Ep 283: Alexa’s Birth Story – A Routine Checkup With a Surprise Ending

Dr. Nicole (00:00): I've said it many times. The only predictable thing about birth is that it is unpredictable, but you can absolutely navigate that unpredictability. In this birth story episode, you're going to hear how Alexa navigated a healthy pregnancy that turned to severe preeclampsia and a cesarean birth. 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 OB GYN, 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.

(00:59): Check out the full disclaimer at drnicolerankins.com / disclaimer. Now, let's get to it. Hello there. Welcome to another episode of the podcast. This is episode number 283. Whether it is your first time listening or you've been here for a while, I'm so glad you're spending some time with me today. In this birth story episode, we have Alexa. Alexa is a new mom to Ezra. She works part-time, but her main job is to stay home with their little guy while her husband works at their local hospital as an anesthetist. Yes, that's right. Her husband does epidurals. She loves hanging out with other new moms, loves going to the gym when she's able to get away, and also trying new baking recipes. When Alexa found out she was pregnant with Ezra, she wanted to be as prepared as possible, so she listened every week to this podcast. Also took my birth course.

(01:52): Her birth went nothing like she planned, but the information in the podcast and the birth course allowed her to feel prepared and empowered. Alexa had a really normal and healthy pregnancy. Then at 35 weeks, her husband noticed how swollen she was, so he took her blood pressure. She went to the hospital. Her blood pressure was indeed elevated. She was diagnosed with preeclampsia. The original plan was to keep her hospitalized for close monitoring and to get the baby to 37 weeks. However, that is not what happened. Things took a little bit of a twist and turn, and you're going to hear all about that inside of the episode. Alexa went into childbirth very prepared. She even had a doula, but nothing about her planned happened the way that she anticipated, and she had to grieve the reality that her birth story was not at all what she wanted.

(02:49): At the same time though, she had a very positive experience with the cesarean birth. She had an amazing OB and anesthesia team, but because her birth was so unexpected and a bit scary, she struggled a bit with feeling attached to her son, and she struggled with postpartum depression, and she hopes that by sharing her journey with her birth and postpartum, she will encourage other women who do all the right things, but still don't have it work out exactly as they anticipated. Now, before we get into the birth story episode, I do want to tell you something. There are some changes coming to the birth preparation course. The birth preparation course is my online childbirth education class that will get you calm, confident, and empower to have a beautiful birth, and these changes are going to make the content more accessible and give you more choices as to what you want to learn more about from me. So the best way to know about these changes that are coming is to hop on my email list at drnicolerankins.com / email. I never sell your information or anything like that. It's just the best way for us to stay in touch. Okay. Let's get into the birth story episode with Alexa.

(04:10): Thank you so much, Alexa, for agreeing to come onto the podcast. I am excited to have you share your birth story today.

Alexa (04:15): Thanks. I'm really excited to share two.

Dr. Nicole (04:18): Yeah, so why don't you start off by telling us a bit about yourself and your family?

Alexa (04:21): Yes, so I am living with my husband and are now almost, he just turned one.

(04:30): Okay.

(04:30): And we live down in south Florida in the Miami area.

Dr. Nicole (04:36): Okay.

Alexa (04:36): Yep.

Dr. Nicole (04:37): Gotcha. So hopefully you haven't been impacted by any of the recent weather.

Alexa (04:41): Yeah, we say that for some reason Miami is a hurricane repellent, so the whole state was impacted except for us, which is a huge blessing. My parents live in Tampa.

(04:54): Oh,

(04:54): Yeah. Their house is okay though. But yeah, they came and stayed with us, which was scary. But yeah, everything's good.

Dr. Nicole (05:02): Okay. Well, good, good.

Alexa (05:04): Yeah, so we live down in the Miami area, and I work part-time at my church. I work with the children. And then my husband, he actually is an anesthetist, which plays a role in kind of my story and my birth plan.

Dr. Nicole (05:24): I'm sure it will. I'm excited to hear how that played out.

Alexa (05:28): Yes.

Dr. Nicole (05:29): Yeah,

Alexa (05:29): For sure. Yep. I knew way too much about epidurals long before I was pregnant.

Dr. Nicole (05:36): I'm sure you did. I'm sure you did. Yeah. So then, in order to understand what your birth experience is, I always like to go back and talk a bit about how the pregnancy played into it. So let's talk about what was your pregnancy and prenatal care? Did you see a physician or did you see a midwife? Who did you see?

Alexa (05:55): So my prenatal care, I saw a physician and a midwife.

(06:00): Okay.

(06:01): Yeah. So I worked in a group that had four physicians and one midwife, and it was really important to me that when I gave birth, I knew the person that was going to be there. And because of that at the office, they let you schedule your appointments with anyone that you would like to see. So because of that, I made sure that I met every single provider in the office because I did not want to be meeting the person delivering my baby for the very first time.

Dr. Nicole (06:35): I can totally understand that. And then did you have any problems or issues during your pregnancy?

