Ep 176: Christina’s Birth Story – An Uncomplicated Pregnancy That Ended With Severe Preeclampsia and a C-Section

Dr. Nicole (00:00:00): What happens when things go a little different than planned and you need to be transferred to another hospital for your birth, you will find out in this birth story episode with Christina. 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 drnicolerankins.com/disclaimer. Now let's get to it.

Dr. Nicole (00:00:56): Hello there. Welcome to another episode of the podcast. This is episode number 176. Thank you for being here with me today. In this episode, we have Christina. Christina and her husband, Adam live in Toledo, Ohio with their son, Henry and golden retriever, Archie. Christina is a collegiate swim coach and in her free time, she enjoys exercising, reading, playing board games and taking walks. After a completely uneventful and easy pregnancy with a midwife practice and lots of plans and preparation for an unmedicated birth, around 37 weeks Christina felt like something just wasn't right? So she went to the hospital. She was subsequently diagnosed with severe preeclampsia, something called HELLP syndrome. HELLP syndrome stands for hemolysis, elevated liver enzymes and low platelets. It is the most, one of the most severe forms of preeclampsia. She was then transferred to another hospital that she was completely unfamiliar with.

Dr. Nicole (00:01:57): And you are going to hear all about her experience today. This is really a great story of managing through a difficult and unexpected birth course. Now, before we get into the episode, let me take a minute and tell you about something that I think is so important. And that's childbirth education, I have a great option for childbirth education. It's called the Birth Preparation Course its my online childbirth education class that will get you calm, confident, and empowered to have a beautiful birth. It uses this really amazing five step process. It's called the beautiful birth prep process. And in that you learn how to set the tone for your birth, where you get your mind and your support, right? And then the next step is learning all of the details about labor and birth. You then get prepared for the possible things that may happen because birth is an unpredictable process, but you'll be ready with the Birth Preparation Course.

Dr. Nicole (00:02:54): And then finally you learn how, how to get off to a great start postpartum because birth is just the beginning. There's a whole postpartum period too. And then of course you learn how to make birth wishes that actually work or a birth plan that actually works to help you have the birth that you want. You can check out all the details of the Birth Preparation Course at drnicolerankins.com/enroll. Thousands of mamas have been through the course, and I would love to have you inside the course too. All right. Let's get into this birth story episode with Christina.

Dr. Nicole (00:03:31): Thank you, Christina, for agreeing to come onto the podcast. I am excited to have you share your story. I know it's not exactly what you anticipated, but it's definitely something that I think folks are gonna learn a lot from.

Christina (00:03:42): Yeah, absolutely.

Dr. Nicole (00:03:44): All right. So why don't you start off by telling us a bit about yourself and your family?

Christina (00:03:48): Yeah. Okay. So, um, my husband, Adam and I, um, live in Northwest Ohio, we live in Toledo. Um, we have one golden retriever named Archie who is almost four, and then our son Henry, um, actually just turned 11 months this past weekend. So we're gearing up and getting ready for his first birthday.

Dr. Nicole (00:04:09): Oh my goodness.

Christina (00:04:09): It's crazy. It's crazy. I don't know where the last year has gone.

Dr. Nicole (00:04:12): Exactly.

Christina (00:04:13): But my, so I am a college swim coach is my full-time job. And my husband is an attorney. So we have very different schedules, but that allows us to both really get a lot of time with our son, Henry. Um, my husband gets mornings with him and I get to spend during the day with him. So it's really the best of both worlds. Being able to both have our careers and also get to spend a lot of time with Henry and my husband's family lives about 15 minutes away. And so they get to see Henry all the time and my parents live about three hours away, but they're both retired. And so we are so lucky that we have a lot of extended family who are able to spend a lot of time with us and with Henry and get to know him.

Dr. Nicole (00:04:59): Oh, that's really, really nice. It's so hard to find a good balance between for the parents to find the balance that works and then for you to have extended family, it, it, that really, um, you know, will mean a lot to you and Henry as he's growing up.

Christina (00:05:11): Absolutely. Absolutely. No, we're, we're very, very lucky. Yeah.

Dr. Nicole (00:05:15): Yeah. So why don't you start off by telling us a bit about what your pregnancy was like and your prenatal care?

Christina (00:05:23): Yeah. So, um, Adam and I got married in the middle of crazy COVID so we got married in July of 2020.

Dr. Nicole (00:05:31): Oh. So like literally like right in the middle of co, like yes. Oh my goodness. Yep. So I'm sure that that affected the wedding plans. Unfortunately.

Christina (00:05:40): It did. We ended up changing. Um, we cut our guest list way down to just, you know, family and ime, uh, close friends. We moved everything outdoors to try to make everything a little bit safer. Um, and so it, it ended up being beautiful, but it, it was not what we were planning, but, we, but we rolled with it and we were like, you know, we're gonna, we're gonna make this happen. Whether it's just the two of us or we can have some more people. And we were originally supposed to honeymoon in St. Lucia. But again, because of all the restrictions, we ended up canceling our honeymoon. And I think kind of our attitude was if we can't go on our honeymoon or go anywhere, let's get pregnant. So about a month and a half after we got married, I found out I was pregnant. I actually,

Dr. Nicole (00:06:21): Okay wait. Christina, Christina, how did you, did you go from, we're not, we're not gonna have a honeymoon to okay let's just have a baby.

Christina (00:06:32): Well, so we had, we both knew that we wanted to start a family pretty quickly. And so it just, I, why not right. And it turned out to be great. Um, we had no idea it would, we were, again, very lucky that it, it happened very quickly. Um, it was about a month and a half after we got married. Okay. Um, found out I was four weeks pregnant. So I found out that, you know, the day I missed my period got a positive pregnancy test and it was definitely a surprise. Um, and it was super exciting being able to tell Adam about it because, um, we weren't necessarily trying, but we weren't not trying. And so it, it was exciting to be able to tell him. And at that point I just had a, a primary care physician. I didn't even have an OB GYN that I was seeing regularly.

Christina (00:07:18): And so when I found out I was pregnant, I just reached out to one of my friends locally because I knew she loved, um, who she saw when she went through both of her pregnancies. And so I went and saw her, her name is Melanie and she was fabulous. Um, she's actually a, uh, certified nurse midwife. Okay. And I didn't know that going into it. Um, I really just went with her because word of mouth, I, I trusted my friend's, um, opinion and she loved her. And so I was like, you know, sounds great. I'll go check it out. I hadn't, at that point, really done any research about the difference between an OB GYN or, um, a midwife. It just, I figured I would go, I was early enough in my pregnancy. Um, I figured I would go and just check things out and she ended up being fabulous.

