it leads to a lot of problems and the problems end up being for those very women that want this to work the way they want it to work. Like the men, it doesn’t affect the patriarchy.
P: Yeah, yeah, yeah. So wait, let’s get back to your story although this is totally fascinating, your sons of the NICU for ten days, sounds stressful and as a doctor does it feel. I mean, not that you have another frame of reference, but are you panicked like the rest of us or do you think like,
Dr. G: Oh no, I think I was like, in a weirdly surreal state of denial, and I’m not joking when I say that so I, in fact, so he has the seizures eight hours after delivery, he ends up being in the NICU and for about 24 to 30 hours, we couldn’t touch him because he was on a continuous EEG machine to find out what was happening with his brainwaves. The MRI shows ischemia ischemia is the medical term for loss of oxygen, so ischemia to two parts of his brain. Now, in our vernacular ischemia or loss of oxygen kind of mean stroke, but in my mind I don’t. I do not equate that word, I just keep saying ischemia Yeah, because in my mind it’s so medical but like, oh, he lost the oxygen and he had seizures and then he’s going to be better the seizures are going to be done and that’s it, until three years later, when a patient of mine who I delivered her son, he had an intrauterine in stroke, and she and I were talking about it, she’s in the nick you at another hospital to transfer the baby, and she says something and I all of a sudden said, Oh my god, I never even thought that my son had a stroke, and I remember her saying Shieva, of course you know that your son had a stroke, I’m like you I kept using the word ischemia, but that’s like in this situation, he had a stroke. So I think that power of denial was actually very, very beneficial for me, and very protective, because I was really able to be in the mode of like, okay I’m trying to nurse, I’m not great at nursing my milk is not coming in, I’m going to nurture who do what I can. I had really excellent NICU doctors who kept reminding me that babies do very well because of the neural plasticity and our ability of their brain to really respond to stimulation. And, you know, I’d say the challenges during that time, or probably more managing my husband and I and how much again he did not know how to deal with this well, and he’s a wonderful person, but really did not show his best side at that point and it was that was emotionally really hard. I think that was the hardest thing for me at the time. And again,
P: he was upset or he was distant?
Dr. G: he was distant, he was like at the time unfortunate he was like interviewing for a job so I was in the nick you like I always had someone with me like between my friends and my family and my parents are both positions and I was never alone but I didn’t feel like he was a partner in the whole thing. And I think again the narrative is very much like the partners, The man man is like the most supportive person and I’m so glad and blessed to have a husband who does these things and again, my husband is an amazing person, but this was not where he shined and so that felt very lonely to me, and certainly nothing that people talked about because everyone like acts like their husband is amazing and like wiping their butt, after the delivery.
P: Yeah, yeah,
Dr. G: and I know that that’s not true, but that’s how I felt at the time. Now I know that,
P: but also that may have been his way of dealing with it right? It was too painful…
Dr. G: maybe… it was like taking our baby. Yeah, but, but, even if that is the case, it’s still
not a, a, that is not a wonderful way to deal with something when the other person is then left taking over.
P: Oh, it doesn’t help you at all. I totally agree. I’m just saying like, you never know what’s gonna look like on someone else and we also had distress in my pregnancies and stuff and it was, you know, I’ve never seen my partner in that context before so I didn’t know what to expect and hey, like right now. Yeah. So you brought him home and how is that?
