Ep 130: Hannah’s Birth Story – Surviving and Healing

Ep 130: Hannah’s Birth Story--Surviving and Healing

Nicole: This is a birth story episode and warning. This is a tough one.

Nicole: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a board certified OB GYN who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicoleankins.com/disclaimer. Now let's get to it. Hello there. Welcome to another episode of the podcast. This is episode number 130. Thank you for spending some of your time with me today. On today's episode of the podcast, we have Hannah. Hannah has been happily married to her husband, John for two and a half years. They welcomed their beautiful son Oleander in February of this year.

Nicole: And we're going to hear about that birth story. In the episode, she works as a registered nurse in the medical ICU and in their free time, they enjoy hiking with their two dogs, Stacy and Nora. They also enjoy going camping, watching baseball and playing card games together. Hannah had an uncomplicated pregnancy and a mostly straightforward birth. However, she experienced several postpartum issues that included multiple visits to the emergency department, multiple hospitalizations, and she ultimately underwent a hysterectomy about a month after she gave birth. And a hysterectomy is removing the uterus. This was from a life threatening infection called group a streptococcus. This is a difficult story to hear. And at the time we recorded this, we recorded it back in April. Actually, this was still pretty raw for Hannah and I really appreciate her taking the time to share this story. And in sharing her story, I don't want to frighten you. I just want you to be aware. Knowledge is power, and that is what this podcast and really all of my work is about empowering you with knowledge. And you need to hear about this story and this rare, but potentially life-threatening complication that can happen after pregnancy. So let's get into this birth story episode with Hannah.

Nicole: Thank you so much, Hannah, for agreeing to come on to the podcast. Uh, I am grateful that you are sharing your story today.

Hannah: Thank you. I'm happy to be here.

Nicole: All right. So why don't you start off by telling us a bit about yourself work if you'd like and your family?

Hannah: Yeah. So my name is Hannah. I live in a suburb of Minneapolis, Minnesota, uh, with my wonderful husband, John. We've been married for about two and a half years now. And in February we celebrated the birth of our baby boy Oleander, um, followed by quite a few complications, but everyone is home and healthy now. So we are happy to be here.

Nicole: I love that name. Is it a family name?

Hannah: It is not a family name. Um, it was the only boy name that me and my husband both enjoyed. So it was a name that we ended up choosing.

Nicole: There you go. There you go. All right. So in order to stay, understand what happens with the birth, I think it's always important to take a step back and talk about the pregnancy first. So what was your pregnancy and prenatal care?

Hannah: Yeah, so I had a very normal pregnancy. Um, we didn't have any health concerns or complications. Uh, mom and baby were healthy throughout. Um, however, I am a nurse that works in an ICU and last March we were told, congratulations, you are now with the COVID ICU, very little choice, um, which was terrifying because me and my husband were trying to conceive at that time. Sure. Uh, so we took some time off just because with all the unknowns with COVID, we didn't want to start a pregnancy, um, and regret me being pregnant and working in the environment that I did. Um, but after a couple months we decided that we felt like we would be safe to try and have a baby again. Uh, so in June we found out we were pregnant and that was very exciting. Uh, however, I did have to continue working with all of the COVID patients, uh, which was terrifying. And then in January we were made or the vaccine was made available to us. So it was a lot of conversations with my OB team about whether I should get it or not. And with my high exposure risk, they decided that it would probably be best for me to get it. Um, so I did get the vaccine when I first vaccine when I was 32 weeks pregnant, which was scary but exciting at the same time, but no complications from that.

Nicole: Good. Good, good. Now, did you, I can't even imagine what that must have been like for you. Did you feel like the hospital supported you in terms of, and this is like not related to birth, I'm just curious, supported you in terms of having the appropriate PPE, like the personal protective equipment?

Hannah: Uh, like most healthcare workers, I would say, no, we had to reuse N-95 masks frequently and working in the ICU, all of our patients were creating airborne particles. So it was quite scary. I can only imagine, especially reusing, uh, wet dirty mask repeatedly. Uh, but a lot of my fellow RNs were really great. And if we were able to give me a non COVID assignment, they would switch patients with me. So that way I wouldn't have to take care of those patients to try and limit my exposure.

Nicole: Gotcha. Gotcha. And to your knowledge, did you ever contract COVID during your pregnancy?

Hannah: No. I only had sent cold flu COVID like symptoms once and I tested negative. Um, so unknown if I did get it or not, but not symptomatic.

Nicole: Gotcha. Gotcha. Good, good, good. And I'm sure your hand washing and hygiene was next level for sure.

Hannah: Yes. Very, very careful.

Nicole: Yeah. Yeah. Yeah. So what did you do to prepare for your birth?

Hannah: I listened to every episode of your podcast throughout my pregnancy. My nightly routine was taking a bath and sitting and listening to one of your podcasts, try and relax and try and prepare at the same time. Um, I read a couple of books with the classic, what to expect when you're expecting a couple others that were recommended by some of my coworkers and me and my husband did an online course through the hospital that we delivered at to try and prepare for labor and delivery.

Nicole: Got it. Got it. So what are some things that you wanted for your birth?

