Ep 278: Jenna’s Birth Story – Expecting More Than Just “A Healthy Baby”

Dr. Nicole (00:00): In this birth story episode with Jenna, you're going to learn how a birth described as a series of traumatic events ended up being the best experience of her life. Welcome to the All about pregnancy and birth podcast. If you're having a baby in the hospital, you are giving birth in a system that too often takes away power from women over what happens in their own bodies. I'm Dr. Nicole Calloway Rankins, a practicing board certified OBGYN, who's had the privilege of helping well over a thousand babies into this world. I've been a doctor for over 20 years, and I'm here to help you take back your power, advocate for yourself, and have the beautiful pregnancy and birth that you deserve. This podcast is for educational purposes only, and it's not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(00:58): Hello there. Welcome to another episode of the podcast. This is episode number 278. Whether it is your first time listening or you have been here before, I am so glad you're spending some time with me today. Jenna, her husband, John, and their beautiful daughter Nora, live up north by Lake Superior. Jenna's birth experience was transformative, marked by what her midwife described as a series of traumatic events. And by traumatic events we mean a 65 hour labor induction and epidural that had to be replaced twice and never really worked three hours of pushing a C-section with a spinal that had to be done three times, something called uterine ane during a C-section, which can increase bleeding. Her baby had a birth injury. She also had delayed postpartum bleeding that required something called a hysteroscopy, and she was diagnosed with something called Placenta site nodule. Now, despite all of those challenges, Jenna said her birth had wonderful moments and was in fact the best experience of her life.

(02:11): She's moved from feeling like a failure to feeling more at peace once she realized she worked hard to keep her baby as safe as possible by trusting her intuition and advocating during a difficult time. By sharing her story, Jenna wants you to know that you're so emotionally raw and vulnerable postpartum. Anything someone says to you can feel true, for example, like she was weak or a failure. But with time work and insight, you can reframe how you feel about your body and your birth experience. Also, you can be both grateful to your team for helping get you and your baby out alive and upset with how things were handled. I cannot wait for you to hear Jenna's story and how she navigated her very challenging birth. Before we get into the episode, a quick listener shout out. This is from Morgan, MWW, and she left me this review in Apple podcast.

(03:16): The title of the review says Birth of My Dreams, and the review says I've been an avid listener for years. I love the quality unbiased education Dr. Rankins provides. I took the birth preparation course and had the unmedicated hospital birth of my dreams. I owe it all to the education I received from this podcast and the course. Thanks, Dr. Nicole. Well, thanks so much, Morgan for that lovely review in Apple podcast. It is so true that the podcast in the course go hand in hand to helping you have the beautiful birth experience that you want and deserve. If you want to check out all the details of the birth preparation course, head on over to dr nicole rankins.com/enroll, and if you use the code, Dr. Nicole at checkout, you will get an additional discount. All right, let's get into this birth story episode with Jenna. Thank you so much, Jenna, for agreeing to come onto the podcast. I am excited to have you share your birth story today.

Jenna (04:26): Thank you so much for having to me. It's really an honor to be here.

Dr. Nicole (04:30): Oh, well, thank you. So why don't you start off by telling us a bit about yourself and your family?

Jenna (04:34): Sure. So my name is Jenna. I am married to my husband John for four years together for 15 years though. Oh, wow. Yeah, it's been a long time. And we have a 19 month old Nora, and we recently moved back to our home state to raise her closer to family, and I work as a medical writer, mostly in the vasculature realm. But since having Nora, I think a lot of moms, I've developed a big passion for maternal care, so I get to work in that field as well.

Dr. Nicole (05:07): Awesome. Awesome. Yeah, I don't think I've ever met a medical writer before, so that's pretty

Jenna (05:11): Cool. Yeah, I love it.

Dr. Nicole (05:12): Yeah. So in order to understand what happened with your birth, we have to talk a little bit about what happened with your pregnancy. So tell us what was your pregnancy and prenatal care?

Jenna (05:22): Yeah, so care actually started before I was even pregnant, so I made a preconception appointment because I Nice. Yeah, yeah, right. I have hypothyroidism, so I just wanted to make sure that was all in check before anything. And I also was at the time in my PhD program, so I was working in a neuroscience lab, so I wanted to make sure that anything I was working with was safe to expose to during pregnancy.

Dr. Nicole (05:49): Okay. Yeah. Wait, I'm sorry. Do you have a PhD in neuroscience?

Jenna (05:53): Yeah,

Dr. Nicole (05:54): Lord have mercy. Okay, okay. I feel like we need to, there's not a whole lot of women walking around with a PhD in neuroscience, I think, so I just like to celebrate that for me. Thank

Jenna (06:07): You so much.

Dr. Nicole (06:08): Yeah, I dunno.

Jenna (06:09): I just love it. It's fun.

Dr. Nicole (06:11): Okay, so sorry, getting back to the pregnancy and prenatal

Jenna (06:14): Care. No, you're

Dr. Nicole (06:14): Totally,

Jenna (06:15): Yeah, so it was kind of interesting with having to make adjustments in the lab. I feel most people don't tell their boss that they're pregnant until farther along in pregnancy,

(06:26): But

(06:27): I had a unique circumstance of having to be like, Hey, here's the plan. We have to make some adjustments, and luckily, he's just the most supportive person ever. So he was great with that. Then I found out very soon after that we were pregnant. I found out on a trip home for Mother's Day. I actually wrapped up the test and put it in a box and handed it to my mom as the mother's taking, and she opened it and said, why are you giving me a Covid test? So that was just a sign of the times.

