Tag: PRES

Diana: So let’s go back to the chronology they told me to go stomp down the hall sleep at night I’ve been in active Labor’s you know for at least 12 hours maybe longer but also I’d been in that prodromal labor for days have contractions that stop and start but little very painful contractions. They just weren’t doing anything. And I’m stomping and like half naked I mean it must have been looked absolutely insane. And then I went blind. I couldn’t see

P: out in the hole while you’re stomping?

D: Yeah.  And I started screaming I can’t see anything I can’t see. And I think my husband had been with me and he calls for the midwife or whoever is attending and they kind of come and get me back in the bed. And I checked my blood pressure. And it is sky high. I mean, I think they’d been monitoring it a little but I hadn’t really shown signs that were in the danger zone beyond maybe like a little bit of elevation. But I had severe preeclampsia. So much so that I had lost my vision because your brain swells and, you know, something had happened to the ocular nerve and I could not see I was blind. And that is where at that point. I pretty much don’t remember anything and I have to take the rest of the experience from my husband Tim story where it’s very, very serious.

P: Today we’re lucky to have Dr. Avi sonra on the show. She’s a doctor trained in ophthalmology and neuro ophthalmology and currently finished her training in neurology at the University of Kentucky, Dr. Abu Samara, thanks for coming on the show.

Dr. Abusamra: Oh, thank you very much for having me today.

P: We’re here to talk about Diana, who runs into severe preeclampsia many hours into her first delivery, and it takes the form of high blood pressure and complete blindness she was shocked by the sudden onset. I’m wondering if preeclampsia tends to overtake a person so quickly.

  

Dr. Abusamra: Yeah, yeah, it can. definitely can. So you know, the definition of the clamp says the new onset hypertension, and that’s associated with the proteinuria. Their success should be certain amount of protein in the urine. Or the new onset of hypertension in a patient who did not have hypertension before in association with some organ dysfunction. And I think the heart and the brain and it can effect the eyes so yeah, it can it can make the patient turn around so quickly.

P: Can you explain how preeclampsia creates blindness?

  

Dr. Abusamra: Yeah, so most of the DataLogic changes that happens in in the pregnancy are actually related to gestational hypertension and preeclampsia and eclampsia and preeclampsia and eclampsia there’s like a vascular damage endothelial damage, and this damage will we’ve cause different pathologies. Blindness in the preeclampsia and eclampsia is rare, but it happens and I think the the incidence rate is around one to 2% one to 3% of severe preeclampsia. Preeclampsia can result in blindness and the blindness and eclampsia. Preeclampsia can happen because of either damage that happened within the eye itself like the ocular structure some somewhere in the eye or damage happen or due to insult to the brain surprisingly. So if it’s if it’s caused by damage to the eye, it’s either caused for example, by bilateral retinal detachment, sometimes eclampsia of severe enough can cause serious detachment of the sample some some layers of the retina, and typically in a big lousier. It’s bilateral and it’s a dramatic and it can cause bilateral vision loss. 

P:  Let me stop you there for one second. So you’re saying high blood pressure causes enough pressure on the eye that it part of the eye is detaching, and it happens in both eyes. That’s how easily

Dr. Abusamra: it’s not exactly the the hypertension itself. It’s what results from the hypertension. For example, there’s there’s edema forming between the layers of the retina because of the severe hypertension and the vascular injury that can cause the Internet to detect. It’s called like serous retinal detachment and it’s a dramatic in preeclampsia, and usually multiple of the eyes

P: do we think that happens in some people because of the specific architecture of veins in their eye?