Hannah: Um, first and foremost was a healthy baby. Um, we had previously suffered a miscarriage. And so there was a lot of anxiety throughout the pregnancy about getting a full, healthy or full-term healthy baby, right? Uh, regarding pain management. I was really flexible. Um, I had pretty confidently said I will use whatever I feel like I need in the moment. Um, but was open to having an epidural was open to other forms of pain management. Um, didn't really have any preferences besides using what I felt like I needed in the moment.

Nicole: Got it. Got it. And did you have to deliver at the hospital where you work?

Hannah: I did deliver at the hospital I worked at. The health insurance that I have through my work requires you to deliver at the hospital that I worked at.

Nicole: That happens a lot for, for nurses and folks who are employed by the hospital. You do have some restrictions in terms of where you can give, give birth. Sometimes that comes as a little bit of a shock.

Hannah: Yeah. But it was really nice. The mother, baby unit was very separate from the rest of the hospital. So it wasn't like I was interacting with a lot of people I interact with on a daily basis when I'm at work.

Nicole: Got it. Good. Good, good. So let's talk about what was your labor and birth like?

Hannah: So leading up to labor and birth, I had a lot of frustration. I'm not a very patient person. I had a very hard time waiting for labor to commence. We have two dogs. And so there was lots of dog walking that occurred in those two weeks before I went into labor. Uh, so I had been having contractions, they would get kind of regular, like every 10 minutes apart, uh, leading up to when I went into actual labor, but it would just be for like an hour or two at a time, and then it would go away. Uh, but then I went to an appointment with my OB. Oh yeah. I forgot to mention, I was seeing a team of OB GYN. So I saw multiple physicians within the group, but they didn't deliver at the hospital that I delivered at. So I would see them in clinic, but it would be a laborist that delivers at the hospital I delivered at. So I didn't really care who I saw through my prenatal care because there would not be any of them delivering my baby. Right, right. Uh, so I went and saw the OB and she asked if I wanted my membranes stripped and I was impatient enough that I said, yes, I'll try anything at this point.

Nicole: How many weeks were you at that point?

Hannah: I was, that was 40 weeks.

Nicole: You were like, I'm done this baby needs to be evicted. It's time to get out.

Hannah: Uh, so I had been having pretty regular contractions that day, but I was only fingertip dilated, but she did strip my membranes. And then I came home and about an hour after getting home, my contractions were like every five to 10 minutes apart getting pretty regular, getting more intense. And my husband was working from home at that point. So he kept working and I kind of just walked around the house, having contractions. They were very manageable at that point and became more frequent throughout the afternoon. And by eight o'clock that night, they were every five minutes apart. So we called OB, and they're like yep. It sounds like you're in real labor. Go ahead and come on into the hospital and we'll get you checked out.

Nicole: Okay. And let me, before we get into what happens in the hospital, had your doctor, had they talked at all about induction, had that ever been put on the table?

Hannah: Yeah, so the week before my 40th appointment, so I went in for my 39 week appointment. I had a high blood pressure. It was like 145 over 90. So I went back the next day and it was normal. So they had talked about induction when my blood pressure was high, but then it came back normal the next time. So there wasn't any further talks about induction at that point.

Nicole: Okay. Even at your 40 week check, they didn't say that's just unusual that they didn't mention induction there either.

Hannah: At my 40 week appointment. They said, they'd see me next week. Or we scheduled an appointment for the next week. And they would induce me at that point if, based on me at that appointment.

Nicole: Okay. Okay. So you head to the hospital and then what happens?

Hannah: Yeah, so we had our two dogs. We dropped them off at my in-laws and drove to the hospital and it was about a half hour drive from, is a pretty long car ride because my contractions are getting significantly more intense at that point when I got in, I was only three centimeters dilated on arrival, but my contractions were at that point every like two to three minutes apart. So they hooked me up to the monitors and said, we'll give you an hour or two to keep having contractions. And we'll see where you at, where you are at with your dilation at that point. So about two hours later, um, they checked me again and I was only four centimeters dilated, but my contractions were so close together that they're like, yeah, we're not sending you home. We're going to admit you now. And my contractions were getting quite painful. Um, so I was happy when they said they were going to admit me because that meant I could finally get some pain medication. So they started an IV and they gave me a dose of fentanyl and I requested to have an epidural at that point. So the fentanyl was able to hold me over until the anesthesiologist was able to get up there and start the epidural. And once he placed it, it was phenomenal.

Hannah: I was finally able to feel like I could breathe and relax. And my husband is an engineer and he just likes to fix things. If there's a problem, having contractions was really difficult for him, just wanted to just fix it and just helping me through it was really difficult for him. So once I got the epidural, he was finally able to relax. And at that point it was after midnight and he had worked all day that day. And then we went to the hospital, so he was exhausted. So he was able to take a nap while I was resting.

Nicole: Okay. Gotcha. And then how did your labor progress after that?

