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Episode 48 SN: Making her Way through Preterm Labor & Surrogacy: Ariel’s Story

In today’s episode, my guest is a friend of mine shares her story. She comes up against a host of extremely difficult situations and challenges in her quest to have a child. Her story has some elements that many people will relate to preterm labor and issues with her cervix, and other issues with IVF and surrogacy that I think really showcase her resilience and strength and make the birth of her daughter a triumph we can all celebrate.

(painting pictured above: The Quest by Andy Davis)

Ariel’s book about her experience is called The Maternity Labyrinth, which you can find here.

Audio Transcript

Paulette: Hi Welcome to War Stories from the womb. I’m your host Paulette Kamenecka. I’m an economist and a writer and the mother of two girls. In today’s episode, my guest is a friend of mine shares her story. She comes up against a host of extremely difficult situations and challenges in her quest to have a child. Her story has some elements that many people will relate to preterm labor and issues with her cervix, and other issues with IVF and surrogacy that I think really showcase her resilience and strength and make the birth of her daughter a triumph we can all celebrate. In this conversation. I also include the insights of an MFM who’s doing amazing research about the cervix, and has the kind of bedside manner that sets the bar very high for doctors, I think gives patients an idea of what we should all be looking for in an OB. 

Let’s get to this inspiring story. 

I mentioned that today’s guest is a friend of mine, we’re in a writers group together, but I’m gonna walk her in just like I walked in everyone else so Hi, thanks for coming on the show. Can you introduce yourself Ariel and tell us where you’re from?

 

Ariel: My name is Ariel, and I am from New York City and now live in California.

 

P: Lovely. Thanks so much for coming on. I read the maternity labyrinth. I knew you have quite a story. There’s a lot going on. I mean, that’s a that’s a perfect title. It is. It is a tricky thing to make it through. Let’s start before the beginning. You have siblings, right?

 

A:  Yeah, I have two younger brothers.

 

P: Did you grow up thinking I definitely want a family. I want a big family. What were you thinking?

 

A: That’s good question. I guess I assumed I would have a family. I not necessarily big I think I probably assumed I have I don’t know two kids. I didn’t get married till I was in my mid 30s. So at that point, I think having a big family was less likely in my mind. But I mean, my mom had three super easy pregnancies, easy deliveries, no issues got pregnant easily. So I just assumed you know, it would have happened when it happened.

 

P: You’d walk into it kind of in a straightforward way like your mother. Yeah. around that age. I had my first kid of 32. So around that age, I feel like when people are starting to have kids and are you like aware of what’s going on with your friends, is anyone having a trickier time or it just that doesn’t have much resonance for you because in your own family, it went well. 

 

A: I definitely had some friends who had miscarriages in the first trimester. And I have one good friend from Boston who definitely had a really hard time. She had multiple miscarriages and they did IVF. So I had friends who had some fertility issues, and I definitely seen friends.

 With IVF. 

P: So it was somewhere in your universe, but you didn’t think it was on your path. And so now let’s start at the beginning. Remind me Was it easy to get pregnant? 

 

A: It was very easy to get pregnant. 

 

P: Okay, good. Okay, good.

 

 

A: So that was the what was so bizarre about it was like once I got pregnant that easily because I was worried I was in my mid 30s. So I thought, you know, maybe it’s not going to be as easy as it would have been a few years earlier. And I got pregnant easily. I thought, wow, this is this is gonna go fine.

 

P: And you found out with like, a home kit. Yeah, that’s fun. And that’s an exciting day in your house. 

 

A: Yeah, no, I was I remember being stunned, right. Frankly, my husband couldn’t believe it either. We really thought it would take at least you know, the good five months or whatever. And so I think it was like, second month I tested and there was it was it was fast and easy. 

 

P: Wow.  Well, that’s a good story. You know, I think all of us walk in thinking that’s how it’s gonna happen just because that’s the story you get when you’re a teenager. So I’m glad it was true for you and it’s true somewhere, and then that pregnancy develops and then I know that you run into trouble with that, but I’m not sure about the timing.

 

A: Yeah, so so everything was going smoothly. I had amnio everything was fine. I had the level two ultrasound and I can’t remember if it was around 20 weeks or something. Everything was great. And at that point, I thought you know, it’s gonna be smooth sailing from here on in because I sort of passed all these markers and I felt fine. And I was it was in 24 and a half weeks pregnant and I was just it was night I was just reading in bed and I went to the bathroom and a bloody clot came out. And so I tried to be rational and calm and I mean, I just felt fine and I wasn’t bleeding continuously. So I got all my trusty pregnancy books. And we’re in then about anything like that because it was way past miscarriage time. And so I wasn’t having contractions I felt fine. So I kind of sat and waited



P: Wait a minute, wait a minute…So this is I feel like I would hit the panic button immediately because 

 

A: Well, I think because it was at that point it was so it is it didn’t fit any bigger. Like I had no idea what like I was completely out of my mind that I could possibly be Miss Karen because it was I was 24 and a half weeks pregnant. I was six months pregnant. So like at that point, it’s not a miscarriage. 

 

P: Like it just no no, I agree. It’s I agree it just meeting is like enough to it’s not like I felt weird, right? It

 

A: it wasn’t like continuously bleeding. That’s what was strange. And then I think part of it may have just been the way I don’t know if the way I was raised but I generally I had never I’ve never heard that in my entire life has been in the hospital. The only sicknesses I’ve ever had are like you know, a cold what happened? Nothing. Like my I think my mom is sort of joke like she is the antithesis of the Jewish mother that she is like, she’s the type like if you tell her to do well, she’ll tell you to go shrug it off like not a worrier. We were not rewarded for sickness. It was sort of like go to school and get over it. So it was like the furthest thing from my mind. I’m generally I’m moderately athletic. I felt fine. So I could not imagine that something could be going wrong. And then I had like everything looked fine and all the tests. So I thought, you know, who knows? Then I started having contractions.

 

P: and you knew that they were contractions. You knew what they were? 

 

A: Well, I mean, again, I started rationalizing, thinking, Oh, they can be Braxton Hicks. It’s about the right time. And again, you know, looking at all my books and nothing made sense. And so I tried to go to sleep and it got worse like the contractions were bad. So I called my doctor the middle of the night and she said go to the hospital now. 

 

P: are you in NY for this?

 

A: No, I was in here in California, California. Okay. So she said, Go now and I’ll meet you there. And she told me later that she almost hesitated to tell me that because I sounded so calm, which is nice. I went to the hospital and I was in full labor. I mean they checked me out I was fully dilated. And I mean, they had to deliver the baby there was nothing they could do. Like once you’re dilated like that…so when the doctor arrived, they decided to do an emergency C section because 24 and a half weeks is a dicey time like there is a decent chance the baby could survive, but it’s not. Not not ideal, but I guess she wanted to do whatever she could to, you know, to see if the baby could learn if no vaginal delivery would not have

 

P: so vaginal deliveries like too much pressure on the baby.

 

A: So they did an emergency C section. And when the baby was born, I mean, she was crying like it was she was born alive and they took her immediately to the NICU. And basically she survived for three days and the thing that I believe develops last is the lungs. 

 

P: Yeah, 

 

A: so the lungs were just not and once that started with just sort of snowballed, like that affected with the brain and then there was bleeding and it’s like there was just no way.

 

P: Yeah, I mean, you it sounds like it was so out of the blue that you didn’t even get the chance to take steroids for a day or two or anything. Like that, because it happens so quickly. I’m So sorry.

 

A: You know, it was seriously like I mean, I’m even at the time I barely reacted because it was I couldn’t cry. It made no sense. It was surreal, truly. And, you know, no one could figure out what like they did. Test. There was no there were no genetic issues. There were no one could figure out why. So after that, 

 

P: something kicked off, Labor’s what that means, right, something 

 

A: Well, that’s interesting. So my professional medical theory. Yes, I mean, in my mind or the way it felt because I wasn’t doing anything. It wasn’t like I was running a marathon. I was seeing getting rejected, right. So in my mind, it felt like there was some chemical thing. Miss something not wired right. That told my body to go into labor at the wrong time. However, I did I went to see a high risk specialist and he said that I have an incompetent, incompetent cervix, not a diagnosis, I can name I really appreciate

 

P:  I was gonna say, in this community of writers, we have to come up with a different name That’s so dumb and and just why why in 2020 like 15 years ago, why?

 

A: It’s like an accusation…So anyway, but he said that it wasn’t definitive because you basically have to go into preterm labor twice for them to be sure of that and there was also like, again, my mom never had any problems. It does tend to be something that sometimes runs in families. I wasn’t particularly large. 

 

P: today. We’re lucky to have Dr. Filthy Rich on the show. She’s a professor at Intermountain Healthcare and adjunct at the University of Utah. And medical director of MFM, obstetrical ultrasound services. So I feel like the cervix is the unsung hero of pregnancy. And I think people don’t necessarily understand exactly what’s going on with their cervix. Maybe you can walk us through the role of the cervix in pregnancy.

 

Dr. Feltovich: So the cervix is just an amazing structure. That cervix is one of the critical pregnancy tissues that performs a diametrical opposite function during pregnancy it’s job for most of pregnancy is to remain long and firm and closed but for pregnancy to occur normally, and allow vaginal delivery at the end of it, it has to go completely opposite by the end of pregnancy. It has to be completely soft and completely dilate and open for normal events to happen and the same is true of the other reproductive tissues. The uterus needs to stay quiet and calm through most of pregnancy but at the end contract strongly for things to go normally, and the membranes also have to stay quiet and intact, and only like break open to allow the delivery at the end. And these structures are all talking to each other all the time. There’s a lot of evidence about, cellular communication between them. The problem is that it’s just such a remarkable transformation that these tissues undergo throughout pregnancy, that there’s just really not much known about it. Not nearly enough known about it. 

 

P: So let’s talk about Ariel. I’ve shared her story with you…and Of course after such a devastating outcome, We want to know why. Why did this happen? So the doctor she goes to see says that maybe she has an incompetent cervix, but it has to happen twice to get that diagnosis. I wonder she’s got no family history. She doesn’t have a high BMI. All the obvious things are not in play. So I’m wondering what the risk factors are for preterm labor. Do we think there’s some chemistry issue at play for spontaneous preterm labor with no obvious trigger?

 

Dr. Feltovich: So first of all, I’d like to react to the term incompetent cervix. I never use that term. I feel like it’s pejorative and it kind of Yeah, it is. And it it sort of imply some sort of personal blame on the patient and their own body or blame on their cervix or, you know, something else that just isn’t fair and isn’t correct. So, I actually use the term cervical dysfunction because there there are certain people whose for whatever reason, those reproductive tissues that are supposed to stay intact and strong and have the molecular scaffolding within them stay intact until the very end of pregnancy for some reason in some people that that isn’t the case. And there are, multiple different reasons for it. There are certain things that precipitate or increase the risk of preterm birth and a lot of it is sort of a chicken and an egg problem. So, bleeding can be both a symptom of cervical dilation. And for Ariel, it kind of sounds like that was the case because she had some, some bleeding and passage of sounds like some mucus and clot and then she had contractions right after that. But bleeding can also be the precipitator of events. So for instance, women who have bleeding during pregnancy, especially continued bleeding, heavy bleeding, bleeding, in the second trimester are at increased risk for preterm delivery, because there’s just something about that bleeding that that irritates tissues and sort of messes with their extracellular matrix, you know, the scaffolding and in the membranes and the cervix that that give it its, strength, it’s biome biomechanical properties, and it’s never clear which thing comes first. Right? It’s a real chicken and the egg thing. Same thing is true with another precipitator of preterm delivery, which is preterm rupture of membranes when that when that bag of water around the baby breaks too early. And same thing is true with cervical dysfunction where the cervical structure just kind of breaks down. So What’s tricky about this is that all three of those things have to happen, right? The cervix has to disappear become soft and dilate, the membranes have to break and the uterus has to contract in order for a fetus to deliver. And he more we learn about it, it seems like those things don’t need to happen in any particular order. So the cervix to go back to Ariel’s problem has long been thought of as the kind of gatekeeper of pregnancy and it is, you know, it’s like sort of the common denominator of all these processes, right. It’s sort of the final step, because you can be contracting, your water can be broken, and unless that cervix opens and shortens the fetus won’t deliver. So it’s kind of thought of as a gatekeeper. For a long time people thought the cervix was just sort of a bystander in the process of parturition, which means, you know, pregnancy and delivery. And then for a long time, people thought it was sort of controlling the event. And there are various different theories on that. The truth is, nobody really knows except that it is 100% clear that all of the pregnancy tissues are involved, and they are all chattering with each other all the time. One important thing for somebody like Ariel to know, is that two thirds of spontaneous preterm births are unexplained, two thirds of them and this is revealing of the real paucity of understanding we have about the process. Many women have zero antecedent history of anything going on until they’re minding their own business laying in bed one day and they pass a clot. So that is a very, very common story. And why this I think, is so complex, is that take Ariel story, she passed a clot and had some bleeding. 55 0% of women will have bleeding during pregnancy. You know, mostly during the first trimester spotting or you know, something like that. But the problem is that there’s this event that can herald a very serious outcome, like what happened to Ariel is also very normal in pregnancy. Same with contractions. You know, people talk about the Braxton Hicks contractions or many of us call those preterm uterine activity without preterm labor. And in fact, we understand so little about preterm birth and why it happens. That the diagnosis is actually retrospective, which means if someone’s having contractions, and I say 32 weeks, which is preterm 37 weeks is term 40 weeks or someone’s due date, but if someone’s having contractions at 32 weeks, I will tell them, you know, I don’t know if this is preterm labor or not. It depends on what happens if you have all these contractions and deliver before 37 weeks, it was preterm labor. If you have all these contractions and deliver at 37 plus zero or later, it wasn’t preterm labor.

 

So the picture is just so complex because all of the things that normally happen for a pregnancy to occur in the right way, which is cervix, changing contractions, breaking water, even bleeding is really normal. All of those things can also be completely abnormal and results in a traumatic outcome. So very, very complex. 



A: None of it really fit or made sense. 

 

P: Right.

 

A: So he basically said, you know, if I get pregnant again, they would do a squash community sewing up your cervix and put me on full bedrest.

 

P: How do we walk away from this and I can fully imagine that it cannot be processed in the moment, but now Is it is it 15 years old now? How long ago was this? 

 

A: This was 2002 

 

P: Okay, so 20 years ago, yeah, almost.

You would say it’s processed now or we just we don’t touch it.

 

A: It’s it’s pretty much processed. I mean, I mean, I think to some degree, you never get over something like this, but I 

 

P: agreed

 

A:  totally about it. I mean, I’d say at first I was just not like totally shocked. And I mean, we we decided we try again because the doctor said he thought it was I mean he couldn’t make any promises, obviously but he thought I had a cat remembered statistics, something like an 80 something percent chance of carrying to term or at least to a safe time. So this second time, it took me a little longer to get pregnant. I think it’s about seven months and then I got pregnant and then I did CDs because they can do it earlier than amnio and everything was fine and then did the start class and I think around 13 weeks, went on full bedrest

 

P: What are you doing in your life at this point? This is a huge thing to ask.

 

A: The timing worked out well because I was teaching and I had this or collage seriously the day after school ended in June sometime and then did not plan to return the following year and then was on bed rest we made arrangements which was complicated like the bed rest rules are just so weird because he wouldn’t give me definitive answers. Like we had a second story in our house or our bedroom was so I said, Well, can I go up the stairs to go to bed and he basically said once a day, like it seemed a little arbitrary. 

 

P: Yeah, 

 

A: so I basically hung out all day on a sofa and our den which was right next to the kitchen, and he told me I could get up to use the bathroom

 

P: one thing that’s frustrating about incompetent cervix is all you’re doing is naming the fact that your cervix open too early, but 1000 routes probably lead to that outcome. So I don’t know what you’ve identified at all except for the most obvious thing. So I’m wondering like how bedrest will resolve whatever force is confusing your cervix?