Dr. Abusamra: we don’t know the exact mechanism is not completed and patients get affected is not clear either, but this can happen. But they will think about it that the treatment is conservative management and once the reason for the detachment stops because I’ve been controlling the blood pressure. It resolves. Nowadays there’s there’s more focus to one or the other cause of blindness and the people I’m seeing eclampsia, which is actually the brain. So there’s something called cortical blindness which means that the patient will develop blindness without any issues with the structure of the eye itself. So if you examine the eye, it’s fine. There’s nothing to suggest nothing to explain why the patient was visual, right? However, it’s closed because of the damage or like an insult to the part of the brain that is responsible about interpreting vision, which is usually which is called the occipital cortex. So this type of disorder the cortical blindness is usually a part of a syndrome called PRES. PRES is the posterior posterior reversible encephalopathy syndrome. And patients in such syndrome will be complaining of headaches, sometimes they’re confused seizure and blindness. This is because of the severe hypertension will cause damage to the autoregulation of the blood vessels inside the brain. And the most common area that’s affected in such cases is the occipital lobe and the parietal lobe. occipital lobe is the is the part of the brain that controls vision. So that’s why patient might lose vision because of preeclampsia

P: what I’m focused on in that description is I thought you said reversible. 

Dr. Abusamra: Yes. First of all, yeah, 

P: so even though it’s we’re describing it as damage it we it can be fixed.

  

Dr. Abusamra: Yeah. And so yeah, it’s, it’s more of a like a temporary damage. That would be because of the severe hypertension and the DIS regulation of the blood supply to that area of the brain. There’ll be a temporary, dysfunctional in that area of the brain that controls the division, and that’s why a patient might suddenly become blind

 

D: at that point to have severe preeclampsia.

P: I had like I’m covered with goosebumps. Oh my god. Yeah, just it seems like it came on so fast.

 

D: It did. I mean, I it’s hard to know what the different markers were. I never asked like Well, what was my blood pressure, you know, a day ago, but clearly they weren’t worried about it. Right. And you know, the, like I said about the the formula like I’ve been so active and healthy and like everything had been great or whatever. Not everything was great. I was kind of depressed and my dad had died and all that but physically, I think I I presented healthy and but then there I was still at six centimeters with the baby and occipital, posterior and I was blind. And it was terrifying. It was terrifying for me. It was more terrifying for my husband who was watching and I think started to be afraid that I might die. 

P: Yeah, 

D: and nobody was paying attention to him. 

P: has everyone said it’s preeclampsia?

D:  I mean, once they took the readings, I mean, I think they had to check my blood pressure right away and they got the whatever they’ve been they put the band on for the baby’s heart rate. And probably I’m not probably getting all the details right because I was blind and I was kind of out of my head. So what they do right away is they give you something called magnesium sulfate, which basically kind of stabilizes you. There was no way I was going to be able to give a vaginal birth in that state

P: yeah

D:, I was blind. I was kind of out of my mind. The baby was stuck. And so they gave me this mag sulfate, which made me completely loopy. I had no idea where I was and this was the thing was really scary for Tim. I had no idea that I was even pregnant and in labor anymore. So I was like hallucinating and calling out things like what’s going on and why does it hurt like?

P: So at some point, obviously they put her on magnesium sulfate. She said she didn’t know she was pregnant or why she was in the hospital. And I’m wondering why magnesium sulfate has that consequence or

  

Dr. Abusamra: I’m not sure if it’s actually due to the magnesium sulfate. Now you’re talking about magnesium because I know that magnesium they use it in pregnancy and patients who have preeclampsia or eclampsia to treat the hypertension and return seizures. But maybe she was confused because I’m not sure what was the reason for her vision loss. But if you if you should see if she’s saying that she was confused at that time, that she actually developed PRES, which is the posterior reversible encephalopathy syndrome, where patients actually confused by the hospital like they disoriented to time to place they don’t know what’s going on with them. So it’s gonna be this is part of her hypertensive emergency that happened in the time of preeclampsia rather than the magnesium is the magnesium should be like a treatment for your condition not causing her to be confused.

D: So they said we need to do an emergency C section. She has preeclampsia. We need to get the baby delivered. But it was I don’t know like Saturday night in a small hospital in Keene New Hampshire. And it took a while to like get the anesthesiologist It was like he said it was two hours of waiting. 

P: wow…Oh my god

D: with me in that state. I mean maybe it wasn’t quite that long. But with me in that state not even knowing I was pregnant, being blind and going from natural birth goals in the walk in like the tub to blind severe preeclampsia and hallucinating so at that point. I really don’t remember anything. He remembers a lot more than I do. When they did this. Like no one was like, we’re going to do a C section. This is what’s going to happen like it was just full on emergency mode. 

