Episode 67SN: The Power of Gut Instinct: Kristine’s Story, Part II
Today we hear the second half of my conversation with Justine. Last week we heard about her first pregnancy that ended in a stillbirth. She just started talking about her second pregnancy, which was looking and feeling too much like the first one for her comfort. And she’s gone into the hospital at 27 weeks to get checked out. Near the end of our conversation, when reflecting on her experiences with pregnancy and delivery, Kristine wonders again about the possible impact that trauma could have on her pregnancies. To give us a sense of prevalent issue.
I spoke with a clinical psychologist who studies trauma and pregnancy. Her conversation is included.
cover art care of: Maddison, owner of County Road Crochet, find her work here
To find Kristine’s writing, go here
Preemie weight
https://www.whattoexpect.com/first-year/ask-heidi/premature-baby-size.aspx
Retinopathy of Prematurity
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/retinopathy-prematurity
Full Interview with Dr. Natalie Stevens:
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 girls. Today we hear the second half of my conversation with Justine. Last week we heard about her first pregnancy that ended in a stillbirth. She just started talking about her second pregnancy, which was looking and feeling too much like the first one for her comfort. And she’s gone into the hospital at 27 weeks to get checked out. Near the end of our conversation, when reflecting on her experiences with pregnancy and delivery, Kristine wonders again about the possible impact that trauma could have on her pregnancies. To give us a sense of prevalent issue.
I spoke with a clinical psychologist who studies trauma and pregnancy. Her conversation is included.
Let’s get back to Kristine’s story.
K: I got to the same gestational age or as became hyper concerned that something was wrong.
P: And that because you because you felt something different or just that I felt like
K: there was too much similarity. You know, gestational li small, not a ton of movements, you know nothing that should have really blossomed as a second pregnancy should you know once your body’s gone through that once but again, my first pregnancy being so a typical no one could really say well, maybe this is just what your body does. Or there’s you know, this is this wasn’t like that kind of thing, but I yeah, there just didn’t come a date in May 2008 Or I said I think there’s something wrong and going in kind of thing.
P: did you drive to the far hospital or you went to the near one?
K: Yeah, I by that time, we we’ve had a few emergency trips for various reasons. And it was very clear that if you’re, if there’s anything at all complicated about it, you’re gonna get transferred anyway, so you might as well just drive there. So we did and we were admitted. And that just started the whole process of figuring out how much of this is normal, you know, yes, your fetus is in distress you know, we don’t know but we don’t know. What’s what’s normal here. And
P: when they say the fetus was in distress because of a heart rate issue? Okay,
K: yeah, and and it became, you know, became our decision quite quickly, you know, within a matter of hours, you know, do you want to just wait this out and see what happens with this traumatic history, or do you want to start on I forget what it is. It’s a surfactant that they unstart to help the baby’s lungs in emergency situation.
P: So surfactant is a substance that makes the lungs more pliable. Premature babies can be born before enough surfactant has been made with the poor lung function
K: and or do you want to just deliver her early and take your chances on what she wants you can get from the NICU. And I don’t remember the pin drop of the decision. But I remember both of us being a man of our chances were better with her being delivered.
P: Yeah.
K: And it was not an easy decision. And it was not scary. But I did discover after the fact that the one thing that was right in that decision is that the NICU was very successful. They hadn’t lost a baby of any kind of distressing many years.
P: Oh, that’s great.
K: And the OB, I discovered after the fact is was a doctor that all the other nurses really wanted on their own case.
P: That’s lucky.
K: Yes. And so between the two of them, we had good feedback, but the OB was very much there’s something wrong my guess is that this is a dire situation. And the NICU, who’s a very cerebral research renowned, published researcher, was much more, you know, thoughtful, he’s like, Well, this could just be normal for your body, but that was came straight out of the confidence that whatever happened happened, and they would deal with it.
P: yeah, Yeah.
K; And, and we were lucky that those two things came together at the same time. So yeah, it was delivered in 27 weeks and five days.
P: What was that birth like?
K: Again, it wasn’t prepared for it. It wasn’t prepared for a cesarean. chose to be awake. Which for me is the cocktail of sedatives and and everything else that I am not familiar with. So when they say as they pull on plunger, this is going to give you a headache it Did you know immediately the headache what was cool about that the operating room. I learned after the fact again, that every single practitioner was a woman.
P: Oh, that’s so cool.
K: the anesthesiologist, t the OB forming a surgery and everyone else attending so
P: that feels comfortable. I like that.
K: Yeah. So they did an emergency C section as well.
P: It sounds like yep.
K: An emergency and then I didn’t see her for a whole night. We didn’t she was going in the afternoon. You know, whisked away before I saw anything. And then a whole night I mean, we got reports, but at the same time, you know, in order to see her you have to get yourself physically out of bed after a C section. Get yourself down there. And that’s after they’d already been flying you to start pumping. You know, in the night I remember thinking whoa, but at the same time, yeah. You have to do the things that no one tells you that you need to be prepared for but you do and yeah, so we got we did that here.
P: let me ask a your question about the birth? Did you hear her cry?
K: No, she was way too small. They you know, if, if there was anything to be observed, I think they could tell me or it’s written somewhere in the record. You know that she’s super active. I think about premies that you don’t realize you’ve never watched one in the NICU is that they’re really mobile. But think about how mobile they are in the womb. Yeah, that’s how mobile they are outside the body too.
P: Yeah.
K: And so they are flip flopping like little fish in their isolettes because they don’t have the body weight to slow them down.
P: Yeah, that’s interesting. Yeah.
K: So I think there was somewhere on our record saying that mobile you know, it moving the clincher that we didn’t know learn until after the fact is that she did not receive she didn’t require intubation. She came out breathing, and stayed that way.
P: Amazing. For 27 weeks. That’s amazing and stayed
K: that way for two full weeks.
P:I feel like you have an Olympian.
K: She does she does like to swim. She preferred to ride horses. And then when she did receive oxygen, this is jumping. headwind go back and get details. But it was supplemental, it was never intubated. And so the weaning process was was pretty easy. And I did meet other NICU families in that timeframe. Some of them are burdened by by oxygen for life. Yeah. And I remember thinking how much how cumbersome it was just to bring them home with a little aid, you know, an eight milliliters of oxygen, which is barely, you know, barely the threshold to even have to monitor for anything, but many families don’t have that experience.