 

A: That’s an excellent question. Well, I believe they think it’s more of a structural issue, not a chemical one. So I think he saw it as putting less weight or pressure on the cervix. So you’re supposed to lie on your side, not even your back, which is mentally uncomfortable. Yeah. And basically just minimize the amount of weight and pressure you put on your cervix. I mean, I think there’s, this is a controversial treatment. I got a second opinion. I went to another expert in San Francisco and she said the same thing. I think it was almost like for lack of a better remedy. I mean, they just end fitness has bad side effects.

 

P: I took this issue of bedrest to Dr. Feltovich.

When you describe the complicated dance between the uterus and the cervix and the membrane and all the chemistry that must be going on to have those things communicate, it’s not I understand bedrest for that since we don’t know. We don’t know what’s causing the preterm labor. 

 

Dr. Feltovich: bedrest. Yeah, it does nothing. You’re exactly right. I mean, I think in in previous days, people recommended it because it makes sense that if you’re like laying there doing nothing, that things should be better. But in actuality, that is not the case. There’s tons and tons and tons of data to suggest that bed rest only results in an increase in blood clots differently than people. And it doesn’t. It doesn’t prevent preterm birth at all. I tell my patients, you know, you could be climbing Mount Everest or laying in bed and if your water’s gonna break, your water’s gonna break so, live your life and I think there’s an element of people including doctors feeling like if you suffer a little bit, chances are your outcome will be better and bed rest just precipitates anxiety makes people crazy, right? So I think there’s some element of that but in fact, the American College of Obstetricians and Gynaecologists completely agrees with you and two years ago, put out a publication that we call them practice bulletins for providers that said there’s no reason for bed rest. Stop it. Wow. Yeah, that there’s some role for bedrest in women with hypertensive disorders, you know, high blood pressure disorders, but not for prevention of preterm birth because it flat out doesn’t work. So I’m really glad you brought that up, because there’s still a lot of misinformation out there about bedrest.

 

P: I can’t remember in like, early 2000s I mean, you certainly didn’t have the internet stuff you have now right? I feel like Netflix was still like, send away the DVDs and get it back.

 

A: Yes, we did. But I did have Netflix was sending us I saw a lot of movies. And it was hard though. Yeah, my husband was working so like he would leave. Like all I had to do was basically just get it. I didn’t cook or anything. I had a couple of friends who’d come over but I mean it was it’s lonely. It’s also just physically uncomfortable to be like, you know, to lie in one position for hours on end. It’s awful.

 

P: And like you feel responsible like if only I lay the right way. Yeah, all worked out. Right. Which even though that doesn’t entirely make sense.

 

A: And then when I was monitored it also like the ultrasounds they would try to measure my cervix and through the ultrasound, and he would tell me things like it was always long and closed. Everything looks fabulous. And sometimes it was longer. I was like it’s growing. I mean, it was ridiculous. Like, the tests aren’t even accurate.

 

P: She said one thing that was frustrating is she had been going in to get her cervix measured, measured, measured, measured, and she was saying every time I got it measured it gave some different reading. And I understand that that measurement means that this is what your cervical length is in this very moment. But she was wondering how predictive that is.

 

A: It’s a little tricky, you know, measuring the cervix after somebody has had a sore claws like that’s a whole separate area. But if you think about just cervical length in general, it is the best biomarker that we have currently, for preterm birth prediction and a biomarker is a metric of discrete measurement that can’t be done in a standardized fashion that actually gives you information. So it is really the only biomarker we have for prediction of preterm birth, which makes what I’m about to say next, even more pathetic, which is that its predictive value is close to flipping a coin. So yeah, so there’s definitely there’s a very well established inverse relationship between the length of the cervix in the middle of pregnancy like between 16 and 24 weeks or so. And eventual timing of delivery. So that people that have a cervix, that is what we call short. And by the way, there are various definitions of short but the most accepted definition of 20 is 25 millimeters or less,

 

P: since everybody’s body is different. I wonder why you wouldn’t take a measurement of the 20 week and then make it a percentage. So

 

Dr. Feltovich: that has also been looked at, okay, and another definition of a short cervix is a cervix that is…What we work on is developing non invasive ultrasound waves called quantitative ultrasound to do things like measure how fast an ultrasound wave goes through a tissue, because that’s directly related to it softness. So I work with brilliant people at the University of Wisconsin Medical Physics Department, my main collaborators, Tim hall there and he’s a well established quantitative ultrasound physicist and we have so many brilliant during your faculty and trainees that we work with there and at Columbia and Duke University and we just have this big group of really invested caring people with brilliant minds turned on this problem or I’m just that person in the lab group that goes and says this is a terrible problem, please fix it. So what what all these people in our labs are coming up with is ways to look directly at properties like tissue stiffness and the structure like how organized is that sort of college and microstructure in the cervix in the membranes? And we have found that the cervix has a wide range of stiffness property and the length at the beginning of pregnancy does. These are small studies. Small studies, but it seems pretty clear that the normal sort of x changes in stiffness by about four to 6% per week, there is a predictable stiffness decrease in normal pregnancy. You’ve just said it makes so much more sense that you basically figure out where a particular person is starting and predict from there rather than just say, well, here’s this number that kind of fits most people. And eventually, we and many other people that are doing pregnancy research, hope that that’s the case hope that we can do modeling and sort of a precision approach to pregnancy.

 

A: Anyway, so that went on I was monitored heavily and the this time into my 23rd week of pregnancy. I then went to the bathroom and my waterpark and I mean this was with all that. So so again went to the hospital and at that point, I was like basically rolling my eyes because I obviously knew what was coming. And it also tells you that the tests they do like like the ultrasounds they measure your cervix like at that given moment. Yeah, this was a few days later. So yeah, it doesn’t it’s not predictive in any way. It’s just they see at that time,

 

P: I had a kind of wait and see aspect to my pregnancy too. And I kind of I kind of appreciate it, at least for today. I know that things are okay. Even though I could go home and it could all fall to pieces right? Did you have any comfort from the actual ultrasound in the moment or you were like this is worthless? 

 

A: Well, at the time, I believed that they were giving me good news. It was only after when I went into labor A few days later, which clearly showed that and then, at that point, I just felt like I had lost faith in sort of modern medicine and my body like I just felt like no one knows anything.

 

P: There’s a lot of unknown. So obviously your cervix doesn’t have to open for your water to break because you have a collage.

 

A: No, but I think it tore through part of it. Like I seriously like first for the stitches. Wow. Yeah. I mean, me and my cervix is highly like I don’t know, it also made me think like it has to be something chemical. Because I wasn’t doing anything. There was no weight on my Surface. Yeah. And I wasn’t like someone who was enormous when they were pregnant, like the baby was not huge. So it just made no sense and I mean, I haven’t seen multiple doctors since then and specialists and ask them about about like it being triggered by something chemical and they will roll their eyes and I’m not kidding. looked at me like I was asking an idiotic question. still contend that is not

 

P: Agreed. Agreed. That seems crazy that they’re not willing to at least entertain there might be something here we don’t know. Since bedrest is not the answer. So this seems very stressful. You know, when your water broke, there’s there you can’t they can’t maintain the pregnancy anymore right

 

A: now. Well, but I mean, it was awful. So what happened was so when my water broke, the umbilical cord came out as well. So that meant the baby could not survive. So they also did a vaginal delivery even though I was told in no uncertain terms by my doctor that it had to be a C section. It was a T cut. It would be dangerous to deliver any other way second time, but they said because the baby was so small it would not be a problem, which would turn out to be correct. So at least that delivery was easy. Because the C section was a nightmare too I was excruciatingly painful for six weeks. We can’t do much of anything. So this was easy in terms of the delivery part. But the baby was stillborn because the umbilical cord had come out…

T

 

P: Did you know it was the umbilical cord like did you find it and they found it Okay, good.

 

A: Yeah. So

 

P: So that seems again, unbelievably hard. And yeah,

 

A: it was also surreal in the I think because it was easy delivery. I mean, I came in, like in the early evening I can’t remember at dinner time and they I left the next morning in the hospital. And the only reason I stayed overnight is because it was essentially I mean, there was no like they said, I mean because there was no baby. Like, I could just go home I was fine, which was also crazy. Like, it’s just like, 

 

P: the whole thing is  crazy, and I’m guessing you’re on like labor and delivery work. 

 

A: Yeah. Which was awesome. Well, they were I do have to say Stanford’s credit, they both times they gave me my own room, but the C section. And that’s, they were I mean, they were very set for the C section. I was there for four days and they were very sensitive to the fact that they were not going to put me in a room with someone with a newborn. And this same time also I was just there overnight that they gave me my own room and I noticed they put something on the door I couldn’t see what it was it was some sign for the doctors or nurses making clear that there was no baby so like not to ask me awful questions. So So I at least they they seem to do that. Well.

 

P: Well good. I’m glad for that. And then I can imagine it’s are you thinking like we’re I guess we’re not going to have kids or we’ll adopt or like how do you what?

 

A: So at that point, well, when we talked to a doctor before I’d asked him about this and he said like if this didn’t work and he said there was another kind of cert clash I can’t remember they call it something else where they I can’t they saw you up like I don’t know if it’s like part of your universe. It’s a much more involved procedure. And you’re, like, again, risky, there was no way I was doing that. And I didn’t really have much faith in anything working at that point. At that point. We were talking adoption. And then my doctor had mentioned that she had had a patient who would use a surrogate. So she told me, you know, she contacted the patient and asked him it’s okay if I talked to her. So I talked to this patient and was willing to entertain and in my mind, I remember surrogacy when I grew up. I was a child, but I remember the very Mary Beth Whitehead case, and it was a huge thing in the news. And basically she carried the baby for another couple, but it was also her egg. And then when the baby was born, she wouldn’t give it up. Oh, this is what I remember, at least. The whole notion of surrogacy seemed insane to me. And that’s really all I knew about it was that story that I remembered.

 

P: But let me ask you a question about you knowing you I feel like you’re not someone who is super attached to the idea of pregnancy like it has to come from my body, right? You don’t care

about that? 

 

A: No, not really, but I definitely and at that point, it was clear like I had no problem getting pregnant. So that part I could do. It was the caring part I couldn’t do which is why surrogacy seemed like the perfect solution. Right? That’s why you couldn’t use our sperm and egg and someone else’s, basically. Yeah, but yeah, so that part I and I, my experience has been pregnant are so negative at this point, that was nothing like that. I was romanticizing accounting, but it still it made me very nervous. Like, you know, I don’t I didn’t know enough about it. I didn’t like my mind. I thought Who on earth would do this and I didn’t understand the legal issues. involved. So we looked into it and the person I talked to had a very positive experience both with her surrogate and the agency shoes. So I called the agency she had used in LA has, for whatever reason, many service agencies. We all seem to be there and I was really impressed with the people I talked to. And then we did look into adoption too. And I taught a cow for adoption in California is quite complicated, actually. Most of it’s done through private lawyers, not through agencies and I talked on lawyer who I really didn’t like very off putting so and then my husband was much more in favor of surrogacy than adoption. So we started kind of doing most of our research on in that direction. And so that was another very lengthy process.

 

P: It there’s no easy way to have a child right there’s no no easy path there. I guess unless you’re like 18 or something. I interviewed a midwife who was a surrogate. Her argument for why she wanted to be a surrogate was that I could do this pregnancy thing pretty easily. And it’s such an amazing thing to give to someone else. And I totally agree with that. And I was like, Oh, I guess if it were easy for me. I could see how that would be an attractive thing to like, make money on the side and do something for someone else. So I think it’s like attractive. If you find that person. It sounds like what the first person you work with. 

 

A: She was fabulous. Yeah, no, they were she was great. Like and that was true of like the people we talked to and interviewed with but they were lovely. They really they all had easy pregnancies. They like doing it. It was like a good deed they could do for someone else. They were mostly people who really cared about family. Yeah, the agency was great. They screen people. Well, I mean, it took a long time, you know, to match us all that. So the surrogate we worked with at first had four kids of her own two Singleton’s and twins, and she was just lovely, warm and like common sensical and just easy to deal with. They thought that I’d be a great candidate because I had no problem getting pregnant. They thought oh, this will be a snap. But meanwhile, also I was turning 40 And so like, who knows what was going on with my fertility at this point, it wasn’t going to be getting any better. So we did IVF. Basically, we ended up doing four rounds of IVF and each time I produced insane number of x for like a four year old, like, minimum of like 18 Like it’s like unheard of. 

 

P: I remember reading that and thinking holy crap. This is a I hear so many stories about people who do IVF and they end up with, you know, after day three or four when they form the embryo and they’ve checked it out they end up with like one or two. 

 

A: I always had a bunch of times and like obviously some of them were not good, but it was like that was not a problem and and then we got plenty of decent embryos each time. And each time the surrogate first was a two time shooting and pregnant third time she got pregnant with four quadruplets. And I was like, This is insane. It was like Octomom story.

 

P: That’s that seems scary. And in your book, I was like,

 

A: No, we couldn’t make this stuff up. It was crazy. The doctor was very aggressive to like he put in a ridiculous number of embryos each time because he kept perceiving me it was like he couldn’t fathom that. It wasn’t that I wasn’t there for fertility reasons. Yeah, we kept like putting in ridiculous amount of it was not good. So anyway, like before, basically we would go down each week with like her for the ultrasounds and each week was like then there was one less and finally the last week there were none and they had to do a DNC It was horrible.

 

P: So it was just sound like emotionally challenging in a totally different way. 

 

A: it was awful like, just like you’re sitting there staring at the screen because like no one’s knows what’s going to come and they ultrasound and you could like that time I would look at the doctor’s face as he was and you could tell he was horrified. And then I asked her around she didn’t get pregnant and then we decided we would try to use donor egg and see what happened with that, because the doctor kept blaming me in my ancient texts, that I had to be the problem and meanwhile, the one thing about our surrogate is she was very overweight. And and that is a factor. I mean, yeah. And I had asked about that when we first met her and my doctor didn’t think it would be a problem because she had had four kids no problem. So we then had to find an egg donor, which was another incredibly lengthy, crazy process. We did that and we had some great embryos and so they implanted a couple in our surrogate and she was pregnant, got pregnant, and they could tell two heartbeats, but one seemed pretty weak and the other same time. And then again, after a few weeks, the one that was weak, didn’t survive, but she didn’t miscarry. And then the second one was not looking so good, and then again on the ultrasound, not viable. So that was when we decided this is like I kept emailing him and saying, What is going on? And he kept proposing things like putting our surrogate on different medications that she Oh, I know what it was. She was pre diabetic, maybe. Like he wouldn’t just say this is not working out find a new surrogate. He went through that. I had to flat out say to him, if you knew what you knew today about our surrogate, would you recommend I work with her and he just wrote back? No. She told me this like two years ago,

 

P: totally. And there’s so much gray area that right

 

A: Yeah, and I’d say that particular placement we use that place because it was within a reasonable distance to our surrogate house. But it was kind of an Idea Factory. It was not. It was a private clinic. It was the office was always jam packed. You never got any you never felt like they cared about you. It wasn’t I don’t know. I mean, it sounds like there are a bunch of different considerations you have to keep in mind like ease of access for the service, right, which is important because you mean she had to go there quite a bit. So we then had to find a new surrogate which was also awful because I you know, we had become close and I felt terrible. I mean, I basically, you know, ruin two years of her life and you know, she had her own life and family as well, like it was terrible. So the agency found us a new surrogate who would carried like she seemed like a surefire bet she had carried twins full term. They were like a powerhouse for another couple years before. Plus she had had to have her own kids. So we used we had frozen embryos from the previous round. So we use that lb changed. Fertility Centers. Which was a huge, like, night and day. This was USC. The difference was amazing. Like, just at my intake, I guys spent two hours talking to the doctor. He was lovely like he it was just a very different experience. So she got pregnant on the first round. But nothing easiest thing on earth. And I mean, at this point, I was a nervous wreck and could not possibly believe in any control.