Christina (00:08:05): She answered all of my millions of questions and made me feel very, very comfortable. And so we got to, um, go a little bit earlier than we were supposed to. I went for my first ultrasound at six weeks because I was having some bleeding and it ended up being, I think it's a hematoma in, in my uterus and, uh, ended up turning out, you know, the next time we went back for the next ultrasound, it was nothing or not. It wasn't nothing, it had gone away. Right. And so it, it turned out to not be anything crazy, but we got to have that appointment, um, a little bit earlier than I think a lot of people get to see their baby. Yeah.

Dr. Nicole (00:08:46): Usually that is a bit earlier than, than is typical, but still sort of scary I'm I'm guessing too.

Christina (00:08:51): It was it. I just had no, I mean, usually, you know, in my head I associated bleeding with potentially having a miscarriage. And so that was kind of what I had, uh, prepped myself for when we went in. And this was kind of really my, my selling point on the practice that we ended up going through. Everyone was so kind and understanding and reassuring. And I felt like I really got the full explanation and the full picture of what was going on. I didn't feel, I felt very reassured and taken care of after that appointment. And so at no point, did I ever deviate from staying with them.

Dr. Nicole (00:09:29): Gotcha. Gotcha. Well, that's great. That's great. Were you worried at all about being pregnant during COVID or at that time? Was it like we don't, maybe at that time, maybe you weren't thinking that this is gonna be like another two years or whatever it's been now. So were you worried at all about COVID?

Christina (00:09:46): Yes. So I was, I was because the nature of my, um, job is that I can't do it remotely. And so with, uh, coaching swimming, I had to be on a pool deck. And, um, so I was surrounded by college girls, um, daily sometimes twice daily. And so that was definitely in the back of my mind. Um, I had no idea what prenatal care was going to look like, but my best friends, my two best friends from college actually, um, one of 'em was two months pregnant when I found out that I was pregnant. Okay. And the other one was about, had found out the week before that I found out I was pregnant, that she was, oh, wow. Wow. And so I, I think, I felt like, you know, if it's gonna be challenging and it's gonna be hard, at least we're doing it together. And so I think that, that gave me a lot of reassurance as well of have someone in it, in the trenches with you.

Dr. Nicole (00:10:41): Yeah. Well, that's really nice that you had people who, you know, and are friends and close with who you could go through with it together. Yeah.

Christina (00:10:49): Yeah. It was great. Yeah.

Dr. Nicole (00:10:51): Yeah. Yeah. So you felt like you're, other than the, the sub chorionic hemorrhage, I'm guessing is what it, what it was. That's the fancy norm fancy term rather for bleeding in the beginning of pregnancy. And then how was the rest of your pregnancy?

Christina (00:11:06): Very, um, uneventful. I had a lot of nausea, the first trimester. Um, luckily I didn't, I, I never threw up, but I ate a lot because the only way that I could kind of sate that nausea was to eat. Right. And so I just had lots of snacks all the time, but other than that, I

Christina (00:11:30): Had a very uneventful pregnancy. It was, it was pretty easy. We, um, I think we got a total of six ultrasounds throughout my pregnancy, just for various reasons. Um, one time I came in and they were searching for the heartbeat and they couldn't find it. And so I got an ultrasound for that just to make sure everything was okay. Um, for our anatomy scan, um, he was breach and also, um, his head was in my hip. And so they weren't able to get everything that they needed at that scan. And so we got to see him again a couple weeks later. And so I think that that really helped my start, like my, uh, anxiety with being pregnant and hoping that everything is okay, that we did get to see him pretty frequently. It felt like. And so that was, that was pretty reassuring.

Christina (00:12:22): Um, I was able to work out throughout my pregnancy, so I, while I was pregnant, um, also coached fitness classes. Hmm. And so that, I think really helped me stay active when, you know, first trimester I was exhausted and all I wanted to do was lay on the couch and sleep, being able to have a full-time job where I'm walking up and down the pool deck kept me active and being able to coach those fitness classes forced me to continue to work out rather than just having to do it on my own. Um, so that I, I really credit to why my pregnancy felt not terribly challenging. Right, right.

Dr. Nicole (00:13:05): Yeah. That definitely helps for sure.

Christina (00:13:07): Absolutely. And I had read that. Um, but it's hard to convince yourself of that when it's the choice between a one hour nap or a 30 minute workout. I would've, most of the time chosen a one hour nap

Dr. Nicole (00:13:19): I totally get that. And then were you seeing the same midwife the whole time or did she have other midwives in the practice?

Christina (00:13:28): So when we, when I first started, um, seeing Melanie, she ha it was only her in her practice. She was in, um, she was attached to the hospital that I was going to deliver at. And there were OB GYNs in the practice that she worked alongside as well. Um, and throughout my pregnancy, I'm not sure at what point she, um, added three additional midwives to her practice. Oh, wow. And so I never saw any of the other midwives. I only ever saw her. It, it never, you know, worked out that my appointments were when she was delivering a baby. And so I was able to see her for every single appointment that I had.

Dr. Nicole (00:14:07): Got it. Got it. Okay. Okay. So what did you to do, what did you do to prepare for your birth?

Christina (00:14:12): Yeah, so we decided to my husband and I decided to go through, well, let's just say I decided, my husband really just kind of left it up to me and was like, whatever you think is best I'm on board with, we decided to go through a hypnobirthing class. Okay. And it was something that my friend who was two months ahead in her pregnancy had read the book and she's very into yoga and mindfulness and things like that. So I was like, okay, you know, this seems like something that I, I would like to learn more about. Um, pre-pregnancy if you had asked whether I was pro medication or not, I would've said, you know, whatever I gotta do to make this, this happen is totally fine. And then once I actually got pregnant, I wanted to do a little bit more research into the unmedicated side.

Christina (00:14:59): And I knew that that wasn't for me personally, that wasn't something I was gonna be able to just make that decision. And then that's the end. I knew I was gonna have to really do my homework and train for that. And so I did some research, found a doula in the Columbus Ohio area. Um, cuz again with COVID, uh, we were able to do it, uh, through zoom. And so there were about eight other couples in the class with us. A couple of them were local to Columbus and were actually using this doula as their birth doula. Okay. And so went through that. I think it was eight weeks. Um, we met for a couple hours every Thursday and really just tried to work on how I was going to relax. And what I loved about the hypnobirthing process is letting your body do what it knows how to do.