P: Yeah, yeah. 

D: No one talked us through it. Even if I had been able to understand certainly no one talked him through it. And I had never read the chapter on C sections in the birthing book, because that wasn’t gonna happen to me. I was a yoga teacher and I was super healthy and I exercised and took my vitamins and like, did my Hypno birthing exercises. So who knows if that would have made any difference but that was part of just my unpreparedness I want to say right now on this podcast like every woman should read the chapter, just read that chapter  just understand that sometimes there are situations where this is a necessary outcome. And like you should understand what it is and also maybe what your options are for that kind of a delivery. So I don’t think Tim was even allowed in the room. Maybe you know, I can’t you know, there’s certain things that are hazy, but eventually our baby was our baby Ava was delivered. And I couldn’t see her. But because I was blind still but I remember this is like such a powerful physical memory was like they took her and they held her up to my face, and I could smell her and then they whisked her away to have the you know, things sectioned out. And that was another real grief because we had had this plan of skin to skin afterwards and you lay the baby on the chest and like none of those things happened. 

P: Yeah, yeah. 

D: And for a long time I worried and I I was so sad that I failed my my baby because she didn’t get that. In fact, my mom had even given me a book on how important skin to skin was. It was some beautiful book of pictures and it was like showing that that sacred time after the birth is very quiet and it was like, that didn’t happen for us, you know?

P:  Yeah, 

D: but here’s the thing. Our baby was so healthy. She was a eight pounds, 10 ounces. And like, you know, she’d been in there, you know, a long past 40 weeks and do this big, round cheeks. She nursed immediately with no trouble ever latching no trouble ever with nursing. And so then by the next day, so we spent like a good three days in the hospital, you know, recovering and everything. My vision did slowly return. So that was obviously a great relief and blessing.

 

P: While you’re waiting for that to happen. Have they told you usually people get their vision back or….

 

D: I don’t really remember that interim time. The timeline between when she was delivered when they brought her to me like all of that like I couldn’t see I think I was just I mean also they gave me I went under for I was fully sedated for the action. Yeah. Which I think I think it’s better to just have local and not have general anaesthetic but

P: my understanding is that is that it’s much faster acting to get general so yeah, when it becomes an emergency. That’s why they flip the script and make it Yeah,

  

D: yeah. So you know, there’s so much of it, that’s just it’s just hazy. They’re these sort of parts of the memory that burn really bright like the baby being like, I could smell that her and then I could hear her crying, which is obviously good noise and but then kind of fast forward to being in our hospital room and there’s baby Ava, and she had a full head of dark hair that kind of stuck with red temps that kind of stuck up. She was totally adorable in a way that like a lot of newborns are and she was nursing and healthy and had all the Apgar you know was a champ and she would like lay on Tim’s on like within the first day lay on his chest and she could kind of frog kick, like up it. I mean, that was amazing. And I realized pretty quickly, like whatever trauma that I’ve been through and that we’ve been all been through together. Like this baby was thriving. And I feel like as I had to process what happened over the next weeks and months and even years I held on to I kept my baby alive and strong. And she is okay. And that’s the most important thing. It’s not whether I had that ecstatic, orgasmic waterbirth in my living room, naturally like you know, be a birth goddess. That’s beautiful if another woman can have it and and I had to let go of that and then instead look at my real life baby who was just amazing.

P: That is amazing. And it sounds like your symptoms resolved slowly. While you were in the hospital. By the time they release you was she was your blood pressure normal?

 

D: Yeah, they kept me on the mag sulfate and they had to get it down to a certain time before they wouldn’t really say one other thing happened that was pretty scary. Was that by the next like by the next day, by the time my vision came back. At some point in the interim after the birth I developed a Bell’s palsy in my face so I had like a whole drooping side of the face. Scary. They were like they didn’t know if I’d had a stroke. Yeah, they didn’t know why they didn’t know if it would resolve.

