Latest / Arrivals: A Birth Story Podcast / Vaginal twin delivery, four under three, an unexpected C-section, and an OBGYN mom
Transcript
- Merelise: Before we dive into today's episode, I want to talk to you about something incredibly close to my heart, and that's maternal health. I've spoken a lot about my own experiences on this podcast, especially related to mental health, and how important it is to seek help, whether through therapy or medicine. But we all know that's easier said than done. That's where MARE comes in, a virtual maternal health care clinic serving women from preconception through menopause. MARE was founded by a mom, just like you or me. Who struggled to find the support she needed during her own maternal health journey and wanted to create a better experience for other women. MARE brings together therapists, women's health providers, and pelvic floor specialists who understand the unique challenges women face throughout motherhood. MARE believes women deserve care that looks at the whole picture, not just one symptom or one appointment at a time. Book a free 15-minute phone call today and learn more at Mare-4EveryChapter.com. That's Mare M-E-R-E dash for every chapter dot com. Merelise Wilson: right. Okay. Let's rock and roll. Let's do it. All right. Ready. All right, hello and welcome to the Arrivals podcast. I'm your host, Mary-Lise Wilson, and today I am so excited to have Jessica O'Connor here with me. Hi, Jessica. Hi, thank you for having me. Of course, I'm so excited. So you are one of my oldest, you're the sister of one of my oldest friends. And so we've known each other a very long time as well. Indeed. And never thought we'd be sitting here talking about all the babies. Definitely not. We've both done some work since college. Yes. Yes. Yes. We've been busy. I want to share as well, you are also a, an OB, a doctor, and you specialize in fertility. That's correct. Yeah, I sure do. That's amazing. Yeah. As one of my daughters likes to say at school, my mommy helps put babies in people's bellies. That's amazing. That kind of gave me chills. That's so cool. I love that. When did you know that you wanted to like pursue that as a path? So, you know, in medical school, well, first of all, I actually didn't know I wanted to be in medicine, so it's kind of a long-winded story. I went to school for engineering, as you know, as we went to school together. But in doing research, I found that I had a passion for medicine and went to medical school. Thought that before starting rotations, the last thing I would want to do would be women's health and OB, and that was my first rotation. I truly fell in love with it. And so I went into OB-GYN residency and then... really loved the science behind fertility and everything we can do in the IVF laboratory and other interventions and ultimately went into fertility and I haven't looked back and it's been just wonderful. That's so cool. It's kind of crazy too. It feeds well into your birth stories because you had twins. got some side eyes. know, I twins for my first pregnancy. I was in training for fertility at the time. And so, you know every time I told people yes it's it's two right they would say well did you take some Clomid on the side? Did you take any the medicines that you prescribe in your clinic? No. But I wasn't kind of overly surprised that twins were a possibility we have a lot of twins in our family on both sides, not a lot but several. So, you know, I think the story of kind of when I found out was when this is actually kind of funny to tell. Because I was in training and had access to ultrasound, I had my co-fellow scan me. knew were pregnant? I knew I was pregnant. I was six weeks along. And at seven weeks, I was going to Iceland with my husband for a trip. And I said, well. co-fellow, I won't say her name, please scan me before I go just to make sure it's an intrauterine pregnancy, there's no funny business going on. And so she is scanning me days before my trip. And she looks through on the ultrasound, she goes, shit, we're having twins. because as a, know, when you're medical training, you spend most of your time with your co-residents, co-fellows, and so. it was like she was having twins too. So we got to that together. It was really fun. So I have the video of that. It's really sweet. But yeah, we saw two little nuggets with heartbeats and then two gestational sacks, which I was thrilled about, meaning they have lower risks for twin pregnancy. At that time we didn't know if they were monozygotic or dizygotic. identical or fraternal, but we found that out later down the line. So you can have, there can be two separate sacks and they can be identical still. Yes. Okay. So this is, yeah, this is really interesting. you know, just to kind of, I'm going to talk a lot about science. I'm so sorry. No, I love it. Well, and also, I don't know if you, if you listen to it, but we have had a triplet mom on the podcast before and hers, she had spontaneous triplets all fraternal, dike, die. think it's what she called them. That's wild. Yes. So the audience knows it has a little bit of experience. Yeah, so with identical twinning that comes from a single embryo, that embryo splits. And based on how far along the