 

P: When I read the book, I was amazed by your tenacity because there’s so much hope put in every single attempt that anyone makes ever and to the IDF seems fairly grueling, right. There are a lot of aspects to that you taking drugs and the shots and all that stuff. And all of it is building building building to the implantation and then the next ultrasound and there’s so many points at which things can go right or things can go wrong and it’s just it’s a lot

 

A: I that’s interesting that you said tenacity, but I felt like I’d started something and you can’t finish like I was going to see this to the end of it killed me it was like I had people ask me that. I think one of my cousins said like, Why on earth are you doing this? And it was like I felt like I had something to fix. And I and it also just sort of snowballs. Like, once you get started, it’s like you can’t you almost can’t stop. Once we had the embryos. I’m like, well, we may as well use them.



P: And that’s totally true. But it’s not costless for you right? I can You can see that you’re when you read the book, like you’re suffering through all of this. On the one hand, I totally relate to the I’m going to see this thing through I’m this is my goal. I want a kid and this is how we’re going to do it. And on the other hand, it’s just, it’s like expensive, right in terms of emotional capital. 

 

A: Yeah, no, it was awful. I mean, I I would definitely say I not the same person. Right. Yeah. And yeah, I mean, it affected me in profound ways. Just like I mean, the whole pregnancy. I mean, seriously until our daughter was born. I did not believe that this was going to happen even after the first trimester when we were basically we were done with the fertility center like after three months. You then go on to your regular OB I still was not convinced this was gonna work. 

 

P: Oh, my God, I would have wrapped the surrogate and bubble wrap. 

 

A: Well, that’s the funny thing is like, first of all, she lived in LA and I live in Northern California. So we felt like I could monitor her noise in my place to do everything right. And she’s also she’s very low key easygoing, which I think is probably great, but for me, that’s inconceivable to me how you could be so relaxed. So it was hard for me to have to sort of let go and just trust her. It’s not like I know her well, but you know, everything was fine. And the irony of all this was that in the end, our daughter was a week late. Wow, that killed me severest.

 

P: So how. So how does all that work? Like how does it work for the bird? It sounds like you’re going down there fairly frequently for all the ultrasounds to be involved. Yeah, and et cetera, like you I needed a bunch of medical help to get pregnant and stay pregnant. And it’s, it’s so not what I pictured to involve all these people in my pregnancy. What it is like a different route to that same outcome. So how did it work for the birth? Like what’s the plan and

 

A: we made plans ahead like we knew we had visited the hospital with our surrogate ahead of time and the hospital and clearly worked with surrogacy before we were warned ahead of time to avoid certain hospitals, particularly Catholic ones who are not so okay with this. So we went down to LA. We were there for about a week we like we went down after her due date because her daughter said no way on earth is she ready yet or giving birth any day? So we stayed in a hotel and was pretty much waiting with our phones on all the time. Basically, when the doctor said he was inducing her, we then moved to a hotel like right next to the hospital, and she called us early in the morning and we went in and then he was born like two hours later. Wow, we were in the delivery room.

 

P: That’s awesome. That was gonna say is it’s weird to be late. This is her fourth pregnancy. Right. Kind of want to? Yeah, of course. But I’m glad that the birth was fairly straightforward. Yeah, no,

 

A: it was, I mean, easy fast. And her I mean, she said they did limit the number of people that could be in there. It was my husband. And I And then her mom, and that was it. And it was again great. They didn’t very they were very sensitive. You know that she had, you know, some like there’s some decorom there. My husband is not suiting like it was it was done very appropriately. As soon as our daughter was born, they handed her to me. It was they, they really did a great job. And then they we had a room in the hospital they gave us that’s awesome. I know. They were amazing. So we all stayed overnight and then the next day we drove back home to our house, with a baby. 

 

P: And a surrogate just says goodbye and that’s it. 

 

A: Yep. So she stayed overnight also, just to make sure she was okay. And she went back to her family and she was 15 minutes away from the hospital. But, you know, we’ve been in touch with her. You know, we sent pictures. It was surprisingly the surrogacy relationship worked out very well, like we were friendly and got along well, but I don’t think there was any indication that we were necessarily going to be best friends for life. But I think, you know, I think she wants to know that our daughter is fine and things are okay. And you know, that’s that’s really the extent of it.

 

P: I do think it’s probably surrogates are similar to NICU nurses, where it’s like special people who select into that work and so they’re able to have kind of the right kind of bond with someone who they who they give this gift to. 

 

A: Yeah, no, she, I mean, I’m forever grateful to her. She you know, what you’re in for life. And, and she, you know, she did a great job, like, there was, our daughter is healthy and fine. And so.

 

P: So that’s amazing. And you guys get home and what’s that like?

 

A: Well, that I mean, this is where we’re going to talk about how I feel like I’ve been profoundly changed like, I’m like, I think like my mom, I was never someone to get worried about sickness or anything like that. And then, like, that was a huge change. Like, my daughter would so much it’s like sneeze and I’d be ready to call 911 Just like I would assume the worst of everything just get much more nervous high strung about particularly things that I’ve never ever been like before.

 

P: Well, that totally makes sense, right? You’re you have had these shocks. So now you understand how things can go and that’s kind of that’s terrifying, right? It’s there’s no, that seems like a legitimate response to experience. 

 

A: Yeah, I would say though, it took years before I kind of realized, you know, she’s basically she’s likely to be okay. But that was a huge difference, I’d say are a huge impact that this had on me.

 

P: And did you guys take turns fingered at you know, when she was an infant, or how did all that go? 

 

 

A: I’d say why I couldn’t nurse and we’d looked into that it would have meant taking more hormones, which not doing any work, but because of that it meant my husband could get up for the night. That was quite nice. That’s super nice. And she was a huge baby. She was big and hearty because she was a week late also. So it meant like she generally slept better through the night faster, and she didn’t need to find a ton of weight fast. So that was also nice. That’s awesome.

 

P: I mean, you’ve had time to process all this stuff that has happened. What advice would you have given to younger Ariel? What would you tell her to have made her path any easier?

 

A: That’s a good question.

 

P: I mean, I think most people learn partially how you did through your own experience. With pregnancy. That is like a giving up of control. And I’m imagining while you’re talking about the surrogate, you have to give up control even more. It’s not even your body, right. It’s not, which is a hard thing to hard thing to do. 



A: I don’t know what advice I’d give. This isn’t advice, but expect the unexpected, which is kind of cynical, but I felt that I was cocky about my pregnancies but the first time but I after a certain point, I felt like what could go wrong? Yeah, like after I asked the first trimester and so it’s hard for me now like when I like even after shortly after that time, friends who were you know, more or less my age who got pregnant and they were just relaxed. And I had one friend, you know, she ran part of a marathon I had, like I was just thinking and they were very self confident and everything turned out fine. But I mean it’s still mystifies me like I still I’ve gotten less so now but at that time, like I would see women, you know, pregnant women, whatever at the gym or biking or doing and I just thought how and I assume with most of them, everything was fine, because I think my situation was also on the extreme end and it’s by no means common. Yeah, all combination of things. And it’s it’s also hard, like, people who don’t know what happened, ask them about pregnancy and I don’t want to give advice to anyone because, like I said, I just was I don’t want to scare people or horrify them again, it’s not what happened to me. It’s not typical by any means. So

 

P: I’m not sure what to do with the scary part. I mean, a lot of people talk about oh, I don’t want to talk about my preeclampsia because it will scare people and I’m not sure that’s the right frame only because it is what it is. This is what pregnancy looks like in all its many forms. It’s not all rainbows and butterflies. I think that’s a pervasive story, but not necessarily a pervasive experience.

 

A: Yeah, no, I think you’re right. I mean, it’s interesting, but in terms of when I was looking for agents for my book, and a lot of them would say things like it’s too much of a downer. People don’t want to read that they want you know, much more optimistic story.

 

 

P: I mean, I think your story is amazing that here you are with a 50 sheet 15 or 16 shall be predictive team soon. Yeah, like a you with a 15 year old. This is an amazing story. I think I you know, all the things that you went through, you know, show that it can be done.

 

A: At the same time. I remember people would ask me, which still shocks me shortly after she was born if I was gonna have another one. I’m not doing this because I also realized that it took five years basically to have one. Yeah. And I knew all the possible things that could go wrong. Doing this again, but people were stunned like they thought because I had a healthy child that somehow erased everything that had preceded it.

 

P: Yeah, or they can’t imagine what it felt like to do although the everything that came before. I think it’s an amazing story and amazing to have a teenager now. Right? 

 

Maybe because Ariel and I know each other. The end of the episode sort of got away from us. We started talking about things unrelated to pregnancy. So I’m gonna end this episode with two more insights from Dr. Feltovich about the culture around specific issues in women’s health. Everyone I’ve spoken with, patients and doctors suggests that they don’t like the term incompetent cervix and I’m wondering how we change the name. How does that happen?

 

Dr. Feltovich: These things happen slowly medicine is very, very, very slow to change. But I don’t hear the term incompetent as much as I used to, even though it’s in the ICR diagnostic codebook has it in there because it’s just it’s been a term for more than 100 years. Some people think it’s better to call it insufficient cervix. And I guess that’s slightly better, but I don’t like that one, either, because lots of tissues can function or dysfunction and it just seems kind of non pejorative. So how do we change that? I guess, like we change everything else, just talking about it and whenever we publish on it, talk about cervical dysfunction. We had a paper some collaborators and I a number of years ago in which we talked about how incompetent wasn’t the right term, and I guess we just slowly talk about it and speaking of talking about things, I think the culture around preterm delivery really needs to change again by talking and you know, sisters talking to sisters and friends and mothers and neighbors and, and talking on blogs. And podcasts. And you know, all of this because I think that one very common misperception

 

really needs to change again by talking and, you know, sisters talking to sisters and friends and mothers and neighbors and, and talking on blogs and podcasts and you know all of this because I think that one very common misperception that ties into terms like incompetent cervix is some sort of accountability for that. As if we as patients have any control or as if there’s something the matter with our bodies and you know, I don’t think I have ever in my multi decade career, done a consult on a patient with a history of preterm birth. Who has not cried when I’ve said and what part of this do you think is your fault or you know, what are the things coming up around the, you know, because they don’t talk about it. People are scared to say, What did I do? You know, so in my clinics, we just hit that nail on the head, we say, Okay, you’re gonna think you’d like like, let’s say Ariel had come to my clinic after her 23 weeks P prom, right? Yeah, I would say all right, you’re gonna think 100 things over the next few days. It’s just it’s the mind is a very, very busy place. And anxiety, and fear, are very, very strong emotions, and they kick things up in your brain, right? You can’t control them. And so we always talk about how there there are 100 things that are going to come up you know, like, that day when you’re throwing up and you’re like, oh my gosh, why did I want to be pregnant? This is awful. Or like, you know that those glasses of wine you had before you knew you’re pregnant, or you know what, whatever else it is, there’s the mind is just a very busy, active place. And let’s pick those things up. But none of them are true, because the truth is that you could be laying on the street doing meth cocaine, you know, like mainlining, crud your whole pregnancy and not have a preterm birth, like you could be really doing things that aren’t good for your body and not lined up with a preterm birth. So culpability is the word I was like. culpability. Yeah, they’re just there, isn’t that and so, a really important thing. That I hope people like you disseminate and communicate to people is that there really is no shame or blame in this. Doctors. Experts don’t even understand what causes it, but we know what doesn’t cause it. And what doesn’t cause it is women doing things wrong. Yeah. Yeah.

 

P: If only it were that easy, right. Then you just say, don’t walk downstairs.

 

Dr. Feltovich: Right. And that is exactly that is exactly what I tell people. I say. That’s exactly what I tell people. I’m like, I wish there was like, I wish I could say, Yeah, thing ABMC that’s what you did. So don’t do those again. Right? But they’re just there. There isn’t that. And so there’s a whole component of classy care. That’s not about the uterus at all, but it’s about self care. And self love, and gentleness and understanding around real uncertainty over biology. And, yeah, and really letting go, self judgment and the judgment of others.

 

P: such wise words to live by…Thanks again to Ariel for sharing her story. And thank you to Dr. Feltovich for teaching us what the current state of understanding is about preterm labor, and what the future might look like. If you liked the show. Feel free to like and subscribe and share it with friends. We’ll be back soon with another story of overcoming






 

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Episode 30 SN: This Midwives Tale, A Story of Birth & Surrogacy: Anne

Getting pregnant, being pregnant and giving birth can be challenging in a myriad of different ways. But for some people, this massive transformation is….fairly straightforward. I totally enjoy talking to people who had a relatively smooth experience because it proves that the ideas many of us come to pregnancy with are not mythic, they do in fact live in the world …And sometimes these lucky souls who tread the untroubled path are intent on sharing their superpower through surrogacy. Today’s guest had an interest in fertility as a young adult, and this interest led her into nursing and midwifery. After the birth of her own child, she gave one of the greatest gifts anyone can give: she helped a couple who, for various reasons, couldn’t carry their own pregnancy, by becoming their surrogate.  It’s a beautiful and totally inspiring story.

Moxibustion

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987875/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3789413/

https://www.hindawi.com/journals/ecam/2019/8950924/

Relationship between fitness and delivery

https://www.ajog.org/article/S0002-9378(21)00604-9/fulltext

Audio Transcript

Paulette: Hi welcome to war stories from the womb

I’m your host Paulette Kamenecka. I’m an economist, a writer, and the mother of two girls. On route to creating this family, I tripped over every possible obstacle–no part of this process was easy for us…that makes sense to me in some ways because

Getting pregnant, being pregnant and giving birth can be challenging in a myriad of different ways. But for some people, this massive transformation is….fairly straightforward. I totally enjoy talking to people who had a relatively smooth experience because it proves that the ideas many of us come to pregnancy with are not mythic, they do in fact live in the world …And sometimes these lucky souls who tread the untroubled path are intent on sharing their superpower through surrogacy. Today’s guest had an interest in fertility as a young adult, and this interest led her into nursing and midwifery. After the birth of her own child, she gave one of the greatest gifts anyone can give: she helped a couple who, for various reasons, couldn’t carry their own pregnancy, by becoming their surrogate.  It’s a beautiful and totally inspiring story.

One thing I should note: this midwife shares a lot of insights about pregnancy and birth, and while you will likely learn something listening to her, as I did, I just want to point out that she’s not giving out medical advice, but speaking both generally and specifically about her own experience. 

Let’s get to the interview. 

Hi, thanks so much for coming on the show; So excited to have a midwife on the show, to share her experience. It’s very cool to hear from the people who know too much. So, 

 

Anne: Thanks for having me, 

 

P: Can you introduce yourself and tell us where you’re from.

 

A: Yes, my name is the Anne Richards. I am a midwife in the Bay area of California. I started my career in Oregon, and have been at my current practice which is a hospital practice for just over five years. 

 

P: That’s very cool. So we’re gonna hear your birth story and then you have a super interesting story because you’re also a surrogate but, but before we get there, I just want to talk a little bit about the midwife career. Are you a midwife before you have your first baby.

 

A: Yes, yes I had been a midwife for five years before I had my son of being practicing as a midwife,

 

P: so I’m guessing in five years you saw a lot of stuff.

 

A: Oh yes, all not probably too much that, yeah, definitely.

 

P: So, How did you walk into birth, did you think, Oh, this will be super easy or what was your feeling about it.

 

A: I started in a birth center up in Oregon, you know we’re, it was just the midwife and the patient until the very end and the nurse would come in, I think knowing what I know now, and I love out of hospital birth, don’t get me wrong, I don’t know if I could go back to a birth center because I was just sort of blissfully naive coming out of, out of midwifery school and hadn’t seen enough births to really see the full spectrum of what can happen. By the time I had my son I’d been in a hospital based practice and a much busier practice for two full years. what I tell my patients is Expect the unexpected was willing and ready to just meet that birth that labor and birth where it was.

 

P: So let’s start from the beginning, yes you start you walk into pregnancy, kind of with open eyes.

 

A: Yes, and kind of low expectations. 

 

P: Ok…Good. And then do you get pregnant easily. 