Hannah: Yeah, so after I got the epidural, I was able to relax and it was about two hours later. All of a sudden the left side of my face started drooping. My, I felt like my eyelid was drooping. My lip was drooping in the whole left side of my body was just kind of numb. And I felt like I couldn't move it very well. So I called my nurse in and I was like, I don't think this is normal. And she's like, yeah, your epidural is not in the right place. We need to get the NCL anesthesiologist back up here. Uh, so he came up and he's like, yeah, it looks like it probably went into your subdural space. Uh, so he had to take that one out and put a new one in at this point I was only like six centimeters dilated. So I was like, yes, I would like another one to put back in.

Hannah: So he put another one back in and things were good for about an hour after that. And then I really started feeling my contractions again and they're becoming more and more painful. And it, I told the nurse, I was like, you know, I've been giving myself all the bumps on my epidural that I can, I feel like it's just not working anymore. And she's like, okay, well, we'll get the anesthesiologist back up here and see what he thinks about it. And he came up and he was like, well, I could put another one back in. And the nurses like, well, before we do that, like let's just check and see where you are at, um, dilation wise. And she's like, oh yeah. So she did a check and she's like, oh, you're, you're nine centimeters dilated. We're not putting another one back in. You're just going to do this.

Hannah: I was like, all right, we're going to do this. Oh, I forgot to mention. Um, before the anesthesiologist got back up there to check the second epidural to see what was going on with it. Um, the physician had come in and recommended or asked both, I guess it felt like a recommendation, but they did ask if I wanted my bag of water ruptured. Cause I, it had not broken yet. And I asked what the risk and benefits were and they explained those. And I hadn't really been in labor that long at this point. Cause it was only like three o'clock in the morning, but really only been at the hospital for six or seven hours at that point. So I felt like it was kind of early for them to ask if I wanted that, but they recommended it. So I said, sure. So they ruptured my bag of water while right after I'd gotten the second epidural placed. And then after they ruptured my bag of water in my labor progressed very quickly.

Nicole: Gotcha. Gotcha. So then you realized you were nine centimeters and then it was like at work, you're doing this, this is going to happen.

Hannah: Yeah. Okay. So that was about six o'clock in the morning that they said, you know, you're nine centimeters dilated. We don't have time to put another epidural and you're just gonna finish dilating and push from there. And I had joked with the nurse that came on at the beginning of the night shift and said, you know, I'm going to tell it, I'm telling you right now, this baby is going to be a shift change baby. Baby of a nurse is going to happen at shift change at six 30 in the morning, I started pushing and I was like, yep, it's going to be a shift change. Cause I was fully dilated around six 30. So I started pushing and it took a while to really get the hang of pushing. It was really hard to coordinate everything. So it's probably like 15 minutes of terrible pushing, followed by 45 minutes of better coordinated pushing and beautiful healthy baby was born at seven 30 in the morning.

Nicole: Nice. Nice, nice, nice. And did you feel like it was your epidural working at all or was it like gone by that point?

Hannah: It was absolutely gone. I don't think the second epidural ever really worked. I think it was just residual coverage from the first one. And once that wore off the second one was doing nothing.

Nicole: Okay. Okay. But you were able to power through obviously.

Hannah: Yes. Yeah. So powering through the pushing was tolerable. I don't know if it was just from the endorphins and all the hormones and everything. Um, but I did end up tearing when I was pushing and when they were doing the sutures, I think the doctors didn't realize that my epidural wasn't working cause it kind of came in right at the end of my pushing. And so the nurse, the two nurses that were there knew that my epidural wasn't working, but it was still attached and you can see all the equipment there. So I think the doctors assumed that I had an epidural that was working. So when they were doing the stitches, that was incredibly more painful, than actually delivering the baby, which is unfortunate

Nicole: And they didn't add any additional local.

Hannah: I think they gave me a little bit of lidocaine injection.

Nicole: Wasn't it just wasn't doing it for me. Okay. All right. So then let's talk about your postpartum experience because that was truly, truly a journey. Um, now I know you were, you went home fairly like two days afterwards, like standard, is that right? Uh,

Hannah: We went home the next morning. So he was born at seven 30 in the morning and then on Thursday. And then on Friday morning we discharged about 10:00 AM. Oh,

Nicole: So you were like, I'm out, like I'm going home.

Hannah: Yeah. He asked all of his newborn screenings that morning. And so they were like, yeah, if you guys want to go home, like go ahead and go home

Nicole: Because of COVID and everything and just like getting out of the hospital. So then things started happening fairly soon postpartum. So what happened with you in the postpartum period?

Hannah: Yeah. So when we went home on Friday morning, I felt kind of overall like all my muscles felt sore and just kind of achy and obviously fatigued. And I just thought it was normal, postpartum, not feeling good just from how much work delivering a baby is. Right. Uh, and we got home and we regressed feeding and breastfeeding was going well and baby was doing well. He was sleeping, eating all the normal stuff. And I went to bed on Friday night and I kind of had a couple of episodes of chills, but I thought it was kind of just leftover hormone, residual changes. Cause I had a lot of like body shakes and tremors in the very early postpartum period. Right. But I just kind of shrugged it off and went to bed that night and then woke up with baby throughout the night. But my husband let me have a couple hours of uninterrupted sleep going into the early morning on Saturday.