process the embryo splits determines how much the fetuses share. So if it splits very early, they have two separate sacs and two separate placentas. If it splits later. two separate sacs, but one placenta is shared. That increases the complication risk. If it splits later, then it's one sac, one placenta, the highest risk. Except for, if it splits even later than that, then you can get conjoined twins. So it just depends on how far along you are in the split. Interesting. Yeah, so you found out you're a partner with twins and did you your eyes and your husband wasn't there since you were just kind of he wasn't there I got home and actually where we were walking we lived in Philadelphia at the time and we were just walking around I think we were walking to get dinner or walking the dog or something like this And I pulled out my phone and I showed him the video Without audio I just or maybe a picture. I don't remember I showed him but he was like Am I supposed to see, there two circles there? Does that mean what I think it means? Yep. So. That's amazing. So did you guys go through a moment of like panic or were you just like, all right, we're doing this. We were excited. like you kind of like had you were feeling like it maybe was a possibility. So I mean, before conceiving, I wasn't expecting it to be clear. But once it happened, I wasn't, I don't know. Yeah. As surprised. Yeah. As I would have been otherwise. So knowing that you're a doctor and you obviously know a lot more than most people, how did you approach your birth plan? Like once you found out you were pregnant with twins? Yeah, so my plan was let's get the babies here as safely as possible. And so I really wanted to have a vaginal delivery. That was important to me as long as safe was the major caveat. And so I specifically sought out an OBGYN to see who I knew was comfortable with doing a breech second twin. Meaning, if the first baby is head down and the second baby is not, you can pull the baby out by its feet. Got it. And why is that? Why is it that it's like safer to do a footling breech with a twin versus like a singleton? Because you've already had a proven passage. So first baby has already successfully come out without getting stuck. And so if they're similar in size, then you don't have to worry so much about. the second baby getting sick. But there are caveats. So you're very careful with growth, ultrasounds throughout the pregnancy, making sure baby B is not significantly bigger than baby A. So I'm sure you probably talked about this in the Triplet podcast, but you name the babies based on who's closest to the outside world. So A is always closest to the outside, B is next, and in triplets, C would be the furthest away. So as long as baby B, who would be second, coming out through a vaginal birth is... not much larger than baby A, then you can attempt a breach second time. And why was it important for you to deliver vaginally? Why was that your preference? You know, think C-sections are not recognized as the major surgery that they are. So why have a major surgery when your body is built to do this? And if it's capable of doing it, great. I think C-sections are wonderful. They save lives. Absolutely. And some people with a twin pregnancy would elect to just do a C-section, because it can be scary. But I felt like I'd already seen all the scary things that could happen. And I'm well armed with information. had certain precautionary steps. I was lucky enough to be delivering at a huge academic institution with really great policies and backup and anesthesia and all the things that you would need. Nick, you stuff fabulous. So, you know, I felt very comfortable. in being in a safe environment to where babies could get here safely no matter what happened. Yeah. And I was going to guess to, correct me if I'm wrong, but I'm assuming just knowing you come from a big family that you thought you might want to have a few kids and maybe didn't want to start with a C-section. Yeah, that's another reason, absolutely. But had I had a C-section with the twins, I definitely would have considered a V-back for a second or third. But yes, you worry about the increased risk of complications with a V-back. with things like uterine rupture and otherwise. Amazing. All right. So how far along did you carry the twins? 37 weeks and two days. Okay. And how was the pregnancy for you? wonderful. It was the best. I felt great. Pretty much the entire pregnancy. I had some nausea on the first trimester as most do, but nothing significant. never threw up. I just felt good. mean, I was one of my, mentors from training always talks about this case that we did together when I was 34 weeks pregnant with the twins and I could barely get to the table because my belly was so big and we were there, you know, doing a, laparoscopic myomectomy for like four or five hours. my gosh. But it was great. It was great pregnancy. we were, we lived a very active lifestyle at the time. we were in Philadelphia, we walked, we used public transportation, we moved our car once a month. it was one of those situations. So, you know, I was walking my dog to the dog park at probably less than a week before I delivered three miles from on trip. No problem. That's