Christina (00:15:51): And rather than trying and, and talked a lot about how stress and tightness translates to being, you know, tight to prevent the baby from doing what it, your body knows, um, what to do. Right. And so we did a lot with the hypnobirthing. Um, we found a doula locally and met with her a handful of times to just talk about our birth plan. I always knew I wanted to give birth in the hospital. Um, that's just what I, I felt more comfortable with, but we talked a lot about trying to labor as long as we could at home. And I think my biggest question and fear around that was how long is too long. And so that's something that our doula Morgan, um, and I really talked a lot about. And so part of her service was she would, when you were in labor, she would come to your house and help you labor at home.

Christina (00:16:47): And then she would help you, you know, we would work together to figure out when it was time to go from home to the hospital. And so that's something that helped me feel really comfortable. It's something that my husband Adam felt really comfortable with, um, because he's like, let's make our team as big as we can and have as many resources as we can so that we can do what's best for, you know, mom and baby. Right. Um, so those were the two things that we, we focused a lot on, um, in the prenatal care. Okay. Okay. Did you read any books at all? Yes. So I read, um, en May's book and I also, we read the birth partner. I don't remember who the author is of that, but we went through both of those. And then I also, um, I have a 30 minute commute to my job.

Christina (00:17:33): And so I listened to the hypnobirthing book in addition to going through the class. I also listened to the book through, um, through all my drives. And then I also listened to your podcast. I loved especially listening to the birth stories. And at first I really listened, I would scroll through and I would just look for the word natural or unmedicated or easy or things like that. I'm like, okay. You know, if I just, if I focus on the positives, I focus on, you know, things that are gonna go go right. Then I feel like that's gonna help me keep my focus on how, how things are gonna turn out. And right. As I got about halfway through my pregnancy, I had gone through all of those. And so I started listening to a lot. Um, I, one of the ones that I found most interesting was your podcast about circumcision, just because that was something I had never, I had never done any research on and we uh, waited to find out if we were having a boy or girl and got it. So we didn't know until Henry came out that he was a boy, but that was something that, you know, as I was scrolling through it, I just found very, very interesting.

Dr. Nicole (00:18:40): Oh, love it. Love it. Good. Good, good. And so for your birth, you wanted, it sounds like you wanted unmedicated birth. Um, you wanted to use hypno hypnobirthing and those techniques, you had a doula. Is there anything else that you wanted for your birth?

Christina (00:18:53): I wanted to, so at the hospital I was going to birth at, um, you were not allowed to give birth in the tub, but you were allowed to labor in the tub. And so one of the things I talked to my midwife about was that we needed to call on our way there and let them know that we were, you know, I was in labor, we were coming to the hospital to be able to request a room that had a tub. And so that was something else. I, I wanted to labor in water. I wanted to avoid getting an IV as long as possible because I really wanted to be able to move and, um, be able to physically feel myself through labor. Um, but past that, I mean, I wanted to stay at home as long as I could. And then once we got to the hospital just wanted to be able to not feel restricted to being in the bed if possible.

Dr. Nicole (00:19:44): Got it. Yep. Yep. Makes perfect sense. So tell us about what happened with your labor and birth because things didn't go exactly as you anticipated.

Christina (00:19:55): Yeah. So I was 37 weeks and five days when, um, we ended up going to the hospital. So I had coached a fitness class that evening and I just, I hadn't felt right. Um, it didn't feel like labor. I wasn't having, I had been having some Braxton Hicks contractions for the last week or so they weren't painful. It really just kind of felt like a cramp in the middle of my stomach and I could see my stomach tightening up. Um, but I had been experiencing that and it didn't feel like that. And the person I was working with looked at me and was like, you don't look great, like no offense, but you don't look great. Right. And so I was like, you know, I'm, I'm feeling something in my rib and my back felt pretty tight and I felt pretty nauseous. I was starting, but I'm also prone to migraines.

Christina (00:20:43): And so I was like, you know, maybe I'm getting a migraine and maybe he's, you know, the baby's just sitting off. And so as I took some time, um, and got ready to go home, I started to feel worse and worse and I felt a lot of pain in my stomach. And I kind of just told, I called my husband and I was like, you know, I don't know what labor feels like. Maybe, maybe this is what labor feels like. I don't know. And so I went and got something to eat. That was something that we had talked. I had, I had read, I had heard, you know, eat when you can, because it, you might have that restricted as you get further into labor. So I went next door and got, um, sushi with chicken and that that'll come into later into the story.

Christina (00:21:25): Um, but I went and I went and got that to eat and ate a couple of pieces of that got home. And, you know, our, our plan at that point was I was gonna labor in the tub if I could. So I got in the bathtub and, um, my husband, Adam, you know, came and sat next to me. I called our, our doula Morgan. And I was like, I'm not really sure if this is labor or not, I'm not feeling great. Um, and she said, why don't you go ahead and give your midwife a call and just, you know, see, see what's going on. And so I called and it, it just kept ringing. And so I was like, oh, we'll just hang up. It's okay. And about an hour later, we had tried to call a couple more times and it, it just kept ringing.

Christina (00:22:10): Um, and we weren't able to get through to anybody in the practice. And I told my husband, you know, I, I was, I was promised during labor that this was gonna come in waves and you know, the pain was gonna come and then you were gonna get a break. And I was like, this is very constant pain. And at that point I felt more nauseous, my head hurt. And so I was like, why don't we just go ahead and go to the hospital? It's only 10 minutes away. Let's just go check things out. Worst thing that happens is they're like, yeah, you're fine. Go home. Right. We're we're sort of last minute people. So neither of us had our bags packed. And so we both just kind of threw some stuff into a suitcase. And at this point, I, I, again, I didn't, I didn't know if it was labor or not.

Christina (00:22:49): So I was like, we can, we're probably gonna get sent back home anyway. It's fine. Right. So we went to the hospital, um, arrived at check-in you check in, in the ER in this hospital, it's a smaller hospital. And I told the guy, you know, I think, I think I'm in labor and he kind of laughed and, and shrugged me off and was like, I think if you were in labor, you would know. I'm like, okay. Like I just wanted to, you know, get checked, checked out. So we went back to the birth floor. Um, there was almost nobody there. It was very quiet. It was about 10 o'clock at night, um, on this Friday. And so the, the nurse said, you know, let's go ahead and get your vitals and check and see where everything is. So they hooked me up to the blood pressure cuff and my blood pressure ended up being, I believe, like one 50 something over high nineties.