Dr. G: so I brought him home. I will never forget the drive home it was 10 days later, all of a sudden you’re like, I don’t want to be in the NICU and you find out you’re in the nick you and then you get used to all the alarms and bells and whistles and the nurses and then 10 days later, you’re like, you’re not going to come home with me I got to go home and our drive home I hope we get our drive home being like, I literally thought we were in a game of Frogger, I remember we were like in the car and I felt like, so vulnerable at any moment, a car was gonna hit us or something was gonna happen we got home, you know, our 12 minute drive home and I remember being like, Thank God we got home like it just felt like we had battled to get home when in reality it was just like a drive home from the hospital, and he was a challenging baby he was not a delightful easy baby until eight months he did not sleep well. He did not nurse well so he got formula right away. I really felt like I couldn’t sit for about six weeks because of my fractured tailbone. And I was swollen…I had so much edema meaning swelling in my hands and feet imperative and everywhere because I was so overweight and so hypertensive and retaining fluid, and then went back to work at I think seven weeks, and frankly, I can’t say like I was miserable, like I look back, when you’re a physician and you’re training and you’re a resident, like working 120 hours a week you’re kind of like prepared to do all this stuff. So I did it all, and I didn’t have postpartum depression, but I would never go back to the first year of any of my three children’s lives like and I say that, openly and happily to people, not because I want to act like it’s the worst for everyone, but I want women who don’t love that first year of their baby’s lives to not feel bad about it, I am not one of those people who’s like I go back to infancy and want to snuggle I’ve zero desire to go back to their infant lives and when I hear babies cry I actually still get a little chill down my spine. And I’m, I’m not embarrassed to say that I’d rather us talk about it some people love the infants, my mother still loves and adores infants. I do not, you know,
P: infants are very very challenging. That is for sure. I remember when we left the hospital and I was like how are they just letting us leave,
Dr. G: like, with no infection or manual or anything. Right, well good I’m glad that worked out. What about the next pregnancy was that, no, no, no, because then I had so he was a year. I had him in April 2004 By July of 2005 I was pregnant again. Great, I got pregnant again. Bleeding like stink. Having to go see my, my husband’s family abroad, in the middle of a miscarriage.
P: Oh my god,
Dr. G: and I thought okay well okay I’ve already had, you know, now I have a baby, now the miscarriage isn’t as upsetting because I know I already have a baby. And if I never have another baby, at least I have one and I know my body can always do it, I’ll probably have another baby. And so I ended up having three more miscarriages after that so four miscarriages after the first baby, some of which needed a D&C, some of which didn’t and the interesting part is at the time if you asked me I would remember exactly like how many leads how many days in D&C, the D&C you know for the miscarriage only thing I know I’m like six miscarriages for DNC is, I cannot remember which ones have D&C is or not and I say that again happily because in the moment that any of us are going through anything. It feels so dire and like just like the details are ingrained in your brain, and I really want all of us to remind ourselves whenever we get through something and actually forget some of the details how good that is that like, it’ll, it’ll always feel better. Like, not necessarily soon after and it doesn’t mean you forget I don’t forget those six miscarriages I actually very much feel attached to those these materials in what have turned out for me to be good ways, because I’ve learned a lot from them, but I’m so glad that it’s reminded me time and time again that all the details that you thought you’d never forget because also, why’d you do. So then I got pregnant with my now second son and that pregnancy, I got antsy, because I wanted to be pregnant I was tired of miscarrying I took the medication to help you ovulate more so just because of timing, I had an agenda, I had to be pregnant. And I got pregnant, bled a lot at seven weeks thinking I was having another miscarriage and as it turns out that was a twin pregnancy and so one of the twins went away before I even knew it, so when I went in to get my ultrasound. I said okay I’m having another miscarriage just like, let’s get through this and I have like one more in me before I’m like done trying, and the doctor said oh actually you know what, there’s a great heartbeat, but the other one. It looks like there was another one that is no longer going to continue, which was not sad to me because I was just happy to have one heartbeat that baby boy is now almost 13 He had a clubfoot, which is where the foot is literally turned up and inward completely deformed, that we knew of, during the pregnancy, and it had to be repaired when he was born so he had casts every week for six weeks, and then these special boots for four years, but compared to a child with a stroke like you know a clubfoot was nothing.
P:Yeah, yeah, yeah
Dr. G: it was cumbersome and annoying. We had to go to the city like once a week every week for six weeks after his delivery, but like, it was fixable, so it’s fine. And then I was done, then I thought, I’m done, and I did not want to go through vaginal delivery again and I planned a C section, and my partner’s at the time, who had not delivered my first baby though I loved the doctor who delivered my first baby, but my medical partners who were still my partners, said, Do you want to go through that again. I laughed, I did what do I want to torture myself my partners are men, by the way and I submit a hell no, sign me up for a C section we’ll all show up in the right time and place and get this done. And I was so happy to do that it was so comforting for me to know that I knew the time and the date and the place and how he was going to come out, which is not to say that a C section is easy, are always the right choice, as I say to everyone. There’s no one right answer.