P: Bell’s Palsy is a facial nerve neuropathy. That’s a rare disorder, but apparently occurs at higher frequencies in pregnancy. Almost 30% of cases are associated with preeclampsia or gestational hypertension. In fact, pregnant women are three times more likely to experience Bell’s palsy than non pregnant women. With a predominance in the third trimester. Several theories exist as to why there’s an increased incidence of Bell’s Palsy and pregnancy. And those include the following increased total body water leading to swelling and our compression of the facial nerve. weakened immune system especially in the third trimester, which can lead the reactivation of the herpes simplex virus. Increased blood clotting factors and elevated levels of female hormones estrogen and progesterone.

  

D: actually there’s a writer Sarah Ruhl are you he said price range she just she had a Bell’s Palsy. After twins and mine did was like over the course of the three plus days, but that was another sense of like, my body has been through some really extraordinary like that and that sense of like am I gonna be back to normal, whatever normal is.

  

P: Yeah, that seems terrifying. And another thing I’m interested in is like you my first pregnancy. Delivery involves a lot of trauma and we have a second child. Yes, and how to walk into that is different for everyone. So, so share with that was like how do we Why don’t we have a second one?

 

D: I know. I know. I mean, I guess the reason like you think why would you ever want to do I mean I started research include camp clam Sia, I went to see how often it was that you it’s actually more common in first pregnancies. And like I think I read the statistic around repeat preeclampsia. I’m not gonna able to quote it now and maybe it’s different.

P: The risk of developing preeclampsia in a second pregnancy if you had it in the first depends on when you had it in the prior pregnancy, how severe it was additional risk factors that you might have to just give a sense of the numbers and article and British Medical Journal using a giant sample found that the risk of preeclampsia in any pregnancy was 3%. The risk was 4.1% in the first pregnancy and 1.7 and later pregnancies during the second pregnancy. The risk was 14.7% for women who had developed preeclampsia, and then first pregnancy and 1.1% for those who had not

 

D; when I did get pregnant the second time and it was like another sort of accident. Ava was I think around 13 months like my kids are less than two years apart. So she was maybe yeah, 14 months when I got pregnant. I was still not menstruating like I was nursing a lot I think I thought it was going to be really hard to get pregnant because I wasn’t it was so there I was pregnant again. And I was like yeah, I’m gonna have a VBAC. You know, like redemption story, and actually a nurse a visiting nurse who’d come to look at my C section scar. And we haven’t even talked about like the C section recovery, which was like really long and arduous but she was like, Yeah, you can always have a VBAC. She kind of said it offhanded and I felt like that was such a, you know, a lovely seed to plant but I the local hospital, like they wouldn’t see me there. I was considered a high risk pregnancy. So the only prenatal care and like the only place that would let me deliver was at a hospital over an hour or like an hour and 15 away. So that’s where I had to go because they specialized in high risk. Pregnancy.

P: If you’re not at high risk to develop preeclampsia, what what are we worried about? I mean, maybe I was at higher risk. 

D: That’s a good point.

P: I’m not I’m not contesting I’m just asking.

D: No, I think also the fact that I wanted a VBAC. 

P: Yeah, 

D: I think it’s I’ve been willing to have a planned C section. We could have done it at the local hospital. Yay. In a chilled out way. And let me tell you, I actually looking back I’m like, That actually sounds pretty relaxed ish. Maybe I should have done that. But I really wanted to try for that feedback. And so I needed to go through these people, you know, the providers who were kind of specialized because I think I think it was more about the the I think the risk of of rupture during you know, that’s what they’re worried about,

  

P: especially if it’s not if it’s less than two years apart, right? 

D:Yes, exactly. So they’re, they’re all these things. It wasn’t just a was a VBAC. It was said maybe the history of preeclampsia but then it was also the close together and

P:  was your first C section. Is it horizontal? Is that it’s horizontal?