amazing. It was. It was beautiful. That's awesome. So you got to 37 and 2. That's really good for twins, right? Yeah. The average twin delivery is about 36 weeks. yeah, they were good. And they were well-grown. I did have to have a lot more monitoring in that third trimester, which was reasonable. But it was great. And then how did you go into labor? So I actually, I guess had essentially false labor a week or two before to the point where I went into triage. And then it was, cause it was during the work day and one of my, essentially bosses and mentors was with me she's like, you just need to go get your cervix checked. It's not good. But my cervix was like pretty stable, you one centimeter or so, even at like 36 weeks. And then just one night at 37, I guess it was the Thursday night, Thursday night, which was at 37 weeks even, I started having contractions. I was like, I already had false labor. I don't think this is it. It's not like really painful, but it's like annoying enough that I can't sleep. So I went, took a warm bath, did all the things. It was kind of up and down all night. Took a few rests. And then finally in the morning at five I was like, Brian, can't, can't, we're going. Yeah, it's time. So we went to the hospital. My surface was changing, but slowly I think I was maybe like three centimeters in triage and I got up to four centimeters. wasn't, nothing was going fast. So then they admitted me. And then I knew. I wanted an early epidural. And the reason I wanted an early epidural was because with twins, if the second twin is unable to come down safely, so like if they're transverse back down, that's kind of a kiss of death for a delivery. And what is that for the layman? What position is that? So that's where the baby's laying from side to side across your belly. The spine is down towards. the cervix and therefore the practitioners who's delivering you can't reach in and grab the feet. The feet are tucked up above and so you can't safely deliver that baby vaginally. And so I knew that if baby ended up flipping, cause the second baby has a lot of more room once the first baby's out. So they can wiggle around, they can flip, can, all sorts of crazy things can happen between the first and second twin. that then I would need a C-section. And so I wanted an epidural early in case an emergency C-section was required. at all hospitals that I've ever been in, and I don't know if this is case at every hospital, twin deliveries typically happen in the OR so that you can then be in a safe setting to then do an emergency serine for the second. That makes sense. And then you have all this, rather than rolling down the hallway, it could be not ideal. So I got my epidural, maybe around five or six centimeters, something like this. But when I got my epidural, my blood pressure plummeted. probably an emotional talking about this, I'm sorry. No, it's okay. But yeah, my blood pressure was like 70s over 30s and baby B had a D cell that lasted about six minutes. baby B, who I now know as Everett. Did you know they were good boys or did you do? No. You did surprise. Didn't know they were boys, girls, anything. But I had a really long, like a six minute D cell. His heart rate was in the 60s, 70s. But it was because my blood pressure was down. So he did all the maneuvers. I got oxygen. me on all fours. Gave me fluids. And then they ultimately had to me tributyline. What is that? So tributyline is a medicine that basically stops labor. Because they've... The problem was I was inactive labor, the contractions were coming. And so the tribunal stops the contractions so that then the baby can get a rest, better oxygenation to the uterus. opposite of pitocin. Yes, it is a complete antithesis of pitocin. And so that stopped the decel. I've never heard of I was locked, I was then, sorry, off my labor curve. So then I essentially had to start an induction after that. So it was tough. Was there any concern with starting induction that like, because I know sometimes pitocin can also cause like the opposite with the baby's heart rate. So we weren't worried about it because we gave enough recovery time. the issue was that because my blood pressure was so low, there wasn't enough oxygenation to the uterus and to the baby when I was having a contraction. Luckily, my co-fellow, the same one who found out I was having twins was in the room at the time. Well, they're her babies too, right? She had just come by to visit, so she kind of hung back with my husband to what was going on, because everyone rushed to the room. But then once his heart had come back up, my contractions had just... And I was having light congenital, but wasn't like it was before that happened. then I got pit. and they broke my water and did all the things to kind of get me back into labor. yeah, so you had that. But so with epidural, do you know why it caused your blood pressure to drop? So that's actually a very common side effect of an epidural. So a lot of a lot of practice will prehydrate you. And that was my experience for my subsequent pregnancies, getting a bag of fluids for the epidural, especially if you know you're prone to low blood pressure. I, you know, even in pregnancy had low blood pressure. was like 90s or 60s was