 

A: Yes…Very we were very lucky. Yes, I just like I tell my patients who are under the age of 35 which I was at the time, be prepared to get pregnant on the first try and be prepared to potentially you know, it takes it takes a year before you’re even eligible in most practices to see a fertility specialist, and we got pregnant on the second try, so I was on the one end of the spectrum like, oh crap, this happened, like I’m there yeah I’m so thankful. But, okay, I was expecting a little bit longer.

 

P: Yeah It takes a minute to sink in, right. So, definitely. I think we all imagine if we’re not educated like you are is the minute you try you’ll get pregnant because that’s kind of the line you’re fed in high school. Yes, and you just kind of travel with that even though it’s not necessarily salutely, and then how was the first trimester. 

 

A: You know I am so lucky with pregnancy and I almost feel guilty saying that now to an audience but again though I had low expectations I knew I could be really nauseous I could be really tired I think the life of the midwife affords you a different perspective on fatigue, you know, working nights, days weekends you know my sleep schedule is already erratic so I was pleasantly surprised. But again, I think that was my, my expectation going into it was like, oh this is gonna be really really hard and it wasn’t easy but it was less hard than I anticipated. 

 

P: Oh good, 

 

A: it was really lucky.



P: If only we could transport that set of expectations to everyone. I think it would be a much nicer ride.

 

A: It’s what I tell everyone, all of my patients, it’s the, you know, the best preparation for parenthood, like set your expectations low going into pregnancy and into parenthood and maybe you’ll be very pleasantly surprised, because, you know, I that’s really what I think has served me so well as both a pregnant mom, a pregnant surrogate and as an in motherhood is just keep those expectations low with you,

 

P:  I’m with you. And the second trimester is fine. You’re, you’re seeing a midwife for your care is that, how you are doing it?

 

A: yes,I just saw my colleagues so I knew I was going to give birth, where I practice, because I adore where I work and feel very comfortable and confident and care. I would just be on labor and delivery and pop over for a prenatal visit and, you know, the beauty of being a midwife is, you know, you kind of know what to expect in terms of prenatal care and I could really do the bare minimum. Still, be safely monitored, and same thing I just knew that I was lucky it was a healthy pregnancy and you know I didn’t need too much and to monitor it safely. 

 

P: That sounds awesome, so it sounds like a smooth ride into birth. 

 

A: Very, very, very, very, um, I again I feel guilty saying this out loud and I feel guilty with patients who are struggling with pregnancy because I am not one of those people.

 

P: I know, but you’re the you’re the ideal it’s fine to be the ideal right.

 

A: I know we’re fair enough and that’s right and when people come in and kind of give me, give me this guilty, you know grin at their prenatal visits and say, I feel really good. I’m like, that’s great, like I own it, that’s okay. It doesn’t mean something horrible is coming, you know you might you might just be someone who is really lucky and also works hard at it, I will say, I do believe that staying very active in pregnancy serves you well for a healthy pregnancy and a more comfortable pregnancy. And so I was very, very active and I think that that really helped get me through it, more comfortably.

 

A: So, let’s be specific about this, what kind of exercise, did you do and what were you comfortable with and how did it change

 

P: when I was in midwifery school, they knew research was coming out saying, you know, we’ve probably been putting far too many physical restrictions on pregnant women, as it comes to exercise and in this country we see way more gestational weight gain than is really recommended, and that has, you know, negative outcomes like your risk of gestational diabetes and hypertension and bigger babies. And so knowing that that we’ve been putting too many restrictions, the new norm kind of is if you safely did it pre pregnancy you can continue it in pregnancy, you know, with some modifications, listen to your body and so that’s what I went with so I was doing, you know, high intensity interval training, like I was doing like orange theory and my water broke out orange theory, 

 

P: oh my god like 

 

A: I yeah I felt great. I mean some definitely pubic bone discomfort towards the end and pelvic discomfort and I would have friends say they didn’t feel sorry for me because I was making it worse, Doing these workouts but I felt really good so I kept doing it and you know I would slow down but I ran the whole way through. I felt really really good. I attribute that to not really changing that routine all that much.

 

P: That’s super interesting to me because I went into it a runner, and I ran until like the third trimester and then it just felt uncomfortable.

 

A: Yeah, that’s what he told me about that I was expecting that, and I didn’t I think I found out later on that he was so low in my pelvis that there was probably nowhere else for him to go so I’ve been carrying him so low that I feel much different in the third trimester, but that’s what I tell people just, you know, one day running might feel great and the next might not for the rest of your pregnancy or maybe it’s just that day, but really just listen to your body, we don’t tell women anymore that you need to wear a heart rate monitor that you need to be able to talk while you’re exercising. The one thing that we really know now is you don’t want women overheating so I do tell people if hot yoga was your jam, it’s not going to be any more, but really I tell people just do what you’ve been doing don’t pick up high intensity interval training in pregnancy if you’ve never done it before, you know, but if you do CrossFit pre pregnancy with, with few modifications you can safely do it in pregnancy if you’re really just paying attention to how you feel,

 

P: that is super interesting and I feel like that story is changing right or has 

 

A:yes oh hugely, hugely enough. That’s again probably in the last within the last 10 years there’s been huge changes in what we can safely advise women regarding pregnancy and exercise

 

P: wait so I want to hear about the water breaking, I was going to take us to the birth like how do you know, today’s the day, This sounds like a dramatic how you found out.

 

A:  Well, so my son was, he was head down, and then we were doing this voting vaginal birth training within the organization for which I work and nurses and doctors and midwives were coming from all these different hospitals within the network to do you know this this training on promoting vaginal birth. And one of the trainings was focused on teaching nurses how to really feel a baby in the abdomen and how to safely monitor with limited intervention, so that we could promote mobility and labor and so I 30 or 31 Weeks was the belly model. So nurses can really put their hands on my belly and try to feel my son’s position. And at the beginning of the day the midwife who first assessed me said oh he’s head down, we didn’t know he was a he, but oh the baby’s head down. Great. And by the end of the day I think so many people have been poking and prodding because it was hard to feel his position at 30 weeks he wasn’t all that big yet. By the end of the day I remember the midwife put her hands on my belly and her eyes got wide, and I looked at her and I said, Who’s breeches me or the baby is breech, she said yeah and I thought well, not a big deal. We know 30% of babies are breech at 30 weeks so we don’t really worry about it. So I was doing, you know, spinning babies exercises every day to try to get him to turn, and he never did. So, we did everything I did all the things I went to acupuncture and moxibustion I did chiropractic care all the things I tell my patients, 

 

P: wait, what’s, what’s moxibustion? 

 

A: moxibustion is through an acupuncturist and it’s I can’t even explain it very well but it’s literally you light this thing you put this thing between the mom’s big toe and her second toe, and you light it and it’s supposed to help turn babies,

 

P: although I could barely pronounce it moments ago, I looked it up and moxibustion is a technique used in traditional Chinese medicine that uses heat generated from a burning herbal preparation to stimulate acupuncture points. It’s supposed to regulate meridian points and visceral organs, and it does this by increasing chi circulation and reducing chi stagnation–chi being the energy that circulates through the body at all times. It looks like this is a procedure that’s been around for 2500 years, has been used to cure all kinds of things, one of which is breech presentation. I found an article on PubMed from 2010 That looked at systematic reviews of moxibustion, and it gave a generally favorable nod to the ability of moxibustion to affect breech presentation, check out the show notes for details. 

 

A: And then we even tried to turn him in the hospital, via a procedure called an external cephalic version, literally, you know, putting an IV in giving a medication to relax the uterus and a physician tries to turn him manually, 

 

P: that doesn’t sound comfortable

 

A: as he wasn’t having it was horrible, it’s the worst of all anything through my labor versus, it’s the most discomfort I’ve ever felt. Because it’s so sudden, there’s no build like in labor, it’s just all of a sudden it’s this massive massive massive discomfort. I really train to be sort of mentally disconnected and be ready for that. And I, I did really well with the relaxation, but he wasn’t having a lot of, you know pressure on the placenta and on their cord, and so we watch to their heart rates very closely during those procedures and he did not like it. And so we had to abandon ship, we almost met him that day, via emergency cesarean because it was, it was 

 

A: Good Lord!

 

A: yeah it was that it was that intense…there is a different level of anxiety I think when you’re caring for a colleague and birth colleague. And I’ll never forget the two physicians were there and one was trying to turn him and the other was monitoring his heart rate and she is a New York provider, former New York provider, calm, cool and collected nothing browses her and I’ve never seen her that frazzle, she was just watching his heart rate and hollering out that that his heart rate had been very low and wasn’t coming back up so I thought we were going to meet him that day. Thankfully we didn’t. We decided then to schedule cesarean at 39 weeks which is, which is the procedure in our hospital and most hospitals when you have a known breech baby as you’re trying to find that sweet spot of scheduling a C section when they’re well beyond 37 weeks and nice and fully cooked, but prior to labor that’s the goal.

 

P: Why can’t we deliver a breech baby vaginally, they get stuck or what 

 

A: yeah so you know some places you can, our practice doesn’t do it, the risk is that the butt is usually smaller than the head. So if the butt comes out of the butt can potentially come out of a cervix that’s not fully dilated say seven or eight centimeters, depending on the size of that baby’s booty. And then the risk is what we call head entrapment, is that the head, the cervix is not dilated enough to let the head come through and the head literally gets stuck in the lower part of the uterus, it’s a true emergency, it’s something that if I’d had a baby before I would have been willing to maybe find a provider somewhere that does vaginal breech births because there are providers who do them, but usually women have to have had a baby before, and there’s lots of criteria like the baby has to be in a specific type of breech position not just butt down but in a position where like the legs are are up and crossed you know they can’t have one leg hanging down, they’ve got to be in a very specific position. So vaginal breech births do happen, but knowing the risk of it, especially as a first time laboring mom I just I was not comfortable with it and we don’t do them at my hospital and I knew I wanted to deliver it my practice,

 

P: if the baby isn’t yet breathing oxygen, what is, what’s the problem with the head being stuck for a minute while the cervix is still opening.

 

A: Good question. The risk is that it sort of like if, if anyone has ever come on and talked about a shoulder dystochia, you know the the head coming out with the shoulders getting stuck. Same thing with eventual breech birth is that, then the cord is getting buried we know the cord gets more compressed as the baby comes down the birth canal. And so you’ve got half of the baby out and so yes the baby is still getting oxygen through the umbilical cord, but it’s usually very limited, and the baby can only handle that for a certain amount of time. 

 

P: Yeah, I’m not sure I would be up for that sport either. Good lord

 

A: Yeah it was I’ve never seen a head entrapment I hope I never do, knock on wood, wherever I, You know where I’m sitting. It was just something where I think of the quotes I use with my patients a lot is like, I respect birth but I don’t trust it. I know that might sound really negative but I just was thinking, there’s a reason that the American College of Obstetricians and Gynecologists recommends cesarean for breech babies I trust the research I trust the evidence and I knew, you know, this was just the way my kiddo was supposed to enter the world and that was okay. I’ve tried everything and he wanted it this way.

 

P: So we’re headed to a C section, but I don’t usually associate C section with water breaking so I how does that work?

 

A:  Yeah. So again we scheduled the C section in my case was scheduled right around 39 weeks. And this, this shows what a bad patient’s medical providers can be at my very first appointment. When you’re sort of trying to estimate what the due date is oftentimes we go with the due date by the woman class period menstrual period, but if that very first ultrasound in early pregnancy gives a different due date. If the duty difference is greater than a certain number of days, we’re supposed to switch it to the, to the ultrasound, because these all fetuses regardless of genetics, and to measure the exact same from head to booty what we call a crown rump length measurement.

 

P: So am I. Okay, they’re all the same size of 20 weeks.

 

A: No at like six weeks, seven weeks at 20 weeks then genetics comes into play and babies have hugely vastly different measurements, but in very, very early pregnancy. That’s why we a lot of practices do a very early ultrasound is like let’s make sure this fetus is measuring, quote unquote, what we expect you know especially based if a woman has a very accurate last menstrual period, so that we can kind of just give them the most accurate and today possible. Okay, so the first appointment, I lied about my period because the, the, he was measuring, not as far along based as far along as I should have been on my period. Now it was still concordance, we should have started with my period due date, but the due date that I was that I could have if I went with my ultrasound was further and I didn’t want to be induced so at six weeks I was already considering I don’t want to be induced which is hilarious now in hindsight, the way everything went. So, my, my due date was like six days later than it really should have been on paper because I lied said oh my periods aren’t regular don’t go with that due date my periods were beautifully regular so I’m the worst patient, so my C section was scheduled at 39 weeks but in reality I was almost 40 weeks.

 

P: Yeah, 

 

A: so I’m went to Orangetheory and at the very end of the workout I did this big squat and my water broke and I knew it. It wasn’t like the movies, it wasn’t the big water balloon popping but I felt it and I was like, oh Gosh. Okay, and again it’s, it was so humbling and such a good lesson for me because I tell my patients like you just got to meet your labor and birth where it is and in my mind, all I’ve had to really forfeit was this optimal birth and I, you know, now it was okay I’m going to have a baby on this day and then lo and behold right things change again. So, I dragged my feet did not want to go in because I thought no no I’m not ready. I’m not ready today. Today’s not the day, any of our patients call, and our breach and their waters broken we tell them to come in right away. Because, again, sort of the risk with the head getting stuck in a cervix that isn’t fully dilated. Bottom sitting in the pelvis there’s more room, pelvis, for a bottom. And so what can happen is the umbilical cord, very rarely, but when there’s so much space that the water breaks the umbilical cord can slip out of the cervix in front of the body in front of the butt, and it’s called an umbilical cord prolapse, and it’s, again, a true emergency because that, that baby’s oxygen supply is getting significantly squeezed. Well, all of that knowledge went out of my head. In that moment, as a soon to be mom and I just thought, no, no, I’m not ready. I’m not ready. So I went home and I showered I called my, my kiddos father and he was at work and I said this happened. Don’t come home yet. I mean, all of the things that I would be mortified if one of my patients did, but I knew it was happening. And very quickly I started to have pretty uncomfortable cramping and still didn’t go in. So the worst patient.

 

P: And you know the cramping is his contractions. 

 

A: Oh yeah, I knew exactly what it was, I knew exactly what it was and I, I just couldn’t wrap my mind around it, I could not wrap my mind around like today’s the day, so I have so much more empathy for patients who have like true preterm births, you know, and thinking, I have another month as another two months, I can’t imagine what that must be like because I was full term, I was 40 weeks about and still it felt like, no, no, this can’t happen. It was, yeah, it was, it was, I was ridiculous. And then finally I get my husband got off the phone at work and told his co workers what was going on and he thought, well, she’s a midwife I’ll trust her and all his co workers asked, you know what’s up. And he told them, and they all said, oh my gosh get home right now, like Don’t listen to her get home, and he came and he could see I was uncomfortable with contractions, and he was like we gotta go. This is crazy. We got to go. 

 

So we went in and I think we got there around noon and my son was born via cesarean and it’s 2:38pm that day. Yeah, so, and But same thing when I got there, they put me on the monitor, you know, to watch his heart rate and watch contractions and the contractions always read differently on people doesn’t mean people feel them I was so people don’t look at the contraction monitor look at your patient Look at mom, you know, what is she, how does she look during contractions because you can see a lot of contractions via the external monitoring mom might not feel them at all or you can have a woman writhing in discomfort and the contractions aren’t picking up well, but the, the physician and the midwife who were on came in to see me and looked at the monitor and said Are you feeling these and I, again, I didn’t want them to rush. I don’t want them to feel panicked. Just like gritting my teeth and I was like no, not really. And they walked out of the room and I was like, Oh, this is terrible. I just…they’d had a busy day I didn’t want to be. I just don’t want them to feel rushed, I want them to have lunch, I wanted them to take their time So, anyways, it was, it was all very humbling, but we met him a couple hours after getting there. 

 

A: So now that he’s How old is he now. He is three, three and a quarter, he was 2018, so he turned three in June of this year. 

 

P: Now when you look back, do you think it was just, you weren’t in the mind space or like you were committed to the date in your head or like what do you think was going on there.

