Birth Story: Jen

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Jen is a pediatric endocrinologist in Madison, WI. Her son, Elliot, is 2 and half. Here she shares her birth story and a surprise…

Did you have experience with birth before you had your children? What birth stories had you heard?

For sure. I mean, I’d delivered babies. I’d been in the room. When you’re training in pediatrics, any time there’s a baby that’s a little early or there’s meconium or just a little minor thing they call you. And if there’s any problem then you’re there to resuscitate and take care of the baby. So I’ve been at lots of vaginal births, assisted births, many, many C-sections with babies of all kinds. I’m really familiar with that process and I’ve also taken care of, in the NICU, babies that were born at the Madison Birthing Center, which doesn’t exist anymore, and babies that have been born at home. Many of those obviously go fine, but I’m also really aware when they don’t. The vast majority of the time it’s normal and natural and it’s great. Actually, Elliot’s birth went great, very smooth. But the sooner you can get resuscitation and access to the best, top specialists if something goes wrong...I just need those people. If something happened, because he had shoulder dystocia or something...I mean, he is giant and I am not! He was 7lbs 10oz a month early. He’s huge. He weighed 2 lbs more than I did, and I was born on time!

One of my best friends from med school has three kids and she had her third in November and Elliot was born in February. I talked to her shortly after Jillian was born. For her first two she had an epidural. Her first one was a pretty typical first labor in that it took a long time. And with both the epidural really affected her legs. She wasn’t able to walk. With the second one, Zach came so quickly that it almost didn’t really have time to kick in. And then her legs were numb forever! So with the third one, her provider said, “Why don’t you just not do it because the third one is going to be even quicker?” And she agreed to that, but, for whatever reason, Jillian took slightly longer. So when I talked to her about 3 months before Elliot was born, I can’t tell you how on and on she went about how unbelievably painful it was. She could say she did a natural birth, but never ever again. I mean, it’s just pain management. Again, I’m a medical person. I get it. I respect somebody who wants to. But for me, I was pretty sure that was going to be part of my birth plan.

What were you most nervous about?

I was incredibly anxious during my pregnancy with Elliot, and I was incredibly worried about miscarriage. I think my number one concern on my birth plan was that Elliot was fine. That was probably the thing I was most nervous about. My mom had 8 miscarriages before she had me. She has an incompetent cervix, which is not something you inherit, but you don’t know you have one until you have a loss. And it’s a late loss. She had several that were late. Her birth stories are very traumatic. It was also hard for my mom because she tries to be so cautious and not getting her hopes up and all that stuff. And because I had so much of the Braxton-Hicks stuff too, it was just...

I think I was also just really nervous about the unknown. You know, it was a later-in-life baby, I wasn’t sure I’d ever have another one, so I wanted to have the full set of information. I was nervous about how I would know when I went into labor and how that whole process would start. And the pain? I don’t know if I was that nervous about it because I felt like there were things you could do about it.

Early on, the other thing I was nervous about was that I have a Chiari malformation and had multiple surgeries and a shunt and all that kind of stuff. I was actually really nervous about being pregnant and not being able to take ibuprofen. So I did a fair amount of reading about that beforehand and it ended up being fine. Although, because Elliot was a month early, I hadn’t met with anesthesia yet, which they were going to require because of that history. When they were coming to do the epidural, which I really needed at that point, they were like “We’re sorry we can’t do it because we didn’t get this pre-approved!” That’s what the resident said, but the attending had paged the pediatric neurosurgeon that I work with. He’s an amazing person and that man called back instantly! He is an incredibly busy person! And he was like “She can have the epidural!”

Were your fears unfounded?

I mean, Elliot’s fine. He’s perfect. My water broke in the middle of the night. That’s how labor started. Apparently 25% of the time that’s how it happens. But it’s how it always happens on TV. So that was pretty obvious. And I’m not traumatized by pain. My water broke at 3am and he was born just after midnight the following day, so not quite 24 hours. It could be way worse! The pushing part of things went for a really long time. And, again, because I’m small, I was little worried about the C-section because lots of my friends had had to have them. But he was fine the entire time. That was my main goal: as long as he’s fine, I’ll hang in here. I was just super lucky. It went ok!