normal for me in the clinic. So the epidural just plummeted a little bit more. But all's well that ends well, right? Now the interesting thing is during this time, so when we left my house in Philly to go to the hospital, called my family, they're all in Atlanta, and my two sisters and my mom flew up that morning. They were there several hours later and they just stayed. around mostly in the hospital room to my husband's sugar inn. And throughout most of the labor. And then they were ultimately able to just stay in the hospital room because then I delivered in the OR as I mentioned previously. So once I got to complete after being thrown off my labor curve, getting back on pototion, it just took a lot longer to get there. So I ultimately didn't have the babies until that Saturday morning. And I had gone in in labor the day before. you know 24 hours for a first labor is not totally abnormal but I think it would have been a lot faster yeah had that not happened of course yeah and so we get rolled back to the OR um I don't know probably around like 2 30 in the morning It's an interesting experience with twins because you have to a lot of staff available. It's not very intimate, assume. There's no intimacy, which I was fine with. It was a training at the time. was like, the more people that can learn, the better. I actually let of. intern, a first year resident, deliver the babies. Wow. That's amazing. So because she had rotated with, it's just a good experience. Yeah. the attending who was new, she could do a breach second when for me was in the room. It was safe. was controlled, controlled environment. Like fine. Whoever needs to learn. That's amazing. Very, that's very generous of you. And people have to learn somehow. It makes sense. Like you've been, you've been the intern. So you get it. Yeah. So delivery, we're in the OR. My sisters and my mom are in our labor room, like our labor and delivery room. And Brian is with you in And Brian's with me the OR in his bunny suit. They're pretty fun. So if it hasn't been talked about before, the bunny suit is given to any sort of partner or support person who's going to be in the OR with you in this little like white basically onesie. Yeah. And you look like a bunny. That's great. So he's in there with his bunny suit on. And then kind of get everything set up, fully in position. My epidural was working really well, which I was grateful for, because they could then just dose it up for a C-section if I needed a C-section for the second. I was gonna ask you, did you start with kind of like a lower dose epidural? Was that your preference? And then can they up it quickly if they need to? it was, I mean wasn't a, it was a normal dose epidural for a vaginal delivery. But for a C-section, they do typically have to dose it up. So you're not, because they don't need to completely anesthetize your abdominal wall for a vaginal delivery, course. But he's like, kind of want them. I forgot to ask, I assume the number one requirement for a vaginal twin birth is that obviously, baby A is head down. Yes. And so how far into pregnancy was baby A staying head down? Were you ever worried about him being breech or was pretty good? He was most of the pregnancy. Cephalic is the technical term for head down. Yeah, so most of the pregnancy and Everett was B was transverse for most of the pregnancy. So we thought it was a good chance that Everett could then just go whoop head down. Yeah. And if not, grab the feet. And he was, Everett was transverse back up. So his spine was up towards my head, which was a good, a favorable transverse position. So we're in the OR. I start pushing it, I probably pushed for like, I don't know, 20 minutes. And then baby A was out. It was quick, it was easy. How much could you feel? Just pressure, nothing, no pain. Just pressure. And so then they had the ultrasound in the room, so they quickly scanned baby B to see what's he doing. And because it's the... because they were di-di twins, diamaniotic, di-chorionic. So they had two sacs, two placemas. He had his own sac. And so he's floating around in there, moving around. And then his head descends into the pelvis. So he was cephalic as well. Amazing. And so then they break his water. I was going to say, yeah. So he had to break a second bag. And where is baby A during all this? Oh, that's what you're talking about. All the teens that were in there. I apologize. I kind of got us off track. So baby A goes straight to the pediatrician in the NICU team. And so they take him over to assess him. then because I'm about to start pushing a second baby, they don't give him to me immediately. So they're just going ahead and doing their assessments so they can figure out what's going on with B. And so then B is head down. They break his water. And he comes out 21 minutes after his brother. It's amazing. And then we didn't know if they were boys, girls, one of each. We had no idea. Yeah. And we didn't want to know because it's one of the, it's just a wonderful surprise. Yeah. And so A came out, my husband got to say, you know, it's a boy. Yeah. And then B, another boy. Aw. And so then after they kind of did their assessments, the placentas were coming out and they brought both babies to me. So there