 

A: Yeah, I think I just thought, you know, my ever since I became a midwife I’ve envisioned my, my, perfect, you know, haha, vaginal delivery. My perfect vaginal birth. And so I thought all I had to give up. Is that vaginal birth like okay, I’m dealing well with the scheduled Syrian, that’s my first hiccup, right, that’s, that’s where I have to give up control. And so when this happened when a water broke well before the the scheduled cesarean and I thought, no, no, no, no, I’ve already given something up, I, you know, that date was it I wanted a little bit more maternity leave. You know I just stopped working, I’m not ready, you know, I didn’t have dog care arranged for my dog, you know, my husband was supposed to go up to Oregon to sell a house, he owned up there like the next couple days it was just the timing wasn’t right, which is so ridiculous, but I tell people all the time, you know, sort of, sort of like with when you’re trying to achieve pregnancy, it could take months, it could take up to 12 if you’re under 35 Well, it could, you know your water can break your labor could start anytime, ideally after 37 weeks and until 42 weeks like that’s all full time it’s a huge window and I know that, and yet ready

 

P: I mean it is it is a lot to give up right, there’s a yes, while you’re pregnant, there is kind of a daily push and pull in that you’re feeling new things you don’t feel well is this something, is it nothing… You’re in this kind of constant Flexi space for nine months. It almost seems like too much to ask to say. And guess what,

 

A: absolutely It’s so wild and I think I I still had no idea what it was like to take a baby home but I had an idea I knew my life was going to change in an instant. That day, forever, and I just didn’t feel ready for it now that you’re ever ready but I, you know, the curtains weren’t hung and, you know, like all these silly things that I was like no I was supposed to get that all done. I just didn’t feel ready, I thought, you know, six more days would make me more ready which is hilarious but I just wasn’t ready that day.

 

P: So what was postpartum likes instead arrived early at your doorstep. 

 

A: Yeah, again, I think my expectations for the C section are really low, thinking I’m going to be in a lot of discomfort so again I was really pleasantly surprised. Was it uncomfortable Yes. Was it awful No, I was lucky that I, you know, didn’t labor, I have a lot of empathy for women who do go through, like all of labor and then push for a long time and then have a cesarean, I feel like that is. I can’t imagine that would be like the recovery of both essentially or like women who have twins and one is born vaginally one’s born via cesarean I really can’t imagine. But it was fairly easy, I was really lucky with breastfeeding my son latched in the operating room, which was really great. We do skin to skin in the operating room at my hospital, we got to watch him come out like they dropped to this, you know, dropped a solid drape, there’s a clear drape so I could watch him come out, we didn’t know if he was a boy or girls, his dad could announce what we had, it was great. Again my expectations were really low so I thought, the newborn phase..it’s gonna be terrible and I kind of loved it but I think, again, I can’t preach this enough that my expectations were low and was it hard did. Are you sleep deprived, do your nipples feel like they’re gonna fall off, you know, yes, yes and yes but it was so much better than I expected.

 

P: That’s awesome. That was a smooth story and I kind of, since I know that you were a surrogate. I kind of imagined that it would be pretty smooth because you don’t go into that unless you had a relatively easy experience so yeah, why don’t you tell us about that. How did you walk into the surrogacy and, you know what had that always been your plan or

 

A: Yeah. You know I’m not a religious person, but I do think there are people up there, looking down on us and intervening in, in, in ways and at times that they need to. So, I actually had wanted to be a surrogate in my early 20s Before I met my son’s father before I ever considered children of my own and and quickly found out as you just mentioned that really no agency will take on a surrogate who hasn’t been through birth herself you know you need to prove that you can have a healthy full term pregnancy without major complications and a healthy birth. So I kind of gave it up and thought, Okay, well, I won’t be a surrogate probably, so I actually did egg donation in my early 20s, and there are at least two girls out there now that are have biologically mine that are, you know 10 Plus, it’s anonymous on my end, so I can’t ever ask details about them but I know that at least two baby girls were born, I’ve just always been really fascinated in infertility and, you know, if people really want to have a baby and I can help them do that. I would like to. 

 

So, anyways, I thought well, surrogacy won’t happen you know I met my son’s father had him, and then actually my husband and I decided to separate at the beginning of the pandemic, and it was very amicable we just, we have two jobs that lead us in totally opposite directions timewise, and we always joke that we would be to single parents in reality we were, because we’re ships passing in the night and it just got to be too much and we just weren’t good at being married so literally one day we decided or I mentally decided like okay I think we need to call it like on a Friday, I still remember it was a Friday and in May of 2020, and I have a colleague who I didn’t know that well but I knew that she was she and her husband were looking for a surrogate, and she couldn’t carry for a variety of reasons, and we thought she’d found one through an agency in Southern California, we live in Northern California. And, you know hadn’t heard anything in several months but I knew it could take a long time so I decided on Friday that I thought my husband I should probably, you know, decide to officially separate and divorce, and the next day at work, she and I worked together and midwives we rarely work together, you know, we’re usually passing off to each other so it was even rare that we were on the floor together at the hospital and she asked me how I was doing and I said you know I think I’ve decided to end my marriage and she looked at me eyes wide and I said no, no, it feels good to say it out loud, we’ve been working really hard, it’s just, it’s not working for us and so I think we need to change something up and I said how are you and she burst into tears and said, our surrogate fell through the one in Southern California. I just don’t think this is ever going to happen. And I looked at her and that moment they said, I’ll be your surrogate, and she, you know, rightfully so, looks at me and said you’re crazy. You just told me you’re ending your marriage. 

 

And I said no no I know, but I’ve actually wanted to be a surrogate for 15 years, you know this is not something, this is not me offering to pick up a shift for you right like I do know that, that this is a lot, and I know that I don’t know just how much it is, but this has been on my radar for a big portion of my life before I became a midwife and I could see that she kind of thought, okay, maybe, but still didn’t believe me, rightfully so. So I just said, Well, tell me what I gotta do you know what medical records do I need where do I need to send them so we got the ball rolling and funnily enough and bless my child’s father the following, when we finally decided like got together in person and decided that week that yes you know divorce was the best option for us. I looked at him, I said okay now I need you to pretend like we’re happily married so that I can we can pass psychological screening so I can be a surrogate and he just sort of shook his head and laughed and was like, yep sounds about right. like, didn’t skip a beat, because he also knew this is something I’ve always wanted to do and I’m so grateful to him because we do psychologists would never sign off on someone actively going through divorce to be a surrogate, and that’s one of the first steps is psychological screening, and he and I sat together on a zoom call you know happy couple so that was May of 2020 and then went through it takes a long time just to get all the screenings done, you know, pass the psychological screening the health screening, And so the transfer was not for another five months was in October of 2020 it just takes that long to get everything done, to lead up to that point,

 

P: and then you’re not donating an egg or anything, you’re just surrogate.

 

A: Correct, they already had embryos they had three healthy embryos and so there was not the discussion, you know, their plan was just to just implant one which I was very happy about to put in a singleton, but they still had two healthy embryos if needed. So yeah, none of it, none of this baby was is genetically mine it is their embryo

 

P: and how did that process go, How did the implantation go and how did the pregnancy go 

 

A: Yeah, the worst part about all that was actually just the injecting hormones, I had to give myself you know intramuscular shots every night, when you’re doing a frozen embryo, you have to do those shots for much longer. A lot of people they’re doing IVF themselves so they’re implanting their own embryo it’s usually what they call it fresh transfers, they don’t have to do the hormones as long but I had to do them for like through I think 12 weeks of pregnancy and so your, your sides and your, your butt gets so sore, but you know that’s really all I have to complain about the transfer was easier than like cervical cancer screening or what we used to call a pap smear it was so easy you know they put a speculum in they look at your cervix, they put a little tube through your cervix and it’s done it’s almost comically fast, and the, the intended. Mom, my colleague got to be there for that which we weren’t expecting with the pandemic so it was really awesome that she got to be there for more of it than we anticipated.

 

P: So it’s interesting to me that they give you all those shots, because I feel like the IVF protocol is usually for people who have infertility problems, which you clearly don’t have. So it seems like you have the chemistry to carry out a pregnancy, Why would you need. Why would you need all this other stuff

 

A: Yeah, that’s a great question. It’s because you know there’s so much as you are in the early phases of pregnancy so when they implant. The implant the embryo I forget how far you know, how many days old, that that embryo is, but my body, You know if you were going through a natural pregnancy, there’s so many hormonal shifts that your body’s already doing once it knows the sperm has met the egg that my body had not done so you’re really and they want to increase the odds of a successful viable pregnancy. So they’re basically boosting your uterine lining making it really nice and fluffy for an embryo to implant so lots of things that would have already happened in my body naturally had it known I was a few days pregnant, plus some, you know, to just really increase the odds that, that it was going to be a successful pregnancy because, you know, with, with say an early miscarriage which so many women suffer. It can be that their, their uterine lining wasn’t fluffy enough for their hormones were a little bit off, they didn’t have high enough progesterone, which is a pro pregnancy hormone. So that’s really what you’re taking so that your body is the the best and most ready vessel, it can be for this embryo,

 

P: that makes perfect sense that’s true that yeah, you’re a little bit skipping the line by by implanting an embryo.

 

A: That’s a perfect way to put it exactly so you’re trying to sort of compensate for that skipping the line. 

 

P: So how was that pregnancy

 

A: It was great. Again, you know, it was a little bit more uncomfortable I again I was really dedicated to staying really active because I was hoping for a VBAC or a vaginal birth after cesarean and that was something my, my colleague and her husband were totally on board with thankfully I mean if they’d felt more comfortable with the scheduled cesarean and I still would have done it, but I thought well you know let’s see if my body can do this, if I can do this because, since I had labored fairly quickly after my water broke with my son, I thought, I think I’m a really good candidate for a VBAC pending this baby is not breech and pending you know other other factors that can lead to a scheduled cesarean so I, even more so was super dedicated to staying really active, you know your uterus is a muscle and though there’s no research I kind of think if you have a healthy toned body and toned other muscles I always think maybe your uterus will be more toned, you know, and that’ll it’ll operate, you know, more efficiently in labor so I stayed really active and was really lucky again and felt great. I really, you know, I’m one of those annoying women that that really does enjoy being pregnant.

 

P: That’s awesome, that’s well and like, you’re the perfect person for surrogacy, so that’s awesome too. Yes. So take us through the day of the birth how the battle happened. 

 

A: Yeah, so, again, all of these things that I discourage my patients from doing in both birth stories but

 

P: this part got momentarily crunched up by a bad internet connection, but basically what Anne said was that she and her partner both have jobs with unforgiving hours without much flexibility you

 

A: our childcare setup is kind of piecemeal, you know, and we just, it’s, it’s build care needs outside of myself, my husband and mother who gets very kind of lays her out laser up and is very time specific, we actually decided to schedule an elective induction which I am so against an induction just to be induced but it sounds so silly but it, the timing was kind of perfect if we did it during this very specific window, and there are actually calculators that you can do to show what your odds of a successful VBAC are based on how far along you are in the pregnancy how old you are, how much you weigh for your height. And so we knew that if I gave birth before 40 weeks my odds of a VBAC were a little bit higher, so we kind of put it all together and we knew we were like we’re being the worst midwives that were thinking that you can control this but lets try it, and, but we both agreed that if the early phase of the induction if I, my body wasn’t doing anything we were both on board that we would stop it and wait for spontaneous labor, Just because she really wanted to support me with having a vaginal birth both both for having it and also knowing that as a single mom to, you know, the recovery of a cesarean was a little bit daunting, and so I was really hoping to have a vaginal birth, we were in agreement that if things were not progressing, that we wouldn’t do it. But they did. we got really lucky.

 

P: So you went in front of induction, and you had a vaginal birth.

 

A: Yeah so, with a cesearan, there are certain medications you can’t use with an induction so you’re really the early baseman induction if anyone’s had one or looking at one, in terms of knowing they’re going to have one coming up or considering one or being told they might need to undergo one, the cervical ripening phase is what takes the longest you know it’s not actually the painful contractions that are causing dilation that takes a while it’s getting your cervix ready to open, getting it nice and soft and thin, so that it can dilate later on. And when you haven’t had a previous uterine surgery, whether it’s cesarean or another type of uterine surgery, you can take an oral medication that helps your body kind of cramp and do that. That’s how most women experience early spontaneous labor, but when you have had a uterine surgery you’re limited to a mechanical method called a cook balloon or Pitocin through the IV if your body’s ready for Pitocin. And my body was not my cervix was definitely not ready for this induction, but you can put in this mechanical tube catheter called a cook balloon and you inflate one little balloon by the baby’s head and one balloon on the other side of the cervix and for 12 hours that stays in place to put constant pressure on the cervix to help it thin out soften and do early dilation. 

 

And so, again with timing this induction we chose the midwife who is supremely skilled at placing these cook balloons, and God bless her, it was the hardest cook balloon she’s ever done my body was so not ready she was sweating, we were putting her hair off, you know, like she was in a ponytail. It was the end of a busy shift she just she stuck with it and capacity me and I stick with it was very uncomfortable and I used nitric oxide which was awesome we have that at our hospital which is laughing gas they use it  very prominently in Europe but not as much here in the States, and usually could balloon placement I don’t know, three to five minutes and mine took like 45 to 50 minutes. 

 

P: Wow. 

 

A: It was, it was intense, and that was really because my cervix was really tucked way behind the baby’s head, because my body wasn’t ready and we just had to get me in all these different positions to make it work and I cannot sing the praises of my sister midwife my midwife colleague enough who stuck with it and put it in. So she got it in and the plan that can stand for up to 12 hours, and because it was so difficult again the intended. Mom and I agreed. Okay, if this comes out in the morning, and the next step was Pitocin there’s really nothing else to do after the balloon, because I don’t have the option of that oral medication to keep the early phase going, so that if my cervix isn’t ready for Pitocin we’re, we’re going to take the balloon out we’re going to go home, but when they put that in I started cramping a lot overnight and so I was hoping to get some sleep overnight but I was cramping really uncomfortably throughout the night, and I was excited by that but okay, this is triggering something, you know, this is, this is a good sign, and the intended moms was in the room with me she slept with me in case anything happened overnight we needed to meet him, you know urgently via Syrian or something. And I was so nervous about her getting sleep knowing that she was the one heading into the sleepless newborn days that I would just like bury my face in the pillow and like try to moan as quietly as possible so that she could sleep. I really didn’t want to know how uncomfortable I was, and I would like to occasionally get up and walk the halls, I just tried to be so quiet to let her sleep. So the balloon came out in the morning, and it had done perfect work, and you know the cramping and combination my body was totally ready and we were so excited that okay let’s, You know, let’s do this. 

 

So the balloon came out at seven or 730 in the morning on the 14, and they started me on Pitocin and the next step, knowing my birth history with my son how quickly I started you know strongly laboring after my Waterbrook was to break my water at some point. So the balloon came out I was actually pretty comfortable they started me on Pitocin I, you know we had some breakfast and then. It’s so funny I tell people write down their birth stories and I’ve already forgotten the details I’ll have to go back and love. Think they broke my water around 10:30am And the next contraction was a doozy. And then when my eyes just getting wide and like, oh, okay, I remember this, You know it got it got really intense really quickly. And I was thinking I was head on into it thinking I would probably get an epidural because I really wanted to be present for the birth, you know, and not to say if you don’t have an epidural, you can’t be present but having attended many, many births by now, there’s this look of a, if you look at birth photos you know on any blog, or social media, there’s this most unmedicated women who have their, their heads are back in the pillow, there’s a baby and they’re just kind of you can tell they’re just so relieved that it’s done physically so focused that it’s, I think the, the, a lot of women report they don’t really remember the baby necessarily coming out because they were you know so immersed in in the labor, so I knew I really wanted to be very present for that and I also didn’t want my, my friend to be worried about me like focused I don’t want her to be worried, focused on my discomfort I want her to midwife me I wanted her to just be a mom in the room, and focused on that baby coming out and if I was in the throes of unmedicated labor, you know, I knew that she would be more focused on me I didn’t want that for her or her husband, 

 

All of that being said now that I’ve experienced it. Regardless of wanting to be present for that moment when contractions started pretty early. I was like, Oh yeah, I’m going to get that epidural. So I did use laughing gas for quite a while, but it was so interesting that contractions felt so much different than I thought they would. So all of that now I talked to women a lot more like what did contractions feel like for you, because everyone I think feels them differently. My whole rim of my pelvis felt like it was going to explode, you know, It was just it was so filled in my abdomen, I felt like in my bones, it was just wild i i was just so thrown by it, and one of my best friends whose a labor delivery nurse, our sons are three weeks apart, she was my primary labor support and, you know, Just put her hands exactly where I needed them and the intended mom just said all the right things like we just have this seamless birth team it was, it was beautiful. 