P:Yeah,
Dr. G: For me the right answer was the C section, it might not be for other people, maybe my second delivery would have been easier, but I did not want to take that chance for my recovery and what my first one had gone through so the C section I learned a lot from that too I learned a lot of little things that I say to patients during C section that I’ve kind of altered since then, I learned what to tell patients to like eat and not to eat before the C section. So I looked at it as, you know, street it was like me learning on the street, how to do things, and I really thought I was done after that I was never going to have another baby. Yes, I was that I didn’t have a girl but it didn’t matter I was blessed to have two boys I’m done this body is done. And then I did weight loss surgery when I was 40. So my first son ended up being 34 My second son was at 3840 I did weight loss surgery, I was done, never gonna have another baby, lo and behold for four months after that surgery I got knocked up by surprise. My surgeon said, I thought I’ve heard you a really great gynecologist what happened I said I know God I relied on my husband. And that was my surprise baby girl who’s now 10 And that was the healthiest pregnancy because I have lost, about 80 pounds. So despite being almost 41 When she was born. It was healthy, and she’s healthy and I had another C section and I had my tubes cut finally at that point, I think, like, each time you go through these things, they, they suck and they’re amazing, right, like I’ve learned great things and terrible things through all of these experiences, and I would not go back and undo any of those miscarriages because now I have my three babies. Right,
P: yeah, yeah,
Dr. G: I think, I what I say to a lot of patients whenever they’re going through miscarriages is that there is a very small segment of the population who will never or can never have a baby but that’s relatively small. So as long as women we are willing to go through either help getting pregnant or help staying pregnant or donor egg or donor sperm or whatever it ends up being. I can pretty much guarantee every woman will have a baby and if we remind ourselves of that almost before we even gotten pregnant, it would be so common because then, Each miscarriage wouldn’t feel so desperate. Yeah, for me, the desperation initially felt like this might be a sign that I’m never gonna have a baby. Right, but I knew I would be maybe I just wasn’t in the mindset of telling myself that and now I’ve learned that that’s really powerful to tell ourselves the fact it’s not snowing yourself it’s telling yourself the truth, you know,
P: yeah, that would be super calming I had trouble getting pregnant, so I know the weight of that, like, this may never work out right which now I have two kids, so we’ll obviously do work out but that that is very common to have that out there.
Dr. G: Yeah, and I think it’s something we should reiterate, and make it a really, like, make it a, a fact for people to remind themselves.
P: Yeah, totally. Do you think the miscarriages are attributable to endometriosis or we don’t know what,
Dr. G: no, I don’t think there was revealed endometriosis because at the time I didn’t you know I endometrioma which was the 17 centimeter growth of endometriosis that I had was removed and I had no other obvious sign of it. I really do think and I don’t say this to be inflammatory to any woman out there who has weight issues I have many many many extremely overweight patients who have very healthy pregnancies. I think in my case, I had a lot of inflammation, and I don’t use that in the kind of Whoo, you know, Eastern like just general sense I had inflammatory markers that were measured on blood tests that dramatically dropped after I lost weight, and I really do think that that was a lot of it because my placenta was not healthy. The miscarriages we had reviewed by a pathologist and each of them that she could look at she really saw some vascular insufficiencies meaning the blood vessels that had formed between my uterus and the placenta weren’t that healthy, and in fact this is something I glossed over. I forgot that in my second and third pregnancies. I used Lovenox which is, if you know what that is but it is a form of heparin so heparin is a blood thinner. Yeah, there are like women who have antiphospholipid antibody syndrome women who have had other blood clotting issues will use heparin during pregnancy because it’s such a high likelihood of a clot or other pregnancy issues like miscarriages, or abruption where the placenta comes off early. And so I did not necessarily need to use the Lovenox my blood test markers at the time didn’t necessarily support it from an academic perspective, or an evidence based perspective but enough people that I respect felt like it might work, and my eighth pregnancy, ended up being my second child. So to me, it’s not a coincidence and he was healthier the clubfoot was probably a coincidence, he was healthy, he was seven pounds he was well grown, and then with my daughter, I probably didn’t need it because I’d already lost weight and my inflammatory markers were already dramatically lower, but I felt superstitious at that point. And so I continued to do the Lovenox which is a daily shot of a blood thinner,
P: that makes sense and that inflammatory markers are an issue because your immune system is so keenly involved in the development of the placenta in the early part of your pregnancy
right and how it’s attached to the uterus and
Dr. G: when that embryo implants into the sidewall, that’s the inception of what is creating the placenta and and the placenta is the interface right where you’re getting your nutrients so a faulty placentation is really what can give rise to preeclampsia diabetes growth restriction, God forbid worse things right, nowadays we’re giving so many women baby aspirin low dose aspirin, starting by ideally, you know 12 To 16 weeks because we know that can improve their likelihood of not getting preeclampsia, and that’s because that comes from how the placenta has invaded into the wall of the uterus. So yeah, decreasing those inflammatory markers just created a healthier environment for the third one, you know to do better.