were actually two separate NICU teams in the room. Because two babies, they each need all the attention. And then they were both brought to me. And I got to hold them. They latched really early. They were good little nursers from the beginning. And then they ultimately... Yeah, I think they ended up when they had to then, I had a second degree so they had to stitch me up. So I think they took both babies and back to their rooms. They got to meet their aunts. And my husband got to go with them. I got to rejoin them afterwards. And how long did you nurse with them? Until we did, so... twins are a special kind of fun with nursing. So we had a lot of struggles with nursing early on because of supply and growth and they were just small. They were actually very sizable. Baby A was six, died. Baby B was six, seven. That's a lot of baby fat. had a five-teenton with six, 11. 13 pounds of baby. That's a lot of baby. So I would tandem nurse them. So I had the My Breast Friend pillow, which was amazing. I one on each side. them. Wow. But we ended up having to supplement just because of weight gain and supply because I would have had to be making you know 60 ounces of breast milk a day and yes never got there. I think I peaked at around 40. I mean even just attempting it with twins I feel like is amazing. So we did that in supplementation. I did that for about three months and then I switched to exclusively pumping because we were supplementing so much. It was logistically getting harder as they were getting bigger to do that and then do bottles. Yes. Stuff like that so. And then I ended up weaning at six months. Funny enough, this was kind of crazy, because we were planning to go to a family wedding. the family wedding was in Mexico. And I didn't want to travel with my pump stuff. Yeah, it's the worst. And we were taking the twins. and I spent about three or four weeks weaning slowly so I wouldn't get mastitis or anything like that. And had a little bit of freezer stash saved up just to like give them breast milk here and there until a year and whatnot. But then the pandemic hit. Oh my gosh. And so we didn't go on the trip. I think it was the week before or two weeks before the trip was when the pandemic hit. But the blessing in disguise there ended up being almost like a second maternity leave because everything was shut down and we were able to spend more time at home. I was doing research. My husband and I were just kind of splitting days. We each got at least eight hours of work in a day. And then otherwise with our twins, we weren't having our nanny come. We didn't know anything about COVID. They were only six months old. It was scary. So it was nice to get that second stretch of time with them because my maternity leave had only been six weeks. Yeah, that's crazy. I mean, we were kind of talking about this off mic for a minute, but I've talked about it with your sister as well. It's wild. Like the, can't imagine being in residency, being a doctor and like having babies and only having six weeks of mat leave and going back right back to it. Yeah. Well, thankfully the year after I had the twins, the policies changed. maternity leave is a little bit long. It's eight weeks. wow. But that sounds magical compared to six. my gosh. Well, I feel like you have to be a different breed to want to be a doctor. And then obviously like, yeah, you're just. Well, add, I guess, insult to injury, I also took my oral boards for OB-GYN, I think three months postpartum with the twins, so I studying for that as well. I mean, so it's just, it was just, there's a lot going on at the same time, but you know, there's never a good time to have a baby. Yeah. And so you just have to make it work. And if you have a good support network, you can do it. Yeah. It's incredible. mean, I feel like my brain was still mush up until like a year at least. So I can't imagine taking boards in three months postpartum. Well, they told me I passed. I think it would be okay. So you've got the twins. You've got two boys. Two boys. They're just amazing. Oh, yeah. They're wonderful. I'm to think if there's anything else interesting about their birth story. I kind of jumped ahead with the breastfeeding question because you mentioned latching and got my brain turning. did they have any complications? That's amazing. No NICU time, nothing. They were good. That's incredible. They were healthy. no. We were very fortunate. And I think, you know, being in this world, you know, you see the... social media twins of the world. Everything is beautiful, sunshine and butterflies, but twins are hard and they can be very complicated. the pregnancies with twins can be incredibly complicated. Deliveries can be very complicated. There can be a lot of things that go south. But I just couldn't get over how lucky we were. Yeah, truly. I mean, I could spend like hours asking you questions about twin stuff. I mean, I remember I always wanted to have twins. Like that was always seemed like a dream to me like growing up. was like, I'm gonna have a boy and a girl twin. It'll be perfect and amazing. And then I had my own baby, a singleton, and I realized how hard newborn life was with a singleton. And then I was like, my God, I can't believe I ever wanted