P: So let’s talk about the NICU. How long was she there for
K: a shockingly short amount of time for a smallest us she was born at one pound? 13 ounces. So you don’t realize how light they are? Because they are they look fully formed? Yes, but they fit in the palm of your hand. And she was there from May 22 Until honestly the middle of July. So probably just under two months.
P: that Does seem really short.
K: Yeah, she came home weighing four pounds
P: How did that go? That’s easily My mind was had all kinds of issues but she was like six pounds. I found that very stressful. Yeah.
K: Oh, there’s I mean, they come home with you know, the tiny micro diapers that they only issue to hospitals and the preemie clothes don’t fit and, you know this and that. Well, it was you know, it was a pretty steady progression. But of course we didn’t know what the progression was at the time, the whatever the developmental hole in their heart muscle that needs to close between the ventricles that closed on time. Even though she was outside the womb. She never had lung pulmonary issues. They were concerned at the time they released her about her vision and her hearing. Hearing is all resolved and vision did not she was she didn’t meet the threshold for retinopathy of prematurity. And that launched into an infant laser surgery when she was a little guy but
P: okay, so retinopathy of prematurity. ROP is an eye disease. That’s my current preemies form before 30 weeks are babies who weigh less than three pounds at birth. ROP happens when abnormal blood vessels grow in the retina which is the light sensitive layer of tissue in the back of your eye. Normally the blood vessels of the retina finish developing closer to the end of 40 weeks. So babies born very early, these blood vessels may stop developing normally, blood vessels can grow in the wrong direction. Blood vessels are attached to the retina. So if they go too far in the wrong direction, they can pull the retina up off the back of the eye.
K: Anyway, coming home at four pounds. What was cumbersome to me was the fact that she did have that whiff of oxygen. And so then they come with a heart monitor. And so between those two things, you’ve got four wires tethering you to 10 feet of space and, and needing to change it a couple of times a day. 24 I can’t remember what that was. But anyway, it was a lot of stuff. And we had to we wanted to make sure we were at least responsible with it. So we had to stay overnight with her in the hospital under surveillance to make sure that you know we could monitor these systems.
P: And Did did you appreciate that adult supervision or did you think oh, we could definitely do this
K: at the time it was an all new parents stuff. I was like Okay, here we go. Because it just is what it is. And in the meantime, there had been this weird learning curve with pumping
P: Yeah,
K: because I you know, I’m felt strongly about it, but I had no idea of what kind of commitment pumping was when your intent wasn’t nursing at all.
P: Yeah.
K: And so I was pumping, freezing it in essentially, you know, those little two ounce urine cups that they issue from a hospital or they used to and happens to be the right size for feeding a NICU. Baby.
P: Yeah.
K: And so I had a stash of Lowe’s at the hospital to refer to it in that and then deliver it to the hospital, you know, every couple of days, but that regimen was working. And so they were very adamant about that. And so that’s what she started on and by the time she was able to take a bottle that she did and stayed on stage on a breast milk regimen. She had a few other supplemental weird things like liquid caffeine. couple little things that had to be added supplements to her milk. But the clincher there was a she refused to nurse and so even though she was home, the pumping continued. I realized many many women do that by choice. It’s their profession and they’re there. The rest of their life more, but at the time, it was still cumbersome. Maybe I just had old technology or bad bad attitude about it. I don’t know I did it. And I didn’t do it begrudgingly. But it was it was a lot.
P: That sounds like a lot. It’s you know, bringing home an infant under perfect circumstances a lot. So in this case, it’s just when we were in the hospital, we have baby in the NICU. Also, I wanted to stay forever with like, you know all the nurses every day. How can you send us home to be on our own? We don’t know anything. So I’m amazed that you did all that on your own
K: well, it was a leap of faith, you know, at the time because I couldn’t afford care for her in order to keep working. So I had some back and forth with my employer at the time as to when exactly my maternity leave should start. Because I had been spending oodles of time in the NICU and it didn’t work out very well. So I ended up needing to maintain whatever my insurance margin was from my employer, but I needed to leave my work to be able to care for her time. And you know, there’s a little tiny baby who sleeps even more than a regular sized infant and you know, so there’s a lot of downtime, but it’s still care. You find the replays, especially in a rural setting. And so that’s what we did.
P: How old is she now?
K; She’s 13
P: Oh my god, that’s amazing. Wow.
K: And what was even more amazing. Besides the scent was written off to the approved maturity is that nothing else seemed to falter. By the time she was a year old. She was on the growth chart for her actual age, gestational age, and has since gotten way off. She’s 510 her feet are size 11 and a half.
P: Wow. That’s amazing.
K: Yeah. Her father is very tall. And so at the time I remember someone telling me well, you know, typical, you know, she gets her overall stature could be stunted by the time I joke, like, Well, I hope I hope so. And she No, I think he’s plateaued out now. She’s taller than I am. She takes very seriously.
P: I don’t know if he was very funny. My daughter does, too. I don’t know if you’re a Phineas and Ferb fan. Have you ever seen that show? Yeah. Well, five for 10 is a flawless girl.
K; I will tell her that. That’s funny.
P: Never less than five for 10 My girls say it all the time. None of us are five or 10. So we’re all yearning for that accomplishment.
K: Yeah. Yep. I have to I have learned field to be as tall as she is. And it’s such a it’s such a strange thing to be looking her in the eye that that she comments on it every time.
P: That is amazing. Wow. Yeah, that is some journey. So with, I wonder with her birth, you didn’t examine the placenta or anything like that after the delivery.
K: I think there was so many things I didn’t know or think about there. She has that big fat medical record. Again, because her NICU primary was a researcher. I didn’t realize until after long months after maybe a year after when they were just codifying everything. That went into her care and everything they surveilled for a year or more that the surfactant they gave her at birth was some of the earliest they’d ever administered to a baby that small
P: oh wow.
K: And, you know, of course, I probably signed signing something that gave them permission to pursue that therapy. But at the time, I couldn’t No, probably couldn’t have lived with that information at the time. But you really
P: you wouldn’t have signed it. You wouldn’t have said yes to it. If you had known.