Dr. Nicole (07:05): Yes, I was here to say definitely a sign of, I've had friends send me tests that I'm like, are you pregnant? They're like, no, it's a Covid test too. Good. Yeah. Yeah. So you got pregnant, and then how did things happen with your care?

Jenna (07:20): It was great. I just absolutely loved being pregnant. It was definitely one of the most special times in my life. Nora took it easy on me. I just had mild symptoms. I would describe it almost like having a constant mild hangover early in pregnancy, and then of course, toward the end, horrible heartburn and swelling. But other than that, absolutely loved being pregnant, but there were definitely some complications along the way. So early in pregnancy, I had some bleeding, and I knew that this isn't totally uncommon, so I tried to not worry, called the OB office, and they said, well, you should. Let's get your blood type checked just in case you need a rogan shot. I thought, oh, interesting. I never even thought of going down that path. Okay, let's do it. And they said, well, we can't. You're not established with us. Go to your family practice. I went to them. They said, no, we can't do it. It's not part of our protocol. So I called the OB office back again,

Dr. Nicole (08:21): So frustrating.

Jenna (08:23): It was like, I just need my blood type checked. This shouldn't be a big deal. And the OB office actually recommended, because nobody else could do it, that I go into the ER for this, and I felt so terrible using ER resources for something like this. It was just such a horrible guilty feeling. But I'm going to take the advice.

(08:47): Right.

(08:47): So we go in and it turns out I was RH negative.

(08:51): Okay.

(08:52): Yep. So it was good. I went in and then they did an ultrasound. It was too early to see her heartbeat or anything, but they found a subchorionic hematoma.

(09:01): Okay.

(09:01): So then they had to give me Rogan, and they said, this is a threatened miscarriage. You have a 40% chance of losing her. And then sent me on my, I was like, oh, wow, that was abrupt. Oh, yeah. It was pretty scary. But I got my HCGs checked over a couple of appointments and it was all good. So I was so thankful for that.

Dr. Nicole (09:28): Sure, sure.

Jenna (09:29): Yeah. And then because of that, they had to do a couple of follow-up ultrasounds just to keep an eye on things. The subchorionic hematoma was fine, but then they found an umbilical cord cyst on her, but they pretty much said, don't worry about it. It usually results on its own.

(09:45): Right.

(09:46): So at this point, I was wrapping up my lab work and my program, and so I only had data and writing left to do, and we really wanted to move closer to family to have her. So I got a postdoc position in a neuropharmacology lab, and we moved closer to home, started the postdoc, and then after working a full day in the lab at night, I would spend another eight hours trying to wrap up my PhD program stuff. So that was exhausting. But I had great support by my husband. I was bound and determined to finish that before she was here and defended it seven weeks before she arrived and dedicated it to her. And we got through,

Dr. Nicole (10:30): Oh my gosh. That is a lot.

Jenna (10:34): It was a lot. Yep. I was tired. I bet you were. I would not recommend it, but you did it.

Dr. Nicole (10:41): Okay. Okay. All right. And then were you seeing midwives or physicians?

Jenna (10:46): I started out with physicians, and then when we moved, I switched to the midwife team. I just liked the idea of having longer appointments potentially with them. So yeah, switched with them, and then pregnancy was moving along. I was loving it, and it came time for the anatomy scan, and they couldn't see everything that they needed to see on her the first time. And so of course, I go down the panic rabbit hole instead of being reassured that, oh, this is common. But came back for a second anatomy scan and everything was just fine. And as the pregnancy was progressing, I to, I want to say it was 28 weeks, and I started measuring about four weeks ahead. I was growing fast,

(11:31): And

(11:31): They wanted to look into why this was happening. So they did an ultrasound and they found out that I had polyhydramnios, and then they wanted to figure out why that was happening, because she was looking good. So they actually screened me for gestational diabetes a second time, and I failed it just fairly, even though I had passed my first screening. So I had late onset gestational diabetes, took my blood sugar four times a day throughout pretty much the rest of pregnancy. And I was so lucky to have it really well, diet controlled, so it wasn't too much of an issue.

Dr. Nicole (12:08): Okay. That's good. That's good. So you definitely had lots of little bumps

Jenna (12:14): Along the way. Yeah, she kept it interesting.

Dr. Nicole (12:16): For sure. Now, did you find that, and I don't know how many visits you had with the physician before you moved, but did you find a difference between physician and midwife care?

Jenna (12:27): Just saw the appointments were a bit longer, but I had only had one or two appointments beforehand with the OB office.

(12:33): Okay. Okay.

(12:35): Got it. But I was seeing maternal family medicine with everything going on, and their appointments were short and sweet. Those were like 10, 15 minutes versus the midwife going up to an hour sometimes.

Dr. Nicole (12:45): Gotcha, gotcha. Okay. So then what did you do to prepare for your birth?

Jenna (12:52): I watched so many birthing videos, all of them that I could find. I listened to a lot of birth stories, and I read some books and just tried to see what might happen to prepare myself.

Dr. Nicole (13:07): Gotcha. So mostly watching stuff on YouTube, I guess?

Jenna (13:11): Yes.

Dr. Nicole (13:11): Yeah. Okay.

Jenna (13:12): Alright.

Dr. Nicole (13:12): Was there anything in particular that you found particularly helpful through videos or books that really resonated with you?

Jenna (13:18): Oh, I do want to mention too, I took a class and what I found to be most helpful was the piece of advice that in labor, your job is to help your baby. Because I was going into the mindset of, okay, labor, I just need to survive this. But I wasn't thinking, okay, this is my job to help her get out too and do well. And I thought that was a really helpful mindset shift.