Alexa (06:41): No. I actually had a really smooth pregnancy. I had of some of the regular pregnancy symptoms. I had carpal tunnel, which I didn't even know that was a pregnancy symptom until it started happening. To me,

Dr. Nicole (06:59): It can actually get pretty uncomfortable and painful for folks during pregnancy.

Alexa (07:04): That was definitely my worst symptom. But other than that, I never got sick and I felt good. I was able to exercise my whole pregnancy and it was smooth.

Dr. Nicole (07:16): Nice, nice. Good. How did you feel then about the care you received?

Alexa (07:21): I loved all of the physicians and the midwife in our practice. Yeah. I felt like they all cared about me understanding. They never made me feel dumb for asking questions, and it was honestly a really positive experience.

Dr. Nicole (07:42): Okay. Good. Good, good, good. So then what did you do to prepare for your birth

Alexa (07:46): So much? Yeah. I was really scared about giving birth. That was the first thing I thought about when I found out that I was pregnant. I was like, oh, no, I have to give birth. Right, right.

Dr. Nicole (08:00): What scared you the most? What were you scared about? And we'll get back to what you did to prepare, but what was it that really terrified? It sounded like,

Alexa (08:07): I think it was fear of the unknown. It just felt so out of my control, which I really value knowing what's going to happen and feeling in control. And I think this was really one of the first times where I'm, at the end of the day, I'm not in control of what happens. And then also, I do think just the pain aspect of it was really daunting to me. I've never had surgery before. I've never been in a lot of pain, so I think it was just like I didn't even know how I would handle that.

Dr. Nicole (08:46): And you felt that pretty much right from the beginning?

Alexa (08:48): Yes.

Dr. Nicole (08:49): Okay. It's like pregnancy test, and then, oh my God, I'm pregnant.

Alexa (08:54): Yeah. I took the pregnancy test and I think one of the first things I said to my husband was like, oh my gosh, I have to push this baby out of me eventually. Which is funny because I had a C-section, so I ended up not doing well. There

Dr. Nicole (09:10): We go. And we'll get to, definitely get to why that ended up being the case.

Alexa (09:14): Okay.

Dr. Nicole (09:14): So then what did you do to prepare for your birth?

Alexa (09:17): So actually when I was pregnant, three of my best friends were pregnant at the same time. Seriously? Yes. All with our first. Okay. Yeah. It was this big joke within our community that we all planned it, but it really was not planned. It was like every two weeks, another friend told us that they were

Dr. Nicole (09:40): Pregnant. Okay. All right.

Alexa (09:42): So

Dr. Nicole (09:42): Then did you all prepare? How did that help or how did that play into your preparation?

Alexa (09:47): So of course, we started chat immediately to talk all about pregnancy, which I think just helps so much if people can have other pregnant women to talk to and just relate and share. That was a huge blessing. And then it was one of my best friends who actually told me about your podcast.

Dr. Nicole (10:12): Okay.

Alexa (10:12): So that's how I found out about all of your resources, and I became pretty obsessed immediately. I just started listening. I think my favorite part about your podcast is the birth stories,

(10:27): Because

(10:28): I think that made birth feel so much more of a human experience, and it's not a traumatic experience. It's scary. Things can happen, but every woman that is a mom, so many women give birth. I just kept thinking about that. And your podcast, I think really just encouraged me. And then I decided to take your birth course through doing your podcast.

Dr. Nicole (10:58): Okay.

Alexa (10:59): And then I also had a doula. So

Dr. Nicole (11:02): You were ready?

Alexa (11:03): I was ready. I was taking charge of what little I could control, and I had an older friend within my community that she has children, and she had a doula. So she was the one that told me about doulas. She was like, you need one of these. And so I interviewed about five different doulas, and that's how I picked it. In South Florida, they have a whole network of doulas, so you can go on their website and you can actually read their descriptions, areas they feel passionate about, and so that's kind of how I matched up with the lady I went with.

Dr. Nicole (11:48): Nice. So you really did your research?

Alexa (11:51): Yeah, I did.

Dr. Nicole (11:55): And at what point did you hire the doula? At what point during your pregnancy?

Alexa (11:58): Immediately.

Dr. Nicole (11:59): Oh, okay. Just right away.

Alexa (12:01): I was like, I need someone to talk to about this. Right,

Dr. Nicole (12:05): Right.

Alexa (12:07): And I just wanted to make sure, I just wanted to get it out of the way and feel like usually the really popular doulas I found weren't always available. So I wanted to feel like I had the most amount of options. So in my first trimester, we hired our doula, so she was a part of our entire pregnancy journey.

Dr. Nicole (12:31): Okay. Good. So what are some things that you wanted for your birth?

Alexa (12:35): I wanted to labor at home for as long as

(12:41): Possible.

(12:42): My husband does anesthesia at the hospital, so we were 100% going to the hospital.

Dr. Nicole (12:51): So at the hospital where you were planning to give birth is where he works?

Alexa (12:55): Yes. So I knew quite a few people that were involved in my birth, which was an interesting dynamic as

Dr. Nicole (13:04): Well. I'm sure. I'm sure.