twins. So it's just amazing. But I do think it was kind of good to have them first because then you don't know any better. And then you can still be on man to man defense with twins when both parents are home. Whereas if you had twins second, then one parent's typically taking care of the older child or children. So I think we were lucky in that regard. Yeah, I've heard several people express that same sentiment. It also, think, in some ways made us better first time parents in that we were better about things like sleep training, synchronizing their feeds. Because if you don't, you will not sleep. And so by necessity, we had to do a lot of those things. Yeah, but they were sleeping through the night by three months and oh my gosh. It was great. That's awesome. I was still pumping overnight. Right. For the milk. Oh my gosh. You know those overnight puns? I don't miss that. Gave that up at six months and I was so glad to be done with that overnight pump. I know, truly. So then how far, how old were the twins when you got pregnant again? I conceived right before their first birthday. Wow. So they and their younger sister are 20 months apart. I mean, it's a 310. But we did this purposely. So my husband and I were kind of strategizing based on when we were moving back to Atlanta. we were up in Philadelphia for three years for my fellowship training. And we knew we were moving back to Atlanta in the summer of 2021. And once I got back to Atlanta, I was going to be starting a new job. I wasn't going to want to take a maternity leave within at least a year of starting a new position. And I didn't want our children to be more than three years apart. So we gave ourselves a window of what we were going try to see. the other kind of sticky thing here is I couldn't. If I got pregnant too early and had a second maternity leave, I would have had to extend my fellowship. Okay. So I could only get pregnant and deliver in time to deliver for a summer 2021 baby. Okay. Right at the end of my fellowship. And I was going to save up all my vacation and use it at the end of fellowship. Yeah. And then move down here. Wow. During that time. and then start my new job in August. So what was like the window like that you needed to conceive in? I had two months. my gosh. If I didn't conceive one of those two months, then we weren't going to try. And so the funny story, our conception story, maybe Brian will be upset with me for telling this. Sorry, Brian. We decided, OK, we're going to go for it. My IUD had been taken out. We had been talking about it for a while. And then we had tried to conceive one month, but it was before I'd actually gotten my positive ovulation kit. the day I got my positive kit, I came home crying. I was like, we're not trying. It's a bad idea. The twins are too young. It's going to be too hard having three under two. And we found out we were pregnant that month. Oh my gosh. Wow. you had gotten pregnant the prior month? No, we had tried to conceive that month, but I just. stopped trying anymore, but we had tried enough before the population. Well, know, and it's funny. mean, I'm curious to your take on this as an expert. Like a lot of times they say if you want a girl, you should try earlier in your cycle. Yeah. And I mean, I believe me with a sister with three boys, I've heard all the woo woo things about, and I don't think that there's really any evidence. backing those or even biological plausibility. But as you know, she tried everything. She has a third point. But yeah, I mean, it follows the rule, I suppose. Yes, yes. Or the suspicion. So we conceived our daughter then in fall of 2020. Yeah. And. We hadn't found out the sex of the babies with the twins, as I mentioned, but that fall it was still COVID. Philadelphia was incredibly strict as compared to Atlanta at the time. This was before the vaccines had even come out actually. But they were being developed at the time. And so we weren't coming home for Thanksgiving. so... We wanted to do something kind of special just for us. So we decided we would sit on her sofa and find out what it was. We kind of were having a girl. It so special. know, it's amazing. And then that pregnancy was harder, actually, interestingly enough. A little girl, know, a girl's still your beauty, all the things. Your energy. Your energy. But also I was chasing after twins at home. So I think that was actually more the issue. I did with Maeve have gestational diabetes, which I hadn't had with the twins, but I was able to control it with diet, glucose monitoring, and it went well. Yeah. Otherwise her pregnancy was uncomplicated. My, the physician who had been my OBGYN with the twins was again my OB for Maeve. And she insisted that she was going to be the one to deliver me because she hadn't gotten to deliver the twins. So gosh darn it, you're moving back to Atlanta and I'm going to deliver this baby. So she said, so we, My due date with Maeve was one week before we were moving back to Atlanta. So we elected for a 39 week induction with Maeve in order to make sure she was two weeks old before we drove all of our stuff to Atlanta rather than one week old. And also in case there were any complications at delivery, we needed an extended hospital stay, anything