Dr. Nicole (13:40): I like that.

Jenna (13:41): Yeah.

Dr. Nicole (13:42): Okay. So you read the books, did the class, and then what were some things that you wanted for your birth?

Jenna (13:48): Yes. So I wanted all of the things that are pretty standard. So I wanted skin to skin delayed cord clamping. I have such a phobia of throwing up, so I wanted prophylactic Zofran were out, and they were happy to give me that. I really wanted that. I did not want residents. I was very nervous about

(14:11): That,

(14:11): And I ideally wanted to pull her up to my chest. And let's see. Oh, my big thing was I really wanted to be conscious for her birth.

(14:21): This

(14:21): Was totally at the back of my mind because with these MFM appointments, they keep warning me, you have polyhydramnios, your water breaks. You could have an umbilical cord prolapse, and you need to be put in for a C-section right away.

Dr. Nicole (14:34): Gotcha.

Jenna (14:35): Couldn't shake that.

Dr. Nicole (14:35): Okay. Okay. All right. Were you in a academic center?

Jenna (14:40): I was, yep. It was a teaching hospital.

Dr. Nicole (14:42): Okay. And what did they say in response to your request to limit residents?

Jenna (14:46): They said that's totally reasonable and fine, but it didn't follow through that

Dr. Nicole (14:50): One. Okay. I guess we'll get into that. Okay. Okay. All right. Was there anything in particular that you were afraid of when it came to giving birth?

Jenna (14:58): The biggest thing was not being able to be conscious when she was born. Gotcha.

Dr. Nicole (15:03): Gotcha, gotcha. Okay. So let's get into your labor and birth, because it is from the little snippets you sent, it was quite a journey, and I want to make sure we have time to get into. It was a lot of peaks and valleys, it sounds like in there, maybe more valleys than you wanted. So how about, just tell us how did things go with your labor and birth?

Jenna (15:28): Well, it was a 65 hour roller coaster of an induction.

Dr. Nicole (15:33): Okay. Okay. Okay. Well, we got to unpack that for sure. So first, then, how did you come to be induced?

Jenna (15:42): Yeah, so I was induced at 39 weeks and one day just with the combination of the polyhydramnios gestational diabetes, they thought she was going to be massive, which those third trimester ultrasounds quite inaccurate. I was trusting them. So we go into the hospital and we get in just before the huge blizzard of the year is hitting, and they check me, and I'm just a fingertip dilated 50% of face and at a positive three station.

Dr. Nicole (16:12): Okay. And how were you feeling mentally about having to be induced? Were you okay with it or, I mean, were your thoughts about it?

Jenna (16:21): I was never ready to be done being pregnant. I loved it so much, but I was starting to just get nervous for her health with all of these appointments and scans. So one of the things I actually was happy about with the induction is knowing that she was going to be monitored the entire time, and it was just time to make sure that she was okay all the

Dr. Nicole (16:42): Time.

Jenna (16:43): So I was okay with

Dr. Nicole (16:44): That. Okay. So they said you were a fingertip, and then what did they say or how did they proceed with the induction from there?

Jenna (16:50): Yeah, so they started out with cyto attack, and I got up to about three doses of that, and I was feeling it was kicking in. Very mild contractions, totally tolerable. And then the midwife comes in and she says, we cannot give you any more of this. Your uterus is doing work. And I thought that was a good thing. I was so naive at the time, I didn't know it meant my uterus was hyper responding to this. So they had to stop the cyto attack, and then the midwife wanted to do an ultrasound to see what position she was in.

Dr. Nicole (17:25): Okay.

Jenna (17:25): Yeah, I don't know if that's standard or why, but

Dr. Nicole (17:31): I mean, usually we do that in the beginning if we can't, maybe sometimes with polyhis is a little bit harder to when you do a vaginal exam to feel the baby's head,

Jenna (17:39): So

Dr. Nicole (17:39): Maybe she just wanted to check and make sure that the baby's head was down.

Jenna (17:42): Oh, gotcha. Okay. Interesting. Yeah, so they did the ultrasound and she was asy

Dr. Nicole (17:49): Clinic,

Jenna (17:50): So I knew we were going to have a journey with that.

Dr. Nicole (17:54): Interesting. They told you that early?

Jenna (17:57): They told me she was the asy clinic. May have been later, but I do think they told me it early. I think it was brought up a couple times throughout the induction.

Dr. Nicole (18:07): And then were they saying it in a way they were concerned that maybe she wouldn't, how did they present it? I'm just curious. Usually I don't tell people. Sometimes you can see it, but most of the time they turn.

Jenna (18:22): Right. Yeah.

Dr. Nicole (18:24): I'm just curious, did they present it in a way like, oh, this is going to be concerning, or how was it presented? Do you remember?

Jenna (18:30): She didn't. She just had a little bit of concern in her voice, but she was very reassuring. I said, can I still go for vaginal? And she said, definitely.

Dr. Nicole (18:39): Gotcha, gotcha. Okay.

Jenna (18:40): Yeah, so she was reassuring about it.

Dr. Nicole (18:42): Okay. So then what happened next? After the side attack,

Jenna (18:45): Then they inserted a Foley balloon, and I was a little nervous about this. My friends were telling me that this can really hurt, but gave me the advice to ask them to go really slow, and I tolerated it just fine. My husband did not. He almost messed up. Oh, did he really? Oh my God, it was so funny. Bless his heart. Why? Just because it was just, I have no idea. I think it just freaked him out so bad. He handled everything, it shut up, but it was just that Foley balloon. I don't know. It'll get you.