Alexa (13:06): So I wanted to be at home as long as possible. I was really hoping to go into labor spontaneously, and then I felt extremely open to an epidural just because that is literally what my husband does. So I felt very open to that. However, I wanted to just go as long as possible without one, so I would have the freedom to walk around the room. However, my entire pregnancy felt like as soon as I felt ready to getting an epidural, I was very open to receiving one.

Dr. Nicole (13:44): Okay. And I forgot to ask, how many times did you meet with your doula during your pregnancy?

Alexa (13:51): We met four times during my pregnancy, and then we had each other's phone numbers, and she would always text me and just ask me how I was doing and if I had any questions. She was amazing.

Dr. Nicole (14:06): Okay. Okay. Good. That support is really, really important. You said, you mentioned you were terrified about giving birth in the beginning, but you did all the things. You were prepared, but then things went a little bit different than what you anticipated.

Alexa (14:23): Yes.

Dr. Nicole (14:24): Yes. So let's talk about that. So what exactly happened with your labor and birth?

Alexa (14:31): So I think the strange part was my pregnancy was completely normal. I've always been really healthy. I exercise regularly. I was showing no signs of having any sort of complication around my 28th week appointment. Actually, it was when I met with the midwife, she noticed my blood pressure had been, it wasn't high, she's just noticed that it was trending upwards, and she was the first person to actually point that out on my care team, which now looking back, I wonder if I would've saw the same person every single time if things would've been more noticeable. But I was seeing a different provider every time. So I do feel like sometimes next time going forward, I do desire to actually see the same person the whole time for a continuity of care, just because of my specific experience. But it was around 28 weeks, the midwife noticed my blood pressure had been slowly going up, and she said at that point it was on the higher side of

(15:44): Normal.

(15:45): So she was like, I'm not concerned about it at this point, but it has gone up every time you've had an appointment slightly.

(15:52): Got

Dr. Nicole (15:53): It.

Alexa (15:53): So she encouraged me to get a blood pressure cuff and to just monitor it at home. Yeah. So I felt totally fine though nothing weird was going on. And then something that started happening was I was getting really swollen everywhere, and it was my first pregnancy, so I just thought it was

(16:23): Normal.

(16:25): And my family members started noticing too. They were like, you're really swollen, Alexa. And I just kind of laughed always. I was like, yeah, ha. I'm pregnant. Right. Still felt really normal. So at 35 weeks, my husband and I, we went to the beach, and since he works in anesthesia, blood pressure is his jam. That's the main thing that he looks at. And so when we came home from the beach that day, he noticed how swollen I was, and he checked my blood pressure and it was really high. Okay.

Dr. Nicole (17:10): Do you remember what it was?

Alexa (17:12): I don't remember what the top number was. I remember the bottom number. What's that one called?

Dr. Nicole (17:20): Diastolic?

Alexa (17:21): Yeah, that number was in the upper nineties. So it wasn't scary high, but it was higher,

Dr. Nicole (17:31): Definitely higher than it should have been.

Alexa (17:35): And I never took my blood pressure because I was so nervous. My husband always did it, and he would do it when I wasn't expecting it, so I didn't have time to raise it myself with my anxiety. So when he took it, he didn't tell me what it was, but he just said, I am going to go call one of my coworkers. And I was like, what? I was like, why? And then he came back and he took my blood pressure again on my ankle. So he was now taking my blood pressure all over my body to kind of figure out if it was just a weird reading, and it was still high. And so we decided it was right before bed, and we decided, he told me, take it in the morning, and if it hasn't gone down, I want you to call your doctor. So I took it in the morning and it had only gone up more. Okay. So I called our practice and she was really great. She didn't freak me out or anything, which I really appreciate that She wasn't like, oh, no,

(18:45): I

(18:45): Need to come in. She was like, yeah, that's a little high. I am sure it's fine. Why don't you just come in and we'll check it out? So she actually told me to go to the emergency room, so I could just go to the Labor and Delivery triage center and they could look at it. And actually the day before my husband and I, we packed our hospital bag

(19:06): And

(19:06): We installed the car seat. And so it was kind of funny in my head. I was like, oh, this is good practice for me. So just as in my head, I'm like, I'm going to practice putting my hospital bag in the car. Right. And when I got to the hospital, they took my blood pressure and it was like one 70 over one 10, and they made me sit down immediately in a wheelchair and started whispering to each other. So I was like, okay, I think something's going on.

Dr. Nicole (19:41): Something goes up. Yeah.

Alexa (19:42): My husband was working that day at the hospital.

Dr. Nicole (19:44): Okay.

Alexa (19:45): Yeah.

Dr. Nicole (19:46): So did he come down at that point, or was he there to start with, or?

Alexa (19:50): No, so he knew I was coming,

Dr. Nicole (19:53): And

Alexa (19:54): He told me after they check it to tell me what they said, and they told me that they were going to have to admit me. And so that's when I called my husband and he came down and met me in

(20:09): Triage,

(20:11): And they ran a few more tests. They did blood work, and then they did a urine sample, and they did an ultrasound in which I found that my son was breached, and he wasn't four days earlier. So that was also a surprise.

