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146 | Outward Growth from Within - Michah Thomas

Michah met pregnancy with sickness in the form of a heavy dose of Hyperemesis Gravidarum, also known as HG. It is a condition that presents in pregnancy as severe and persistent nausea and vomiting caused by hormone fluctuations. HG caused Michah to experience weight loss, food aversions, and anxiety about her baby's growth. She found comfort in the power of watermelon and OTC nutrition shakes.

Despite her challenges, she moved forward with planning a homebirth with her partner. The midwife they chose was informative and supportive, helping ease any concerns. Everything was going as planned until the baby started measuring smaller than expected. She started having routine growth scans until her provider discovered an amniotic fluid leak.

An amnioinfusion can treat an amniotic fluid leak. Unfortunately, this was not the case for Michah. She reported to her local hospital, where she would receive excellent care during her induction and subsequent labor. Michah delivered her baby with the help of forceps due to heart decelerations at the pushing stage to avoid a surgical birth. Her baby was sunnyside up, challenging her descent into the birth canal.

Physical recovery from the forceps assisted birth added to her healing process, but she was supported by her partner. Michah has connected with herself on different levels as postpartum has taught her grace and patience. Her work has been affected as it has become the focus of her Master's degree program. Building supportive relationships and honoring boundaries to grow as human beings and build healthy, strong families, they manage life on the other side of birth. Stepping in to support each other without local family support has been challenging, but again grace is sufficient, and Michah is slowly coming back to herself.

Hospital Birth, PostpartumLaurel GourrierMay 12, 2022Hyperemesis, Induction, Amniotic Fluid Leak, Forceps DeliveryComment

137 | Birthing Joyfully Through the Unexpected - Beatriz Gutierrez

A seemingly normal pregnancy was quickly unraveled when Beatriz received the news that she had preeclampsia. She had been managing a plan to birth at home with a hospital-based midwife to support any medical challenges and a homebirth midwife to support the birthing space she wanted. At the top of the list item was a midwife that spoke Spanish, as her husband is a monolingual Spanish speaker. Unfortunately, her blood pressure (BP) readings at 36 weeks with the homebirth midwife were too high, causing her to refer Beatriz to the hospital for care. She would no longer be eligible for a homebirth after it was confirmed that protein was present in her urine. Not only did her plan fall apart, but she no longer felt she would have the safety of her home because she was scheduled for an induction at 37 weeks. The homebirth midwife accompanied her and her husband for the induction, and she helped her manage the interventions. She didn't know how much she would need to self-advocate, but things took a turn as her care provider didn't align with her preferences.

The messaging Beatriz had received from people in her circle had focused on a healthy baby arriving safely. Beatriz wanted to uphold the same priority level to how her baby would arrive safely. She went home for a couple of days by signing an AMA (Against Medical Advisement) form. Beatriz saw herself heading towards a surgical birth, and she pushed pause on the induction.

During this time Beatriz leaned into her own source as she communicated with her homebirth midwife monitoring her own BP and baby's heart rate at home. When she noticed a rise in her BP, she reported back to the hospital and started the induction over. The conversation of breaking her water came up again, but she refused and stated that she would wait for the next nurse on shift to check her cervix. The new midwife told her that the baby was too high and it would be dangerous to break her waters. Beatriz felt defeated as labor progressed slowly, even flirting with a cesarean just for it to end. But she had the love and support of her husband and sister and would eventually push her daughter out safely. She was no longer having to fight because she accomplished her goal while maintaining herself and the newborn child's health. She was able to have a hospital birth, but on her terms, at her pace, with a birth team that supported her fully. Most of her birth and postpartum team were Latina women who heard her and answered the call.

133 | Birthing in the Body - Gianna Fay

Gianna Fay, a Certified Nurse Midwife (CNM), tapped into herself as a resource as she ventured into her pregnancies. She also called upon people she had connected with along her journey as a birthworker. She started her first pregnancy living and working in Alaska. Gianna had access to the military base for care and where she worked. Allowing her to try out "centering pregnancy" at the base and thought it was a good option for them to allow her to "be the person pregnant." "Centering Pregnancy" is the process of having private physical exams completed by CNM's and doing all the other care as a group with other pregnant people. Other preparation included working out and curating a birth team to support her preferences. At the end of her third trimester, introspection through journaling and reading lots of positive birth stories (as a CNM, this helped clear her mind of all the things she sees daily). Gianna knew that she wanted to be in labor land, wanted to be a midwife and experience birth in her body with no interventions if possible.