Dr. Nicole (19:20): Right,

Jenna (19:20): Right, right.

Dr. Nicole (19:23): I'm trying not to laugh at your husband, but I'm laughing at your husband

Jenna (19:26): A little bit. Oh, I was laughing at my husband. It was actually a nice distraction in a way.

Dr. Nicole (19:37): It was good. I'm glad you tolerated that well. So then how long did that stay in, and what happened from there?

Jenna (19:42): So that stayed in a little over 12 hours, and that really ramped up contractions. I mean, they were still tolerable, but I was having to stop and breathe through some of them. And this whole time, my husband and I are just walking up and down the halls. I'm bouncing on the ball, we're doing different positions, just trying to get her to get in a good position. And then after about 12 hours, a nurse came in and she said, do you mind if I try to take this out? Sometimes you have to give it a good yank. And I thought that was interesting. I was told it would fall out, but I was like, alright, let's do

(20:14): It.

(20:14): And she slingshot that thing across the room. I will never, I'll never forget the sound or the visual of that. She got it out. So I was about three and a half or four centimeters dilated at that point. So they were going to start Pitocin.

Dr. Nicole (20:36): Okay. Okay. All right. So then when the Pitocin started, how did things ramp up from there?

Jenna (20:42): Things they actually hurt less for a while, and I was told, right. I was very surprised by that. But a nurse said you kind of had the miso and the Foley working in you at the same time, so maybe it was just kind of a double whammy. But of course, that did not stay the case. Things really ramped up with the Pitocin eventually, and I kept waiting for this break in contractions. I had always heard about that didn't come. I mean, it was okay.

Dr. Nicole (21:12): They were just like, boom, boom, just

Jenna (21:16): Okay. The nurses were saying, I was having a series of five in a row without my uterus fully kind of resting in between a few times, and it was just in between the contractions, this constant ache, but counter pressure was really getting me through.

(21:33): Okay.

(21:33): And then at that point, I got in the water, and that was such a big help.

Dr. Nicole (21:39): Okay. Yeah. Oh, you were able to get in the water while being on Pitocin? I

Jenna (21:42): Was, yeah. I just had to keep my arm out.

Dr. Nicole (21:45): Okay, nice. So obviously they have monitors that can work in water.

Jenna (21:49): Yes. Very thankful for those because the water was a godsend. It was

Dr. Nicole (21:53): Great. Good, good, good.

Jenna (21:55): And it got to the point where the midwife said, we would like to break your water. You're progressing, but it's very, very slow. And this was where I was warned about this umbilical cord prolapse. I was so fearful of not being awake for her birth. So I had to really talk through this for a half hour with my husband if I was going to get an epidural or not, because I wanted to experience it all, but I wanted to be conscious at the same time, and I couldn't really get over that potential fear,

(22:28): The potential, the fear of that happening. So I agreed to an epidural, and the anesthesiologist came in and they were very rushed. They were talking about this meeting that they had to make after, and it was a resident and attending, and the nurse looked at me and said, if it were me, I'd rather have a resident do it here. They do more than the attendings do. Okay. So I said, okay. I asked him, how many of these have you done, and are you good at them? And he was very reassuring. He went ahead and placed it. I remember during this, the nurse couldn't get my daughter on the monitor. She really wanted to monitor her during this process, and they would not pause for her. They just wouldn't let the nurse get her on. So I could see the stress in her face. But Nora, my daughter, tolerated it just fine. I got the epidural in, it took on half of my body. I'm turning around trying to get it to kick in the other half,

(23:29): And

(23:30): They come back after their meeting and ask how it is, and it was pretty good. It was eventually working. Yeah.

Dr. Nicole (23:37): Okay. Good. Good. So then did they break your water after that?

Jenna (23:41): Yes, they broke my water after that. Luckily, no prolapse. Good. Yeah. I felt so much relief after that.

Dr. Nicole (23:49): Sure.

Jenna (23:49): Yeah.

Dr. Nicole (23:49): Sure. And how dilated were you? Do you remember?

Jenna (23:52): I was only about a four.

Dr. Nicole (23:53): Okay. Okay.

Jenna (23:54): Yeah. So they got it broken. Water was clear, but my husband, my water was still coming out up until I had her. I felt it coming out even with the epidural, and he was keeping an eye on it for me. And he actually noticed at one point he saw meconium in it. So I was lucky that he saw that because then he could alert the midwife, and they made sure the NICU team was on standby when she was born.

Dr. Nicole (24:19): Got it. Got it. Okay.

Jenna (24:21): This is the point where eventually this epidural started really wearing off, and I have a suspicion it was because Nora was so hard to keep track of on the monitors that they had to constantly be readjusting. We didn't go 20 minutes without them readjusting, I don't think,

Dr. Nicole (24:39): Maybe

Jenna (24:39): Even less. But anesthesiology was in and out quite a few times, trying to give me boluses, even tried repositioning the catheter at some points, and I would get some decent relief for a while, but it was temporary, and then things would kick back in really hard. But I had the most phenomenal nurse at this time, and she spent her whole shift giving me counter pressure. She was just totally on our vibe of what was going on. She wasn't trying to act like, isn't this wonderful? She was just there with us. And yeah, she was just phenomenal. And she actually was the first person who came and met my daughter after she was born. She visited me

(25:25): After

(25:27): I love her, and I nominated her for a Daisy award, and I hope she got it. She was just an angel to us. So labor is progressing slowly but surely. And a midwife came in, I think, yeah, I was on my third midwife shift at this point,

(25:43): And

(25:44): She brought in an OB just to kind of talk about the slow progress, how things were going, and they wanted to talk about my Pitocin. I was nearing 20 units, and that's where the midwife wanted to give me a Pitocin break. But ob, they got in this weird disagreement in front of me, and the OB said, no, let's go to 30. And the OB won. So the Pitocin was going up to 30, and my husband was so great. Every time they would come push it up, he would make sure that I was okay with it and know that it was happening because he was freaked out because he said the machine was flashing warnings at them at this point about putting it over 20. Yeah.