Dr. Nicole (20:29): Okay. Okay. So now you're in the hospital. Your blood pressures are, I'm assuming they stayed elevated because they kept you, and then on top of this, they're like, oh, also your baby's breach. So hadn't been four days earlier. Now, four days earlier, had you had an ultrasound or was it just by feeling that they thought that he wasn't

Alexa (20:57): Breached? It was just by feeling. So who knows, it could have been the wrong end that they were assuming.

Dr. Nicole (21:05): It's hard to know. Do you remember, I mean, it's been a while, but do you remember feeling any big movements in between that time or like, oh, whoa, what was that? That kind of thing.

Alexa (21:17): Yeah. Actually, the night before I went to the hospital, I have a video that I took of my stomach because I felt like he was doing somersault, so maybe he turned at that point.

Dr. Nicole (21:30): So then how were you feeling in the moment?

Alexa (21:34): I felt really calm, strangely. I just was not even thinking that I was going to be giving birth. It was just not in my head, which I really think I just felt like looking back, I feel like I was protected from that fear. I don't know why. I just had this sense of calm at that point, at least.

Dr. Nicole (21:59): Okay. Okay.

Alexa (22:00): Yeah.

Dr. Nicole (22:01): Okay. So then what did they tell you? What was the plan? How did things happen after that?

Alexa (22:07): So at that point, my OB came and saw me, and she looked at the ultrasound, and I also had low fluid. So that was basically every test that they did. It was not good news. It was like, oh, and this happens and this happens. And I was like, okay. So my OB came and she said that she was going to work with a specialist, and that she said that she at this point, feels pretty confident that I have preeclampsia. And that's when I kind of started to freak out a little bit. My only visual of preeclampsia was watching down Abbey and one of the characters us, this is hundreds of years ago, and she has a horrible experience. So that's what's going on in my head head. Gotcha,

Dr. Nicole (23:09): Gotcha.

Alexa (23:09): Yeah. So she told me that she's going to work with a, I don't know specifically, I'm assuming it was an ob, GYNA

Dr. Nicole (23:19): Maternal fetal medicine or high risk pregnancy doctor.

Alexa (23:22): Oh, okay. Yes, that sounds familiar. So then that doctor came and saw me and looked at all my charts, and she told me that she wanted to put me on bed rest

(23:37): Because

(23:39): She said that my blood pressure was becoming more stable, and all of the other things that they tested was not scary high at that point. And because I was still in my 35th week, she was like, I want to put you on bedrest and see if we can get you to go a little bit longer.

Dr. Nicole (24:01): Okay. So then you ended up going on bedrest then? Is that what happened in the hospital?

Alexa (24:07): At the hospital? Yeah. I thought that meant I could go home. I was like, okay, so I'll just be hanging out at home. And she was like, this is when it became real to me. She was like, oh, no, you're not going to be going home until you have your baby. And I was like,

(24:24): What? Yeah,

(24:28): I'm sorry. I think I misunderstood

Dr. Nicole (24:30): You. Right, right, right. Gotcha. Gotcha, gotcha. Okay. So then once you got over that shock settled into the hospital, how long were you in the hospital before your baby was born?

Alexa (24:45): I was only in the hospital for one day. Oh, okay. Yeah. Okay. Yeah, things got a little crazy. Okay. Okay. What happened? Yeah, they admitted me. It was around noon that day that I went to the hospital, and they sent me to a room. The rest of that day, they just had me hooked up to a monitor for myself and then for my son as

(25:17): Well.

(25:18): And then I called my doula and she was so great. She came to the hospital. I think she could tell that I was just not in a good head space. She was so sweet. She came to the hospital straight from another birth that she just finished. This woman had not slept in two days. Oh my

Dr. Nicole (25:37): God. Okay.

Alexa (25:38): I know. And she came to the hospital and she talked me off the ledge basically, and got me back into a good head space and just reminded me that there is a plan for how this child is going to come into the world, and I'm in good care. And she was just that external voice that my husband and I couldn't be for ourselves at that point.

Dr. Nicole (26:07): Gotcha. Gotcha, gotcha.

Alexa (26:09): Yeah.

Dr. Nicole (26:10): So then what ultimately led them then to go ahead and say, Hey, it's time for this baby to be born.

Alexa (26:18): So that night, they took all my vitals again, and they told me, and they told me this in advance, and honestly, this kind of upset me, but I understood why. They told me every night after eight o'clock, I wasn't going to be allowed to eat in case I would have to have a C-section. They didn't want any

Dr. Nicole (26:43): Really?

Alexa (26:44): Yep. So that upset me a lot.

Dr. Nicole (26:48): I can imagine. Yes. Okay. So they were like, just in case, if the next day you have to have a C-section, we want your Okay.