K: I don’t know if I wouldn’t have said yes, but I didn’t want to know about that risk. And I would have had an opinion about that risk at that time. But the way it worked out, you know, that’s what it is.
P: Yeah. In those emergency situations. It’s interesting to see what they would do. And it’s amazing that she spent such a short time in the NICU given how young she was. And it sounds like you didn’t get steroids before they delivered you to help with lung maturity.
K: Probably they probably did, but the window of time was too short. Yeah, yes. So the, you know, as you needed, what, eight hours, 12 hours, something like that, and the gap was only three hour.
P: oh Wow, that that’s kind of amazing, right? The progress they’ve made in helping premies to breathe is is an amazing accomplishment. Yep. Yep,
K: I follow up on that was good again, or hearing if good or vision is not a you know, not great, but it’s not a documented you know, when people from getting a driver’s license or anything that is isn’t a hardship that they will have dealt with
P: But does that mean that she wears glasses or it’s something more expensive than that?
K: She had surgery when she was an infant infant, like babies basically at her term date. And what was interesting about that time was that she saw an ophthalmologist at Mayo in Rochester. And they had recently changed the threshold for qualification for surgery, and it’ll have lowered and so because she was one of the first babies to meet that threshold, the entire clinic was looking at her she was probably served by 12 different physicians just to make sure yes, definitively, this qualifies and we’re going to do XYZ.
Some kids have that needs the same surgery and never need visual correction. In her case, by the time she was a year, maybe, you know, their eyes can still pass but by the time she was a year they were they were starting to look at lenses and then as soon as we could keep goggles on her head she started wearing lenses and then there was the biting your nails wait and see how long it takes for their eyes to fully adjust and settle and stop changing stop getting worse. So the first couple of years of her life and probably stabilized by the time she was around nine. But it is what it is. And I don’t think it necessarily gets worse. But the question then becomes what has their little infant brain done to account for the fact that their vision has always been lopsided, substantially lopsided, even with correction.
P: does that mean one I worked for them the other way better?
K: Yep, revision even with glasses is probably 20/40. And without it I don’t know. And and that launches into my most recent chapters, which is you know, how to address education issues, and how much of them can be pegged to prematurity. So vision was a first thing developmental delays. And, you know, I’ve been the one along the way saying, you know, what, yeah, there’s this, this and this happening where there’s clearly delay, but I don’t see the gap necessarily getting bigger. I just see that it’s a delay that we’ve defined a little bit better with each passing year. You know, is it a year, two years, you know, what’s, what is it? And then you want to say that you just learned to compensate for all for all the things vision for academic things that are academically challenging things that are socially challenging. In her case, it helps a lot but she is so called because she was there. And people wouldn’t notice that she might have any kind of academic challenge unless she was around and asked to do something that’s difficult for her
P: that’s such an inspiring story. That she’s done. So well. If you are looking back on this experience. Now, is there any advice you would have given to your younger self?
K: I’m not sure. Honestly, I think I’m just that much older than people who would be experiencing or pursuing anything. Even like what I experienced because of the age of the internet that you can, you know, as scary as it is to research anything medical on the internet, you have such access to all the scenarios. And I think you could at least learn more about what could happen and be aware. So you know, my younger self, I think it’s all the same options. I’m still learning and I’m now divorced, still learning all the same license that when your gut tells you there’s something wrong or stressful or toxic in your life, your relationship. It’s not always wise to just bootstrap it.
P: Yeah.
K: That’s you, you really have to stop and get to the bottom of those things because you know, whatever you want to read about epigenetic trauma.
P: So this is an issue that Kristine has brought up a few times how trauma could have affected her pregnancy, and the development of her babies I took this question to Dr. Natalie Stevens. Today, we’re lucky to get a chance to talk with Dr. Natalie Stevens, a clinical psychologist and assistant professor at Rush Medical Center in Chicago. Thanks so much for coming on today. Doctor.
Dr. Stevens: Thank you for inviting me.
P: I wanted to talk with you because you study the importance of the impact of a history of trauma on pregnancy, and how trauma informed care can benefit patients. But rather than distill all your work and effectively capture the scope, why don’t you tell us a little bit about your work?
Dr. Stevens: Yes, absolutely. Well, prior to going to graduate school for clinical health psychology, I trained as a childbirth doula, and I was trying to see which path seemed to fit most whether I wanted to go a midwifery or medical school path or more psychological path and I knew that I needed to have some experiences from the setting in which I would be working and it turns out that I chose the health psychology path which doesn’t involve providing any medical care but rather depends on understanding from the patient’s perspective, what it is like being in a medical setting when you’re going through some kind of health related experience. And so my research and clinical focus has always been on the transitions. of care, through pregnancy and postpartum which also includes fertility and fertility loss, other topics like that. And when I started this over 10 years ago, it the concept of trauma really wasn’t considered a lot of the attention. Back then was mostly focused on depression, preventing and treating perinatal depression. So that area has come a long way.
Paulette kamenecka 23:17
For sure. It’s kind of shocking that this is new, which given the pregnancy is not that new but so thank you for your work, because this seems vitally important. One thing that when we talk about trauma I think people can get confused by is, is what does that mean? Does that mean, you know, a child survivor of a war or, you know, what’s the scope of that? Can you maybe define for us what we’re looking at
Unknown Speaker 23:41
Absolutely. And it depends on who you’re talking to. Because when I started my work early on, working pretty closely with obstetricians and the obstetric residency program at Rush, the word trauma in the medical setting means a physical trauma that requires even more clarification. So a psychological trauma is more often what we’re thinking about when we use the term trauma and it’s an event that is a stressor that is out of the ordinary beyond the the intensity or level of threat to a person’s health, life, safety, bodily integrity than what is typically experienced.
P:Today, we’re gonna talk about perceived concerns about how trauma may have affected the outcome of our pregnancies. Can trauma cause slower growth for the fetus in utero and trauma cause issues with the placenta? Do you think there’s any connection there? And and, you know, is it related to premature delivery?