Christina (00:23:39): And she was like, oh, you know, were you holding your breath when I did it? I was like, uh, maybe I don't know. And so she's like, okay, don't talk, make sure you're breathing through this. So she did it again, and it was the same and I have pretty low blood pressure. And I had actually just been at my midwife two days before this for, you know, my weekly checkup and everything was totally fine. So she said, you know, it might just be, you're getting a little bit close to the end of labor. Um, we might just need to monitor you for a couple of hours. We're not gonna go ahead and call the midwife on call yet, but we are going to go ahead and get some blood work like, okay, cool. Sounds great. Right. So they kept me hooked up to the blood pressure cuff, um, took the blood.

Christina (00:24:21): And at this point, my blood pressure for 20 minutes had been staying pretty steady and my headache was getting worse and I was feeling a lot more nauseous. So they said, you know, we're gonna go ahead and call the midwife on call. So fun story. My, when I had gone to my midwife that week on Wednesday, she was like, I'm going to visit my son in California this weekend, but you know, you're not close to labor. So just make sure nothing happens this weekend. I'll be back on Monday. Like, and then we'll be good. I'm like, oh, you know, he's not coming or baby's not coming anytime soon. It's fine. Right. So this was one of the other midwives in her practice, um, who ended up coming in. And when she came in, it was about half an hour after they had done the blood draw.

Christina (00:25:04): And two other nurses came in with her, one of them holding a bag for an IV. And she came in and just sat down next to me and held my hand and I was like, oh boy. Right. So she said, you know, she she's like, I was worried about possible preeclampsia because of the, your blood pressure. But we ended up getting your, um, blood work back. And at this point my platelets were hovering right around 146,000. And my liver enzymes were very high. And so, you know, she told me these, those things, I'm like, okay, I don't really know what that means. And right. She said, it's something called HELLP syndrome. And so she, I could tell it was like, not gonna be good news because she sat down and held my hand and just like, looked me in the eyes as they were hanging the IV.

Christina (00:25:56): And I knew when they brought the IV in, I'm like, okay, this was not what we talked about on the birth plan. So something's happening. So she explained that at that point, they were gonna start me on magnesium. Um, and then they also put some like bumper pads on the, on the side of the bed, because, uh, you can be prone to seizures. Um, the magnesium was gonna hopefully hold that off. Um, but put the bumper pads on, she also let me know that they were gonna have to insert a catheter and that was not fun, but is what it is. Um, and that I was going to be in bed and I said, okay, you know, how long are we gonna do this for, um, before I'm gonna be able to go home. And she's like, oh, no, no, no. We're also gonna be starting to induce labor because she explained, you know, the only way to get rid of HELLP syndrome is to get the baby out.

Christina (00:26:48): Right. And so they went ahead and set all those things up. And then the, the Mo the kicker part of it is that she said that the hospital that I was at, um, they were unable to keep me there because they just didn't have the resources needed to be able to monitor everything that was going on. So I, after they did all those things, I was transferred by ambulance to another hospital. Um, I asked if they would turn on the lights when I was in the ambulance when they said no, but just trying to, you know, make light,

Dr. Nicole (00:27:20): Lighten things up

Christina (00:27:21): The situation if I could. Yeah,

Dr. Nicole (00:27:23): Exactly. I mean, how were, how were you, how were you feeling? Cause you got hit with like a train of stuff all at once. Yeah.

Christina (00:27:33): So my philosophy on thi situations like this, where it's a very high stress situation, um, when you're in a partnership is that one person tends to freak out and the other person become like, almost has to counteract that by becoming extra calm. And so I knew that my husband, um, we had talked about, you know, one of his big fears just in general was potentially something happening to me during childbirth. It's something that we had talked to before we even got pregnant. It was just, you know, kind of something that he felt. And so they told me this, and my immediate thought was, oh, no, oh, no. Like I'm not worried about me. Um, I'm worried about him. And so I felt like I needed to stay as calm as I could to show him that I was okay. Okay. And so at no point, do I really feel like, uh, the gravity of what was happening really hit me because my immediate instinct was okay, like, this is all gonna be okay. We're taking, um, where I'm supposed to be. You know, I'm in the safest place I could possibly be. Um, they're gonna get the baby out. Everything's gonna be fine at no point did I think that anything was gonna go any other way than that? Okay.

Christina (00:28:46): Okay. And so, um, and he did, I mean, he did stay very calm, but I knew that in the back of his mind, he was very worried. And so my attitude was I'm gonna keep it together just to make sure that he sees it's all gonna be okay.

Dr. Nicole (00:29:00): Gotcha. Gotcha.

Christina (00:29:02): Um, so at this point I called

Dr. Nicole (00:29:04): Sorry. How far was the, the, how far was the ambulance ride?

Christina (00:29:08): Only about 10 minutes. Okay. So it was just a bigger hospital in the Toledo area. Okay. Um, so an easy, easy ambulance ride. Okay. I think my biggest worry with that though, was I didn't, I mean, everyone who I had met with, through the, my prenatal care was at the other hospital. And so I knew a lot of people who had delivered at the hospital I was being transferred to. Um, but I didn't know, I had never met with any of the medical team that was, I was gonna be working with at the new hospital.

Dr. Nicole (00:29:36): Gotcha. And I'm guessing that, you know, most hospitals can take care of full term babies. I'm guessing that they were worried that they cuz sometimes folks need blood transfusions and things like that when they have HELLP syndrome that they didn't have the support. Um, in other ways for you actually it's, it wasn't for the baby. It was most likely because people with HELLP syndrome can get really, really, um, sick. So I'm glad that they recognize that maybe they didn't have the resources Ian sent you to a different place.

Christina (00:30:05): Yep. Yep, absolutely. They said that it, it was, it was because of me and um, that the nice thing is, is throughout everything that it has happened that I we've talked about so far and is going to happen. Um, Henry was in perfect health the entire time. He, I felt like every time they came and told me something more, that is, is happening, they would follow it up with, but baby looks great. Right. Baby looks great. So at no point, were they worried about him or, or anything like that. Gotcha. Was again, very comforting, comforting for me as well.