Alexa (26:59): Yeah, because I think what they were going to do was they were like, we're going to run all the tests in the morning, and so we want you on an empty stomach in case we have to deliver. And my OB, GYN, she was great. She told me that if my son had flipped, she would induce me, which is what I wanted. I really wanted to try for a vaginal birth, but because I had low fluid, she didn't feel comfortable trying to flip him herself. I forget what that's

Dr. Nicole (27:33): Called, external cephalic version. So trying to turn him, it's hard when there's not a lot of fluid. There's just not a lot of space for them to turn.

Alexa (27:42): So she told me he has to flip himself. And then also she told me I wasn't allowed to do any of the spinning babies movements because of my blood pressure. She was like, I don't want you really hanging upside down, which I guess is fair. So yeah.

(28:04): Gotcha. Gotcha.

(28:06): So the next morning they took all of my vitals and my ob, GYN looked at them, and she called me and she said, okay, I looked at your vitals, the specialist, she's going to look at them too, and we're going to just confirm with each other, but I don't think you're going to be giving birth today. I think we'll keep you another day. So at that point, I told my husband and we were trying to hold off on him using any of his leave because he doesn't get that much leave. So he decided to just go upstairs and go to work for the day. And this is funny, I hadn't finished your birth course yet because I thought I had

Dr. Nicole (28:56): More time

Alexa (28:57): A little bit over a month. So when she hung up and told me that it was going to be another day, I was like, all right, well, I guess I'll just watch the videos on the C-section. Bless your heart. I know. So I was watching the last part of the section on your birth course on C-sections. I had literally just finished the

(29:21): Video

(29:22): And the phone rings in my hospital room, and it's my doctor again. And she was like, so I just talked to the specialist and she doesn't feel comfortable with where your vitals are, and she doesn't want to wait. So your son's going to be born today. And I was like, what? Right. Yeah. I could tell she felt bad, but she did a good job. She was like, you're going to have a birthday party.

Dr. Nicole (29:52): Oh my goodness. So do you remember what your blood pressure was?

Alexa (29:56): No, I don't. I remember what it was right before I had this C-section, and at that point it was 180 over one 15.

(30:09): Okay. Okay.

(30:10): Yeah. So I was by myself when I got the news that I was going to have a C-section

Dr. Nicole (30:18): Right that day.

Alexa (30:19): That day, I called my husband and he came down immediately. And because my husband works at the hospital, it was his coworkers that were going to be doing all of the anesthesia for my C-section. And they originally told me it was probably going to be about five hours of a wait just because of the schedule that day. But because Caleb works at the hospital and he knows the OB anesthesiologist, she saw our name and she came into the room and she offered to basically put us first.

Dr. Nicole (31:02): Okay.

Alexa (31:04): Which I was going back and forth about of like, do I wait or do I go now? And ultimately, my husband, he was like, you're so anxious. I think if you wait five more hours, you are just going to be even more anxious. So it was a lot of pressure because the OB anesthesiologist, she was in the room with us, and she told us, she was like, I need to know now though if you want us to put you guys first. So we decided, yeah, okay. We think it's better to just, since we have the option to get it done versus sitting here and just thinking about it.

(31:46): Okay.

(31:46): Yep. So as soon as we said that she made a phone call and two minutes later there was 10 people that came into the room to prep me.

Dr. Nicole (31:57): And your OB doctor was okay, obviously with going sooner.

Alexa (32:01): Yep. Yeah, she was happy about it? I think so. I think she was already there, and I felt really, it was so great. She was actually my favorite one out of the four physicians. And so I think that motivated me too, knowing that she was currently the doctor on call, and I was like, if I can guarantee that she's going to be the one to do the C-section, that motivated me even more to do it right then.

Dr. Nicole (32:28): Gotcha, gotcha. Now, did you ever have to go on magnesium at all?

Alexa (32:33): I did. They put me on magnesium. I don't remember if they did it before. I just know that they did it after as well.

Dr. Nicole (32:43): Gotcha. Gotcha. So then how exactly did the C-section go?

Alexa (32:47): It went perfectly. I was really scared, but my ob, she was so great, and I was during the part where they were going to give me the spinal anesthesia. She was showing me photos on her phone

(33:05): From

(33:05): Her last vacation, just distracting me. And then I knew the OB anesthesiologist and the CRNA from my husband. So that did make it feel like a really fun and warm environment. Everyone knew me and knew my husband, so that was really sweet. And because of that, normally the partner has to leave the room while they prep you at our hospital, at least. I don't know how they do it at your hospital, but because my husband works there, they actually let him stay in the entire time.

Dr. Nicole (33:44): Yes. Since he's familiar with how things go and all of those sort of things,

Alexa (33:48): He wasn't going to pass out.

Dr. Nicole (33:51): I would hope

Alexa (33:52): Not. So he got to hold my hand while they were prepping me, and it took to get my son out, it took about two minutes.

Dr. Nicole (34:05): They

Alexa (34:05): Were so fast.