like that. We wanted to get the first couple of PEDs checks in. So we did a deduction. I went in on May the 4th for an overnight balloon and the balloon fell out. early in the morning. think when I went in, I was probably a centimeter or two. When the balloon came out, it was four or five centimeters. And so... How did you find that experience? Easy, no problem at all. I've heard mixed things about people who've had the balloon. So I think the balloon is much easier when you've already had a vaginal proliferator because the cervix has already opened before. It's less uncomfortable. It's more receptive. It changes the... And also the... I think the nervous system really changes a lot after delivery and kind of the impact of your nerves having experienced that pain before, nerve stretching, tissue stretching, kind of all the, all of the many amazing things our bodies do as women. So the balloon was not hard for me at all. I was not uncomfortable. I got to rest that night before the delivery the next day. Balloon came out in the morning and they, Specifically, my attending had said, do not break her water before I'm back on a call at 7 a.m. And so they had to wait until she came in. And then when she was there, they broke my water. We started a little Pitocin. I wanted to see if I would kind of labor on my own and if things were going well, I was just going to go sans epidural. But once we started the pit, it got harder. And I know you did it with Pitocin. You're amazing. I just had like a whiff of Pitocin. wasn't a true induction. was just like a little pit. Because I had started from nothing. Yes. They were ramping it up. They were just trying to speed my delivery up. So it different. It was just a little bit of potassium. So then I was like, yeah, I'll just get the epidural. And I was probably around seven or eight centimeters when I got the epidural and I had her by 11 a.m. Yeah. my gosh. It was just short, sweet, beautiful, easy delivery. It was funny because my husband, who is non-medical, had no idea how a typical delivery goes. was his only experience in the delivery room, then with the twins in the OR. So the attendant came in to check me at, I don't know, 10.30. and said, complete, we're ready. And then they start setting things up for pushing. He goes, wait, wait, ready, so like, we're doing it now? Here? And so they set me up, three pushes, she's out. my god, three pushes? Three pushes. Wow, that is awesome. Yeah, eight pounds, 14 ounces. my gosh. She was a giant. Full head of black hair. and perfectly round hair, head, because the labor had been fast. She hadn't sat in the canal for a long time. She looked like a C-section baby. That's amazing. That's a super successful induction. It was second, you know, don't worry about beautiful. Yeah, highly recommend. That's amazing. And the appropriate candidate. Yeah. And I was kind of meeting all the mouse's. I'd had two bachelor deliveries before in one pregnancy. She was. growing well but not too big. The gestational diabetes makes you worried about that and that will kind of bring us to the story of my fourth, which is another fun thing. And then, you know, timing-wise it made sense and it great. And so she's a Cinco de Mayo baby. joked. She's got a birthday coming up. Margarita Maeve. It's gonna be her nickname when she's older, hopefully not in a negative way. But yes, we celebrated her birthday yesterday and then her true birthday's on Tuesday. So we usually have five on May 5th. Five, five. Wow. May, Margarita, Maeve. All the Ms. Yeah, she's ready. And that, to be clear, that was not the reason we named her Maeve. Maeve had been her name since 20 weeks pregnancy. Yeah, I love that. Yeah, but she was wonderful and she was exclusively breastfed, no issues, never needed any supplementation formula, anything. Her only issue postpartum was a little bit of issue with blood glucose initially, which is common in women with gestational diabetes. And so they just had to monitor her blood glucose levels a couple of times. And then we went home post-op day two. The logistical fun with that delivery was that we had twins at home who were 20 months old. And so we had a nanny at the time, Inga, who we trusted so deeply with our twins. She had been on, we had basically been paying her, we had no family in Philadelphia, so we had been paying her to be on backup call overnight and to keep her phone on her. You can't go out and have a bender. Keep your phone on, on loud. These couple of weeks before the induction, just in case, because I had had the twins at 37 weeks. But likely because they were twins and there was 13 pounds of baby in there. But. Just in case, but we ended up having the induction. So she and her boyfriend at the time who also living out, he had been around our children a lot and everything. So we were very comfortable. They just stayed in our house and they took care of the twins for us. were like a little family for us while we were here a few days. Yeah, that's also a probe and induction. feel like with subsequent like second, third, etc. kids, like you can plan childcare for your older kids. Yeah. And that's huge. That was really nice. and then it wasn't rushed or scary anyway. And then we brought the twins