 

And so my water broke I think around 1030 I’m so I’m so appalled. I don’t remember the time but I labor for a few hours and then I think I got the epidural around the 2pm, and it didn’t work for about an hour and so now to another level of empathy for patients when you’re just kind of can’t really move in the way that was working for you, but you’re still feeling pain it was so intense. And, and I remember the look on the intended mom’s face– she just felt so horrible, you know, like it was her fault or something and of course it wasn’t I just, I was trying to sort of grin and bear it like, I’m fine, but of course you can tell I was in a lot of discomfort, and I think for a lot of people, they might say the same thing that once you decide to get the epidural you probably actually wanted it like an hour before, so it feels so long until you’ve got that relief. It was finally got the relief. I did have the midwife who was on was busy and so I had my nurse. See how far dilated I was and I was nine and a half, like as soon as, so I had, I had labored quite quickly. And so our plan was I was going to get a nap because I had, you know unexpectedly been up all night, and I was going to send the parents out to get a breather, you know, and, you know, knowing they were going to meet their baby soon. And my friend said, oh, you know, you can start pushing even more not here and I texted her and I said, No, no, we’re not pushing for long. We’re not going to do this forever, We’re getting this baby out. So we started pushing at five o’clock and he was born into his mom’s hands at 545

 

P: Oh my god, that’s awesome….they don’t really know, muscular uterus.

 

A: Oh yes, yes, exactly. Yeah, that’s right I want to say that I was like, Do you remember how hard I’ve been training for this. We’re not doing this for a long, and again, so much empathy for women who do push for hours and hours and hours because I knew it would require everything in my body but again, until you’re in it you just have no idea how much effort it is to push the baby out, and I use the mirror because I was unfortunately very very numb with the epidural so I didn’t have that that rectal pressure that a lot of women experience, which I know is uncomfortable but I was kind of looking forward to that to help guide me. So without that I used, I used a mirror and that was a game changer so I know if women are offered that it can be, you know, it can be unnerving to see your reproductive system for lack of a better phrase or and your vagina, totally on display, but it’s so different when you’re focused you’re focused on that head right you’re not just looking at, oh how swollen are my labia or how bad are my hemorrhoids, it’s, it’s so motivating so something to consider if women are offered that by their nurse or their provider, a mirror really I think helped motivate you in guiding your forces, especially if you don’t have a lot of sensation of where to push.

 

P: So if you’re using the mirror because you can see the muscles tense and then you know the contraction,

 

A: I can see the head. No, I could see the head, like I could see where I was, I was pushing, when I was pushing quote unquote correctly, and when I wasn’t so I could just see his hair and I was like oh okay that’s the spot that’s the spot. And would tell myself like do that again do that again, because without that sensation it is so hard and I knew that for women who do have very dense epidurals, which is sometimes will try to turn them down or get them into other positions so that they can have more spontaneous sensation to push, but without that, you know, I saw I use the mirror and didn’t really need to feel that pressure because I could see him move and I would just remember like okay that’s your spot pushing that spot again.

 

P: So if you see him move then you know you’re doing it effectively. 

 

A: correct. And luckily he was nice and low before we started pushing apparently when I carry babies they hang out my pelvis super super low which is why my breech son would never turn because he was wedged in my pelvis and, and luckily he’s this baby started at a low stations ri My body had really helped to get down to where I can quickly see his head,

 

P: that’s super cool, I’ve never heard of the mirror before and I had awesome, I had two C sections and so I have no kind of experience 

 

A: Oh interesting, yeah, yeah, it’s something that a lot of patients are, they’re either totally for or totally not for, and I never push it on people but like if a woman’s been pushing for, you know, quite a while, the baby isn’t descending I’m like let’s just try it, and it’s crazy how often it can work really really well, because they just get that instantaneous feedback.

 

P: I would think for everyone who here feel very well have gardens, right, this is totally,

 

A: totally. And I, you know, I think people are just like, oh I don’t want to see all of that, staring right at my own vagina

 

P: a brief sidenote not here, I’m ending this conversation after I talked to him and listening to it again. I am a little bit surprised that women have a problem with the just comfort looking at your own anatomy seems like a learned behavior that is not serving us, so kudos to him for helping people with this.

 

A: tell them like it’s different, like you’re going to be focused on your baby, not, not your vagina, and, and it can work really well most women even if they didn’t think they want it, I find it very helpful

 

P: is super cool and so yes Warren and then does he do skin to skin with his mother.

 

A: Yeah so that was one of the first things that we talked about in the psychological screening was, you know, in the the psychologist that we talked with knew that we were both midwives and so she said you know this baby will not be my skin to skin with you, you won’t touch the baby, I said oh I absolutely I know that. And so there’s actually one of the nurses who’s in the room filmed the birth without us knowing, and she filmed it from like right behind my shoulder so you can really just see the intended parents which, you know, I watch it daily for a good cry, Because the Dad’s tearing up oh it’s so beautiful, until I’m getting, you know goosebumps just thinking about it, like knew the baby was not going to go to me, and I knew it was, I had such a different perspective on this pregnancy, you know I really sort of mentally trained like this is not your embryo, this is not your fetus. This is not your baby, and so I didn’t have that connection that I had with my son, you know, I, I knew I wouldn’t be inclined to reach down for him I didn’t feel like my baby ever, but he actually had the umbilical cord wrapped around his neck twice, which we didn’t expect because he didn’t show signs in his heart rate during labor which is usually how we kind of know an umbilical cord might be getting pinched somewhere. And so because of that, his mom needed to put him on my belly to unwrap the cord. You see my hands like fly up towards my head because I didn’t want her to think I was like no, no, no, he’s not supposed to be on me I was like kind of panicked, and she says like we’re just using you as a landing pad like don’t worry I knew that I wasn’t having this like, give me my baby you know I did. I just wanted to make it very clear that I was aware of where he was supposed to be but he went skinless he had a nice long umbilical cord so we could do delayed umbilical cord clamping but he could go skin to skin with his mom and oh it was magic. It was totally magic.

 

P: that sounds Awesome. That’s amazing. Well, I can’t even. I’m like the opposite of you and so in terms of birth and delivery and all that, literally, everything was hard or didn’t go right or whatever. And so I look at, but, but I look at people who are willing to be serious and I think like, I don’t even think you can imagine what you’re giving to someone else.

 

A: Yeah, and it was so enormous. And I think because it’s always been on my radar, I felt selfish like I get to do this you know I really, if anyone else did it, I would be you know is crazy and ever looks at me, the looks I’ve gotten. Okay, but, you know, one of the things when my husband I decided to separate I’m an age right. Don’t think I’ll probably have more children of my own, and I was sad not to be pregnant again I was sad not to try for a VBAC and experience labor and so, you know, selfishly, I was like, I need to do this like yes I know I do know I’m giving this family, this this couple, a huge gift but I felt like I really don’t. I went out to, because I got to experience and then I thought I would not get to again.

 

 

P: And the whole thing is amazing, I just, you know, in our case we had doctors who saved our child’s life, and I think, yeah, I think daily for sure. No idea how you change their lives, right. Yeah, absolutely. And the same is true for you though because it’s not only have you changed your sister midwives live and her husband, and that baby but everyone a baby touches, right, like,

 

A: yeah grandparent Yeah,

 

P: right. It’s just a million people.

 

A: Now that’s a good point that’s probably where I’ve been the most touched is, is there, the parents, families or friends reaching out to me and saying like you have no idea, it’s like, oh yeah you do forget that ripple effect like this little boy is in so many people’s lives. It’s not just them but that’s a great point because that is that is probably where I was most overwhelmed by my love is, is the love I received not from them but from other people around them who, who were so excited as well. 

 

P: That’s amazing. That’s so awesome, thank you so much for sharing both your story with your son and the surrogate story because they’re both amazing.

 

A: Thank you. It was, I feel so lucky and it is um, as a provider to now having been, you know, I say we just the introduction was good for me as a midwife to that I’ve experienced, you know spontaneously when then an injection into a vaginal birth and so it’s really, really ramped up on the view of the provider, just have this perspective that I would never give up and I’m so grateful for and talking to patients. That’s awesome. Yeah,

 

P: thanks so much for coming on and sharing your story

 

 

 

Posted on

Episode 23 SN: One Woman’s Story of Surrogacy: Cheney

In this episode, my guest tells her own story of pregnancy and she shares her experience of being a surrogate for another family.  It is, as you can imagine, a very involved process in part because it involves IVF, which always sounds to me like a full time job. Despite the fact that the pregnancies were relatively straightforward, there are challenges along the way, like postpartum depression, which can make other issues that come up more daunting to manage and we discuss those, too.

Tests to verify that your water has broken

https://www.healthline.com/health/pregnancy/premature-rupture-tests#diagnosis

https://www.qiagen.com/us/products/diagnostics-and-clinical-research/sexual-reproductive-health/maternal-fetal-testing/amnisure-rom-test-10-min-us/

Epidural

Epidurals increase in popularity, Stanford study finds

https://pubs.asahq.org/anesthesiology/article/129/3/448/22292/Maternal-Body-Mass-Index-and-Use-of-Labor

https://pubmed.ncbi.nlm.nih.gov/15477051/

Surrogacy

Surrogacy Facts and Myths: How Much Do You Know?

https://www.cdc.gov/art/key-findings/gestational-carriers.html

Surrogacy laws differ in different states

https://www.thesurrogacyexperience.com/u-s-surrogacy-law-by-state.html

Surrogacy Laws By State

https://www.hatch.us/blog/best-worst-states-for-surrogacy

The US Surrogacy Law Map â„¢

Postpartum depression

https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

https://www.webmd.com/depression/postpartum-depression/early-warning-signs-postpartum-depression

https://www.webmd.com/depression/postpartum-depression/postpartum-depression-baby-blues

Audio Transcript

Paulette: Hi, welcome to war stories from the womb. I’m your host Paulette Kamenecka. I’m an economist and a writer, and the mother of two girls. I had trouble getting pregnant and being pregnant, and at some point my husband and I considered using a surrogate. Although we ultimately didn’t end up going that route. I’ve always been interested in surrogacy. Maybe because when we were repeatedly failing to get pregnant, it seemed like such an amazing thing for one person to do for another. So I was particularly interested to talk to today’s guests. 

In this episode, my guest tells her own story of pregnancy, and she shares her experience of being a surrogate for another family. It is, as you can imagine, a very involved process, in part because it requires IVF, which always sounds to me like a full time job, despite the fact that the pregnancies were relatively straightforward. There are challenges along the way, like postpartum depression, which can make other issues that come up more daunting to manage, and we discussed those too.  After our conversation I went back into the interview to add information about medical issues we discussed.

Let’s get to this inspiring story. 

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

Cheney: Hi, yes. My name is Cheney and I’m originally from San Diego, California. I’m currently in Louisiana, however,

P: wow, that’s a big shift. 

C: It’s a huge shift.

P:  So let’s talk about pregnancy you have a really interesting story in part because you have the experience of a surrogate and the experience of having your own child, which I’m totally interested in.  My husband and I, at some point, were thinking about using a surrogate, because I have all kinds of medical problems, so I’m interested to learn from you. Why did you get into surrogacy. What did you imagine pregnancy would be like and, and we’ll get into like how it was different as a surrogate and bearing your child for yourself. So why don’t you tell me first. How did you get into surrogacy?

C: My now ex husband and I, we, he was in the military. So, you know, we moved around, and I was a stay at home mom with my one child, and we had friends of ours that she had done a few surrogacies And she was like, you know, it’s such a great way for you to still be able to stay home and make money. 

P: Yeah, 

C: right? and she’s like if you had an okay pregnancy. If you know, because she knew like I didn’t want another one I was kind of a one and done. So she knew I didn’t want to have another one so they like need for another baby wasn’t really there, so she’s like I think that you would be a perfect candidate because you know it is a great way to make a little extra income, I mean yes you are having a baby, but you know it’s just a good way to get a good chunk of money to pay off some bills and things like that so that’s kind of how it got started was just like a friend of ours was like, I’ve done it, she’s like on her third baby now and like, she’s like, it’s so great and fulfilling and you know all the stuff and I was like sure, like, let’s do it.

P: So that’s super cool and I could see, I mean it’s an amazing thing to give to someone else so I could see like why you might be attracted to it, but, but then let’s hear about your pregnancy first because this must be what, in some ways convinced you that this would be a thing to do. So before you got pregnant the first time, what did you think pregnancy was going to be like?

C: I didn’t really know. I didn’t really hot like my sister was pregnant, she had twins, the first go round. So I was like oh man if I get twins, that’s gonna be hard, but, um, but yeah I didn’t really like have any expectations I didn’t really know what to expect, what not to expect just like things that my sister had been telling me, you know, I asked my mom how her pregnancy was, you know, a few friends of mine, and they all were like it was fine. I didn’t have any issues you know yeah morning sickness sucks but then it goes and it’s just like it’s fine, you know like they went about their merry way and it wasn’t like a big deal. So, I was just like okay cool, it seemed really easy, I guess, to get pregnant, nobody in my immediate group had trouble getting pregnant, so the IVF and all that stuff I didn’t know about any of that because I hadn’t experienced it, so 

P: that’s a good entrance right like yeah, you know, it’s good,

C:  it’s easy. Yeah, my sister had to write that in there first time and I’m like okay, we’re fertile, you know, 

P: yeah, exactly.

C: So did you get pregnant easily.

C:  The first time I did, yes. Yeah,

I stopped taking, I was on birth control. I stopped taking it. I get I did all the, you know, proper protocols when the doctor said, Okay, we’re going to try, you know, made sure everything was good to go. And then I stopped taking the birth control. And then after three months I was pregnant.

P: Good that is pretty good. 

C: Yep. 

P: And then, what was the way you want to walk us through pregnancy is there anything that kind of stands out as, oh, I wasn’t didn’t expect this, or this is not what I would be. 

C: I didn’t expect to get pregnant so quickly. Yeah, so that was kind of a shock when I I just on a whim took the pregnancy test I wasn’t like oh my god I’m a weak lead and you know like I wasn’t kind of that. I’m not an overly excited person just naturally. 

P: Yeah, 

C: so I just took it on a whim and I was like well I think I’m supposed to start today I’ll just take it right, and then then the pregnant and I was on my way to the gym. And I was like, Oh, I just left it. My husband was still sleeping. It was early, and I just left it in the bathroom. And he was still sleeping and I was like let’s just see like if I get a call right so I went to the gym I was being a friend you know I still went to the gym and did my thing, and never got a call never nothing I called him and I was like, Hey, did you notice something in the bathroom and he was like, What, no, and I was like, Oh my gosh. Can you go look in the bathroom and he was like, Oh my God, he’s like, go buy another one make sure this is right. Okay, so I went and bought another test and I was pregnant.

P: that is sort of that, that is the tricky thing about getting pregnant quickly is there’s no Runway Right, 

C: yeah, 

P: for people who, it takes a little while he get used to the idea and I mean you have nine months he’s the idea but it is kind of immediate right,

C: yes. Yeah, and you’re just like, wow, my life has now changed. 

P: Yeah, 

C: this is weird, you know, but yeah, and then it was like the anticipation of like, Am I gonna get sick, am I gonna get sick, you know, like I just kept waiting to get sick and I never did.

P: Oh, that’s interesting. 

C: Yeah, 

P: and so was it the second trimester also easy everything’s easy.