Dr. Nicole (34:06): Yeah. I

Alexa (34:08): Had no idea. I just assumed it would take a long time. It doesn't. But I remember asking my OB when she was showing me the pictures and they were prepping me. I was like, how long is this going to take? And she was like, I'll be done in about five minutes to getting him out. And

Dr. Nicole (34:24): I'm like,

Alexa (34:25): What? Yeah.

Dr. Nicole (34:29): Yeah. It doesn't take long. It doesn't take long. And then did he have to go to the NICU or

Alexa (34:34): He did not. So that was such a blessing given all the other scary things that were going on. They told me that because of where I was at in my pregnancy, that they would have to immediately take him and check him, which that made me sad that I wouldn't get that immediate skin to skin. But I understood. However, she did do some delayed cord clamping, which was something I wanted. And she told me if he comes out and he's crying, i'll delay cutting the cord. And he did.

Dr. Nicole (35:12): Okay, perfect. Yep. It can absolutely be done at the time of C-section, so that's good to hear.

Alexa (35:17): Yeah.

Dr. Nicole (35:18): So then what was your physical recovery from the C-section? And then talk about, I know you said you had some challenges maybe bonding with your baby. So what was that about?

Alexa (35:31): So physically, it was a pretty intense recovery for me, and that was partly because my vitals did not go back to a normal level after I gave birth. So they put me on the magnesium and they tried to take me off of it, and they had to put me back on it because my blood pressure immediately went up again,

Dr. Nicole (35:59): Was just too high.

Alexa (36:02): The magnesium made me so tired, I was so drowsy, I could not stay awake. That was very difficult. While I was that first day, day and a half postpartum, I felt like I was just fighting to even keep my eyes open.

Dr. Nicole (36:20): Sure. Yeah. It can make you feel very, very fatigued.

Alexa (36:25): But two days later, the nurse came in and she was like, we're going to need you to get up now. And I was like, no. And she was like,

Dr. Nicole (36:39): You're like, no, thank you. I don't want to

Alexa (36:41): Do

Dr. Nicole (36:41): That right now.

Alexa (36:42): I'm like, I'll just stay in my bed. Well, I just didn't even believe her. I'm like, what do you mean I can't get up? And she was like, no, no, you can. And that was a sweet experience. I had a great experience with my postpartum nurses. They rallied around me and they helped me stand up.

Dr. Nicole (37:06): Yep, yep,

Alexa (37:07): Yep. And I did not fall. And yeah, just mental health wise, I was just not doing well, which it is hard to talk about on the podcast. I obviously don't want other women to hear this in get freaked out, but I also think that this is a very real story for a lot of women. So it's also good to talk about. Yeah,

Dr. Nicole (37:36): Yeah, definitely. To normalize that this is a possibility that could happen, and then how you manage it. So what was the mental health? What were the issues that you had?

Alexa (37:47): I just felt extremely low, and I did not know this prior to giving birth. I didn't know that they do a little assessment, at least at my hospital, they do a mental health assessment, so I failed that. When I took it, they sent a social worker to my room, and it was funny, she came in and she was really nice, and I was like, oh, do you visit everyone? And she was like, no. I was like, oh, okay. And I actually, I just felt like I could push through it, and so I actually sent her away.

(38:35): Okay.

(38:35): Yeah. I told her, no, I'm fine. I think I just had a really overwhelming experience. And then the next day, my nurse, she actually encouraged me to actually talk to the social worker because I was still just, I was very low. I was having a hard time even wanting to hold my son. Breastfeeding was really challenging because he was so little. My milk hadn't come in,

(39:08): And

(39:09): He was only five pounds. So we had to introduce formula, and that was really sad for me. I did get to exclusively breastfeed, I will say, after I got out of the hospital, but I just felt like everything that I wanted wasn't happening, and it wasn't anyone's fault. It was just out of everyone's control. And that just sent me to a really low place. So the social worker came back and I actually talked to her and she gave me resources, just different counseling options that I could seek out or just what signs to look out for. Told my husband too for him what to look out for when we would consider what I was feeling to be postpartum depression. So we decided that we would wait six weeks before doing any major mental health steps. That's just what I wanted. I really wanted to kind of wait to see what would happen with giving it some space with my hormones, kind of going back to normal. So I ended up being in the hospital for four days because of my blood pressure. And finally my blood pressure had gone down slightly. It was still high, but my ob, GYN, she was really great, and she recognized that my blood pressure was also probably high because I was really anxious

(40:47): About it

(40:48): Being

(40:48): High. So she was like, I feel like we're not going to get an actual good understanding of where you're at until you can actually get home and relax, because everything else looked fine. It was just my blood pressure, blood pressure. So she was like, I think this is anxiety.

Dr. Nicole (41:07): Gotcha. Gotcha. Were you on any blood pressure medication? Did they start any blood pressure medication at all?

Alexa (41:12): They did. Yeah. They put me on a blood pressure medication, and so she sent me home with that that she wanted me to

(41:20): Take. Gotcha.

(41:21): And then I had a follow-up to come back to the office just a few days later for them to do a blood pressure check.

Dr. Nicole (41:28): Gotcha. Gotcha. Then I guess a couple questions. How long were you on the blood pressure medicine, and then what do you think helped you get out of that low place?