P: That’s awesome. So it knowing what you know now because you’ve been a doctor for many years after those births, is there something that you would have told young Shiva earlier, maybe that she didn’t know
Dr. G: well here so hard right, if I put on like my coaching mindset I would say, well I could have told her, but she only did what she could have done at the time, right, so at the time, I was working like crazy as a resident, I’m still I would say very food addicted I have a lot of like food issues right like I love food, I use it as a comfort it’s, I haven’t cracked that code yet so what I have said she admits unhealthy to be 250 pounds and you probably should try to be less stressed at work, and you should exercise. I guess they would have told me that but I knew that right like I definitely regardless of being a doctor, we all know that, could I have done anything differently. The fact is, it would have had to take a lot of work, mental health and emotional work right I was a very mentally healthy person I’m happy I’m engaged I’m, you know I don’t tend to go become depressed and things like that but, but I also like, I just I’m going to do what I’m going to do and at the time I had to work I was a resident I worked a lot, there was no way around it then I was an attending, I liked working I like involving myself with my patients so yes I would tell myself that but I don’t know that it would have changed anything. I will say that I think that and this is why I always joke about my street cred right because of everything I’ve been through and my weight issues I feel like I can talk more openly to patients, and most of the time, at least I think they don’t think that I’m like shaming them or blaming them or you know acting like you should do better. I really can emote with them because I’ve been through it, but I still find the weight issue to be so hard, not because I’m reticent to talk about it openly, but I think that many women understand and know what we need to do to be healthier as far as weight and exercise, but it’s hard to do it for a million, like purely academic reasons like time and for a million emotional reasons right. So I don’t know how much us telling patients that is going to help right, I think there’s a small group of women who have I say, by the way, do you know if you exercise more, and eat less carbs for example you’re gonna be healthier in your pregnancy. I think there’s a small group that’ll benefit, I think the rest of them already know that, and then in fact maybe hearing it over and over from the medical community just leads them to feel more like shame and avoidance and feel like this is paternalistic group of people telling them that they shouldn’t be doing these things so, so I actually, I talked about it but I don’t talk about it as much as like I should, according to the medical professionals, But I think I try not to talk about it too much because I think it shames women and I don’t think it’s beneficial.
P: Yeah, yeah, I can see that pregnancy I found really stressful, I’m just not even like putting aside my issues before I’ve had any issues. It’s just, it’s so much uncertainty, and it is for me and probably for a lot of women, the first time where you really are confronted with the fact that you have no control over this, like wildly important and powerful process going on inside you. It’s such a weird dissonance between kind of your outside life where you feel like you’re in control of everything and kind of what’s going on. So…
Dr. G: and the world keeps telling you, I mean the world as it stands right now, where they get social media and this entire other world of like pregnancy, telling you like, you should take control, you should empower yourself against the medical professionals, don’t let them try to tell you what to do. And I think that’s equally confusing right because then you have this the medical professionals are clearly trying to harm me, which is just not true. Like, there’s plenty other ways I can harm people, not this, and it means that women like you and I who are very type A and work really hard and are used to being able to control things. We’re going to try and, damn it, we’re going to do it. But the fact is we’re not going to do it because it’s undoable, you cannot control it, and then it just leads to more and more that cognitive dissonance, you feel self doubt, you feel doubt in your practitioners, which just creates more and more angst, and I really feel like it is like the demise of the doctor patient relationship and what leads to, again, an anti feminist potentially really dangerous situation for women. I think it’s what’s driving a lot of people to feel like they should deliver in in their home for example, and some women will do very well but we know the data stands that there is a higher rate of postpartum hemorrhage and other problems when they’re delivering at home. So it’s it’s a challenge, and I do think like you’re to your point, you’re used to controlling things you can’t control things, but yet no one’s actually explaining to you like it’s okay that you can’t control it and here’s why it’s okay that you can’t control it because not controllable but together we can still give you a great outcome and that’s really what you want, and the is you don’t want to control it but you’re being told that you should.
P: Yeah, yeah, yeah, I think that’s true, you’re doing a lot of amazing things in the world of data ecology and medicine. Do you want to tell us a little bit about your path forward or your hope for the future.