How did your labor start?

At 36 weeks, you have your first check up where they do an exam and I was 80% effaced and 2 cm dilated. They said that was relatively normal and that it’s first a baby, it’s going to take a long time. I had my shower with all my friends from out of town. It was great. But that same weekend (I had a ton of Braxton-Hicks contractions the whole pregnancy) I had a lot more of them and then my mucus plug came out, which at the time I didn’t really know what that meant. I had an appointment on the day he was born, thinking, you know, I’ll just talk to her. The night before my water broke I was waking up in the middle of the night and I had this big contraction that didn’t hurt at all. I think I still have a picture of it; it was so tight you could clearly see the outline of his head.

All my friends had left. My mother was still in town because she’d come for the shower. And because I hadn’t been feeling well, she just decided to stay. So she was here, thank goodness, because she lives in Milwaukee. I woke up at 3am, I started to walk towards the bathroom and then my water broke. So I woke my poor mother up. I said “Mom, I think my water just broke.” And she was so exhausted she was like “What water?” Thinking I meant the pipes or something!

I still had charts open and everything and I was just completely not prepared. I was supposed to be giving a presentation the next morning. I had just had my shower, so all the things you buy if you don’t get them for your shower I didn’t have. I had this bassinet that my friend made that broke during shipping. I didn’t have anywhere for him to sleep! There were just all these things I was kind of freaking out about! I did call my OB and she said come in by 7. Get a shower, clean up. So I’m buying stuff on Amazon and closing charts! At least I had the car seat that we had just installed in the car. They actually called me at 7 because I wasn’t there yet. We didn’t have anything packed. We had to do laundry! When she called at 7:30 when I wasn’t there and asked me how my contractions were, I was starting to say “I can still talk through them.” Except then while I was saying that I had the first one that I definitely could not talk through. Again, that was the other thing. How am I going to know what a real contraction was versus a Braxton-Hicks? That was not subtle. Which I feel like people told me, but you just don’t know. You’re nervous.

Describe your labor:

When I got there, I had all my stuff and we checked in. And they were like “Oh, we’re just going to do the test to make sure your water really broke.” And then they were like “Uhhhh, it definitely broke.” Then I was actually in active labor. But before I got the epidural, it actually slowed down quite a bit. My plan had been to get in the bathtub and soak and roll around on the ball and walk the halls and all these things for awhile. I think I remember, even though epidural was definitely my plan, I didn’t want to be stuck in a bed the whole time. And, in retrospect, that was not a problem at all. I got in the bathtub and I couldn’t even wait for it to fill up. Then I started throwing up and that’s not pleasant. At that point I was maybe 5cm dilated and 90% effaced, which is where I stayed for a really long time. My mom was an OB nurse, I should say that. So she was all buddy-buddy with this OB nurse. My mom does not love being an OB nurse because pregnant women are a pain in the ass. In fact, she preferred GYN. They were both like “I think if it hurts so much that you’re throwing up then it’s ok to get the epidural.” So they did. Then there was the craziness with saying I couldn’t get one. And then they actually did it wrong. They did a wet tap which is where they go too far. That was a problem later. I got a spinal headache, and I had to get a blood patch. The spinal headache was really terrible, but it didn’t come up during labor.

The thing that was really frustrating was when they finally said I could push the contractions were every 8 minutes or something. It was ridiculous. So it just took forever. The other sad thing, the thing that was disappointing to me at the time, his name is Elliot Adam, the Adam after my grandfather. He passed away just a few years ago, and his birthday was February 16th. We were so close, but the pushing part was taking forever. In retrospect that was amazing because it gave me an extra day in the hospital which I ended up really needing because he got admitted to the NICU. So I was just feeling really disappointed in myself that I couldn’t have him on my grandpa’s birthday, that they wouldn’t share a birthday. But, I mean, he did work really hard to be a whole month early. Maybe it was just too much to ask!