After carefully planning and preparing for her pregnancy and labor support, she went into labor at 39 weeks three days with a huge gush of fluid in bed that woke her up. Labor moved faster than expected, and she welcomed her healthy son after managing her own choices.

Gianna and Evan discovered they were expecting again at the beginning of the Covid-19 pandemic. They would welcome their second child as an unexpected blessing after experiencing the joy of their first child's birth. They were no longer living in Alaska and transitioning into new roles and responsibilities. Gianna desired to birth in a natural birth center, especially as she met most of the criteria to qualify for a low intervention experience. But her fetal growth ultrasound indicated severe intrauterine growth restriction. A wave of emotions began to move through Gianna as her midwife brain and birthing person brain started to conflict. She sought a second opinion and started to utilize her resources again to manage her care. However, she had unintentionally pushed the first domino, leading to a cascade of interventions. She would have an induction that tested her patience and will. She did not experience labor land or even feel like she was in her body like her birth with Jacob. Gianna had to pause and reset before going further down the road of interventions. The reset worked, and baby Elijah was born healthy and was not small, which confirmed what she knew in her heart.

128 | Mothering the Mother - Megana Dwarakanath

Megana knew that she wanted a family, and before meeting her husband, she had even considered taking on the role of parenting without a partner. But soon after moving to a new city, she met her husband; they fell in love and began discussing expanding their family. They both wanted to have two kids before Megana got a bit older and had planned to start trying to conceive after getting married. But their March 2020 wedding was canceled due to the beginnings of the COVID-19 pandemic, leading them to move forward with a small ceremony and begin trying to conceive in May.

As a healthcare worker (pediatrician), Megana was aware of the studies around birthing folks in her field having two times the rate of infertility than others. Many of her friends in residency with her had shared their struggles with infertility. With that in mind, she was emotionally prepared to have some struggles of her own with conceiving but was grateful that she was pregnant within three months of trying. The beginning of her pregnancy was layered with many parts. They were going to be moving cross country; she had lost both her grandparents, dealing with the pandemic and also working through the pandemic and didn't fully have care established where they were moving; Megana describes that time as "surreal."

Amongst her birth preparation, she was journaling, reading, and listening to positive birth stories and remained active, running up to her 39th week of pregnancy. Her due date came and went, making Megana uneasy as she knew she was losing time from her maternity leave. Her jobs maternity leave policy would give her 12 weeks, and she had already begun using some time waiting on the arrival of her baby. Taking that into consideration, Megana elected to support her progress with an induction. Induction included two doses of misoprostol, moving her quickly into intense labor. Reviewing all her options and managing the frequency and intensity of her contractions, which had started putting her baby in distress - Megana decided to have an epidural to provide them some rest and allow her body the space it needed to continue to progress. After about an hour and a half of pushing, her daughter was born. Megana did suffer from a 2nd/3rd-degree periclitoral and labial tear, which would impact her in ways she wasn't prepared for.

Within her great support village, Megana's sister would be the guiding light in helping her navigate all the new transitions. The reality of how debilitating her tear was, combined with the level of rest she needed and what maternity leave entailed for caring and bonding with her daughter Megana was falling into a postpartum anxiety/depression cycle. With the support of her sister, they established some concrete strategies to guide her through this time and enable her healing.

Megana's journey with an extremely short maternity leave due to the American Board of Pediatrics policies has led her to be a driving force for changing maternity leave policy. She wrote an oped that has changed policies in her department and has a postpartum group for other South Asian women to discuss some of the cultural misogyny and expectations they contend with. Check these essential resources out in the show notes.

126 | Blocking Out the Noise - Charlene McCraney

Charlene read, watched, and listened to anything she could to prepare for her birth. Knowing all the negative messages surrounding the birth experience for Black women, she wanted to make sure she was educated for her birth. As she started learning how hormones and the body worked together and the cadence of physiological birth, the layers of fear she was holding onto started to peel back, solidifying her decision to have an unmedicated birth. Other things that supported her during this time included hiring a doula and guarding herself against any negative stories or news about childbirth to stay in a positive mindset.