Dr. Nicole (00:30:38): Sure, sure, sure. So you said you caused your, you called your doula, um, at that point,

Christina (00:30:43): Yes. And just kind of explained what was going on. And so before they transferred me, they did, um, check my cervix. And so I was as high up as it could possibly be. And I was, I think, 20% effaced maybe. And so they said that they were gonna start the induction, um, at the other hospital, they didn't wanna start it before I was transferred. And so I told Morgan, I was like, you know, this seems like it's probably going to be a long process. I'm fine. Like, I don't feel like, and she has children as well. So I was like, you don't need to come spend the whole night at the hospital with me. Um, so I just told her I would, I would be in touch with her and let her know, you know, what's going on from there, went to the second hospital. And the first thing that they did was inserted Cervidil to start the induction process. And they explained, you know, at the end of it's gonna be in for 12 hours. And at the end of the 12 hours, the, the hope is that I would've been dilated at least a one and then they would be able to insert a balloon.

Dr. Nicole (00:31:49): Got it.

Christina (00:31:49): So that was a little bit uncomfortable when they inserted it, but nothing crazy. And at this point they did not start Pitocin or anything. Um, but the magnesium definitely. So the magnesium triggered a migraine. And so I had to get some medicine for the migraine and it made me throw up quite a bit and just, I felt pretty terrible from, and they warned me and they said, you know, magnesium, nobody loves being on magnesium. It's not fun. Um, so that I did feel like I was definitely prepared for that. Right. So they inserted the Cervadil and said, you know, just try to try to get some sleep. And when the on-call doctor had come in to insert their Cervidil, I could see it on her face that she didn't have a lot of hope that this was going to get me far enough along in enough time.

Christina (00:32:41): So they explained that my platelets were continuing to drop. So every four hours they were coming in and drawing my blood again, and it continued to get lower and lower. And so they did the cervidil, um, and I think like six or eight hours after they had had the Cervidil, um, it was about 30 minutes after I had gotten my most recent blood draw. And they came in and explained that my platelets were just over a hundred thousand and they, and we had our birth plan, you know, that said, please don't offer pain medication unless Christina asks for it. And just a multitude of things. And I will say that when, when we arrived at the new hospital, the nurse asked me for my birth plan and I jokingly told her, I was like, oh, you know, I ripped it up and threw it away because it's not going this way.

Christina (00:33:28): And she was like, no, like, and, and she was wonderful. She was like, no, let me see it because I wanna try to do as much as we can. Right. The way that you hoped things would potentially go. Right. So I appreciated her so much for that. And so, you know, she saw that we talked about it, so they knew, you know, I, I preferred no pain medication, but at this point I had kind of told myself this is gonna be a marathon. And so I had given myself a little bit of grace of if, if that needs to happen, that needs to happen. So when they came in, uh, about 30 minutes after that most recent blood draw, I explained where my P platelets were. So they, at that point explained that if I wanted to get an epidural, it needed to happen before my next blood draw.

Christina (00:34:15): Because the way that everything was trending at the next blood draw, it was probably gonna be under a hundred thousand. And so they said at that point, the anesthesiologist will not place an epidural if your platelets get that low. And what that would mean for us is that in the event that I would have to have a C-section, I would be put under general anesthesia. I would not be awake. And then Adam, my husband would not be allowed to be in the room with me. Right. And I didn't feel at that point, they were telling me what to do, but they definitely did wanna give me all of the information, basically, you know, if you wanna get an epidural at any point during this now is when you need to do that. Right. So we talked about it and I said, you know, I, I wanna be able to be awake for, uh, to watch my baby be born.

Christina (00:35:01): Right. And so I said, let's go ahead and do the epidural. Um, at this point, still not in labor, the Cervidil was in place. So they came in and placed the epidural and it went wonderfully. It was not at all as I was what I was expecting. I think I was expecting it to hurt a lot more than it did. Um, it was just a little bit uncomfortable and ended up being a fabulous epidural. I, you know, when I was laying on my side, I was able to lift up my top leg. Um, but I really had very little feeling in the lower part of my body. Okay. So, okay. I wish I had been able to, you know, use that for birth, but you know, it is what is.

Dr. Nicole (00:35:38): So why, in fact, were you not able to use it for your birth? What happened?

Christina (00:35:45): Okay, so they came in, took the Cervidil out, and this was a new doctor. They had had this shift change. So she came in, took the Cervidil out and checked me and was like, uh you're maybe at 0.5, not quite at a one. Um, she said the next step would be to insert a cook balloon and she just explained, you know, they would fill that up. So it would press on my cervix to open it. And she said, you know, even people who are dilated to a one, this is still a very uncomfortable thing to happen. Um, and she's like, and you're barely not even quite to a 1. And I was like, oh, you know, I already had my epidural, so it's okay. And she's like, oh, okay, great. So she basically explained, I'm just gonna kinda have to shove this up there to be able to get it through.

Christina (00:36:30): Right. And I was like, Nope. You know, I already had my pain medication do what you gotta do. So she inserted that. And when they inserted that, they also started me on Pitocin, um, a low dose of Pitocin, but hoped that the goal was when that balloon came out, when they were able to pull it out, I would be dilated to a four. So like, okay, sounds great. They said it was gonna be in four, 12 hours. And I was flip flopping from side to side. So I would lay on my left side and then I would lay on my right side and, um, laying on my back, even tilted up a little bit, didn't feel very comfortable. So I was just flipping side to side using the peanut ball between my knees, hoping that maybe that would potentially get things moving a little bit faster.

Christina (00:37:13): So waited that out, tried to get some sleep. Um, and they, a couple hours after that, um, the nurse who was with me at that point came in, woke me up and held my hand and just said, you know, I wanted to give you an update on what's going on. The doctors are gonna come in and talk to you shortly. But I wanted to give you an opportunity to kind of wrap your brain about around what they're gonna come in and say. Um, so she said they are going to recommend that we probably, that we go to a C-section because of how low your platelets are getting. Um, and at this point, Adam and I had talked about, we knew that that was where things were gonna go, um, his frustration a little bit, um, at that point was why are we waiting so long to go to that point?

Christina (00:38:01): Okay. If we know that that's where we're going. Right. Um, because what he just kept hearing is every couple hours, when they would draw my blood, they would come in and just explain, everything's getting worse, everything's getting worse, but we're gonna wait. And I think that kind of our confusion throughout this, not knowing, and I, we made it a point to not Google things while we were there. Or like, you know, we just need to trust the people who are taking care of us. And I don't, I don't wanna, you know, try to do my own research at this point. Right. And so I think that that was a little bit of the miscommunication, not even miscommunication, but just us not understanding, you know, if, if that's probably where we're gonna go, why aren't we just doing that? Like, why are we waiting for my health to, just to continually decline, decline, decline.