Dr. G: Well, I’m trying, I mean I’m as you can tell I’m like really really aggressively and obsessively wanting women to like just understand their psyche, a little bit more and you know I really I want women to trust their intuition, but when I say intuition. I think women supplant thinking their intuition is actually like listening to someone on Instagram and I keep saying like that’s not your intuition. That’s someone else’s intuition telling you. So yeah, my business partner I built this platform called tribe called V and it’s initially, the two products that we’re now, one has launched one is launching are pregnancy products but then the third is going to be a gynecology product and when I say product, a platform where we’re really trying to encourage women to have a lot of pre emptive information. So our my OB and new pregnancy program gives them an ebook, and then two to four lives every month where I talk about pregnancy issues and we do q&a My whole purpose being if I give you pre emptive information and explained to you. Hey, you’re gonna go for your ultrasound next week, here’s what might happen. Don’t be alarmed if you hear, you know, XYZ, like cysts in the baby’s brain, or a spot in the baby’s heart because those things are common and don’t freak out, the more preemptive information I can give you but in a calm way that educate you without freaking out, the better you’ll be because then when you hear those things because they’re common your brain did not devolve to like death and destruction or in the gynecology platform side, I want to really educate people about HPV and herpes and menopause and perimenopause and birth control and, you know, bleeding and endometriosis and all of the things that, because we don’t hear about them, We only then hear again on the internet or from our mother or from our aunt or from our sister or from that woman who almost died and then it becomes horribly anxiety and inflammatory provoking. So if instead we all talk about it more, and you hear it from someone who’s like not only teaches about it but has been through all these things, then hopefully it won’t. I’m not saying that any of the things are not easy like endometriosis still sucks anyway you cut it miscarriages are terrible anyway you cut it but they are less terrible when you understand them, when you understand how common they are when you understand what can be done to help them, then you’re not blindsided by it, and again if you hear about it ahead of time, you’re just not as worried.
P: Yeah, I agree. That’s amazing. So, I’m gonna sign up for the perimenopause thing because that seems like a black hole in my limited experience. So how do we how do we find these things.
Dr. G: Well, so the gynecology platform part will be out enrolling hopefully in the next like I’m going to say three to six months so people can go to tribe called v.com and just get on our mailing list for now. If they’re pregnant or trying to conceive, they can enroll in our pregnancy program, because then they get immediate that the PDF or the ebook, and they get to be part of our lives every month, so we do literally two to four zoom lives where we talk about all this stuff and the community of women is already starting to kind of bond with each other and everything, and then our pregnancy course will be coming out, but again the GYN platform will come out in the next couple months where all this stuff will be discussed, really, like, in detail in detail by like the woman who has you know I’ve been through menopause because I had my ovaries removed four years ago and I deal with it every day with my patients, and most of it is not complicated. When someone explains it to you but no one ever had the time to explain it to you.
P: Yeah, yeah, that’s right.
Dr. G: Yeah, and I think if we can do this, not only for women our age but for our young girls if we can talk to them about their period or about masturbation or about what it’s like you know when we if you decide to have a baby or if you decide not to have a baby or what if you have pain during your period or what if you find out you have HPV, I mean, literally, that the number of things we do not talk to them about is so endless that they all end up being so freaked out when they hear about it, even educated women don’t hear about this.
P: Yeah, that sounds awesome. Thank you so much for sharing your story and for sharing this new platform I’m excited to check it out.
Dr. G: Thank you for being here and thank you for sharing, millions of women’s stories because we need to get it out there.
P: Yeah, Totally. Thanks.
Dr. G: Thanks, Paulette.
P: Thanks so much for listening to this episode, and thanks so much to Dr. Ghofrany for coming on the show. She was best friend from high school was my college roommate, which is how we know each other, which is lucky for me because she is an amazing person and a force for good and gynecology, you can check her out on Instagram at Big Love fierce Juju or tribe called V. For more in depth information about women’s health issues. If you’d like to share your story on the podcast, go to war stories from the womb, calm, and sign up. We’ll be back soon with another story of a person who’s overcome the many challenges that pregnancy and Birth invite.
Episode 12: A Double Sided View: pregnancy through the eyes of an OB: Dr. Nicole Rankins
Cover Art from David Janelle https://www.etsy.com/search?q=pregnancy+OB+david+janelle