Dr. Nicole (26:27): Yeah. I mean, it is debatable whether it works when you go over 20, and I guess I should say when it was slow progress, how far had you gotten to when they came in with concern? Do you remember? Let's

Jenna (26:45): See. I'd say I was probably around 40 ish hours in at this point, and I was dilated to, I think I was around a six at this

(26:56): Point.

(26:58): And then things are progressing. I finally start dilating more with that, and the OB says, Hey, can I check and see what position she's in? She could feel at this point still and asynclitic. And she said, do you mind if I try an internal manual rotation and maybe we can get her in a better position for pushing? And so I agreed to that and oh my God, the pain of that, I left my body. It was unreal, and it didn't work.

(27:30): Okay.

(27:31): And so she asked if she could try it again,

(27:33): And I

(27:33): Said yes, and I held out as long as I could, and I told her she had to stop. It was just

Dr. Nicole (27:40): Too much,

Jenna (27:41): Way too much. Yeah, definitely.

Dr. Nicole (27:43): Okay. And did she actually stop?

Jenna (27:44): She did.

Dr. Nicole (27:45): Okay.

Jenna (27:45): She did stop. I was very grateful for that.

Dr. Nicole (27:49): Good. So you must've been completely dilated by that point.

Jenna (27:52): I want to say I was around nine.

Dr. Nicole (27:55): Okay.

Jenna (27:56): Maybe nearing 10, but I think it happened at nine. But then I was at nine for about six hours, and I finally got to almost 10 where they said, okay, you're close enough, you can start pushing. And at this point, the back labor was so horrible. So contractions, I describe it for myself. I felt like a towel being rung out my whole body. But the back labor felt like, have you ever had a really sensitive tooth and cold hits it?

(28:27): Yeah.

(28:27): Okay. It felt like that was my whole back. And someone had an ice pick and was just hammering it nonstop and it would not let us. And then the contractions just kind of ramped it up in between. I was not prepared for that. I thought contractions would be the most painful thing. It was not for me. Yeah. That was pretty wild.

(28:47): Okay.

(28:48): Yeah. They tell me, you can start pushing. And I'm thinking, okay, that means maybe this will be over with pretty soon. I never felt the urge to push because she stayed so high up. So that was interesting too, because I always hear you get this intense urge when it's time, but I went ahead and I started pushing, and they said, you have a cervical lip. Can we try to reduce it?

(29:11): I

(29:12): Said, go for it. And she was pushing it while I was pushing, and that was intense. Yeah. I had to ask her at some point to stop on

(29:23): That. Sure.

(29:24): I don't know if she didn't hear me or if for some safety reason she couldn't stop. But that continued throughout pushing. I just accepted it was something that probably had to happen.

Dr. Nicole (29:35): And this was with the midwife, or

Jenna (29:37): This was

Dr. Nicole (29:38): Okay. It sounds like your epidural was almost barely working at this point. I mean, was it? Yeah.

Jenna (29:46): I don't know. I don't think it was working at all at this point. I mean, the anesthesiologists were doing checks to see if it was working with an ice cube, and I could tell them every time where the ice cube was on my body, I totally feel it.

Dr. Nicole (30:00): Then it wasn't working.

Jenna (30:03): Okay.

Dr. Nicole (30:04): So

Jenna (30:05): I got to experience the feeling. Okay. You did indeed. There was

Dr. Nicole (30:09): That. Oh my goodness. Okay. So then how long did you push, and I guess, let me back up. They were okay with you being nine centimeters for six hours?

Jenna (30:22): I guess so,

Dr. Nicole (30:23): Yeah. I mean, not everybody would wait that long. I mean, I think it's great to give people an opportunity, so that part is good.

Jenna (30:30): Yeah, definitely.

Dr. Nicole (30:30): Okay. So then you pushed for how long? You said

Jenna (30:35): It was a total of almost three hours, and after about one hour of pushing, I just felt like things were not right. I don't know how to describe it, but I said to them, when are you calling the C-section? And she, yeah. Did you really? I just knew, yeah. Things just did not feel right. It was like the physical feeling, the intuition. Things were just, I knew she was not coming out this way. And the midwife kind of laughed me off, and she said, oh, we'll talk about it when we're at about three hours. I said, okay. And so I keep trying to push her out, and I'm passing out in between pushing. I don't know if I was somehow falling asleep through the pain or fainting, but I am losing consciousness in between pushing. It was so bizarre. And we're nearing about three hours, and that feeling just hits me hard again.

(31:32): And I said, you need to get her out. Please do a C-section now. It was almost a feeling of doom at this point. Oh my God. And I was so out of it. So a lot of this is my husband's description of what happened. He said, the midwife got up, flew out of the room without saying a word. All of a sudden, the room just filled up with a whole team. I had anesthesiology at the top of my head saying, we're going to try to keep you awake. I had the getting as informed of consent as you can get from someone in that state and saying, we need to go in for an urgent go. And so, I don't know.

Dr. Nicole (32:15): And you knew it?

Jenna (32:16): Yeah. I don't know. I think a mother's intuition or something just kicked in at that point, but I wasn't even really aware of it being urgent at the time. I just thought this was like, wow. They sure responded to my request fast.