Christina (00:38:45): But I think that we had a hard time expressing that. I mean, we were sleep deprived, we were stressed. We didn't know totally what was going on. We just kind of were listening to what was going on and we felt very taken care of. Um, but in hindsight, we kind of talked about, we don't know quite why we, why we waited so long. So the nurse came in, explained what was going on. Um, and she's like, you know, ultimately they're, they're gonna listen to you guys. Um, but I wanted to give you just an update to you guys have some time, just the two of you to talk before this, this happens. Um, and so she left, gave us some time to talk and we were both on the same page of whatever you gotta do to, to keep things, keep things going well, so it actually took them a little bit longer to come in.

Christina (00:39:27): Um, the nurses came in shortly after that and had me sit up in my bed because they said that the baby, they couldn't find the movement of the baby. So they're like, you know, you've gotten a lot of medication. Um, the baby's probably just sleeping, but we need to get them moving a little bit. So at that point they sat me up and all of a sudden the labor pains hit me. And so I, I think my epidural didn't quite get up high enough to where he was. Okay. And so, um, feeling delirious of not being able to eat and all the medication that they had given me, um, I was like, please just lay me back down, please lay me back down. I don't understand, like when I was laying down, I felt fine. Please don't make me sit up. Right. And so they had me sit up, they had me cross my legs, um, to be able to, and at that point they were able to see, um, him moving and they were like, baby, again, still looks great.

Christina (00:40:25): So about an hour later came in, they explained everything that the nurse had already kind of let us know what was going on. Um, and said, this is, this is where we want to go. Your platelets are getting too low. Um, and again, the only way to really get rid of this is to take in for the C-section. Um, and I was like, you know, I had had enough time to mentally wrap my brain around that of okay. Like that's okay. And so they ended up taking the, or deflating the balloons, taking that out, um, and then wheeling us back for the C-section. And I, they had to give me a lot of the medication to get me to kind of calm down because I couldn't stop shaking. Um, so, you know, strap me in, put up the curtain. Um, and then Adam was able to come in and sit next to me for this C-section it all went very quickly. Okay.

Dr. Nicole (00:41:21): And how was the C-section itself?

Christina (00:41:24): I fine. It was fine. I, they did a great job of while it was happening, explaining what was going on, explaining what was happening. He, um, I had known throughout my pregnancy because of the ultrasounds that he was kind of in my hip, his head was in my hip. Right. And so they had to kind of do some maneuvering to be able to get him out, but I mean, went totally fine. Um, he cried as, you know, came out, cried, he looked great. He luckily didn't need any NICU time. Um, you know, they took him over to the warmer and then they handed him to Adam to be able to hold him, um, sewed me up and then wheeled us back to kind of the recovery area there. It was 11, 11, 12 at night. And so, there was nobody, there was no nobody else back there. And the nurse just kind of handed Henry to me and were like, okay. And, and walked away. And I, uh, felt so out of it that I didn't trust myself to hold him. And so Adam had to like, hold my arms around him and because I was sure I was gonna drop him.

Dr. Nicole (00:42:29): Oh, wait. And you, and you were probably back on the Magne. I mean, you should have been on the magnesium yes. At that point. Yes. And they let you hold the baby without anyone standing there.

Christina (00:42:39): Adam was there. Okay. I mean, so he helped me and I, and I didn't, I didn't, I mean, I didn't trust myself. I didn't, I didn't feel great about holding him. Right. Um, I felt very shaky, very out of it. Um, and it felt at that point, like I had just had an out of body experience. Sure. I felt like I, it wasn't me who had been experiencing all of this, um, cuz it all, I mean, it all just came through so quickly. And so, um, and so we were there for probably about half an hour. Um, and then they rolled us up to the postpartum area. So they did explain it this point that I needed to stay on the magnesium for an extra 24 hours, um, after birth to make sure that everything was, was still okay. And I was like, okay, like, that's totally fine.

Christina (00:43:25): Like, can I eat something now? You were like, oh no, no. Um, why until you're done in the magnesium, you still can't eat anything. Right. And so I think at that point, I mean my last meal had been almost 48 hours, uh, before that. And so I just felt pretty terrible and trying to figure out breastfeeding, trying to maybe get some rest, trying to, while not being able to sit up, but until I was able to get some food in my system, I feel like I was very much in that kind of hazy delirious state. Right. Um, for about the, the 24 hours postpartum

Dr. Nicole (00:44:02): Gotcha. Gotcha. Gotcha. So then once you came off of the magnesium, then did things start to feel more normal?

Christina (00:44:12): Yes. Yes. Once I was able to eat, I definitely did start to feel better. Um, I, I had a bunch of nurses coming in and trying to help me breastfeed. And I think we all kind of at a certain point were like, this is not gonna happen right now. Um, and so they had me actually start pumping okay. At that point, which was in hindsight wonderful. Because I ended up being an exclusive pumper, um, throughout my postpartum journey and we just never quite figured out breastfeeding. And I think that that is what really helped get my milk supply established is that they were very pro getting me on a pump, um, and helping get that started. So I would pump, and then we would like syringe feed him or use a spoon and feed him. Um, but yes, once I got off the magnesium, I did start to feel a lot better.

Christina (00:44:58): I was able to eat, um, and post magnesium. I, so I had again been bedridden for like a day, two and a half days at this point and um, the nurses had been coming in and asking me, um, okay, you know, we have a prescription for your pain medication, would you like it? Um, as I was starting to have the epidural wear off and, and everything I got during the C-section, I was like, you know, I'm, I'm laying here. I feel okay. Um, I've already had so much medication at this point. I feel fine. I don't, no, I don't need it. So they took me off the magnesium and that was right around shift change. So the new nurse comes in and she looks, and she goes, why haven't you taken any of your pain medication yet? I was like, I just, you know, I don't, I don't feel like I need it yet.

Christina (00:45:47): And she looks at me and she goes, um, honey, you are going to have to get out of this bed in the next hour or two. Um, trust me at that point, you're gonna wish you had been starting to take the pain medication so she convinced me, I ended up taking the pain medication and man, she was so right. Um, you know, they said you have to start getting things moving. Yeah. And I just, I mean, I remember when they had me sit up in bed, um, to get up and go to the bathroom because they had taken the catheter out I was like, mm, absolutely not lay me back down. I'm I'm gonna die in this bed. Like, I, I cannot get up. This is not happening. Right. Um, and so that was really where Adam got to have his, all the birth training. We went through, got to get in my face and be like, you can do this, you're gonna have to do this, get up. It's okay. Like, we'll get there together. Um, and so again, I mean, I knew in the back of my mind that before any of this had happened, you know, a C-section is always a possibility for a multitude of reasons. And so I knew that that could potentially be something that I would go through, but I don't think I was actually mentally or physically prepared for what that was going to feel like.