Alexa (41:39): So I was on the blood pressure medication for about a month because it was still just high, which I did not know that about preeclampsia that you're still at risk after you give birth. That was news to me. And then she also wanted me to see a cardiologist to bring a cardiologist into the loop.

Dr. Nicole (42:04): And so you ended up seeing a cardiologist just to get your blood pressure under better control or just look at your overall health and the risk and kind of make sure everything was being optimized.

Alexa (42:13): So high blood pressure runs in my family. So that motivated, I think my doctor of, let's see a cardiologist and let's just get everything checked out. And since it's not going down very quickly,

(42:26): I

(42:27): Think she just wanted someone who was an expert in that area keeping track of me. So I did see a cardiologist, and then at that point, the cardiologist took over and she and I together, she helped me come up with a plan to wean off of the blood pressure medication. So that took about a month, and I still have to see her once a year now to just have a checkup, and then when I get pregnant again, she wants me to keep her in the loop with all of that.

Dr. Nicole (43:03): Gotcha. Gotcha. So then how did the mental health challenges go?

Alexa (43:10): In some ways naturally got better going home, and then in other ways, I think I just felt, even in my happy moments, I just did not feel like myself. So I think that was a key indicator for me of seeking out additional help of, okay, I am happy right now, and something still feels off. My mom was a really helpful part of that journey for me. My mom struggled with postpartum depression, so she was just my biggest cheerleader and encouraging me to not ignore it, and then also not making me feel like this wasn't my fault. I'm not a bad mom for feeling this way. So at my six week OB appointment to get my incision checked, and I talked to her about how I felt, and she was just so gracious and uncomplicated, and she just asked me, she was like, do you want to try to take some medication and just see if it helps? And I think something I was anxious about was that it was going to be this whole process getting on something, and she just made it so simple. She was like, this is normal, and I would love to get you some help. And I just remember crying to her. Thank you so much. Right, right. Yeah. So I started taking

(44:43): Zoloft

(44:44): Of really low dose, and that ultimately I think was the tool in my toolbox that I needed to get back to myself.

Dr. Nicole (44:54): Gotcha. And did you stay on the Zoloft, if you don't mind sharing, or did you eventually come off of it?

Alexa (44:59): No, I don't mind sharing. I did stay on it because it has only helped me, and I just have felt like, if it's helping me, why change things? There you go. Yep. Just simply that's how I came to the conclusion.

Dr. Nicole (45:16): Gotcha. Gotcha. And you were able to, you said, get to exclusive breastfeeding, and how long did you breastfeed for, or are you still breastfeeding?

Alexa (45:26): No, I'm not eating. I exclusively breastfed for about seven months. My son had some health issues, so he started having blood in his stool around two months. I got all of the things that happened too clearly, yes. So we started working with our pediatrician and then a pediatric gi, and he had a dairy allergy.

(45:58): Okay.

(46:00): So I had to cut out dairy completely in order to keep breastfeeding, which at that time, that was worth it to me. I liked breastfeeding, however, dairy is in everything I realized.

Dr. Nicole (46:14): Yeah.

Alexa (46:15): Yeah. It's in all good desserts. Yeah. We cut out dairy, and then about two months later, the blood had cleared up, but he was struggling to gain weight at that point. And so then they allergy tested him, and they also found out that he was allergic to eggs. So at that point, because his weight, he had actually lost a little bit of weight. Our pediatrician had us start supplementing with formula, which was a great transition that she didn't ask me to just stop breastfeeding. She asked me to add it in addition.

(46:55): Got it.

(46:56): Which I think there's an unhealthy culture sometimes around formula.

Dr. Nicole (47:01): Absolutely.

Alexa (47:03): Yeah. I was really struggling with feelings of failure, and then when I started the formula and he started gaining weight and was thriving, I was like, why was I so hesitant to do this?

Dr. Nicole (47:18): Yep. Yep.

Alexa (47:19): Agree. So we did both for until he was 10 months old, and then at 10 months old, he kind of just honestly naturally weaned off of direct. And at that point, we just switched to fully bottle formula feeding, and then he was having solids too.

Dr. Nicole (47:35): Okay. Okay. Well, then as we wrap up, what would you say is your one favorite piece of advice that you would give? I mean, you had a roller coaster for real of ups and downs and all of that. So what is your biggest takeaway from everything that you want to share?

Alexa (47:55): My biggest takeaway would probably be prepare and educate, because that made me feel empowered. But at the same time, be willing to surrender your plan and know that you can make all the plans you want, but none of it could happen, and that's okay. And what's important at the end of the day is that you healthy and your baby's healthy, and you're not a lesser mom because of that.

Dr. Nicole (48:32): Absolutely. Absolutely. Oh, and I forgot to ask, was your doula at your C-section, and then was she involved in your postpartum care at all?