Dr. Nicole (32:31): Right. I wonder, did they say her heart rate dropped or anything?

Jenna (32:35): Yep. She was a category two quite a few times, and I think it was just starting to get a little less reassuring toward the end. And so they wheel me out for that. My husband is trailing behind. He gets to my side. He looks horrified, so I'm trying to reassure him. They keep pushing me. And at one point, I opened my eyes and I saw one of the nurses who was pushing me was someone who said to me earlier in the process, don't let them talk you into a C-section.

(33:04): Well, that's,

(33:07): And here we are.

Dr. Nicole (33:08): And that's just, oh my gosh.

Jenna (33:09): I felt like the biggest failure ever. I somehow just internalized all of that. Well, here we go. We're doing it. And I knew I needed it. There was something in me, and clearly they knew I needed it, but I just felt like, well, I guess I just gave it or something ridiculous at the time. But they get me back into the, and the anesthesiologist calls me the wrong name like five times. Yeah. I was like, do we know what we're here for? The midwife actually said, everybody stop. We need a safety moment. This is Jenna. She's here for a C-section going over everything. And the anesthesiologist said, how am I expected to remember this at 1:00 AM And all I could think of is, but I'm expecting you to remember,

Dr. Nicole (34:02): And you're responsible for taking care of me. Exactly what is happening.

Jenna (34:07): Yes. Yeah. So that was the attending

Dr. Nicole (34:12): Him and the So no, like, oh, I'm so sorry. I've been calling you the wrong name. Oh,

Jenna (34:16): No.

Dr. Nicole (34:17): Just how am I,

Jenna (34:20): God. Oh, God. It's funny looking back, but it's

Dr. Nicole (34:25): Not though. How about, okay, I'm just, you know what? Let me just let you finish your story. It's just not appropriate. And I think you can accept that people do make mistakes sometimes for, but that was the opportunity to be like, oh my gosh, I'm so sorry. I know who you are. I'm going to take care of you and reassure you.

Jenna (34:50): That would've been nice.

Dr. Nicole (34:52): Yes. Okay. All right. So then how were you comfortable wise, they get you back in for the C-section. So how did that go

Jenna (35:03): At this point? I was so excited for that spinal, the amount of pain I was in.

(35:08): So the resident does the spinal. He does a check on me. I say, Hey, am I supposed to feel that? And he goes, what? And no, you're not. Describe it. And I told him the sensation and where it was, and he said, okay, let's try this again. He attempts the second spinal checks me again, and I'm still feeling it. And at this point I thought, well, here it is. They have to put me under the one thing I wanted to avoid. But the attending saved it, and he got the spinal working on the third attempt.

Dr. Nicole (35:40): So they didn't even try the epidural. They're like, we're not even going to use the epidural

Jenna (35:44): Epi. There's no point in that.

Dr. Nicole (35:45): Okay. So your epidural just definitely wasn't working. Okay. So you did finally get the spine, thank goodness. Because that would've been just like,

Jenna (35:53): I know. I mean, at that point, I was honestly thinking like, well, of course. Of course. This is how it's going. Why not? But so thankful that they got it in. And so they start the C-section. My husband is brought in, and it felt like, no time, my beautiful baby girl is brought up. I am. I just can't even believe what I'm seeing. I can't believe she's here. And it was just amazing.

Dr. Nicole (36:19): Okay. So they did show her to you right away and

Jenna (36:21): They did. Yeah. I had a clear curtain and everything too, so that was great.

Dr. Nicole (36:25): Yeah.

Jenna (36:26): I got to see her and she was just perfect. And she didn't cry right away. She had to have some deep suctioning by NICU because they found thick meconium, but that got her crying. So

(36:39): I

(36:39): Felt a big wave of relief there. I told my husband, go be with her, go see

(36:44): Her.

(36:45): And then all of a sudden I feel things getting pretty tense in the room that OB says something like, where's, if I'm pronouncing this right pathogen?

(36:55): Yeah.

(36:56): Yeah. And the attending or resident said, what? I didn't hear you call that. And the OB said, I called it, she got after him, and that methy was there real fast. And I didn't know it at the time, but I had uterine AP acne. I found that out later. And I read in my notes, they had to exteriorize my uterus, vigorous massage, push the utero tonics. And thankfully they got me back. It was all good. Okay.

Dr. Nicole (37:23): Do you know how much blood you lost at all? Did they say it was?

Jenna (37:26): Yeah. So she actually said that I lost less than a typical amount, but I also had acute blood loss anemia, and I've always been kind of curious how that adds

Dr. Nicole (37:38): Up. Okay.

Jenna (37:39): Interesting.

Dr. Nicole (37:40): Yeah, I agree that those don't necessarily go together unless you already started off with the lower hemoglobin to start with. So it didn't take much to get you to an anemia?

Jenna (37:51): I don't think so. My hemoglobin was 12.

Dr. Nicole (37:53): Oh God, that's head drop. Okay.

Jenna (37:57): I've always just been curious about what happened there.

Dr. Nicole (37:59): Right, right. Okay. So then how was the recovery from this?

Jenna (38:05): Yeah, the recovery was pretty rough. I guess honestly, the hardest part of the recovery was my baby had a birth injury.

Dr. Nicole (38:15): What happened?