I definitely remember when I ripped down there. He was pretty blue, which, I mean, they all are. They put him right on my chest and they were all things that were perfect and amazing. I mean, he was crying and they gave him to me and he stopped. I absolutely and immediately loved him. So clearly my baby. I actually feel like that whole part of things was pretty perfect and amazing.

Jen and baby Elliot

Jen and baby Elliot

Was the labor what you expected?

It took a long time. It was not as horribly painful as it could have been. It was just really long. The other thing I had planned in-depth was all these various snacks that I would have. It was little bit upsetting to me that we didn’t have all those packed and purchased.

I couldn’t sit up (after he was born). They try to make you get up right away, but they were like don’t even bother. I think they knew that the spinal headache was going to be a thing. And I was super exhausted, so I didn’t fully appreciate that was going to be a thing. But that was challenging in the 24 hours afterwards because I couldn’t sit up. And it was challenging to get the blood patch.

There were several things that were not in my plan afterwards. So, one, he was early. Two, he was large for gestational age, that means they check the blood sugars really regularly. And if they’re low they want you to feed him formula. One of my best friends from med school is like a breastfeeding expert, and I was definitely planning to breastfeed. As a pediatrician, I know that you can supplement and still breastfeed and that doesn’t necessarily affect supply and all that, but I was weirdly fixated on that. That was extremely stressful. And we did have to give him some formula because he had low blood sugar. And then because he was big but just early enough he was not good at eating, just too sleepy. I really struggled with the nursing in the beginning.

He was having trouble breastfeeding, and he started getting jaundiced. I couldn’t sit up, so finally I had to get the spinal patch. The next day, I was giving him a bath, his very first bath, so we’re all in this idyllic place still. Then I almost fainted when I was carrying him and that’s because my hemoglobin was 5.5 which is really, really, really low! In retrospect, I’m almost positive a stitch tore and I had bled. So here we are, he’s starting to get jaundiced and they’re wanting me to supplement formula and the breastfeeding people and the pediatrician are saying completely different things like give him a ton of formula or only exactly how much he needs. My breastfeeding friend is saying you can try expressing into a spoon and then feeding with the spoon. And then we were doing this finger feeding thing. I hadn’t slept really since he was born because my mother, I love her, but she really snores so loudly! And she hadn’t slept either and she’s older, so I couldn’t wake her up. But I had not slept. That was the low point of the birth story. Again, I feel like the whole front end went really well. A couple days after, things just piled up. There was a point in which they knew that my hemoglobin was low and they were in the middle of the exam trying to figure out what was wrong; they had just told me they were gonna do a CT with contrast. We couldn’t figure out how that was going to interact with breastfeeding. And somebody came into the room and said he was too jaundiced and he had to go to the NICU. All of that happened at exactly the same time. I was also just completely irrational at that point with the exhaustion. I felt like a little bit of a failure at the breastfeeding because he had gotten so jaundiced so quickly. Just how little I noticed how yellow he was is just again an example of how you’re a mother not a doctor. Then I went up to the NICU, and that was actually the first I felt like I wasn’t the patient; I was his mother.

The whole first week we were home, I had to take him in every day with the jaundice checks and stuff. We were doing this crazy system. It’s a miracle! He breastfed until a few months ago. It’s a miracle I didn’t quit. Every 3 hours you had to try to feed him, do the supplementing after that, which I was still trying to do with the stupid finger thing. Then get him back to sleep. And do all this while he’s on a biliblanket, which is really difficult to move. And then I had to pump. Then you had to start over again in 3 hours which meant there was an hour of sleep in there, maybe. I also just felt like I never felt my milk come in because I was constantly pumping. Because I never got a break long enough to feel it build up. And when he hit 42 weeks, which is what people said, he could do it! Then we had to work on getting rid of the nipple shield.