Dr. Stevens: Yeah, that this is such a fascinating and complex question. But the short answer is, yes, there. There are physiological things, processes that have been sort of teased apart by various researchers and projects to try to see what the connection might be between both having a history of trauma, but not necessarily a diagnosis of PTSD having a history of PTSD that isn’t present during the pregnancy. Or having PTSD while you’re pregnant, that has been examined in relation to prematurity, low birth weights. And those are those are the two primary outcomes, but there are a number of complications and things that quote unquote, can go wrong. That I think feed into a lot of the anxiety that pregnant people feel. So there are other things going on here. Trauma doesn’t only lead to PTSD, there’s also the risk of depression, substance misuse and anxiety. So I was thinking about that and the story you described, that person doesn’t have to have all the full criteria for PTSD in order to have a lot of hyper vigilance in the subsequent pregnancy when all of these signals are coming up that remind them in parallel. What happened before. So then there are other studies that have looked at anxiety symptoms, not specifically traumatic stress symptoms, but anxiety symptoms, that have also shown an association with these outcomes. But I think the important thing to remember about all of that is that this is the larger scale epidemiological research and it’s really, really difficult to if not impossible, and as researchers and scientists we don’t we don’t do this to extrapolate from those findings to an individual case. So the other thing I think it’s important to mention, and there’s some really great, accessible information at the National Center for PTSD website that talks about different risk factors for PTSD and how women are more likely to develop it than men are. Part of that is greater exposure to trauma, greater exposure to things like sexual violence, which are more likely to lead to PTSD and that the key here is the idea of what what does the brain do, what does the person’s thinking do or how does their thinking change as a result of the trauma? And so there’s some evidence to suggest that women are more likely to blame themselves for things like sexual assault, but also the instance you’re describing something that happened to my pregnancy and that self blame coupled with the social support, not not having those supportive people around you, that you feel safe and and perhaps are helping you to challenge that narrative are really important process. So I’m speaking more to the psychosocial processes because that’s more my area, but there is absolutely some fascinating studies that I have read about the links between trauma and inflammation. The way that it affects the fetal placental unit, you know, this kind of unit where the pregnant person’s body and the fetal unit are coming together. And there are certainly many studies that have pointed to, although not completely described, or found, that there’s there are alterations when there’s a history of trauma, even even epigenetically even in previous generations. If I can repeat back what I think they’re saying is two things. Thing Number One is there’s definitely research on the fact that history of trauma and maybe trauma during the pregnancy can have physiological effects that might be correlated with low birth weight or prematurity that can’t explain one person’s experience. But he somewhat natural inclination we all have because the pregnancy is going on in our own body to claim responsibility for the outcome is not helpful and probably not right, given how complicated this
P; process is. Right? If you had that much control over your own pregnancy, everyone would be born with like an eight pound share. Right? Exactly
Episode 64: Giving Birth to Motherhood: Amie & Katie
Episode 64SN: Giving Birth to Motherhood: Amie and Katie
Today we hear from two women, one’s an author and generally in the book world and the other is an author, grief counsel and therapist. Individually, these women encountered challenges with their own pregnancies. They’ve come together to write a book that helps women to process the events of their pregnancies and birth by writing about it.
To see more of Amie’s work, click here
To see more of Katie’s work, click here
To find their book, Giving Birth to Motherhood, click here
HELLP syndrome
https://my.clevelandclinic.org/health/diseases/21637-hellp-syndrome
https://www.preeclampsia.org/hellp-syndrome
Audio Transcript
Paulette: Hi, Welcome to War stories from the womb. I’m your host Paulette Kamenecka. I’m an economist and a writer and the mother of two girls. Today we hear from two women, one’s an author and generally in the book world and the other is an author, grief counsel and therapist. Individually, these women encountered challenges with their own pregnancies. They’ve come together to write a book that helps women to process the events of their pregnancies and birth by writing about it. Let’s get to their story
So thank you both for coming on the show. Why don’t you introduce yourselves and tell us where you are and a little about your background.
Amie: Yes, so I’m Amie McCracken. I’m originally from Colorado, but I live in Munich, Germany now hence having met Katie. She’s also here. And I’m an editor and author, a book designer. I worked in kind of the book world. But when I had my son, it brought up a whole different topic that I wanted to write about, about birth and all that stuff. So that was how I ended up writing a book on that topic.
Katie: Yeah. And I’m Katie Rossler. I’m a transformative grief guide and licensed counselor and author as well. And this is my second book that we’re coming out with. And I have three kids. The first one was a quite traumatic birth experience and so when Amy and I first met, somewhere along the lines, we started to talk a little bit about birth story somehow it really did come up like quite naturally and we shared our stories and from that, we knew there was a partnership later on. We’ve become great friends, but we knew there was a partnership later on it and writing something to help others.
P: And Katie, what puts you in Germany?
K: I married a man with an accent. You know, they hook you and pull you in and you’re like, Oh, sure. Sounds great. But I grew up in a military family. So moving around, was like, Yeah, I can live in Europe. I had lived here before. Yeah, but now it’s six years here. And I’m like, Oh, we’re staying over here, which I do truly love. I mean, I’ve talked about this. It’s, it’s very hard once you really fall in love with the place and you get used to it to go back. I don’t know.
P: So I’m guessing you’re both fluent. In German.
K: Amie is me, not so much.
P: So you can you can live there easily with mostly English.
K: Yeah, we’re in a major city, so it helps. Awesome. Great. Yeah.
P: So why don’t we start talking about your book project that you get together on birth? Stories. So what’s the name of the book?
A; It’s, let me get the full title. So that I have that. It’s giving birth to motherhood, embrace being a mom through the powerful healing process of writing your birth story.
P: Cool. So we’re all three of us very much aligned here. So would you like to talk about specifically what brought you to this project? And then we’re what the project does for other people? Sure,
A: definitely. Definitely. So initially, I when I had my son, I thought everything went fine. I mean, it didn’t go fine. It was problematic. It was traumatic. It was difficult. But he was healthy. I was healthy. So I was like, everything’s fine. Everybody told me that everybody was like, everything’s fine. But I sat down when he was five months old to write down what happened just for my own memory. And through writing that I started to discover what actually went wrong and that I was actually angry about what went wrong, and that I was very frustrated by the control that I lost.
P: So I asked, let’s go slowly here. So the issue here is the birth itself, the pregnancy is fine
A: sort of so I’m a type one diabetic, so the pregnancy was high risk. Anyways, that’s how I ended up in kind of a more problematic delivery.