Jenna (38:16): Yeah. That's still what we are wondering. Basically, the next morning, the pediatrician comes in, does her checks. So she is perfect. She looks great. I call my mom, tell her the great news, and she says, honey, did you ask about her wrist? And her wrist was completely limp, and you can see it in the C-section. Pictures where she's being pulled up, just could not flex it at all. And I just thought that was to be expected after that long of an induction. She was working so hard to come out for so long, but I brought it up. So they had another pediatrician come in and do a consult, and he did a really thorough workup on her. He did imaging, and he said, your baby has a brachial plexus injury. It's called herbs palsy. Usually this is a birth injury that happens with a rough delivery. And I'm getting just really confused because I was told by the OB that everything went smooth, even though I found out weeks later, I had uterine acne. So I was asking, could this have been the internal rotation attempts? Was this a rough delivery? Was it too long with too much pitocin?

(39:33): And the OB said to me, no, no, no, it's none of that. It's the way your body carried her. Your body hurt her. Not in those exact words. I can't remember the exact words. That was very clearly the message. And I'm this very hormonal postpartum. New mom cannot see logic past that. And I internalized that so deeply that Oh my God, my body. I worked so hard to take care of her and protect her and get her out, and I hurt her. Oh. So that was rough. That took some time.

(40:09): I can imagine.

(40:11): Yeah. Yeah. She started physical therapy when she was six days old. She worked her butt off every single day doing these exercises and stretches and going in for appointments and seeing neurologists. And there were talks about surgery and permanent issues, but by six months old, you would never know anything happened to her. She graduated physical therapy. She has a little diploma. It's my favorite diploma in my life. Yeah. She worked so hard and recovered so beautifully from

Dr. Nicole (40:49): It. Okay. Okay. All alright. I mean, it's unusual for it to happen at a c-section.

Jenna (40:59): Right, right.

Dr. Nicole (41:00): Yeah, it's, it is just not typical. How much did she weigh?

Jenna (41:06): Seven pounds, five ounces.

Dr. Nicole (41:07): Oh, so she wasn't huge or anything like that. How much did they suspect she was going to weigh? Did they tell you?

Jenna (41:14): At one point it was over nine pounds. Okay. Yeah.

Dr. Nicole (41:20): Yeah.

Jenna (41:20): She didn't quite get to there.

Dr. Nicole (41:21): Yeah. Not quite. Not quite. Well. I'm glad that everything ended up improving with the herb's palsy and now that everything has resolved, but that was quite the journey for you. So how did you come to, I mean, I'm guessing that it helped that she got better, but how did you come to wrap your head around all of the experience?

Jenna (41:47): Yeah. Well, it just, things kind of kept unfolding across time that I needed some more help with. At my six week, I asked, am I a candidate for a vbac? The midwife says, I don't know, you had a uterine incision extension. It turns out that was fine. I was still an okay candidate and I was still bleeding at this point, and I wanted to get an IUD placed. And she said, let's wait it out until you're at eight weeks. I want you to be done bleeding before we put that in. And I said, okay, how long before? And she said, oh, let's call it five days. She was very wishy-washy.

Dr. Nicole (42:27): I dunno. I don't know why she said that. I mean, we can put in IUDs immediately postpartum, so I don't understand what the rationale was to wait until you, okay. Well, let's just keep going. Okay.

Jenna (42:43): Yeah. There's so many things that I always still wonder about this. Right. But I go in to my eight week appointment to get this IUD placed and the midwife, I stopped bleeding exactly five days before that appointment. This was with a new midwife, it was a team. And she said, I'm just not comfortable putting this in. You've had prolonged bleeding. I saw in my notes, they wrote down, it was like a secondary postpartum hemorrhage, even though I didn't have any severe bleeding. It was just prolonged abnormal bleeding. So I don't know. But they did an ultrasound and it said I had retained products of conception scattered throughout my endometrium. So yeah, I had to get that out. And so I had a consult with a different OB at this point. I was just having some trust issues with the OB that delivered her. I'm

Dr. Nicole (43:40): Sure.

Jenna (43:40): Just like saying everything went smooth and blaming her birth injury on my body. It was just, I didn't really want to work with her again. So I saw a different ob, she was fantastic. It was a consult for the surgery. She did an operative hysteroscopy. She said it's a little less intense than a DNC and co spare some tissue. And it was something I have to bring up. I loved the soy. I loved her so much. Totally trusted her in the appointment. She said, we were talking about the birth experience, and she said, well, all that matters is a healthy baby. And I know so many people say that, right. So I didn't hold it against her, but it's like I'm sitting there with a baby with a birth injury, and I have placenta scattered throughout my body. I've been guilty of saying it, but I was like, this isn't adding up.

Dr. Nicole (44:33): No. Yeah. I dunno. I've said that. I was like, we have to stop saying that that's all that physically making it out alive is the, that's the least we can do. We could do a lot more standard. It should do a lot more than just like, oh, everybody's alive. You know what I mean? People don't mean anything by, but not, we have got to to stop saying that.

Jenna (44:57): Definitely. So that was just kind of jarring to take in. It's like when I have an injured baby, but okay, we are alive, and that's what you mean. But she was still a phenomenal ob. She did the surgery, she got everything out, and I had a placental site nodule they found.

Dr. Nicole (45:15): Okay. That's pretty not very common. And also after a c-section, it's not usual to have, but maybe it was just an area that was particularly where the placenta particularly embedded in your uterus. But it sounds like she got everything out and everything was

Jenna (45:34): She did.

Dr. Nicole (45:35): Okay.

Jenna (45:36): Okay. Yep. Yeah.

Dr. Nicole (45:39): So then after that, did things settle down?

Jenna (45:41): Yes. So I needed a little therapy.