Hannah: And when I woke up from that couple hours of sleep, I had severe chills. Uh, just felt like I had a raging fever. So I took my temp and I had a fever of 102 or something around there, but called my OB and was like, Hey, this is what's going on. She's like, yeah, I think you should come into the ER to get checked out. Right. So we had only been home for like 24 hours at that point. And having to go back to the hospital is kind of scary. We called my in-laws because we didn't want to take the baby with us to the ER. Taking a newborn to the ER just sounded terrifying to me with all of the exposure that could happen. Like in laws came over and they kept the baby and me and my husband were off to the ER and there wasn't any obvious infection source.

Hannah: There was no indication of mastitis or any looks of infection with my stitches. So they just kind of assumed that I had endometritis and gave me antibiotics to treat me for that. But my discharge looked normal at that point, there wasn't any foul smell or anything. So they decided they were going to put me on IV antibiotics and admit me, which was terrifying because I had a two day old baby at home. So I had requested that they put me on the postpartum unit and allow my baby to come in, just cause we were still trying to establish breastfeeding. And it was scary being admitted to the hospital for being sick and having a baby at home. So they were able to pull some strings and let that happen. There was a lot of issues because with COVID visitation, you had to be over 18 to even come into the hospital.

Hannah: And there was only certain visiting hours, but they were able to put me on the postpartum unit and let my baby stay, which also meant that my husband got to stay too. Yeah. So they admitted me. I got up to the room, my husband went home and got the baby and all the stuff that we needed because we weren't really expecting on being admitted and he got back. And then later that evening I passed a chunk of tissue with my discharge. And so they assumed that I had retained a piece of my placenta and that caused the endometritis. So I had an ultrasound done to make sure there wasn't any more retained tissue and they didn't see any. So we were admitted for three days at that time and got IV antibiotics. And then they sent me home on oral antibiotics and I was feeling a lot better.

Hannah: So that was a three-day hospital stay. We discharged Monday morning and we were really excited to get home and just try and establish our new routine as a family. My mom and sisters live about 12 hour drive away. So they were going to come visit. So I was really excited to see them and let them spend time with our newborn. Uh, so they came and it was really nice to have them here to help out. They were really helpful with helping take care of baby and helping take care of stuff around the house. And it was just really nice to be able to visit with them because we didn't gather for Thanksgiving or Christmas. So we were home for about a week and a half and my family had visited and then they went home and I just wasn't feeling that great. I went to a follow-up appointment with my OB a week after discharging and I told her, you know, I just, I feel fatigued.

Hannah: I just feel kind of achy and she's like, you know that's just normal postpartum. Your body's recovering. You're breastfeeding. You aren't sleeping at night. Like these all just sound like very normal postpartum things to me. So I had finished my oral antibiotics at that point was at home, trying to recover and get into the hang of being a new mom. My husband went back to work. He was off for a week and a half and then he went back to work and I just continued to feel worse and worse. I was having a lot of perennial pain. I was having a lot of lower abdominal pain, just really fatigued. And I had been taking stool softener starting as soon as I had the baby at the hospital and just to help keep my stool soft, just cause I had a lot of pain in my perennial area with all my stitches and my stool had been normal up until that point.

Hannah: And then all of a sudden I was just having severe diarrhea and it was really concerning because of how much diarrhea I was having. I was really dehydrated. I couldn't keep anything down. As soon as I would drink something, I would be running to the bathroom, which was just really abnormal for me. And I was, I just felt terrible. And so I called my OB and I was like, Hey, like I want to come in and see you guys. Like, I feel like something isn't right. So I went in for an appointment and I was so weak that I couldn't even walk myself into the doctor's office. My husband had to go get a wheelchair and wheeled me into the office, which just felt humiliating for me. I'm very independent. And I am colleagues with these people and I just felt really embarrassed that I was so weak. I couldn't even walk myself into a doctor's appointment. So I met with my OB and she was concerned that I was really dehydrated. So she sent me to the ER for a second time and I got to the ER and again had to be wheeled in, in a wheelchair and then triaged, they took my vitals and my blood pressure was like 72 over 30.

Nicole: Oh my God. For those guys, for the listeners, that is very, that's very low.

Hannah: Yeah. And it was when they told me that they, it really was terrifying to me because I knew how bad that was.

Nicole: I was scared to say, you're an ICU nurse. You knew what was going through your mind at the time?

Hannah: I was really scared. And then the triage nurse picked up the phone and called back to the stay room. So I was at my hospital that I work at and we have a couple of stay rooms, which is where the sickest of the sickest patients go in the ER, um, to help stabilize them and get them, um, stabled out before they either go up to the ICU or go to different rooms. So she called back to a stay room and kind of gave them a quick rundown. Hey, we have a 24 year old female looks like she's septic. We're bringing her back and hearing that I was going back there just scared me. Cause that's where most of my patients come from is the stay rooms. So hearing how sick I was was really, really terrifying. So they wheeled me back there. And at this point I was mentally kind of checked out.