P: What is it what does it mean to be a type one diabetic and pregnant? Why is that immediately high risk,
A: for the same reasons that gestational diabetes has high risk tendencies, basically, the baby will grow larger because my body has harder has a harder time processing insulin.
P: Even if you’re even if you’re like on medication, and it’s controlled.
A: Yep. Yep. But I have to be much, much more controlled during the pregnancy in order for the baby to not grow too big. And so what ended up happening is I was induced at 37 weeks because he was too big. So yeah. And it like that, that brings up its own complications, because then vaginal births are more difficult because the baby’s bigger and all kinds of things but also, when he comes out if my blood sugar was not controlled during delivery, he could have a low blood sugar which ended up happening so he had to go to the NICU and be taken care of right away. Yeah, so it it just presents some problems, which I knew all of that. ahead of time. I was aware of it. I was ready for it. I was prepped for it, which was actually quite different. For Katie’s story. She was not prepped for a traumatic birth. She was prepped for everything to be normal. But for me, it took writing my birth story out to realize that I was angry about what had happened that I was not satisfied with how it went down.
P: What would you have changed?
A: I don’t know that I could have changed anything. And that’s unfortunate about how the system works is that what ended up happening is in the middle of well, near the end of my delivery when they decided to go for a C section because I wasn’t progressing. They took over the control of my blood sugars that I had been controlling them and they took that over they put me on an insulin drip instead of my insulin pump which I had control over. And my blood sugar went up from there, and they didn’t quite deal with it. And so then when he came out, his body produced too much insulin that made his blood sugar low, and I could have prevented that. But it felt like the system didn’t allow me to prevent it.
P: Did they take away your control because they thought you’d be incapacitated by birth or?
A: Yeah, so essentially, when they were prepping for the C section, they were like, you can’t possibly take care of this while you’re on the operating table. So we have to now take care of this. They would do that also for a diabetic who went into a vaginal birth when you get kind of through transition they take over because you just can’t pay attention anymore. So on the one hand, it’s a good thing. I mean, they are they are taking care of it, but I feel they didn’t pay enough attention, but then they also didn’t give me options afterwards.
There were a lot of things. If he had breastfed right away. There’s a lot of sugar in the colostrum. If he had been left attached to the umbilical cord, there’s a lot of sugar left in that blood if he had been put on my chest that can help regulate blood sugar, but I wasn’t allowed any of that because the system calls for a C section where the baby is kind of whisked away, right away. And so I lost that control. I lost the ability to bring his blood sugar up in ways that naturally my body could have done so in part it was frustration at my body and frustration of the system.
P: Yeah, that sounds like that sounds extremely frustrating especially since you’re used to type one means you were born with it. Is that what type one?
A: No, I’m I wasn’t born with it. I was 11 but I’ve had it
P: for so long that you have for most of your life control your own blood sugar. So to have that whisked away at such a critical time I can imagine it would be would feel really unnerving and not right especially I mean, I guess if he if the care team had taken over and he did not have high blood sugar. Yeah, you’d have been okay with that.
A: I think yeah, I mean, it would have gone different if it had been a vaginal birth. They could have left the cord attached. They could have put him right on me. The C section definitely complicated things. But of course in other countries in Australia, I know specifically in Australia, they do allow skin to skin contact on the C section table. They will put the baby on mom on the operating table while they close mom. And we had even asked if they would let my husband do it because any form of skin to skin will regulate breathing blood sugar, heart rate all those things. And they said yes, so he had his or jacket on backwards so that he could put him on his chest he took his shirt off and had the OR coat on but then they took him away and just didn’t didn’t let my husband do that either. So that was definitely anger the system. They even took him to the NICU and didn’t tell us where he was they my husband had to go searching around the hospital for him
P: Yeah, that that feels like a dream where you show up to a test with no clothes on or something. Exactly. Where is my baby? I’m sure you know that the placenta develops insulin resistance later in the pregnancy. So it becomes harder to regulate.
A: It’s nuts because actually the hormones in the first trimester make you super insulin. Sensitive. So you’re full of very, very low blood sugar in the first trimester. second trimester is that honeymoon period. And then third trimester you become resistant so then you need more insulin. So it’s just it’s it’s massively frustrating to to control all of it because it’s really even though I’ve dealt with it my whole life. It was very different in a pregnancy, adding on the worry of like what it’s doing to the baby. I’m like, Oh, I gotta get this right.
P: And I can’t imagine it’s made worse by the fact that everyone told you it was fine.
A: Yeah, I mean, he was healthy. He came out of the NICU after a couple of days and everything was okay. We went home. I was okay. We were both healthy. And yeah, but I think I really started to realize it because I would see articles on Facebook, about like skin, skin and how good it is. And I would just be mad. I was so angry. And so when I sat down to write it down, that was when I realized it was about the control that was taken away from me. I was frustrated. I wasn’t happy with my birth. I really needed to process it and heall it and understand what happened. And so then that brought up the idea of like, I need to help other moms do this. I need to write a book that teaches them how to process their birth by writing about it. So that’s where the idea was born was. I processed my own birth by writing it down. And I filled a whole journal. It was like, three days straight, where I was just writing and scribbling and going crazy.
Paulette kamenecka 11:00
So that’s amazing. And so and so now let’s was hear how Katie comes into the same vein. Why don’t you give us a little like, sense of what your experience was
K: the traumatic the other traumatic birth right? Yeah, so I knew right I had the boring pregnancy, the textbook pregnancy, and then I read about the book but like I never read anything about C section, because everything was progressing normal, flipped, everything was good. This
P: is this the first birth?
K: this is the first birth. And then it would have been five days before she was due. So she was born on July 6, and fourth July fireworks are wonderful. Then on the sixth, I had a couple of days where I noticed some upper back pain that was just a little off and felt like I assumed I’d done the like moving furniture in the baby’s bedroom. And you’re not supposed to do that. I just pulled something but it was like progressively getting more painful and at night it was really really bad. So I woke up that morning and I just went ahead and called my doctor was like, you know, hey, maybe just muscular like let’s just beach like we don’t come come into the hospital. I’m on call this weekend. And I was like, oh, you know, that’s sort of a dream. Like your doctor is the one who’s on call, like, Okay, sure. Yeah. So we go and they take my blood pressure and they’re like, have you had blood pressure problems during this time? You know, it’s funny here in Germany, you get this mother book, like it’s like a past book that keeps all your blood pressure’s all your all your stuff. And I look at that now I’m like, Man, that would have been amazing to have because I was like, No, it was always normal and like perfect textbook, and I wish I’d been able to show the book like, here’s all the stuff.