 

D: Yeah. But, you know, I’ve sort of learned some things about C sections. Definitely the ones that are like fast and urgent or refer surgery my body, right. So for Carmen my second, it was also an August I did certain things different during that pregnancy. They didn’t want to let me go beyond 40 weeks for whatever reasons it was about the chances of preeclampsia start increasing after that 14 week mark. And I did a lot of different things like acupuncture and rosemary Evening Primrose oils and like, all the different things herbs to try to get things ready. But Carmen came right on her due day and I think I had a I had like the checkup prenatal checkup like right around that time. I think they might have done like they swept the membrane, that membranes and then I basically like went into labor. So I didn’t need the kind of induction that I did with the first baby. But I actually had an amazing I did a different Hypno birthing class with a different teacher who knew the full history of trauma. I also had a therapist who I had done a really cool technique on trauma processing called EMDR. Without that, I don’t think I would have been prepared to go into labor again, given how scary it was. So I you know, it was a more I don’t know, like maybe a more normal progression, things went faster. When you try for a VBAC. You have to wear the belt the entire time. So you are being monitored. There’s a lot of precautions. And basically, I I got to a certain point it kind of stalled. Carmen was in that same position, that occipital posterior and later a midwife would say, yeah, there’s probably something about your pelvic geometry. That is why your babies are in that position. And I didn’t even know that was a thing, but there you go. That’s nothing I could control. 

P: Yeah. 

D: But you know, I was like, probably, I don’t know, like eight centimeters and I was really tired. And then I was like, I want an epidural. My fears around the same interventions were totally gone in the same way because I saw what had happened before. So I kind of went to sleep because I was so so tired. And during that time, I basically fully dilated and started feeling the need to push which I’ve never gotten to the first time. So I kind of woke up out of that sleep and I was like I need to push I need to push and it was exciting. And then like it was like I’m doing it this time like this, you know, I was ready. I’m gonna like push this baby out. Like I Hypno birthing like everything. And then you know, I had this big monitor on and the baby’s heart rate went way down to like 30 or something and it stayed down and all the alarms and buzzes are going off. 

And then it goes way up, and it starts doing tech cardio doing like up and down, up and down, up and down. And they called in the big guns. And it was like, something’s not right and when you’re having a VBAC and something like that happens, they don’t give you another chance. I was like, I’m like, Come on, I’m ready to push like I want to do this and they’re like, they’re afraid of a uterine rupture and that’s why the baby’s not okay. And at that point, they rushed me like I was naked on the bed. They got me on a gurney and they ran me down the hall naked to the O R. And they’re like, We need to get this baby out now. And I was I was like, no, no, please let me try like I want to push her out. And they kind of they checked me one more time and there was like a tiny lip of cervix which hadn’t like fully dilated, and they’re like, it’s gonna be too long. Like it’s gonna take too long for and the baby’s in distress, and we can’t risk it.

 

And that was that and they same thing they put me under Tim wasn’t allowed in. It was a very fast, very urgent, very scary emergency C section. And I had a great doula at the time. In fact, it was the same woman who had been a nurse who had said you could always have a VBAC. I’d asked her to be my doula. And she was like they were outside. of the window. And I feel like they kind of put me under still like, protesting like, let me keep trying. And my Doula was like, I saw your C section. It was really rough. Like there was a lot of blood, you bled a lot. And here’s the thing that happened, which again, didn’t know could happen. The surgeon cut my baby on the face with a scalpel. 

P: Wow, 

D: she was faced up again. So Carmen was born with a cut on her cheek. And the first pretty much the first thing that needed to happen to her once she cleaned up and everything but before she was given to me to nurse in the recovery room was she had to go to the plastic surgeon and she had like four tiny stitches on her face. 

P: Wow.  I have never heard of that. wow.

D: I was me when I finally heard about that. I was really angry. It was like, what was that doctor doing? You know? Anyway, I actually asked like in my six week chair, I was like, I want to talk to that doctor. I want to ask her what was what that was like, what happened? And that I never got the opportunity to do that.

 

P: But now do we think it was just a frantic rush to get the baby out?