Hannah: I was so sick that I don't have a whole lot of memories of what was going on, but they started an IV. They drew a bunch of labs. They gave me over five liters of fluid. And finally my blood pressure was starting to come back up a little bit. I was up in to like the nineties. Um, so that was good for them and good for me. And I was feeling a little bit better. So they transferred me out to just a regular ER room to continue giving the IV fluids and wait for test results to come back. So they moved me out to a regular ER room and my husband was like, okay, I haven't eaten yet. I'm going to go get something to eat. So he went out to the cafeteria and not five minutes after he left all of a sudden my blood pressure tanked again, I was down in to the seventies.

Hannah: I was feeling shaky and weak. And so they took me back to the same room. The doctor put in a central line because I was going to need vasopressors. Um, which for me, the central line was kind of the point of crossing a line of you are very sick and something is very wrong. So he put a central line in, started coming on. I ended up meeting two vasopressors on top of all the fluids that I had already gotten. And at this point, everyone thinking that I had a really bad C-Diff infection because I had been on oral antibiotics to treat me for my previous uterine infection

Nicole: And with the diarrhea

Hannah: And with the severe diarrhea, everything just made sense very well clinically. So my husband came back and he was confused cause I was in a different room and all of a sudden, all this other stuff was happening. And all of a sudden I had eight different pumps that were running in. And that was really scary for him to walk into when I had been downgraded and he left on a good note. Um, but then my C diff test came back negative. So the doctor came in and he was phenomenal. He was like, you know, I don't really know what's going on. We've tested a bunch of stuff. And I just really don't know. So we're going to cover you for any infection that you could possibly have, and we're going to get you to the ICU and do continue to do our workup on you.

Hannah: Okay. Was this the ER doctor or this was the ER doctor. Okay. And I was also having really severe abdominal pain. Um, I told the doctor, it was worse than having a baby without an epidural. Uh, so the doctor that was going to admit me, came down to meet me in the ed. And she was one of the intensivist and I work with her at work all the time. So when she walked in, I told her, I was like, I wanted a lot of PCA. I want to continue to still send a demand goes because I feel terrible. Right? So she was like, yep, you got it. Whatever you need. And like, we're here to support you. And that was something that continued throughout my entire stay was that the entire team was really supportive of me and everyone just felt awful for the situation that we were in a so wheeled up to the ICU. Uh, finally got some pain management and I was feeling a little bit better, but with all the narcotics and the infection, my memory is pretty foggy. I don't remember a lot of what happened that first night. I do remember having to say goodbye to my husband when visiting hours ended. And that was really hard.

Hannah: It was really hard when he came back the next morning, you said that was the hardest thing he'd ever had to do because he wasn't sure if I was going to be alive the next time that he saw me. Oh my gosh, it was just difficult to be away from my husband away from my baby, who at this point was just shy of a month old. And I was so sick that my body had stopped producing breast milk at all. I had been breastfeeding up until this point. I requested a pump and I couldn't even pump anything. I was, my body was just too sick to even try, but I made it through that first night. And my husband came back when visiting hours started in the morning. And I don't really, really remember a whole lot of that day until that evening, the OB came into the room and I thought it was really weird because I had already talked to one of the OBs that day and the docs don't usually come by that late in the evening.

Hannah: So I knew something was kind of off. And the look on her face was very grim. So me and my husband grabbed each other's hands and like, we know what's going on. Um, talk to us. She said, I'm not going to sugar coat anything. I want to be very honest with you. A swab of your vaginal discharge came back as group a beta strep. And we were like, okay, what does that mean was like, well, this is a infection that has a 50% mortality rate. And at this point we would recommend that we rush you down to surgery now for an emergent hysterectomy.

Hannah: And at that point, our jaws just kind of dropped. Of course, um being told that you're a healthy 24 year old prior to having this baby. You have a newborn at home. And the chances of you dying within the next 24 hours are 50% was life changing. Yes. So she said, we recommend that you have a hysterectomy right now. The other options would be trying to treat it just with antibiotics. So you could keep your uterus, but we don't recommend that due to the infection that you have. So me and my husband looked at each other and we're like, you know, me being alive is more important than me having more babies in the future. So we decided to go ahead with surgery.

Hannah: So they had to get prepped and we wanted to do a couple things before I went down for the surgery. I called my parents and told them what was going on. It was a really quick conversation and it was really hard to tell my parents that I might die. Um, I also asked my mom if she could drive out here. So that way someone could be home with the baby. While me and my husband were in the hospital. She was happy to do so she works remotely. So she was able to do that. So she's like I can drive out right now. And I told her, no, mom, it's nine o'clock at night. Like get some sleep and just come home in the morning. Um, but I told them, I love them and hung up with them. We called my husband's parents and told them was going on.

Hannah: And, um, they were staying with the baby at this point at our house. That way my husband could be at the hospital with me and baby was not allowed to be at the hospital this time. And then I wrote up an advanced directive quickly because I wanted to be able to have a say in my choices, if things didn't go right. And I also recorded some voice messages, one for my husband and one for Oleander. So that way, if I didn't make it through surgery, they would at least be able to hear my voice.

Hannah: Lots of emotions. So, yes, absolutely. So after about an hour of us making phone calls and getting stuff arranged, um, they wheeled me down to pre-op. My husband, who was able to come down and at this point, visitation hours were over, but they told him, you know, you're more than welcome to stay tonight. Um, we're not going to kick you out. We're making exceptions for you. So he was able to stay thankfully. So he didn't have to go drive home while I was in surgery. And they were able to, they told me that they would open me up and see if they could, um, look at my uterus and see what it looked like. And if it looked okay, then they might be able to leave it. And if it didn't look okay, then they were going to take it out. So they took me back to surgery and got me prepped.