P: Yeah.
K: So they call the doctor because every time they took it off, like I’m sure I’m just nervous being here and it’s just affecting me and like No, no, it’s that. Like it’s it’s really quite hard. And they call the doctor and she ordered blood work. And that’s when they found that I had HELLP syndrome and showed up really fast. Some people get in their second trimester, some getting the third and then it’s you know, they have a little bit more warning than I did. And yeah, what was happening in my upper back was my liver was struggling. And so I was feeling the basically the spasms or pain of that. And they were prepping, they had to prep me very quickly for a blood transfusion. And they were like, you know, we just don’t know we don’t know if you can clot and My poor husband, he he was just a big shock to both of us. I was still willing like, oh, everything’s great. Everything’s fine. I wasn’t feeling worn down. I wasn’t feeling like something that’s happening. And the doctor she was an amazing doctor, and she truly said like, you know, we don’t have time to even induce you. Like baby really needs to come out because it’s not anything wrong with a baby. It’s basically killing you
P: Yeah,
K: so it’s time. It’s just time. And yeah, it was one of those where you don’t have time to think you go into like Project mode and truly was primed for a moment like that. Throughout my whole life has always been, you know, crisis management or helping with you know, in the university helping with different things. I always had training on this I knew exactly call my mother do this do all these things. And it was after she was born. So I got I got to meet a 45 minutes after I was under my husband was in the nursery waiting for her. Nobody got to be in there with us. It was after that that it kind of set in I was on magnesium sulfate. It was a big shock to the system and then I had the sweet little you know, baby which I attached very quickly to her and my husband for man was like for three days having to just do it himself. Like get her dressed change a diaper quarterback next to me anything I needed, so exhausted, and I had not for a whole year after saying I gave birth, because for me giving birth was vaginall. And it was wasn’t until I did EMDR therapy that it was like okay, I can say I gave for and it wasn’t about control of the system. It was my own body. A feeling like my body had failed me. And that you know, like, how does this happen? Like, everything was textbook and then all of a sudden it goes south really quickly. You know, and it’s kind of like what he did. Like you just learn as much as you can after the fact and you start to better educate yourself on some of the things and my doctor handled everything so wonderfully. But there were parts of the story that did upset me. And I realized, you know, really it was also writing the story. And I actually had two miscarriages in 2019 and was able to reconcile and heal some of the stuff from the first trauma of my daughter being born by the anesthesiologist, at that first birth was talking about the murders that had come through the night before and all the blood and glory all the seven I’m like I’m about to go under and you’re talking about these deaths. So when I had to have a operation for the first miscarriage, I was like Can I speak the anesthesiologist and she came in she’s like, What can I help you with it? I was like, you are only allowed to talk about positive things around me. This like weird, like, only positive thing and I am walking to the OR. You’re not wheeling me on anything. I am walking I can get up I am going like there is nothing where my body feels like I can’t do I can’t take care of it kind of thing. And it was amazing. I had a wonderful team. I was visiting my family in the States when it happened. And it was just an amazing doctor and nurse staff team as well. And we’re like only positive you can you’re in control. You can do this whatever you need. That healed that first trauma fully after that first year with EMDR therapy being able to say for and then being able to heal the I had a voice and I could say hey, stop talking about things that are negative when I’m about to go under and I don’t know if I’m gonna make it that was really really powerful. Really, really helpful.
P: Yeah, that sounds like a lot of good lord. After the three days I’m like he’s gonna sulfate blood pressure’s normal. Everything.
K: You have to stay on blood pressure medicine for I think I stayed on for about four to six weeks mine my blood pressure regulated pretty fast went back to normal so you’re you’re checking it every three to four hours still at home, and you’re taking the medicine. And then there’s a point where as I with my third child, I had blood pressure issues after the birth and there’s a point on that medicine where you’re starting to regulate and then it gets to be too much and you get really lightheaded easily so like, call them you know, like it’s time to get me off with me off this. Yeah, so they had to put me on that to just keep things regulated until my body could just go to more baseline status.
P: And so being a therapist, my sense is you understood the obviously the power of talking about what happened, but there’s something special about writing it down, right?
K: Yeah, completely. That was the big thing that when any came to me and we really started talking about this book, it was like it needs to have a therapeutic side to why writing is going to be so helpful and there is something about seeing it in front of you because when you speak it, it’s not there anymore. Unless you record it and watch it again. When you write it and you have to look at it, you know or type it out and you look at it. There is a you’re more in touch with what happened in a big part of the book, we talk about how you really get to be the observer versus go through the trauma again and that and we guide you on how to do that in the way that you storytel And the way that you write about certain situations that occur. It’s not to dumb anything down or make false positive it’s truly just still see it on the paper but not feel it where you feel like everything’s just been ripped back up again. And that was really important for both of us like we wanted this to be a therapeutic tool not a write it all out and then like then good luck… Hey, even up up you know, we teach a lot of therapeutic tools of how to deal with the emotions, how to deal with the analytical mind that wants to attack, criticize your writing. And then at the very end, we talked about closure practices and what to do with your birth story. Because most of us feel even more empowerment by helping others to not have to go into what we did and that was a big thing that he said like this book is going to be about other women able to save each other from future situations and maybe change the system. By being able to speak out more so many of us forget you can go back and talk to your doctor or your nurses afterwards. And they feel like oh, you know, it’s not my place and things like that. But the reality is is you are paying them to do the service. And they are human. They’re going to make mistakes. That’s like me as a therapist. I am human. I’m going to say the wrong thing. I’m going to ask the wrong question. But I know that people hold me to a certain level just like we do doctors and nurses. So talking with the person and then being able to go like even just saying I’m sorry, or I didn’t realize or you know, you were our fifth C section that day, and I was just exhausted.
P: Yeah, context can be really helpful. Right?