Breastfeeding is really hard! In the beginning it just takes work, especially with the little babies. I knew that the number one cause of readmission was not gaining enough weight and dehydration, so I was so conscious of that. I had so many risk factors for not having good milk supply, so I was also just trying to do everything, which made for a difficult 6 week period. I know many of the residents and lots of people have to go back to work at 6 weeks. That was where I had just finally gotten to the point of not being a zombie. I remember thinking that there’s just no way! How unbelievably fortunate I am that I’m at a stage in my career where I have a little more flexibility and the support. It makes me feel really strongly in the US that we just need to do a better job of having help in the postpartum period, especially for first-time moms. I feel like I had all the resources and education and support and it was still super hard! Another friend of mine, their daughter’s a year older than Elliot and they’re both pediatricians. There daughter was born at 36 weeks, so about the same as he was. And she pumped for 9 months; her daughter didn’t breastfeed. I think they just felt like it was never going to happen. And actually the same thing happened to my other friend who pumped for a year and, same thing, her son was born at 36 weeks. That’s the thing with those late preterm babies. They look pretty healthy and they just send you home. If he hadn’t had jaundice they would have just sent me home. There’s just not enough education and support around that, particularly around breastfeeding and the challenges there. And then they scare you and people just end up doing formula. I think it’s totally fine if people want to do formula. But if you wanted to breastfeed...I mean, god, just pumping...nobody likes to pump. I did not enjoy pumping. I loved breastfeeding once it got better, once he was bigger.

What would you do differently for your next birth?

I’m actually 6 ½ weeks pregnant!

That’s so exciting!

Please, god, don’t let this be multiples! Just one healthy baby. It’s amazing how attached you are before they’re bigger than a blueberry.

Elliot was IVF (in-vitro fertilization) too. I have a picture of him as a blastocyst, which is amazing! He’s the cutest blastocyst! This one we did the IUI (intrauterine insemination) because we were going to cancel the IVF cycle. And it was a 5-10% chance she said. That made it seem even more surreal. All that just happened inside. I feel really lucky.

The reason I did IVF the first time was because I wanted two at some point and I was older. I’d actually thought about preserving eggs, and then we might as well just do embryos. Not enough fertilized and really only two made it to day 5 and only one of them looked good. So that was very disappointing. We thought it wasn’t going to work, so that was a miracle. I’ve never taken a negative pregnancy test!

I think it will be really interesting to see how it’s different this time around now that I have experience. Obviously I hope that the labor will be quicker. The breastfeeding though, I think I will just have so much more experience. I feel a little less anxious.

I’m considering the doula thing because my mom is 71 now and just does not have the energy. That’s a lot to ask of her. They weren’t thrilled about the idea of me getting pregnant again mostly because the same thing the first time: my surgical history. They were just so worried about my health with Elliot. They’re worried about their kid, as much as they love Elliot. I’m their only daughter. I want this to be something joyful for them, not hard.

I won’t have unrealistic expectations about how much I’ll feel like doing. Nor will I have the expectation for myself that I should be rolling around on a birthing ball. I hope that I will have another vaginal delivery. I hope this baby will not be giant!

What words of wisdom do you have for expectant parents?

Try to be easier on yourself, to completely recognize that, while it’s fine to have a birth plan, things probably aren’t going to go exactly the way the plan was meant to be. It’s probably better to think about your big ideas and goals in that birth plan, as opposed to all the little teeny tiny details and be able to be flexible within that. Really remember that the first few weeks after the baby is born it’s important to have plenty of support through that process and also do your best to be patient with yourself. Know that even if things didn’t go the way you wanted or you supplement or take a break from breastfeeding, letting you and baby sleep a little more, doesn’t mean you’re never going to be able to breastfeed. You’re not making any irreversible decisions.

I think flexibility is key. I also think it’s really important to advocate for yourself or have someone there to advocate for you and to ask the questions. You don’t want to feel like you’re a pain in the ass. You want to listen to the specialists and the medical providers, but I think it’s also important to advocate and ask those questions. Thinking long term and thinking big picture. For me, yeah, I had this idea of what I wanted the birth experience to be like, but number one priority was the health and safety of Elliot.

Maggie Mehr