Hannah: I don't remember any of it after they wheeled me down a pre-op. I didn't remember any of it, except for saying goodbye to my husband. And a lot of different staff that I work with at the hospital, um, came down to wish me good luck, which was really appreciative. I really appreciated it in the moment, but also seeing how grim their faces looked. It just kind of really put it into perspective how sick I was, but it was really nice to have everyone's support with the COVID visiting restrictions. It was really hard to just have my husband go there and not have the support of the rest of my family. Um, so having my work family there, it was really nice. They took me back to surgery and then after surgery, they took me back up to the ICU, um, to recover. And then I woke up to where I can remember a couple of hours later.

Hannah: And the first thing I asked was, do I have a uterus? They weren't sure if they were gonna take it out or not. And my husband was there and he was like, no, you don't. They took out your uterus and your cervix. Um, but they were able to leave your ovaries. So I do still have my ovaries. So I didn't go through menopause. And if we wanted to pursue IVF in the future with a surrogate we could, but which I was happy to hear that they were able to leave my ovaries. Um, but they removed over a liter of pus from my abdomen, my uterus and cervix.

Hannah: So that was a lot to process and having a big abdominal surgery while I was still trying to recover from delivering a baby was a lot to physically manage. Um, so I spent four days in the ICU and then I was able to downgrade to a regular floor and continuing to try and work on recovering. Um, I hadn't left my bed in three days. So trying to walk again was a lot of work. I had to use a walker. It was really, um, I can't even think of a good word. It was really humbling to so many of my patients go through. I really put a lot of my nursing care into perspective, and I had a lot of grace for what they go through because I was going through it myself. I wasn't able to eat for that entire hospital stay. Um, so I was very weak, very, very tired, very sore all over. But after a week I was able to finally discharge all of them, which I was so excited to go home and see my baby because I hadn't seen him in a week at that point.

Hannah: So I got home. I was still feeling pretty terrible, very weak. I couldn't even lift my baby. I had to sit on the couch and have someone put him in my arms so I could hold him. Um, it was really hard. I just wanted to be a mom and I wasn't able to do that. So I wasn't even home for 24 hours. And suddenly I was starting to have very sharp abdominal pain again. So went back to the ER, had another CAT scan and it turns out I had pancreatitis and a bunch of fluid in my abdomen. So I had to have a paracentesis and get drained, get all the fluid drain out of my abdomen. And I got readmitted to the hospital to make sure it wasn't an infection in my abdomen. On top of the previous infection that I had already had as well as treat the pancreatitis that I now had.

Hannah: So this hospital stay was another week of being in the hospital without my baby. And that was really hard. So to be away from him after being away from him for a week beforehand. But at this point it was starting to get nice out. We live in Minnesota, so it had been pretty chilly. Um, but it was nice enough out that my mom was able to bring him to visit. And we were able to sit outside and visit with each other. So I could at least hold him for a little bit, which was really nice, but again, really hard to be away from him. And my husband could only visit during visiting hours, but he is phenomenal. He was there from sunup to sundown until they would kick him out at night. And my mom and my in-laws were pretty much running our household and taking care of the baby. So me and my husband could focus on getting me healthy and getting me better so I could come home. Um, so I was in the hospital for a week that time, the second time. Well, I guess third time. I had three hospital stays after delivery. So I was in for a week, continued to rehab, um, was finally able to eat something which was so nice. Even if it was hospital food. It was so nice to finally be able to eat something after two weeks of not being able to. And I discharged home and finally was able to stay home with my family, which was one of the best feelings that I could have.

Nicole: Oh my goodness. I, that is just a lot, a lot. How are you doing now?

Hannah: Yeah. So has been probably about three or four weeks at home. It's about three weeks at home of again, still being really weak. I couldn't take the dogs for a walk, which was something that I really enjoyed and they really enjoyed. And I just felt a lot of guilt for not being able to do that with the dogs. And I felt a lot of guilt for not being able to do stuff around the house. My mom was awesome and she stayed for another week and a half after I discharged from the hospital just so I could continue recovering. So she did all the cooking and cleaning and did a lot of taking care of the baby. My husband had taken two weeks of unpaid leave from work so he could spend it in the hospital with me. And so he had to go back to work and it was just a lot of weird transitioning when we really just wanted to be a family learning how to take care of our baby and spend time together. But after about three weeks of being home, I was starting to feel more physically capable and was able to help start doing stuff around the house. And I was able to fully take care of the baby at this point, which is really nice, just cause I felt a lot of mom guilt for missing two weeks of his life at this point.