K; totally
P: Yeah. So I totally agree that conversation is ephemeral and so it’s hard to get the same feeling from it. It’s hard to become the observer that although there is something I think in the back and forth and having people ask questions, and it’s, that’s a little bit like editing, right, where you’re reviewing things that you said, and is this true? And how do I feel about this really, and especially in your case, Amy where There’s there’s a lot of subtlety to it. And there’s a lot of things that go on slightly differently. You might feel totally differently about your birth story.
A: Completely. Yes. But I think that’s why writing it down and understanding what did happen. Was was what helped me is that beforehand, there were a lot of what ifs there were ton of what ifs and so I researched the heck out of it. I knew everything that could possibly happen. But it was the processing afterwards and understanding the path that things did take what reality actually happened and we talked about this a lot in the book we actually start out with looking at what your expectations were; what you hoped was going to happen what you dreamed for. And then you’ve turned that around and you compare it to what really happened and why did that not work for you and why did you feel the way that you felt? Because, again, we don’t have a ton of control over how it plays out?
P: Yeah, I think you’re I think it’s smart. And I’ve spent a lot of time on the podcast talking about what your expectations were because so many of them are so deeply varied that you don’t really know about them until they’re frustrated right until it doesn’t happen. So like Katie and your story where you’re saying, I couldn’t call it a birth because that wasn’t my idea of a birth. That idea came from somewhere, right?
K: Right. And that was something that when we the expectation section is quite thorough on you know your mother women’s voices near life, social media, society, culture, religion, all of these things that really embed messages into your mind. And the beautiful thing is the book is a journal as well. So it has lots of prompting questions. So you’re not just like, okay, read this. Now. I’ve got to figure it out. Even in the writing of the story. There’s so many questions to help you break it down. So you don’t get caught up in the Okay, where do I go now? Or how do I do this? And with the expectation section, I think it really helps you start to put on paper oh my gosh, I I thought this thought this
P: Yeah,
K: you know, there are simple things that most of us don’t even realize that we actually think like that good things happen to good people and bad things happen to bad people. That’s why we go why is this day like this thing? What did I do to deserve this? So many women feel that way when their birth doesn’t go, right? What did I do? What did I did and they put the blame on themselves. And when you sit down and write down what expectations you have in life, and of birth and pregnancy, it helps you go like, well, that’s kind of crazy because that’s not how life really goes like okay, so how do I start to rewrite those beliefs because I’m now raising a little being and I don’t necessarily want them to, especially if I’ve three girls, I don’t want them to fall into that same pattern. I want them to know that that scar that mom has is the same way that they email is one of them came out badly to C section. All of it was giving birth. So I talked about that, you know, how do babies come out? Well, you know, there’s there’s a couple of ways here and here. You see this this right here this bar, how to um, you came out. One of your females are here, and it just normalizes it. I didn’t have those conversations growing up. I grew up in a Southern Baptist family. We didn’t talk about things. You know, there was no, it was only on my birth was fast and simple and easy. Or for my mom the birth was difficult. But there were C sections in my family. And there were miscarriages or things like that. So it’s, you know, you just didn’t talk about those things. And that’s something I want different. You know, it’s a generational thing that I’m breaking, really that we can talk about our bodies and how babies come out and how difficult it can be.
P: Yeah, I think it’s unfortunate that feels like culturally there isn’t space for and so like all these birth stories, have things about them that are complicated and hard and frustrating and not what we expected and beautiful and completely miraculous to have a healthy children at the end of them. Right. So it’s just a much more complicated story is kind of the real one, but that’s never what you’re sold, right? You’re sold ice cream and butterflies and that’s all there is it’s
K: Yeah, rainbows and unicorns always turn out that way and we even address you know, those moms who did have there are some moms who have wonderful birth experiences. And then that want to sell you on how they did and how you can follow in their footsteps. Our bodies are all different, like my HELLP syndrome was not anything on my health radar. Whereas with Amy having type one diabetes, she already knew, hey, I have these risks. You can’t then go oh for both of you it would work to do this, like this. Yeah, no birthing and all these things like it’s beautiful that there’s all these resources, but it’s not a one size fits all.
P: Yeah, for sure. I’m guessing Amy and Tom will correct me if I’m wrong here but even preparing for things that might happen. feels different than actually experiencing it
A: very much. Very much so because I knew the clinical terms for things I knew what to, quote, expect, but I didn’t know what emotions would come along with that. I didn’t know how it would feel
P; Yeah.
A: To experience all those clinical terms that I understood and I my my dad’s a veterinarian, so I grew up in a somewhat medical family like we do understand how bodies function.I’ve watched Cows and dogs and horses give birth and sheep like I’ve watched a lot of animals give birth but the the internal the mental, the like going through it is just so different than reading in a book or watching someone I took photos of a friend at her birth so I had been out of birth. And it still you can’t know what to what you’re going to feel what you’re going to experience internally. That that mental hurdle that mental marathon that you’re running, when you give birth is just an explanatory like you just you cannot explain it
P: Yeah, the embodied experience like type defies language, right? It’s
A: very much and that we kind of discuss that a little bit in the book as well because we want women to understand that your identity is entirely new from one moment to the next you you go from a pregnant woman to a mother, and it’s just a massive shift that isn’t really mirrored in anything else in life. There. There are other big shifts. There are other big changes in life. But that is one that is so wholly and completely different. And it’s it it takes a little bit of getting to know yourself again, because you are a new person on the other side of it.
P: Yeah, I interviewed someone not that long ago who said like the old you is gone, right? There’s no cross that threshold and then you without children no longer will ever exist. And it’s just a completely different space to occupy, which is which is a giant thing that we don’t talk about at all. You know, we talk about the strollers and the Boppy and the you know, baby clothes but not the really important thing. So it’s so great that you guys are are talking about that.
K: Yeah, I mean, this is this is why there’s so much of the grief work I do because people hit the midlife crisis and they’re just like, this isn’t the life I signed up or I’m like because you weren’t grieving all the shifts and changes up until now.