Dr. Nicole (00:46:57): Gotcha. Gotcha. Yeah. It's it's, it's tough. It's tough. It's tough. It's tough. So then as you, well, did things turn well, I should say, how was your postpartum recovery overall? How long did you stay in the hospital? Like after the birth did things pretty quickly get to, I guess, as close to normal as, as one could, could have.

Christina (00:47:21): Yeah. Yeah. So they continued to draw my blood until I went home. So they were taking it every couple hours and my platelets after birth continued to fall. Um, and the doctor just explained it now that the baby's out, like, it's just gonna take a little bit of time for it to start going back up. So we were on, um, in the PACU, um, or that's not what it's called, just like the, the, we weren't quite in postpartum yet. We were in like surgical recovery and they told me that I wouldn't be allowed to leave there until they started to see my platelets trending up. Um, cuz I thought it was gonna be a number that it had to get to and they said, no, they just needed to see that they were starting to go back up. Cuz once they started going back up, they would continue to go back up.

Christina (00:48:03): So we stayed there, I believe for another 36 hours. So we went to the hospital originally on Friday night and we got up to the postpartum floor where everybody gets to go to on Tuesday. So, um, once everything started trending back up, they took us up to the postpartum floor. Um, and I, we needed to stay there. Um, I believe for another 24 hours. So Henry had a little bit of jaundice, so he had to be under the, um, lights and the hard part about that is the room we went to right after, um, the C-section he was not allowed to be in that room under the lights with me. So when he had to be under the lights and there, they had to take him up to the nursery. And so that was really challenging to be away from him. They would bring him down so I could feed him. Um, and then they would have to take him right back up to put him back under the lights. So once we were able to go up to the postpartum floor, they were able to bring the little box with the lights, for him to lay under, into our room with us, which was great. Um, you know, you spend nine plus months with this baby inside of you. You don't realize how challenging it's gonna be if they're away from you for any, any period of time.

Dr. Nicole (00:49:17): Yeah.

Christina (00:49:17): Yeah. Um, so once we got up to the postpartum floor, that was a lot more comfortable, a lot, a lot better. I mean, everyone took fabulous care of us, but that made it feel a little bit more normal. It felt almost like a hotel room kind of um, where we really got a little bit more privacy with just the two of us in Henry and kind of starting to get, get the hang of things.

Dr. Nicole (00:49:38): Gotcha. Gotcha. So then as we, as we kinda wrap up, like how was, did you feel, did you have to do anything to like process your experience? Like once you got home, how did you feel about things?

Christina (00:49:52): I feel like I just kind of put it off mentally. Um, at that point I'm like, you know, I, I have this baby, I need to take care of, you know, women do this. Like this is birth is what it is, how many people, you know, have had to have C-sections and you know, everybody has pain, post postpartum. Um, mine just happens to be in a different place than I was expecting it to be. Um, and so I feel like I just kind of kept telling myself like, you're fine, you're gonna be fine. It, it didn't turn out the way you wanted it to. Um, but what, what in life turns out exactly the way that you, you wanted it to and so I, I feel like that was kind of my original coping mechanism was just don't think about it. You're fine.

Christina (00:50:33): You're fine. You're fine. Um, and it took a little bit of time, um, for me to, so I, I went to a class postpartum, um, that was, it was centered around physical recovery, but we did a lot of talking as well and she would give us homework once a week. It was a six week, um, class and she would give us homework weekly. And the first homework assignment she gave us was go home and write out your birth story. And I was like, oh cool. Like, you know, I, I haven't really done this yet. And so this was about eight weeks postpartum. So I went home, sat down at the computer to write my birth story and couldn't type anything and just had to close the computer and go back upstairs. And I feel like that at that point, I had like started to kind of open the door of processing what had happened and I was like, Nope, not ready.

Christina (00:51:26): So close the computer. Um, and it took, it took a while for me to, and it was always in the back of my mind of like, I need to do that. I need to do that. I know it's gonna be helpful. Um, but I'm just not ready yet. And so being able to, actually, the first time I wrote it down was when I, um, submitted it to this podcast. And I, that was really, really helpful for me to be able to do that. And, you know, I got done and I was like, I don't know if I'm, if I'm ready to talk about this yet, but you know, why not? This is, you know, I love this podcast. I love listening to you. And I was like, it, it might be something that could be really beneficial. And so, um, at that point, I mean, postpartum hit, hit hard.

Christina (00:52:11): We had some, some issues with, or, uh, some health issues with Henry with his eating, um, that we ended up having to get figured out. Um, and postpartum was just, it was challenging. And so I feel like there were a lot of things for me to give an excuse to, you know, I'm worrying about this. So I, I don't need to worry about myself yet, or I don't have time to worry about myself yet. Um, and it, and I think it took getting my postpartum hormones a little bit under control, um, about six months after to be able to recognize, okay, like, I, I do need to kind of talk about this, think about this. Um, and so have found some people to talk to, um, and been able to talk through it and come to terms with the fact that if I wanna have more children, like this is a possibility that this could happen again. Um, and so I think that that's something that is, is a little bit hard to wrap my mind around, but also, you know, I mean, I did it once I can do it again. Um, so yeah, I mean, it, it, I, I feel like going into birth, I, I had told myself, like, things are probably not gonna turn out, you know, exactly the way you picture that's okay. That's okay. But I don't know if I had like, actually accepted that or considered to the extent what that could look like.

Dr. Nicole (00:53:27): Yeah. I it's, it, I feel like it would've been impossible for you to see that. So, yeah. Um, I mean, there's just, it it's, it's just not something that would even cross your mind. So it's not something that happens very, very commonly at all. Um, right. You know, so to, to, and so it's not something that you may necessarily hear, hear about HELLP syndrome is the most severe form of preeclampsia and folks can get pretty sick with it. So it's just, it's just not something you could have, could have predicted, but it sounds like you handled it like extremely well, considering the circumstances and managed to ride the waves of a very unpredictable birth experience.

Christina (00:54:09): Yeah. I mean the best that I could. Um, and I think that getting home, it was also kind of in the back of my mind of, um, I wanna have more kids potentially someday. And at, at that point, um, Adam my husband, I think was like, I, we are not having any more children. Like we are not going through this again. Absolutely not. And so I was like, you know what, like if, if I ever wanna have more kids, I gotta make sure that, that this is okay. Like we gotta get, we gotta get through this. So that way potentially that, that could happen again in the future. Yeah. Um, and I, our original plan was to be able to have our kids a little bit closer together. Um, and I think that this kind of reframed our, our plans of when, when more children might be on the table of giving us a little bit, which in hindsight has been wonderful of being able to spend a lot of time with Henry, um, and as a family of three.