Hannah: Um, and now I am not back to where I was with my fitness, um, pre delivery. I would say I was probably more in shape and at 39 weeks pregnant than I am now. Um, but, I'm able to walk the dogs and take care of the house and all the cooking and cleaning. And I finally got cleared by all of my different medical teams that were following me in the hospital. Uh, and I feel like life is getting more normal. We're able to just be a family. I'm able to be a mom. And normal feels so good. It is crazy how after knowing that you might not even get to live to see the next day, how wonderful normal feels,

Nicole: Uh, I can only imagine. And then how is this impacting, like your maternity leave? Do you have to think about work and going back to work anytime?

Hannah: Uh, so thankfully my hospital is a pretty good hospital to work for as a nurse. Um, we are given up to a year of maternity leave if we want it. Um, it's unpaid, but able to take up to a year. So I had planned to do about three and a half months of maternity leave. Um, but with everything that I went through with my hospitalizations, the doctors said it would probably be a three month recovery for me to get back to where I was physically beforehand. Um, and with my job, it's very physically demanding being on your feet for 12 hours, taking care of patients that are fully dependent on you for all the cares.

Nicole: I mean, ICU nurses run the ICU. So

Hannah: Yeah, it's, uh, it's a lot of physical demands at work. So I was able to extend my maternity leave another month. So thankfully I don't have to think about going back to work quite yet. And I'm able to at least spend some my maternity leave at home rather than in the hospital. I joked with my boss that I spent more of my maternity leave in the hospital than I did beforehand.

Nicole: Yeah. Yeah. Yeah. And it's glad that you don't have to worry about you all are able to I'm assuming handle the financial piece as well, because that can be challenging if it's unpaid.

Hannah: Yeah, it is challenging and it was a big stressor, but we were able to get it figured out. And our bosses, our, our friends and family have been phenomenal and instrumental on us getting through this. When they say it takes a community to raise a baby. They are not kidding.

Nicole: 100%. And then how are you dealing mentally and emotionally, if you don't mind me asking.

Hannah: Yeah, I am very open to talking about that because it was really difficult and I hope that other people don't have to go through it, but having a stressful postpartum period was difficult and exhausting. So I am happy to share my story. So that way other people that feel like they're having a difficult time feel validated in their feelings. Um, mentally, it was really difficult knowing all of the details of what was going on while I was in the hospital. Um, you know, looking at my medications, looking at my vitals, it was really difficult having so much knowledge about what I was going through and having the guilt of not being at home, taking care of my family was really hard for me to go through physically, I'm getting there and then emotionally it was a really traumatic experience. Um, me and my husband are seeing a therapist to try and help us process through everything that we went through.

Nicole: Did you just find that on your own or did the medical system help you? Cause I felt like the medical community is terrible about helping people in these situations. We just don't know how to do a very good job of it.

Hannah: Yeah. So we had asked one of the social asked one of the nurses to get us in contact with a social worker at the hospital because we knew we were going to want to see a therapist after discharging and just to help us process through everything. And they were really great. They brought us a big list of the different, um, therapist in the area and they tried hard, but the first therapist that I tried to call the call was disconnected or the number wasn't even active. The business had been out of business for the last three years they put in effort, but it wasn't really that helpful.

Nicole: Yeah. It wasn't, you have to, I mean, it's a shame. I mean, and sadly we both know being in the medical profession, how sadly, unfortunately that happens way more than it should.

Hannah: Yes. Way more than it should. But we were able to find one that's close to home and we enjoy seeing. And so we were able to do that on our own and have been doing that together.

Nicole: Okay. Okay. And do you feel like you've had the support from your, from the medical community in general in your recovery and just throughout the process, is there anything that you feel like you wish was different?

Hannah: Um, I wish that I would have had more confidence in standing up for myself, um, prior to the second hospitalization and third hospitalization, because I always felt really rushed whenever I was seeing my OB. I mean, I feel like stuff could have gotten addressed earlier and maybe not have had severe consequences if it would have been addressed earlier, but I always just felt rushed whenever I was seeing any of the physicians. Um, like they just didn't have the time to sit and talk with me.

Nicole: Gotcha. Gotcha. Oh, so I, I just, I mean, I can't thank you enough for coming on to share your story. Cause this is still fresh for you. Um, uh, that this, that this happened. So I'm incredibly grateful for you sharing your experience. If you had to pick one piece of advice that you would tell other women, what, what would that be?

Hannah: Um, definitely, definitely educate yourself. And don't let people tell you that everything is normal. Um, I had mentioned my abdominal pain, my perineal pain multiple times to my OB team. And they're like, oh yeah, it's just normal. It's just normal postpartum stuff. And I felt like it wasn't normal. And I felt like I wasn't getting the validation or the treatment that I needed.

Nicole: Did they look and make sure things looked okay?

Hannah: Some physicians did some didn't. I won't make follow up for my first hospitalization. Um, I had the nurse had me undress from the waist down so that way the physician could do an exam. And she was like, oh, well, based on talking to you, I feel like I don't even need to do one. Okay. Call us if you have any questions. And I just felt like things were really rushed and the physicians didn't take the time to listen to my concerns, but my biggest advice is educate yourself. So that way, you know what normal is, and don't be afraid to stand up for yourself. If something doesn't feel normal or it doesn't feel right, because things could be wrong. There's a lot of different postpartum complications that exist. And sadly our mortality rate in the US is unnecessarily high. So don't be afraid to stand up for yourself.