P: Yeah,
K; when really look at that. That career didn’t work out the way you thought or motherhood wasn’t what you thought it would or being married or divorce or you know all of these things. And if you’re not grieving men doesn’t mean like you’re holding on to it and wailing and all that but like, really, truly embodying grief and going through that work. Then you’re going to hit a point in your life where you really feel the identity crisis that makes you kind of go do other things that you regret later on or hurt other people are really implode on yourself. So for us it’s like a good stepping stone of like, okay, we want this experience
Unknown Speaker 0:03
It takes a little bit of getting to know yourself again, because you are a new person on the other side of it.
P: Yeah, I interviewed someone not that long ago who said like the old view is gone, right? There’s no you’ve crossed that threshold and then you without children no longer will ever exist and it’s just a completely different space to occupy, which is which is a giant thing that we don’t talk about at all. You know, we talk about the strollers and the Boppy and you know, baby clothes but not the really important thing. So it’s so great that you guys are are talking about that.
K: Yeah, I mean, this is this is why there’s so much of the grief for it and I do because people hit the midlife crisis, and they’re just like, this isn’t the life I signed up for. I’m like, because you weren’t grieving all the shifts and changes up until now. Yeah, and really look at that. That career didn’t work out the way he thought or motherhood wasn’t like he thought about it or being married or divorce or you know, all of these things, and you’re not grieving. That doesn’t mean like you’re holding on to it and wailing and all that but like, really truly embodying grief and going through that work. Then you’re gonna hit a point in your life where you really feel the identity crisis that makes you kind of go do other things that you regret later on, or other people are really implode on yourself. So for us, this is like a good stepping stone of like, okay, we want this experience, to not be something you own for so many years that you don’t later on, though you are.
P: So it sounds like what you’re saying is processing the experience in some way once you integrate it into your life to get a better sense of where you are in the moment.
K: Yes, that’s a wonderful Yeah, summary.
P: Okay, good. That sounds that sounds. That sounds amazing. I love that there’s space to journal and that there are prompts because for many people, it is a giant experience where it’s hard necessarily, unlike your experience, Katie where it’s obvious where the extreme elements lie. You know, for some people, it’s all over the place, right? There’s something weird in the first trimester or the whole pregnancy felt weird or something right? It’s just it’s not so cut and dry. So those signposts about like, what are you feeling about this or that seem like they’d be totally useful to help people plot that out?
K: Yeah, a lot of what we were finding already in the market around the story of create your birth story, didn’t guide you enough. Didn’t really walk you through the steps. And because of that, you lose motivation. Yeah. And with each tab or to have a chapter that has so many questions, that kind of keeps the ball rolling, you stay invested, and you start to really see the healing power of what you’re doing.
P: And do you guys have like a repository for those stories once women write them? Like a website? With the book or
A: that’s, that’s in the works? That will be a thing? Yes, definitely.
P: That feels like wailing wall or something. That’s cool.
A: Yeah, I mean, one of the things we want to be careful of is not pushing that, that same trauma onto the next mothers. So we want to make sure that if someone is sharing their story, that they’re doing it in a way that shows that they’ve healed that shows that they are empowered by learning their story and working through their story. Because what we’ve found is that you know, you have grandma who comes in and tells you your baby shower and you’re just like, Okay, I’m terrified now. Thank you. And we don’t want people to be pushing their trauma onto everybody else. So the end of the book really works towards finding ways that you can help others using your story. So either you learn how to tell your story in a way that doesn’t everyone else, or you potentially create an oral version, which is what Katie has done with her girls is created an oral version for your child which helps you understand how to tell the story in a way that it doesn’t get rid of the nasty parts, but it makes them powerful, it makes them mom went through this and she did it. And that’s the good part of this. So yeah, we
P: are able to see the action. And I would say good news. Bad news is that, no matter what, although, I’m sure if it’s your grandmother, you think there’s genetic connection, like maybe I am in the same line or we’re dealing with our mothers, right? How were how were their births to kind of project what will happen with us and mine bear no relationship to my mother’s. So I don’t know how useful it is but but like I can feel the nervousness when you describe like the grandmother saying that to the granddaughter, but I think, you know, this is like a tricky line to walk out. Sharing the trauma, scaring other people. I think it is it is necessary to get really, really out there to get like a true narrative of this is what it could contain. This is how I managed it
A: . Yeah, I think and I think you’re less likely to push the trauma on someone else if you have processed it. The problem is grandma has not actually dealt with the fact that her birth was crazy and insane and scary. And so she’s just kind of pushing the scary onto the next person. Whereas if you actually process it and deal with it and heal from it, you can still share the parts that were not so great, but not in a way that’s going to trigger the trauma.
K: and I think they can sayThings like I wish I had told the nurse I wish I had stopped and asked more questions or that allows that to go okay, let me make a mental note of that or tell my partner we need to ask a lot of questions and write my questions down. It’s how you start to help others by sharing also when you realize looking back wished have been done differently. Or you know what, like you said sometimes, context helps so much so being able to heal that you can say hey, well I realized my doctor is human, and he or she will make decisions on the spot visual variety. That then are out of my control unless I yell stop. Yeah, no, you don’t have the right to do that. But we’re not going to do that because this is a doctor bus. So it allows the next generations of moms coming up to think differently in the moment or to feel empowered to get a doula or someone to be in there with them that can empower them. Because they thought oh, wow, you know, story, and I really need another support person because my husband might almost pass out. Might not be able to handle what comes to me. And that’s a lack of any. Why not? Why not have that extra support? So really, that’s where we think it can start to shift shift how people speak to the system, how they handle things going on around them and how they feel more empowered.
P: That’s awesome. We remind us again what the title is?
K: yes, it’s giving birth to motherhood.
P: that’s a great title. So congratulations on that. Congratulations on the book and where and when can we find it
We’re launching it to tember 26th Although around the first week of September, it will be available for pre order. Okay, cool. That’s anywhere, anywhere, anywhere and everywhere and anywhere.
PThat sounds awesome. Thanks so much for coming on and sharing this is such a great idea.
A&K: Thank you for having us.
P: Thanks again to Amy and Katie for sharing a little bit about what motivated them to write the book, Giving birth to Motherhood. I love it when someone uses the challenging parts of their own experience to try to pave the way for an easier experience for the people who follow after them. I’ll share links to Amy’s website and Katie’s website in the show notes. You can check that out at war stories from the womb. Com. Thanks for listening. We’ll be back next week with another inspiring story.