D: Yeah. I mean, who knows what was happening? how long she’d been on for where she’d been on call for whatever. It was late. It was 1040 1035 at night. You know, I don’t I don’t know. I mean, people are human. There’s error in anything ADA. But that’s a pretty big errors to cut a newborn baby when you’re delivering a C section. And yeah, I mean, when we talk about birth trauma for our babies, you know that to come into the world that way for sure. So I I made sure like after we got home and everything I got like cranial sacral treatment for Carmen. She then she went on to have like, extreme colic like she would scream and scream for hours and I always felt like some of that was connected to like a really traumatic birth.

P: Colic sounds unbelievably hard, and I think it’s hard for people to understand just how difficult it is to live with a colicky baby unless they can witness it.

D: Oh my gosh, yes. She used to come down outside. And it luckily she was born in August. So it was like summer into fall that this was happening. I mean, it went on for like I want to say like for at least four to six months, like Oh, four months like I would walk around the neighborhood and sometimes I’d be walking her and she’d be screaming Unknown Speaker  0:02  

meaning and I’d be like wondering if the neighbors were going to call like Child Protective Services. And I would be like, I’m trying to comfort my baby and I was totally powerless. Eventually she fall asleep and then I try to transfer her really carefully to like the little tick tock swing from my like baby carrier, and then maybe she would like sleep for 20 minutes and then she I mean, it was that was its own thing. You know, now she’s a fierce and incredibly healthy 14 year old varsity ice hockey player. Like she’s a very fiery Leo. You know, I think sometimes I’m like, Oh, that was just kind of her fire that we were. We were seeing that was she was expressing in that in that kind of first first few months of her life. I mean, somehow we made it through but I will say my recovery from that C section. I think if you have a planned second C section, and they kind of carefully go through the same star, like I almost have like two stars, that kind of cross. It was 

P: oh wow.

D:  Yeah, I mean, I’ve also had like a pelvic chronic pelvic pain condition which I had had before getting pregnant the first time that kind of came back, which I think was connected to the surgeries and trying to heal and all that scar tissue there. So and you know, so that’s when we started like, did you want a big family? You know, I knew that too. That was all my body could take. Yeah, yeah. And there was a lot of grief there. My sister just had her third baby a few months ago, and I really, you know, I felt the heartache. I mean, that’s over for me. I’m in my late 40s. I’ve two beautiful teenagers. I’m really grateful for the family I have but there’s always that sense of oh, what is or you know, it just it wasn’t my karma not for this life.

P: Yeah, it is. It is a hard thing to let go of, and we were in the same boat or we wanted a big family and it was too because of all these physical things that happened. So it is it is hard. To hard but makes sense to hold both like the gratefulness for what you have some sense of loss

D;loss, I think the loss is real and I that’s really why I’m grateful to you for having this podcast and holding the space for women mothers, I don’t know do you have dads on here too or is it just women?

P: So it’s funny I have it is just within and I tried to get most of the experts to be women because it’s yeah, I want it to be kind of women’s voices. But I was suggesting to my husband that maybe I would interview him about our birth story and he was like, Absolutely not. 0% chance.

D:  That’s what my husband works. I mean, he the first birth he describes as hands down the most terrifying experience of his life. 

P: Yeah, 

D: I mean, he no one was telling him anything. He fully thought that I was gonna die. Maybe our baby was gonna die and he was just gonna watch it toddler Don’t be by myself. Waiting for tins are watching and I didn’t know what it was but it was the episode daughter those until April. In literally she dies. 

P: Yeah. Yeah.

D:  It is one of the most riveting fighting scenes like a television show. Talk about pts. Like I really did some trauma because it was so activated was like I felt and I think I understood like the day if it had been 100 years ago for me, kind of in 2005 that had been 95 There was no mag sulfate yeah and been in a hospital that would have happened like they saved my life in a way that seemed that helped me put aside my what ifs. I had a good friend at the time who had a C section and went on to have a very empowering VBAC and wrote about it and I felt a lot of jealousy and like, sense of failure. But I also just felt watching the worst case scenario play out on Downton Abbey. That actually helped me to just feel odd what I’d been through survived and like gratitude for the medical care that saved my life and like gratitude that I have these had these like strong, healthy, thriving babies, you know, because like, Isn’t that the most important part?