Alexa (48:41): Yeah, so she was at the hospital for the C-section. They would not let her in the room, which I was bummed about, but I guess that's just a rule. I don't really know why I never,

Dr. Nicole (48:55): Yeah, it doesn't have to be. We just need to move forward from that. Doula should be able to be in, we're getting better, but we have some room to go with that. Yeah.

Alexa (49:03): Yeah. I felt like it was a step in the right direction that my husband got to be there the whole time that they didn't make him leave, even though he does work there, but

Dr. Nicole (49:13): Right, right, right. And then did she visit you postpartum?

Alexa (49:18): Yeah, so she was the first person I saw besides my husband. They did let her come into the recovery room right after my C-section, and then she visited me once in the hospital and then two more times at my house.

Dr. Nicole (49:34): Okay. Good. Good, good, good. Well, thank you so much for sharing your story. There's so many jumps. I have a whole page of notes of things that were really important points for people to know. I appreciate you coming on. It's just sharing that how you can manage, just if you listen to the podcast, you heard me say it, birth is unpredictable. It's just an unpredictable process, and you just managed it so beautifully. So thank you for coming on and sharing.

Alexa (50:02): Yeah, thank you so much. I was excited to share my story and hopefully normalize a more common experience than I think people realize.

Dr. Nicole (50:12): Yeah, absolutely. Absolutely. All right. As usual, wasn't it a great birth story episode? Alexa has such lovely, exciting energy, and I really appreciate her coming on to share her story. Now, after every episode when I have a guest on, I do something called Dr. Nicole's notes, which are my top takeaways and thoughts from the conversation. Here are my Dr. Nicole's notes from my conversation with Alexa. One is the importance of having community during pregnancy. Having community can be really, really helpful when you're going through something similar with someone. Alexa had four girlfriends who were pregnant, just happen to be pregnant at the same time. You may not have other girlfriends around you who are pregnant, but you may find community in local mom groups. You may find community in an in-person childbirth class. You can find community online as well. I have an online community.

(51:11): It's called the Inner Circle Facebook Group. You can go to Facebook and search for Dr. Nicole Rankins Inner Circle, and it'll pop up. Just hop one in. It's a great place to connect with other people because again, that community and that sense of going through a shared experience can be really, really helpful. Next up is that Alexa interviewed five doulas. Yes, five doulas. I think it is so important that you take the time to make sure you have a doula who fits with you. I've seen, unfortunately, a lot of people just say, because someone has that title of doula, that they're, oh, there must be good. They must be fine. Just like anybody else, you have to take the time to interview, think about it, make sure that person is a right fit for you. I have questions you can ask in episode two 18 of the podcast is dr nicole rankins.com/episode two 18, and that gives you a list of questions to ask before you interview a doula so you can make sure that you get someone who is the best fit for you.

(52:21): And then the last thing I want to talk about is preeclampsia and severe preeclampsia. So severe preeclampsia is when you have preeclampsia, but your blood pressures are above a certain level above one 60, top number one 10 over the bottom number. The risk of preeclampsia are that it can cause issues with growth, it can cause issues with mom of seizure or stroke. So it's a really serious thing that we have to address. Now, it's not unusual if you have preeclampsia during pregnancy. Sometimes you need to take blood pressure medicines for a short period of time afterwards, anywhere from four to six weeks. And I do want you to know that there can be some potential long-term risk for people who have preeclampsia during pregnancy. It can increase your risk of having heart disease later in life. So it's important to let your doctor know your family doctor, know who takes care of your health outside of your pregnancy, that you have preeclampsia.

(53:19): And it's just important for you to know if you have preeclampsia, that you need to keep a closer eye on your health. And I mean, of course we all do, but make sure you move your body, monitor what you're putting into your body through your nutrition, and just take the best care of yourself that you can. Okay? Because you do have that slightly increased risk of having heart issues down the line if you have preeclampsia. Another thing that I always get a lot of questions about is aspirin for prevention of preeclampsia. And a baby aspirin a day is actually one of the only things that we know that can reduce the frequency of preeclampsia. It can reduce the adverse pregnancy outcomes of preterm birth and growth restriction by approximately 10 to 20%. It should be started after 12 weeks and ideally before 16 weeks and continue daily until delivery.

(54:15): There are a lot of different people who may qualify for taking aspirin, whether you are lower risk, moderate risk, higher risk. So check with your doctor if you're currently pregnant, to see if you should be taking a baby aspirin in order to help reduce the risk of developing preeclampsia during your pregnancy. Okay? So there you have it. Be sure to subscribe to the podcast wherever you're listening to me right now, and I would so appreciate it if you leave a review on Apple Podcast. I really, really appreciate those reviews. Love to hear what you think about the show, but those shows are really important to help the show grow and help the show to reach and serve more folks. So if you can drop that review in Apple Podcast, I would be most appreciative and also share the podcast with a friend too. Do hop on my email list at drnicolerankins.com/email. That's the best way to stay in touch about things that are going on in my world, and you'll be the first to know about anything that are coming up in the future, like the changes to the birth preparation course that are coming. So that's it for this episode to come on back next week and remember that you deserve a beautiful pregnancy and birth.