Nicole: Well, thank you so much. I don't know. Are you on social media or connecting with, if you can say no, if you don't, um, have any public facing sort of stuff. I just always offer people the option

Hannah: On Facebook and Instagram. On Facebook, it's just my first and last name Hannah Penshorn. And then on Instagram, it's Hannah15banana. And I'm happy to talk with anyone that'd like to talk about anything.

Nicole: We'll link that in the show notes. Well, again, thank you so much, Hannah. I so appreciate you coming on. Thank you. Thank you. You again, Hannah, for sharing your birth story, that was really, really powerful. Now, you know, after every episode, when I have a guest, I do something called Nicole's Notes where I do my top takeaways from the episode and conversation. Here are my Nicole's Notes from my conversation with Hannah and I actually have several for this Nicole's Notes. I just want to tell you a little tiny bit more about group a streptococcus. So it's a bacterial infection. It's not common. Um, the incidence of postpartum infection is roughly six per 100,000 live births group. A streptococcus is much worse in pregnant people compared to non-pregnant people. So the attack rate of invasive group a streptococcus is 20 fold higher for pregnant and postpartum women compared with non-pregnant women.

Nicole: We're not exactly sure why that's the case. We think maybe it's related to the immune system in pregnancy for women that have pregnancy related group a streptococcus infection, 85% or more occurs postpartum. And the mortality rate is indeed 50%. Some risk factors for pregnancy related group a streptococcus, our upper respiratory tract infection with group a strep like it could be like from strep throat, also premature rupture of membranes and actually contact with young children during pregnancy may also be a risk factor for maternal group aged up to caucus, but that is something that's still under understudy. The treatment for this infection is, um, antibiotics and hysterectomy. Okay. So point number two, this is an example of where modern medicine really shines. I know there's some issues with medical care in the US around pregnancy and birth, but this is where modern medicine shines with ICU intensive care units, um, prompt recognition and treatment of severe conditions.

Nicole: Antibiotic use surgery being available right away. This is where modern medicine can make a difference and can save lives a hundred years ago or even 60 or 70 years ago. This would have been fatal because we just didn't have the same things to treat it and recognize it. So again, this is just an example where modern medicine shines. All right. Point number three is that it can be tempting for someone to say like, well, just be happy that you and your baby are alive. Listen F that. Okay. It is completely okay. If you're not happy with your experience, even if you and your baby make it out, physically just making it out alive is the bare minimum for your birth. Now, obviously this is an extreme example with Hannah and I think, you know, I would hope no one would say something as ridiculous as you should just be happy that you and your baby are alive, but sometimes people will say that when they perceive or make judgements about your experience, that, oh, maybe it wasn't that bad kind of thing.

Nicole: And I want to be clear that it's okay if you're not happy with your birth, um, you can both be happy that you and your baby are alive and not be happy with your experience. The key is to not let that detract from motherhood. Um, you may need to take some time to process what you felt about your birth, but let's not buy into that. Just be happy that you and your baby are okay. Okay. Number four is, if something is not right, please, please, you must speak up until you have answers, whether that's during your pregnancy or your birth, or at any point, really for your health. Hannah is so right, that things are rushed. IN our medical system physicians don't have enough time or don't spend enough time to spend with patients. I can say that from the physician perspective, there's certainly some pressure in terms of like administration to see as many patients as possible in the least amount of, of time.

Nicole: I'm not saying that that's an excuse, but I'm saying that that's the reality of the business piece of medicine. It's something that physicians are trying to work on changing. So I say all that to say, if something's not right, you have to continue to speak up until you have answers. It can truly be a life or death situation. And then a final thing I want to tell you is that I have a free guide that you can download on warning signs to look out for after birth. Roughly 60% of maternal mortality actually happens after birth. So you want to grab these warning signs so you can be on the lookout for things to be mindful of. It's just a one-page sheet. You can print it out, you know, stick it on your refrigerator, just have it nearby. You can grab that free guide at drnicolerankins.com/warningsigns. And then I go even deeper into those warning signs inside the Birth Preparation Course with the more detailed explanation and the Birth Preparation Course is at drnicolerankins.com/enroll, where you can find out the details there. Alright. So there you have it. Be sure to subscribe to the podcast in Apple Podcast or wherever you're listening to me right now. I'd also love it if you leave a review on Apple Podcast in particular helps the show to grow helps other women to find the show and do check out that free guide for sure, drnicolerankins.com/warningsigns. And if you want a more in-depth review check out the Birth Preparation Course, there's of course more information in the Birth Preparation Course. It gets you calm, confident, and empowered to have a beautiful birth by helping you have a calm and peaceful mind, you learn all the details of what happens in your body during labor birth and the postpartum period.

Nicole: And you also learn how to advocate for yourself. You can get the details of the Birth Preparation Course at drnicolerankins.com/enroll. All right, so that's it for this episode, come on back next week. And until then, I wish you a beautiful pregnancy and birth. Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website, drnicolerankins.com to get even more great information, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class, on How To Make A Birth Plan That Works as well as everything you need to know about my signature online childbirth education class, the Birth Preparation Course. Again, that's drnicolerankins.com and I will see you next time.