  

P: Yes, yeah. easy to lose track in the 10 months of getting there, but that is the ending we’re all looking for. Yeah, also, it was really interesting for you to watch a thing that you were kind of not present for right so now you can see everything your or some version.

D: Find and selfie and various and hallucinating so it was with all my faculties observing. It was really shocking. Yeah, that was really interesting. And so here’s like, the final thing is that I did get pregnant again

P: Wow. 

D: Accidentally flare up of my chronic pelvic pain could come back and it was really ideon for years, I guess, since Carmen’s birth. That was our birth control. And I became convinced me to do everything to relieve where I was with this plane failure, which was really scary and I got the idea. And Tim scheduled a vasectomy lesson that was like the best and most compassionate thing that a man could do, especially to a woman who’s been through the kind of pelvic traumas that I have, but there was a window of time between the IUD coming out and we use some condoms. I don’t know. It has easy for me to get pregnant. I thought it’d be really hard to get pregnant at age 40. 

P: Yeah, 

D: it was not. And I got pregnant again. And we I had to make that decision. But it was an agonizing I understood that I would have needed a third C section. Like no one there was no not going to be a VBAC. I talked to the doctor about it, a third C section through that scar tissue which had already was in in rough shape, and hit I was already trying to treat the scar tissue to try to help with the pelvic pain. And I just knew I had like a very deep level and I talked with my doctor that like my body couldn’t really go through that or maybe it could but there was going to be a real cost in the long term for my health. And that was the decision I made and I was able to do like a medical, a chemical abortion like at home where I took the two pills and it was like just induced a miscarriage, and it was much less traumatic. than that first experience. When I was a teenager, I knew it was the right thing. And never looked back. I was just very grateful that I had access to that kind of care and could make that decision with my health care provider. So yeah, but so a lot of what ifs you know, sometimes I have because that would have been I would have had a baby like in 2014. So I would have a eight year old now, you know, so there’s definitely that. I’ve had some moments of that. But when I come back and get grounded in my body, and I almost like visualize what what’s going on down and then the C section scar and like everything. I just just like that was my limit. That was my limit. Were those those two babies, those two pregnancies, and those two surge emergency surgeries and I knew I couldn’t have gone through it again.

P: Yeah, I mean that that sounds wildly reasonable, especially since now you look at the two kids you’re responsible for right to say this becomes a bigger a different decision. I think. I think it’s most common for people to have abortions if they already have kids. 

D: Oh, really? 

P: So I think yeah. Okay, to be more clear about the abortion statistic according to the Guttmacher Institute, a research organization that focuses on reproductive health policy 59% of abortions are obtained by women with children. 

So I think many people are making that calculus, right. What what’s cost and what can I do and now it’s not just me and it’s not just my partner. It’s yeah, it’s this family that we’ve already created.

  

D: Totally. And I mean, let me tell you, I don’t know what your teenage years are like, but like, we’ve gone through some intense stuff, past few years. And it’s been, I mean, at times, it’s brought me to my knees again and the ways that

  

P: surrender Yes, right.

  

D: So yeah, I’m not trying to say like people have more I mean, I think whatever you given what you can handle maybe but like two was what I could handle, you know?

  

P: Yeah, yeah. Yeah. Yeah. Well, that’s an amazing story and I am grateful for your good ending there.

  

D: Okay. Thank you. This was really cool. I like how you kind of, we kind of made a full circle.

P: Yeah. Thanks so much for coming on. Thanks so much today and for sharing her story. We didn’t get to talk too much about her writing, but I’ll link to her website in the show notes at war stories from the wound.com and you can check out our work. Thanks also to Dr. Alessandra, are insights about preeclampsia and blindness. Anyone listening to this story can relate to the fact that pregnancy and birth are complicated processes that really require flexibility and more grit than you can imagine. So many things happened in Diana’s two pregnancies and we only focused on the most dramatic aspects. We didn’t spend one minute talking about recovery from the C sections, and how challenging it must have been to have these difficult births close together in a period of intense childbearing. Her resilience and her partner’s resilience are really are really just inspiring. Thanks for listening. We’ll be back next week with another amazing story.

Transcribed by https://otter.ai