Charlene described her birth as being "uneventful," so two days before the birth of her daughter, attending her routine appointment, she was thrown off that her blood pressure was elevated. It remained elevated throughout the visit, prompting her care provider to have her stay in labor and delivery for a while so they could monitor her. Considering the additional symptoms, Charlene was having - headache and seeing "sparkles" combined with a blood pressure that would not drop. The conversation shifted to signs of preeclampsia and her needing to be induced that day.

The initial shock of such a significant shift in her birthing plans caused for pause for her. Utilizing the "BRAIN" tool (Benefits, Risks, Alternatives, Intuition, Nothing) she had learned in her childbirth education class, Charlene was able to walk through the process of next steps feeling fully informed and focused on trusting her intuition. As she moved through her induction, the rest of her birth plan became just as important; she made sure to use hydrotherapy and movement. She was trusting her body, and as she exclaimed: "blocking out the noise" from her care providers about how to listen to her body. So when her daughter made it earthside, she was still happy that she could have her birth her way.

121 |Aligning Care - Dr. Petagaye English

Dr. Petagaye English graciously joined us to share her experiences with pregnancy and birth. Her pregnancy would challenge her health and wellness and desire to be a "model patient." Because Petagaye is a physician, her provider did not follow AGOC recommendations which would have helped release her from being her own caregiver. There is a difference between being your own advocate and being charged with monitoring your own vitals and determining when you need additional care. Petagaye deserved to have a provider who took medical history into account every step of the way. She changed providers but still found herself back under that physician's care in postpartum. A birthing person deserves care that allows them to take off the hats they wear every time they enter a space to be cared for. Her provider honed in on issues that didn't match Petagaye's concerns and missed vital information that ultimately led her to change providers at 32 weeks gestation. Her new provider was focused and attentive to her medical care and monitored her closely. She was eventually scheduled for an induction.

The labor process proved stressful as her pregnancy had been shrouded with medical issues beyond her control, leaving her feeling robbed of some of the joys of pregnancy. Leading up to her delivery, she experienced anemia, hypertension concerns, and intrauterine growth restriction. She would deliver her baby after 40 hours of labor. But because her baby was smaller than average, she stayed in the hospital longer for bilirubin treatment and blood sugar monitoring. Unfortunately, she would return to the hospital for postpartum preeclampsia under the doctor's care she had fired at 32 weeks.

Dr. English credits her pregnancy challenges with shifting her practice in the care of her patients. She never wants anyone to feel the way she did during her pregnancy. She spent so much energy trying to be a "model patient" that her care from other medical professionals was neglectful and dismissive. Her advice is not to be afraid to seek care from somewhere else if the care you are receiving does not match your research and preferences.

113 | Embracing Change - Charlotte Shook

By 40 weeks gestation, Charlotte had not started labor, and her provider was supportive in honoring waiting for any interventions until 41 weeks and not beyond 42 weeks. She found herself feeling anxious about the possibility of induction and the cascade of interventions. Fortunately, Charlotte’s body had spontaneously started labor, and her doula and doctor helped comfort her and ease her into the labor. Charlotte knew her membranes had ruptured but did not believe she was experiencing surges (contractions). She went to see her doctor after having ruptured membranes for 24 hours at her doctor’s request. Surprisingly, there was no physical evidence of progress in the labor, and the cascade of interventions began - cervical ripening, Pitocin, two epidurals, all over three days. Finally, her body relaxed and began to respond to the interventions. She called in her doula as they had managed virtual support due to Covid protocols at the hospital. After an hour of pushing, Charlotte was able to grab her baby and pull him out as he peacefully entered the world.

Postpartum sleep deprivation marked the experience once they went home. Charlotte made sure to step out for fresh air for walks with her husband. Family and friends were supportive by preparing and paying for meals and some limited in-person support. After a 12-week family leave, her husband returned to work, and things shifted for Charlotte and her son. He started having latch issues and losing weight. They tried a chiropractor, allergen tests (for dairy), and two lactation consultants. The second lactation consultant could meet “in person” and was the most helpful in addressing the issues.