Dr. Nicole (45:45): I mean, I am glad that you sought help because that Yes, yes. That was a lot. Did you find a reproductive there? Was it somebody who specialized in perinatal trauma or was

Jenna (45:58): It I did eventually. Okay. Yep. She was phenomenal. And we did EMDR, which I was very skeptical about, but it worked wonders for me. And I was able to finally kind of transition from accepting that I did not hurt my baby. Just because somebody told me I did, doesn't mean that's what happened. And yeah, I just really needed to get to that point.

Dr. Nicole (46:23): Good deal. Okay. I have heard several people talk about the benefits of EMDR and they all say the same thing. I was skeptical about it. And then it worked very well for them to help them specifically with birth related trauma.

Jenna (46:39): It's great. I recommend it for sure.

Dr. Nicole (46:41): Okay. Wow. So that was a lot. So looking back, how do you feel There must be a lot of emotions with everything. I mean, how you feel about things.

Jenna (46:53): Yeah. It really is so many emotions, and it depends on the day you ask me. But overall, I can say that looking back, I am thankful for the experience because it gave me this opportunity to prove to myself that I can take care of and protect my baby even during tough times.

Dr. Nicole (47:14): Okay. Okay. All right. That's a beautiful way to reframe it, for sure. And then has it impacted your thoughts on having another baby?

Jenna (47:24): It definitely has. Even though I worked through my body didn't hurt my baby, I just always have that in the back of my head. Well, could I somehow hurt another baby? And then just knowing with the uterine acne, how bad things could have been. I feel that responsibility of, well, I don't want to leave my family if something were to happen. But yeah, I'm really just kind of working through that, accepting that I don't have control over what happens. And we want to give Nora someone to grow up with.

(47:57): Sure.

(47:58): And I really want to experience labor again, actually, even though it was crazy. I loved it. Okay.

Dr. Nicole (48:06): Fun

Jenna (48:06): Little challenge.

Dr. Nicole (48:07): Right, right, right. So then what would be your one piece of advice that you would give to someone who is about to have a baby?

Jenna (48:16): Yeah. I would say don't be afraid to listen to your body. If you know something doesn't feel right, try to speak up. It's not easy to do your best. And also listen to all of the birth stories, the good and the bad. Because I remember when all of this was happening, I was just feeling so weird about it. Like, oh, well, what did I do wrong? Rather than just realizing this is how birth can go.

Dr. Nicole (48:44): Right, right, right. Okay. Well thank you so much for agreeing to come onto the podcast. There were so many things to learn from your story. I really, really appreciate you coming on.

Jenna (48:56): Thank you so much for having me. I appreciate you being able to share my story and so many other stories. It helps a lot.

Dr. Nicole (49:09): Wasn't that a great episode? I so appreciate Jenna coming on to share her story, and I know someone is going to find it helpful. She really triumphed through a difficult situation. Now, after every episode when I have a guest on, I do something called Dr. Nicole's notes, which are my takeaways from the conversation. Here are my Dr. Nicole's notes from my conversation with Jenna. One is that I really want to point out that she did a preconception consult, A preconception consult before you get pregnant. In her case, she had hypothyroidism or low thyroid is really important. Can be really important, particularly if you have any health challenges, to make sure you are optimizing your health before you get pregnant. So if you have anything like thyroid issues or diabetes or high blood pressure, or you take any long-term medications, definitely do a preconception consult because some medications may need to be adjusted while you're getting pregnant, or some tweaks may need to be made to what you're doing.

(50:10): So do get a preconception consult. You can do it either with an OB GYN, or you can even do it with a high risk pregnancy doctor, a maternal fetal medicine specialist in order to best optimize things for yourself before you get pregnant. Okay, next up is, can we please, this is a hill that I will die on. Stop saying that all that matters is a healthy baby. Don't say it. Don't say it, don't say it. And I'm saying that to us as doctors. I'm saying that to us as health professionals. I'm saying it to us as family members, friends, because there is more to the birth experience than just a healthy baby one, physically making it out of the birth, the mom and the baby. That's like the absolute minimum of what we should be able to do, right? For everyone to make it out physically healthy.

(51:09): And there's so much more to health than just that physical health. There's that mental health and how you feel about your birth experience. So and so important, so important to take those things into account. And I think we do this for a number of reasons. I think physicians may do it because of a fear of blame being placed when a birth experience didn't go well. Sometimes I think it comes out of a bit of judging people and saying, well, was it really all that bad? I mean, all that matters is the healthy baby also not cool? And then the third thing is, I think sometimes people do it from a place of wanting to try and highlight the positive in an experience. And so I understand that. But really, when you say all that matters as a healthy baby, you are so minimizing the experience of the mother and her mental health.

(51:59): And what is most important for a healthy baby is a healthy mother. So let's stop saying all that matters is a healthy baby. There's more to it than that. Let's acknowledge that there is more to it than that. And then the final thing I want to say is birth trauma is real. It's an unfortunate reality that giving birth can be traumatic for some, and you may need to get help to deal with that. And that may be things like groups or therapy or EMDR. I'm learning a lot more about EMDR. If you want to learn more about birth trauma, then listen to episode 2 62 of the podcast. It's with licensed clinical social worker and birth trauma survivor, Kaylee Summers. That's dr nicole rankins.com/episode 2 6 2. And there's a lot of information in that episode about what is birth trauma and how to help get through birth trauma. All right. So there you have it. Please share this podcast with a friend. Sharing is caring. Also, subscribe to the podcast wherever you're listening to me right now. Leave me a review and Apple Podcast. I love to hear what you think about the show in helps other women to find the show. And you may get a shout out in a future episode. All right. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful and birth.