C: Yeah, everything was super easy. The only thing I’m about Super stood out was, because I am I was waiting to get sick because my sister had gotten really bad morning sickness. So, I was still working full time, you know I was a manager at a sporting goods store at the time, and I was just working and working you know and I remember this one day I did go out to get lunch and I ordered a iced tea, which I normally do. And it did not sit that I had to immediately go, you know, let it all out. And since that day I have not been able to touch it, 

P: oh, no

C: yeah, so that’s kind of that weird thing of like wow, I totally like him and smell it. Yeah, wow, you know, yeah, it was it’s so that’s like the thing that I didn’t really. The surprising thing that came out of it was Yeah, well I can’t drink iced tea anymore. Cool,

P: yeah that’s that is like a surprising thing after drinking it all the time, right,

C: right, and then just that one time and it was like right at the very tail end of my first trimester, and that was the one time that I ever got sick and it was because of the iced tea, and I was just like that is so bizarre.

P: Yeah, that’s weird. And so, it’s smooth, up until the third trimester and then take us to the day of the birth like how did you know today was the day.

 

C: Yeah, so my water broke at work. 

P: Oh, Wow. 

C: Yeah, yeah. 

P: was it like a Hollywood splash?

C: No

P:  Okay good. 

C: No, thankfully, yeah, thankfully it was not like that, I yeah I had an early shift that day and I was the only manager on the floor. At the time, you know until we opened, there was just like one manager, looking over, like the truck. 

P: Yeah 

C: and so I was there early, and I was just like, kept kind of leaking. And I was like, what is happening you know because it would just like dribble and I’m like pee, like what’s happening so I kept like running back to the bathroom and I’m like, It’s not pee. And then I would stand up and stuff would dribble and I’m like, This just seems really weird. 

P: Yeah, 

C: So, so I went up and I told one of the team leads and I was like, Yeah, can you call like the other manager like I needed to come in early, I think my water broke and everyone of course freaked out. And I was like, No, it’s totally fine. Like, I can wait until she gets here, you know like I was super nonchalant about the whole thing. You know so she got there and then I was able to leave and I drove myself to the hospital, you know, I called 

P: so no contractions at this point, 

C: no nothing. 

P: Okay, yeah, 

C: just some leakage and yeah so I called my husband and he drove like 45 minutes to work was like hey have you left yet and he’s like No, and I was like yeah you might not want to I’m headed to the hospital, you know, Can you meet me there. And so we did and you know they did the test of, I guess there’s like a paper strip that they can stick down there to see if it is actual breaking. Yeah, or nothing.

P: So if your water breaks the way Cheney’s did without much fanfare and there are no contractions, there are a few tests available in the hospital to determine if it’s amniotic fluid. Some use a paper strip to test the pH of the fluid because amniotic fluid is more alkaline than normal vaginal fluid which is more acidic, and there are newer tests to try to measure the presence of certain protein markers that are highly concentrated in amniotic fluid to verify that the liquid leaking down your leg is, in fact, evidence of your water breaking.

C: and it was, my water broke, so but it was just like yeah just a super slow trickle and I was like, I was like okay, no, no contractions, no nothing. This was like it probably eight in the morning I think I got to the eight or nine in the morning I got to the hospital. 

P: And are you like 40 weeks are you close to your due date, 

C: I’m 38 weeks, okay 38 weeks. 

P: Yeah, yeah, 

C: so a little early, I mean, around. It wasn’t until I really started, they did they induce, no I don’t think we did, but it wasn’t until my, you know contractions started getting stronger, that’s when, kind of, I was just like, oh my god what am I getting myself into, you know, that’s kind of when it all hit me was like it’s been so easy. 

P: Yeah, 

C: and no one has really told me about the aftermath, and the actual birth that I was like, wow, like, this hurts. Yeah, yeah.

P: And it is a weird feeling of this is happening to my body and I have no control,

C: Yeah, totally, like zero control. Now I ended up throwing up and I was like why did I just do that, like, what the heck you know and the nurse was like happens a lot, like almost everybody because of the hormones and you know, it’s just like, it’s like came out of nowhere and, you know, I ended up getting the epidural. And it didn’t take all the way. So I felt a lot of everything.

P: So wait did you, you just so you can imagine like I want a natural birth or if you just thought it will

C: I knew going in that I would get the epidural, okay. We didn’t go to Lamaze classes I didn’t, you know, think about doing the, you know, learning how to breathe correctly and all of that in hindsight, I totally wish I would have done all of the breathing techniques and stuff like that, like, you know, because now I’m super into yoga and breathing and it’s like, you know how I feel my body. After some other stuff that happened but, but at the time I wasn’t super into yoga or anything like that. So, so yeah I didn’t, I knew, like I was like yeah I’ll just get an epidural and I’ll be fine. That was kind of my thought going into the birth. 

 

P: good, well good. Like, it’s nice to be on kind of the mainstream path but you won’t be flustered when they offer you an epidural you’ll be like, Sure, I’ll take two, right, like there’s right yeah, yeah. 

C: Can you just make sure it all just works. 

P: So you said it didn’t really work, what was the one side of your body, or

C: basically yeah yeah I felt. I think my left side was actually numb, but my right side I could feel everything. And because it was the first one I guess, everything was obviously still super tight. 

P: Yeah, 

C: down there I hadn’t ever been that large, it doesn’t know what it’s doing. 

P: Yeah, 

C: never need to expand. And it just felt I could feel how tight it was, she was coming through, and that on top of the pressure pain was so unbearable. I just remember like screaming it hurts so bad it hurts so bad you know. 

P: Yeah, 

C: they’re just like push you to make better hurts you know, yeah, yeah, it’s just yeah, it wasn’t good like no one told me oh the epidural might not work all the way. Yeah, yeah, I have another backup plan in case this happens because I can’t redo it, you know like I wish that I would have had that kind of like, make sure that you do understand the breathing that you’re able to calm your body you are able to get through the pit you know like I’ve used other techniques in place. If the epidural doesn’t work

P: well so I’m assuming pretty early on you report to them like I can feel everything and what do they say, so sorry. 

C: Oh yeah, sometimes that happens and I’m like Wow, guys. Thanks. Excellent. 

P: As of 2018, roughly 70% of birthing women get an epidural, according to a study out of Stanford, some fraction of these epidurals don’t work. The most recent article I can find on the subject is from 2004. And those authors report that 12% of the time epidurals fail, they attribute the failure to three things in general. First, labor progresses too quickly, it takes something like 20 minutes for the payments to kick in. Second, the needle is inserted into the wrong space in the back, or third, there are some anatomical issue that compromises the effectiveness of this kind of anesthesia. 

Pain is a really hard experience to describe appropriately.

C: It is because everyone experiences it differently as well. You know some have higher pain tolerance, lower pain tolerance is, you know, I always thought I was on the higher pain tolerance and childbirth is a whole other different ballgame,

P: I was gonna say, maybe you are I’m not sure childbirth yeah but right 

C: yeah exactly. 

P: So did you labor for a long time and was the pushing a long time or how did all that go. 

C: No, I didn’t have to push for a long time, Maybe 30 minute 2030 minutes. 

P: Oh good. 

C: Yeah, so it, it was smooth, though I didn’t have any complications from the time my water broke, and then she was born at 5:50pm. So you know, like, eight, nine hours, like that was it. So no, I can’t say that I had this like long tremendous horrible labor I wasn’t, you know, pushing for five hours or anything like that, you know, you know, it, it was fine. My biggest struggle was the aftermath.

P: So what So tell us about that like so she’s born, and then, yeah, 

C: so she’s born, the umbilical cord is wrapped around her neck twice. 

P: Oh wow. 

C: Yes, so she wasn’t breathing right away. And, you know, they put her in my arms and I like was crying just like, you know, breathe, breathe you know when she finally did and everything was fine, but I ended up tearing, just so painful, which nobody talks about. 

P: Yeah, 

C: or told me about anyway. And so then they had to stitch all that up, the hemorrhoids, the breastfeeding, you know, like, she couldn’t latch on. And it was just it was so frustrating like you have this, now human that you need to keep alive. 

P: Yeah, 

C: and you yourself feel like death, because you’ve been through this like traumatic experience basically. And I was just like my hormones were crazy. It was just it was such like a huge shock that I didn’t expect it to be so hard. You know because I’m, you know see pictures of people with their babies and they’re so happy and I was just like, I was so miserable. 

P: Yeah, yeah it’s babies are really hard right the first month so much work, and you just, I feel like, very few people are prepared for it the first time. Yeah, it is really hard so, but it sounds like you probably did not like imagine I breastfeed for a year and a half or something you just thought you would breastfeed for a while and see how it went.

C: Yeah I mean I wanted to at least breastfeed for a year. That was my plan was to go for the year, and I was determined to breastfeed. So I was like, No, like she’s gonna latch you know she’s been like, maybe I’ll get full 24 hours and she hadn’t eaten because I she wouldn’t latch. And this nurse finally came in and she’s like baby tried this nipple shield, and I was like, what, what is this Why did someone give this to me like the second they saw she wasn’t latching you know, and that was a total game changer. 

P: Oh that’s awesome.

C: Yes. Yeah, so I was able to do the nipple shield and she was able to drink from that and I had to then use that the whole entire time that I was breastfeeding, 

P: wow 

C: I couldn’t get her off of the, the nipple shield. 

P: Well, you know if it works 

C: exactly what they are, don’t fix it, and I had to it took me a while because I was so determined to breastfeed like, you know, do it naturally and to me naturally was beyond breast. Yeah, and having this other foreign object between us, like, to me it was like the but that’s not breastfeeding, you know, so it kind of took me a little bit to let go of that and be like, it’s working and it’s fine you know she’s getting what she needs just leave it alone. But then when I had to go back to work, it actually made the transition from me to bottle so easy because she was basically having the bottle on my boob. 

P: Yeah, yeah, 

C: you know, so then my mother in law was able to feed her when I was at work, and I was able to pump at work and no I mean it all worked out. But yeah, I mean it took like a amount of time for just that one nurse to be like, try this. You know, 

P: yeah, yeah. I mean it’s described as natural which doesn’t mean it’s easy, right, it just means. 

C: Nothing’s easy. 

P: Yeah. It also like every part of this process like even like the birth right to coordinate the cervix opening and the hormones and the, you know everything, occurring at the right time. Doesn’t always work that’s like a tricky thing. So 

C: yeah, 

P: and to have your baby have the right latch to match with you perfectly is awesome. You know there’s no guarantee of that. And so it’s great that you figured out a way to make it work.

C: Yes, yeah, thankful and I’m very thankful for nipple shields and I’m thankful that that nurse introduced me to.

P: So it’s interesting that you, that sounds like a relatively straightforward experience. Although having gone through the birth, you’re willing to say yeah, I’ll do it again. 

C: Yeah, because the pregnancy part of it is so easy that nine, the nine months, you know 38 weeks. So easy, that I was like, Yeah, I can do that again, like the birth is one day. But then I don’t have to care for this thing after I can just heal and be done recover. 

P: Yeah, right. 

C: So for me it was like yeah by, you know, let me heal. Let me recover, let me get back to my life. Let me get back to my daughter, you know, and then it was, it was fine. So in my mind it was, it was kind of an easy yes because the first pregnancy itself was so easy. 

P: That makes sense. Okay so for people who have no experience with surrogacy like, walk us through how it works, how do you find a family or how do they find you and how does that stuff all work out. 

C: Yeah, so there’s a couple of different ways that people can do it.

P: A little background here, so it looks like there are two kinds of surrogacy gestational surrogacy in which the surrogate carries the pregnancy of another woman’s egg, and the father or donor sperm. There’s also traditional surrogacy, which the surrogate egg is used to create the embryo she’s carrying surrogates can be altruistic so they carry the baby for another family, and only their medical bills are paid, or commercial surrogacy, which as the name suggests, involves a fee beyond the medical bills. How common is it. The CDC estimates that between 1999 and 2013 2% of all assisted reproductive technology cycles are for gestational carriers, which amounts to about 13,300 deliveries and 18,000 babies, half of the pregnancies have multiples.

 C: I personally went through a agency where you’re kind of put into this database, like, it’s almost like match, right, so you’re put in this database you like fill out your profile you put pictures of like you and your family what you like what you do you know all these things. And then this other family comes in and views, the profiles, and then they pick what one they think is best. So through this agency we were matched, and then it’s like this whole long process of making sure that I am physically fit and able to go through the IVF treatment. And they also had to test my husband, they had to do some blood tests and things on him, to make sure that he was clean, you know from STDs and things like that, 

P: yeah, 

C: obviously, you know, still gonna be having intercourse with this other person’s day but you know so they had to make sure all that was clear. So it was a lot of blood work, it was a lot of back and forth to the IVF facility that we were using. So, yeah, it was a lot of doctor’s appointments, 

P: and the people who are, who are giving you the embryo, they’re, they’re covering all that, are they going with you to all these things. 

C: No so the couple that we ended up matching with didn’t live in the States. 

P: Oh wow

C: So, I Yeah, we didn’t end up meeting them until I was six months pregnant, I think, wow, that’s when we finally met them like we were emailing, you know, back and forth, we had phone conversations and we would communicate via email, but we didn’t actually meet them until they were able to come to the States. And I was like six months pregnant.

 

P: Wow. So what they just they shipped the sample over to you and then is that is that is that how it worked.

C: So what happened. Well this with my particular instance, the mother, her eggs weren’t viable at all. So they had been trying to do EBF the IVF themselves for a few years 10 years I think. 

P: wow

C: And she just couldn’t get pregnant, and it ended up being her eggs just aren’t viable. So they ended up getting an egg donor and the husband, flew in donated his sperm, and then you know flew home, so the facility was able to do what they needed to do with the egg and the sperm. So all I had to do was just go then to the facility and get implanted

P: and is that painful or it’s easy.

C: No, it’s, it’s not painful at all. It’s a little awkward. So, my couple wanted a girl, they were very like they want, so they did the gender they can figure that out, like, you know what they, what the embryo is. So they ended up having I think three boys and one girl embryo. So they only implanted the one. 

P: Yeah, 

C: with like, you know, oops, that that one would attach because I know they like to do multiple, yeah, yeah, eggs, but we only had one egg that was a girl. So my process into being ready to then be implanted, um, if you’re not familiar with the IVF process is that I’m getting injected with hormones to prepare my body to accept this embryo. So it’s basically tricking myself into thinking that I’m pregnant. 

P: Yeah, 

C: so that my body will accept this embryo, so for the, I think two or three months prior to getting the implantation. I was injecting myself with hormones and taking them orally as well. So then I, you know, so I was ready to go, everything’s good. They measured my cervix. Think beforehand before all this started part of the process was also measuring the cervix so then they knew exactly where to implant the embryo. So they had all this so I’m ready to go, you know, two months later, I’m full of hormones, and I go in and they put you on this table right with your legs up in the air basically like you’re giving birth, and then they tilt you backwards. So my head is at an angle, it’s like a 45 degree angle or my head is down at the bottom and my legs are up. So, I guess gravity helps them 

P: Yeah, 

C: put in this embryo and then I have to lay there in that position for a couple minutes, um, that was, that was the the awkward thing like it didn’t, wasn’t painful or anything at all, it was just super uncomfortable and I was like wow I really don’t want to be hanging upside down. Okay, yeah. But, but yeah other than that it was super easy they implanted real obviously took, and, and then I had to continue doing the hormone replacement for the first trimester. I was doing it before the implantation and then for through the whole first semester was doing.

P: That’s interesting. That’s interesting because your body at this point is pregnant. So why do they need to supplement your hormones, after you’re like I understand the pre pregnancy thing to some degree but once you’re pregnant. Isn’t your body supplying the hormones you need. 

C: Yes, but they wanted to make sure that it was getting the hormones that it needed that the embryo was getting the hormones because there. There was a very high risk of the pregnancy failing within the first trimester, 

P: okay 

C: at the IVF so that’s why they just wanted to make sure that I was getting all the hormones that I needed, so they just kind of upped it.