Charlotte encourages birth preparation, and despite the shifts in her labor plans, she still used many techniques to center herself. She learned about all of the possibilities beforehand and offered herself grace to mourn the loss of the experience that she wanted.

86 | Leaning Inward - Destiny Benson

When Destiny found out she was pregnant with her second son, she expressed initially being in a place of denial. While she had always wanted a second child, feelings of hesitation began to arise as the age gap between her first and second was more extensive than she wanted and there was also being nervous about how she would be as a mother of two. But, being able to lean into her ROOTT doulas and husband allowed her to ensure that even within the doubt, she was taking care of herself and understood that she had within herself everything she needed for this birth and transition.

At 37 weeks, due to pre-eclampsia symptoms, she needed to be induced. Destiny would need to tap into that part of herself. After some time to re-center and regroup from this unexpected turn, Destiny knew moving through the induction, she wanted to take her time, introducing medical interventions very slowly and always starting at the lowest dosage available. Doing this gave her the space to work through challenging and tiring labor. To make the call to get an epidural because she knew she needed to allow both the mental and physical parts of herself to relax. And when it was time to push, she knew, and delivered her baby in a position that felt most comfortable for her, caught him and her hands were the first to lay him on her chest.

Hospital BirthLaurel GourrierJanuary 14, 2021Preeclampsia, Black Families Matter, Black Doulas, InductionComment

45 | A Blessing Amidst Covid-19 - Karabo Rankapole

Karabo joins us from South Africa to share her story of courage amid a changing world. She gave birth on April 6th, 2020, during the COVID-19 restrictions, which changed their birth plan so abruptly and drastically that it would alter all of her best-made plans.

When Karabo arrived at the hospital with her parents and awaiting her partner’s arrival. The door attendants simply stated, “This is where your journey ends, and hers begins.” They took her bags into the hospital, and while in labor, she separated from her loved ones to take on the task of giving birth to strangers in an unfamiliar space. She would later learn that her partner would be able to visit for one hour per day, but the visitation time would conflict with his work hours and the city’s newly implemented curfew to help reduce COVID-19 exposure. Every step further, she took into the hospital required a shift in her mind and spirit. She would come out of her labor delivery as a new being with tremendous strength, and her postpartum recovery continued to bring about change.

41 | Inner Strength - Kayla Lucas

Kayla Lucas shared her experiences with both of her sons, being diagnosed with hyperemesis, which made pregnancy physically challenging as she worked to stay healthy and maintain good nutrition and having un-planned inductions. While neither experience was what she expected, she describes them as helping her dig within herself to find a voice to advocate for herself, her strength and determination. Aspects she hopes to encourage others to use in their own birthing experiences.

Postpartum depression would mire her experience as a mother in the months after her birth. She sought support through therapy and was able to come out of it after becoming pregnant again. Kayla's grandmother helped her by acknowledging what her granddaughter was going through. She opened her home to her for respite during the day and watched her son during therapy sessions. Her family gave her time, space, and resources for a time to herself to help relieve anxiety. Kayla wants women to connect with themselves to build self-trust before pregnancy to help them be self-advocates in their care. Find your voice, speak up, and be heard.

18 | Tatia - Shared by Maddy Oden

This is a story about loss - In memory of Tatia Oden French & Baby Zorah

We had the honor of having Tatia's mother Maddy Oden to share Tatia's story with us. Maddy and her family knew that they didn't want others to go through the same experience. From their loss, they developed the Tatia Oden French Memorial Foundation in March 2003 to continue Tatia's memory and provide education to others.

This experience highlights the importance of informed consent, the medicalization of birth specifically with the induction drug Cytotec and infant/maternal mortality. We hope that as you listen, you don't sit in fear from their story, but instead take in the information, share it with others and help extend the mission of the foundation.

We can't control birth, and we can't predict outcomes, but we can gather information to ensure decisions are lead by our informed voices!

Hospital Birth, Cesarean Birth, LossLaurel GourrierDecember 11, 2018Induction, Cytotec, Informed Consent, Maternal Mortality, Infant MortalityComment

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