Dr. Nicole (00:55:04): Gotcha. Gotcha. So what is the one piece of advice that you would tell other women as they get ready for their birth?

Christina (00:55:11): I would say be ready for anything and absolutely listen to your body. Um, you know, at any point in your pregnancy, if anything feels off trust yourself, because there are people who, who wanna take care of you. Um, and it's better to be safe than sorry. Um, and I'm glad we decided to go to the hospital when we did, um, because things did progress so quickly, um, with my health. And so I would say definitely, you know, if you are feeling something trust it.

Dr. Nicole (00:55:41): Absolutely. Absolutely. So where can people connect with you? And you can say nowhere, like some folks aren't on social media.

Christina (00:55:49): Um, I do have social media, um, but everything is on private.

Dr. Nicole (00:55:53): Gotcha. Gotcha. Well, Nope. We can just leave it at that. We can just leave it at that. Okay. Well, thank you so much, Christina, for agreeing to come onto the podcast. I really appreciate your story. There's so much to learn from this.

Christina (00:56:04): Absolutely. Thank you so much for having me.

Dr. Nicole (00:56:13): All right. Wasn't that a great birth story episode? Birth story episodes are always my favorite episodes of the podcast. And I appreciate Christina coming on to share her story today. Now, after ever epi, every episode, when I have a guest on, I do something called Dr. Nicole's Notes, where I talk about my top takeaways from the conversation. And I have a few Dr. Nicole's Notes from my conversation with Christina. Number one, she mentioned that she only listened to positive birth stories, and I totally get that because it is important to listen to those positive experiences, but I encourage you to actually listen to all types of birth experiences, listening to it helps you be prepared for possible things that can occur. You're not gonna manifest tragedy just because you listened to a birth story where things don't go as you anticipated. I learned that from a recent birth story episode, where I had someone that had a, um, bad outcome after homebirth.

Dr. Nicole (00:57:05): So listen to all of the birth stories so that you are prepared for the possible things that may occur. And if things take a turn, it doesn't seem so, um, overwhelming. Okay. Next up, this is so important. Pay attention to your body. Christina didn't feel right. She went in and she got checked out. Now sometimes, maybe even most times when you feel like things aren't right. It may be, it's going to be okay. I should say, and it's not gonna be anything serious, but it is always better to call, always better to go in and get checked out. If you think that things are not right, it's so much easier to go in, get a quick check, get some reassurance than wait too late for something bad to happen. The third thing I wanna say is about preeclampsia. I get the question a lot about whether or not aspirin is safe to take in pregnancy in relation to preventing preeclampsia.

Dr. Nicole (00:58:03): Aspirin is actually the only thing that has been shown in studies to reduce the chances of getting preeclampsia. And there are some specific criteria for being on aspirin in pregnancy. If you've had a prior history of preeclampsia, if you have hypertension, um, diabetes, if you carry extra weight. So there are several things, um, also being Black can increase your risk. There are a lot of things that qualify you to take aspirin during pregnancy. And again, it is the only thing that we have known that has, uh, been proven to help reduce the risk of preeclampsia. So if your doctor has prescribed or said, you should be taking a baby aspirin, feel confident that it's the right thing to do. Okay. A couple more things. So next thing is that not all hospitals will have the resources to care for all situations. Some people don't realize that not all hospitals are capable of dealing with all issues related to birth.

Dr. Nicole (00:59:03): That doesn't end up being a big deal, but it is something that you may wanna be aware of. If your particular hospital is one that doesn't have the full spectrum of care. Often it ends up being that the hospital doesn't have a NICU, a neonatal intensive care unit for the smaller babies. Those tend to be regionalized centers. So if you have a pre-term baby, then your baby may need to go to another hospital, but just be aware of kind of what your hospital has to offer in terms of resources, to care for moms and babies. Again, usually it ends up being the baby that's an issue like there are levels to the NICU level, 1, 2, 3, and four level. One is the most basic one, level four, they can take care of anything. I happen to work at a hospital, that's a level three NICU. So just learn that.

Dr. Nicole (00:59:51): So you have that information in the back of your head. And then the final thing I'll say is that birth is a moment to moment process, and really is unpredictable. I totally get where she and her husband were coming from in the sense of like, why are we just doing a C-section, why are we waiting for things to get worse? Well, you actually want to try for a vaginal birth if you can, in most circumstances, because it's going to be safer also with the Cesarean, it's a surgery, it's a major surgery when platelets, which help the blood clot, when platelets are low as in HELLP syndrome, if they're really low, that's probably going to increase your chances of bleeding from a major surgery. So it really is a balance between watching things and, and aiming for a vaginal birth. It's a moment to moment process and things can change quickly in birth.

Dr. Nicole (01:00:50): So don't think you can kind of see the whole course of how things are gonna go. Think about it, of being in the moment in that moment. And then you reevaluate the next moment, reevaluate the next moment in order to make decisions that are best for you and your baby. And when I say moment to moment, typically that ends up being like a few hours, like four to six hours, reevaluate four to six hours, reevaluate. Sometimes it's a little bit sooner than that, but you cannot see all the way down to the end. Think of yourself, of being in that moment. These are how things are right now, and then we'll reassess and see where things are in a bit. Okay. So there you have it. Do me a favor, share this podcast with a friend, sharing is caring and sharing helps me to reach and serve more pregnant folks, which is the heart, soul and passion of my work.

Dr. Nicole (01:01:39): Also subscribe to the podcast in Apple Podcast or wherever you're listening to me right now and leave a review, an honest one, in Apple Podcast. I love to hear what folks think about the show. Do also check out the Birth Preparation Course. It is an amazing online childbirth education class that gets you calm, confident, and empowered to have a beautiful birth. And please know that it's not a class where you sign up and then I just leave you flopping in the breeze. There's also an online community where you can get ongoing support. You also get lifetime access, and it's been really lovely to see folks come through for their second births, um, sometimes even third. So, um, to get all that information and, and, and rejoin and, and do it again. So I say all that to say, check out the Birth Preparation Course, you won't regret it. It's drnicolerankins.com/enroll. So that's it for this episode do come on back next weekend and remember that you deserve a beautiful pregnancy and birth.