P: can you feel that made you feel the hormones like Do you feel anything at all.

C: No, I mean I felt, I felt fine before the implant. Yeah, after the implant natural hormones kicked in, plus I was taking the added rounds, and I was sick time. 

P: Oh 

C: nauseous 24 hours, I would get sick, in the evening. Nothing tasted good, like it was bad, I was sick, and I was like I didn’t get sick, the first time but it was because all the added hormones on top of everything. Yeah, so then I ended up getting very sick. The first three months it was great.

P: Yeah, well now you know what your sister was talking about, 

C: I’m sure she’s Yeah no I do it. 

P: And so what’s the rest of the pregnancy like.

C: So after I was able to stop the hormones. Yeah, the added in hormones. It was fine. The pregnancy was great. I didn’t have, you know, after the first trimester, my hormones balanced the baby was doing great. I had a great pregnancy, it was actually during the baby was much better for an easier the second time around. I just remember the first time just being so uncomfortable and I gained a lot of weight. But my daughter didn’t gain a lot of weight she was only five pounds 10 ounces, when my daughter was born, and I have gained like 40 pounds. So, I know I had gained all that weight…where in this instance, I didn’t gain a lot of weight.. I didn’t retain liquids like I did the first time. The baby was getting all of the weight. The second go round so I this I thought that was kind of interesting how my body, almost, I guess it remembers right how what it’s supposed to do so the second time around it was like, Oh, yes, you get all the nutrients you’re good, you know like, We don’t need to hold on to all this extra water in the face and get fat and gross, you know, and it was like just the baby got it and it was fine nice the pregnancy was totally fine, and

P: that’s super interesting and do you feel like, like emotionally it was different for you or you thought it felt the same or

C: emotionally I think I was fine and I knew, you know, we have to obviously sign contracts that I’m not gonna steal the baby and all those Yeah, and that’s funny enough, that’s why a lot of people come to actually California when I was doing the surrogacy I was in California. California surrogacy laws are the strictest laws. So a lot of people come to California, to do the surrogacy because of the laws, which I found kind of interesting. 

P: They’re strict in terms of like their surrogate can’t keep the baby is that the issue. 

C: Yeah, I mean that’s the gist everywhere but I don’t know like the legal obligations, I just remember that each state has specific laws to pregnancy, all of them do state know you can’t keep the baby, but I just knew that California is laws were, there were more laws in place, I guess, to do the surrogacy, 

P: that’s interesting. And yeah, yeah. 

C: And this was like, you know, a few years ago so the laws may changed now, but we’re

not being super that’s why a lot of international couples were coming to California because of the laws that makes sense.

P: It looks like surrogacy laws differ in each state. Many states don’t have any laws at all like Georgia, Hawaii, Idaho and Kansas to name a few. And some states have restrictive laws like Louisiana passed a bill in 2016 that says that gestational surrogacy is restricted to married heterosexual couples using their own egg and sperm, but there are all different kinds of restrictions. For example, Texas says the parents have to be married he’s a surrogate and California as Cheney suggests, is considered a surrogacy friendly state because laws protect both the intended parents and the surrogate, and they’re very good IVF clinics in the state so ostensibly surrogates wouldn’t have to travel far to initiate that part of the process. And if you want to be a surrogate, or use a surrogate, you should look into the laws in your state, as things change frequently. 

And so, when you meet them at six months is that an exciting meeting.

C: Yeah, it was really fun. The mother didn’t speak any English. So, a lot of the communication was through the Father, and there were just the sweetest people, they were so nice so genuine. You know obviously super happy to be becoming parents, and they were just so sweet and yeah it was a really good meeting.

P: That sounds amazing and I could just imagine, you know, from the mother’s perspective how grateful she is to have this, right after like 10 years of not working, this seems amazing.

C: Yeah, she was just she was so, so grateful that you know that it was working and she, she could like see it grow, you know what I mean, like seeing growing we’d send pictures and things like that and I think for her it was just like, this is actually happening, you know, kind of surreal for her and it was just it was such a cool experience to have.

P: So do they get to be at the birth, or how does that work.

C: Yes. So, remember, they were coming to the states around 38 weeks just to make sure that they weren’t close by. Yeah, and yeah so then when I, I ended up having contractions. And, yeah, and then I you know I emailed him and was like hey you know I’m having contractions, you know, I’ll let you know obviously want to head to the hospital. And, you know over I think it’s like two hours or so that contractions started getting closer and closer together. So I was able to get to the hospital and then they met me there. When I got to the hospital was already seven centimeters. 

P: Wow. 

C: Yeah. The second time around I was like, I was prepared, I guess, like it wasn’t super painful like the contractions were intense but I wasn’t in excrutiating pain or an Yeah. So by the time I ended up getting to the hospital I was seven centimeters, and I remember them like checking. And they were like, yeah, like how much longer can you go like pain wise and I was like, Yeah, I’m done, I would like the epidural. Okay yeah, let’s do that right now. Great, so I was able to get the epidural really quickly and my water had never broke, he’s like I can feel the sack it’s like there, it’s protecting the baby’s head right, that’s it. He’s like it hasn’t broke yet. Yeah I was just kind of there, and it’s like weird. Okay, so I was able to

P: did the epidural work this time?

Ca little better than the first. Yeah. Yeah, it took, I could feel the. My body was having a contraction. I a sharp pain running through the back of my right leg. That’s when I knew I was having a contraction. 

P: Wow. 

C: Yeah, but other than that it did. It did work, so I was able to push you know better and more concentrated because I could feel that sharp pain I was like oh I’m having a contraction, and they’re like, how did you know that I was like I have a sharp pain running down my leg. So yeah, the second experience was, was much better, and the parents were in the room with me, so it was just my husband and then the parents and then obviously all the nurses and doctors were in the room, and I pushed her out. And they swept her away in, that was it, and then I got to watch the parents like hovering over her and they cleaned her up and, you know, the dad was holding her and he was crying and I was like that was totally worth it. Like just that, seeing that, you know, 

P: that’s amazing. I want to cry at the thought of that so I just I can’t even believe how generous that is for you to do that. I understand that it’s a job and you’re, you know, there, there are other things that come with it but it just seems like the best thing you can do for another person.

C: It truly is giving life right to someone who tried and yearned for it for so long just giving that to them it was just it made all like the whole process worth it

P: That’s amazing. And so how long ago was that 

C: that was six years ago. 

P: Do we get to hear about their little girl like do you guys keep in touch or 

 

C: they went back to, to where they live in. Yeah, they went back four weeks after the birth, they were able to travel and I pumped for them, for those four weeks. And that is something I will never do again. It was so painful to just strictly pump. Yeah, nipples were raw, and bleeding off the whole four weeks. It was horrible. It was horrible. I was like I’m not getting paid enough, it wasn’t enough extra money to, 

P: yeah, yeah, that sounds hard, 

C: I had agreed to it and then I was like wait, how much is it I was like oh that’s not worth it but I already agreed.

P: Aren’t there milk banks for babies are isn’t, isn’t that a thing.

C: It is a thing, and I realized that after, because I was producing so much milk. I was like well what am I going to do with all this extra so once they leave, you know, I was like do I keep pumping and selling it and or donating it or you know whatever I was like you know what, no, I’m done, like, 

P: yeah, yeah, yeah

C:  I want my boobs back. So, um, so I pumped as much as I possibly could and I would portion it out into bags, the breast milk bags, you know I would portion it out like you know three ounces for ounces however much she was drinking at the time, and you know I told them, you know, because first time parents right I’m like hey just like put it in warm water and let it like slowly warm up and then just add it to the bottle, so I had it all perfectly portioned out for them and then they ended up being able to put, put it in a cooler with dry ice, so they were able to take whatever I had back to their country. 

P: That’s awesome. 

C: Yeah, yeah, they had no I haven’t heard from them or spoken to them since. So, well,

P: I’m sure yeah I’m sure every family has their own way to handle it right.

C: Yeah, and you had the option to either stay in touch or not stay in touch. You know, due to some other circumstances, we, you know, I ended up needing to change my telephone number and email address and all that stuff so the agency doesn’t even have my current, you know, contact information, so even if they were trying to contact me, I wouldn’t even know that, you know Yeah. So, but that was it was a really, really good experience and I have been asked to do it again and I don’t want to.

P: Yeah I mean it’s a lot of strain on your body right it’s like a hard thing, I mean, even though it was relatively easy for you like it is a lot to go through.

 

C: Yeah, physically I was fine. It was the emotional and mental health part of it, so I ended up getting bad postpartum depression with my child. And then, it was never taken care of properly. So when I had the second child, 

P: wait, so let me pause right there, no you’re not taken care of appropriately because you didn’t know what was going on or like what happened there.

C: Yeah, I didn’t know about postpartum depression. I mean I knew that hormones got wacky, and they were fine, but no one in my immediate family or friends group had really bad postpartum depression so I didn’t know what was happening I just chalked it up to, oh it’s hormones because I had a baby, but you know I remember just like hating her so much. No, and I was like why do I feel this way you know I was just like I had so many emotions and I didn’t know what to do with them properly, you know I wasn’t seeing a therapist. You know I think I was ashamed or scared to tell my doctor that I was having these feelings, so they don’t want to do, 

P: they didn’t have you fill out like a little depression form or whatever like a survey,

C:  I’m sure, but I was like yeah normal normal normal. Yeah,

P: so it’s really tricky, you know, I, I’ve talked to a bunch of people who’ve had postpartum depression and it’s the most common side effects of pregnancy.

Which is kind of shocking given that almost everyone says what you have said which is, I had no idea, right i i couldn’t kind of see it in myself and one woman I spoke, it was a therapist, and she was like I you know I still couldn’t see it in myself. So it seems like a really tricky thing to, to fix or address because many people going through it don’t recognize it maybe until the second pregnancy or something changes, or there’s something to compare to 

C: right and I yeah and it was like I just showed me because this was like, you know, a week after I was home with her and I was just like oh my god like trying to figure out, like she wasn’t sleeping and our sleep schedule and, you know, my then husband just sleeps through everything and I was mad at him because you know I’m like I’m the one absolutely you know, feeding her every two hours and you’re just frickin sleeping, you know what I mean so of course there was like anger there and confusion and then the depression on top of that and.

P: Okay, Web MD says, 80% of women experienced baby blues, feeling overwhelmed or exhausted and having mood swings, which makes sense given that introducing a new baby into your lives is a dramatic change in circumstance. It comes with a lack of sleep and hormone swings, but feelings associated with baby blues, usually wane in one to two weeks and peripartum or postpartum depression is a much more intense version of this. According to the Mayo Clinic here are some of the symptoms of this kind of depression. Depressed mood or severe mood swings, excessive crying, difficulty bonding with your baby withdrawing from family and friends, reduced interest and pleasure activities you use to enjoy an intense irritability and anger. I’ll include the full list in the show notes, but it’s important to communicate with your doctor about this to get help. 

C: Yeah, I didn’t really know about postpartum and how bad it could get until after the fact, until after the second pregnancy, and then I got it again. You know, and then I was like, I refuse to get out of bed, you know like with Elise I would get up with her you know like, we would be doing things I would still be doing my normal activities, so maybe that’s why I didn’t think it was so bad because I could still do everything I needed to do. 

P: Yeah, 

C: you know, as a mom as a wife and things like that. But the second time around. I just didn’t want to go to bed. I was just done with life. I just didn’t care, and, and that I think is when it hit me and my husband was like yeah sums up, like, you know, let’s say, going to the doctor. And that’s when we went to the doctor and you know I felt comfortable enough telling him exactly what happened and he’s like yeah, you’ve probably been dealing with depression, and now you’ve had, you know this traumatic experience and your hormones are all out of balance, so that you put me on antidepressants and. 

P: Was that helpful. 

C: No, it made me feel worse. 

P: Oh no, yeah. So, how did you find your way out. 

C: Um, that’s a whole other story. No, I don’t know. Honestly, there. Like I was saying there was a whole lot of other factors to my story than just the pregnancy, my husband, ended up being a drug addict, so I was dealing with that, he told me that he was addicted to pain pills, Three days after I had birthed my birthed our daughter. 

P: Oh wow, 

C: he told me that, so I was dealing with a lot. 

P: Yeah, 

C: and our relationship, and his addiction just kept getting worse and worse and worse and worse as time went on, and I agreed to do the surrogacy I was under the impression that the money was going to be going to pay off our car to pay off credit cards, things like that. Well, he ended up using all the money for his addiction. So there was like a lot going on in my world. 

P: Yeah, 

C: and I ended up because of my depression I think and because of, you know this codependency relationship that I found myself in, you know, I knew I needed help. I knew that he needed help. So I ended up having family take my daughter and I ended up using with him. and the uppers that I was using actually kicked my depression. Not saying that that was the right thing, 

P: yeah yeah yeah yeah, 

C: but because I was so low. 

P: Yeah 

C: the uppers that I was using boosted the, you know, endorphins or whatever. and it actually ended up balancing that out 

P: Good Lord, that is not a straight path through 

C: It was a lot it was a lot, and you know that’s a whole other podcast but, but that’s honestly how I how I got out of it was by doing drugs, and I don’t want anybody to take my how I got out as a way to get out, don’t do it that way, you know, go to the doctor do it the right way, tell them this isn’t working and they’ll put you on something else that will work, but, but yeah, because of all my other circumstances, it just I lead I, I let myself go down that path and help my depression. 

P: All I can say is, Cheney, you seem like an incredibly, incredibly strong person to get through all that each of those separate things, has enough weight that it will take long to get through sort of mix them all together, is, is just seems like way too much, right, like

C:  it was, it was a lot. Yeah, 

P: so that’s amazing to have you on the other side.

C: Yes, yes. Yeah, and you know I wouldn’t be here without the support of my, my family, they they took me in, when, when things got really hard and, you know, kind of showed me their love again and I was able to, to get out of this situation to get away from him, you know, and start building this this new life for just my daughter and I and it’s been pretty amazing. 

P: That sounds awesome. How old is she now. 

C: She is almost nine. 

P: Oh, wow, what she into 

C: dolls. She loves the imaginary play with dolls I think she has 15 right now. 

P: Wow, 

C: yeah it’s getting a little obsessive, but she you know will do her chores and earn her allowance and then she you know buys them herself. But it’s, it’s just so funny and then she watches these YouTube videos of this other little girl who plays with the dolls for YouTube and then she’s now creating her own YouTube channel, playing with her dolls, it’s just it’s really cute to watch.

 

P: That’s super cute my kids were very into dolls too, which is fun like to listen to those conversations right where they’re making sense of the world around them in this relationship they’re creating it’s very cool.

C: Yeah, it’s so funny and new she’s like disciplining them you know and it sounds like me and I’m just like this, you know, or it’s like better I was like oh I wish I would like a thought of, that’s a good idea, like I’m gonna use that on you later, you know. Yeah, insane. Yeah, that’s really good.

P: That’s very cute. So I’m wondering, now we’re down this road and looking back, is there any advice you’d give to your younger self about like the pregnancy stuff.

C: Gosh….ask more questions. Don’t hold back. After the fact, like let the doctor know let people know around you how you’re feeling, you know because you’re not the only person who have felt that way, like it’s an okay feeling to be struggling, and to not shut people out. 

P: Yeah, 

C: well I should have let more people in.

P: I mean, clearly, I think most people do it your way so that seems like a natural response but it is, you know the statistic is like one in seven women experienced postpartum depression you know so it’s really common and, and it’s just a matter of people understanding that like, oh I need help with this and this can, You know where there’s a way to manage it and

C: and not be ashamed of having these thoughts because you know if you have them, then other people have them too.

P: Yeah, and  think of all that your body has gone through right, it makes sense that there’s some expression of that experience. 

C: Yes, yeah. Absolutely. Awesome, well that’s great advice. 

P: Thank you so much for sharing your story is super interesting to learn about surrogacy. And that’s such a amazing thing to do for someone else so it’s like a nice, nice No it’s going on. 

C: Yes, yeah.

P:Great, thanks so much for coming on.

C:Thank you so much for having me. It was fun.