home to, or the, Maeve home to the twins. They were so excited to see her. It was just beautiful. And then we moved to Elmcote two weeks later. Oh my gosh, what was that like? So, um. you wild. Yeah. But we had movers come and move the big moving truck. Yeah. But then, you know, my husband and I packed up our SUV. And so the twins were in the second row and I was in the back row of the bench seat with my daughter in a car seat. And during we had I had purposely introduced a couple of bottles of breast milk to her during that those first two weeks so she could use to take the bottle. Yeah. So she could take a bottle in the car while you're like pump. So I didn't have to a full hour break. Yeah. So then I was pumped. and feeding her bottles in the back row of the car and we drove down overnight. Wow. We've been here ever since. Oh my gosh. So that was wild. Yeah. But really fun. And then during my postpartum phase with Maeve, we were newly in Atlanta. we didn't yet have childcare or anything. So it was just me and the twins and Maeve. And I was studying for written boards for REI, which I took when think when Maeve was like six or eight weeks postpartum. And REI is reproductive endocrinology? Yeah, infertility. And infertility, okay, yes. Yes, not the sports recreation store as we talked about earlier. So when I was studying for my fertility boards, essentially, I took those six or eight weeks postpartum with Maeve and then got to enjoy the rest of maternity leave. But I got three months of maternity leave with Maeve because I had her in May. June, July, August, and then I started working August. I mean I guess if you're gonna be up with a baby anyways, you might as well be up studying. So a lot of my nursing would be nursing with notes in front of me, or answering questions, or... Pass those too, obviously, yes. But it was, I don't recommend it. All of my boards, except for my written boards for OBGYN, were taken either postpartum or pregnant. So your rocks are. You just gotta do it. Like I said, there's no good time. Yeah. And then my husband and I always knew, well, I always knew I wanted four children. My husband says between two and 12, and I said four. I come from a family of four, so it was just very familiar, very fun. And then, you know, we just felt like our family was not yet complete. Yeah. we had our fourth. in 2023. And so my pregnancy with him was, I also had gestational diabetes. He though was a lot bigger. And so that's where lot of the complications arose for me during pregnancy with him. On my growth scan at 38 weeks, they were estimating he was gonna be 11 pounds. And I said, he's not 11 pounds. Like having had the twins, 13 pounds a baby, and then having had Maeve who was nine pounds, he felt a little bigger than Maeve, but not two pounds bigger. No, that's significant. But because of that and because I had gestational diabetes, there are very well documented risks of having a badger delivery based on the growth of a baby. And so I can't remember the grams off the top of my head, which is terrible given that I took boards on this years ago. But I don't practice the third trimester anymore. I only do the first. trinester now. Yeah. But he was over the weight of what's safe. Okay. And then why does it become unsafe for vaginal delivery? Because for gestational diabetes, the baby's essentially more at risk of being chunky and when they're chunky they can have broader shoulders and they're a much higher risk for a shoulder dystocia and so that's just very scary. So my OBGYN very appropriately said let's just do a C-section at 39 weeks. I said that sounds reasonable but let's give we know I had I delivered my 8 pound 14 ounce daughter in three pushes let's just see what happens if you sweep my membranes. Also it's your fourth baby like your body knows what to do. said if anything goes south yeah we do a c-section right we know that we have that and so she swept my membranes I went it was funny I had my appointment in the morning I was laboring and having I was bleeding at work I was at work that day contracting it wasn't terrible but you know I was having to breathe through my gosh And then that night, but it wasn't nothing active. Yeah. It was all kind of that early. Like sporadic kind of sporadic stuff. so then I went home and I was having more contractions that night. They were calming regularly, but they just weren't that painful. And so then my sister came over because she was going to take care of my kids. Yeah. And children. No, actually. Okay. So our middle sister who has the three boys came up over my house. Who's been on the podcast as well. Watching me like breathe through a contractions on the sofa. She's like, you need to go. You're going to have like someone else that's been in your pocket. So a baby in her car. You're going to be just like her and you're going to not make, you're going to have the baby in the parking lot at Piedmont hospital. And I was like, okay, fine, I'll go. But I just don't, I knew it was not yet active labor. So I went, got checked out. Lo and behold, my cervix was dilating but slowly. I it was only three centimeters or something when I was admitted. And I had been one that morning at my appointment. Again, one centimeter seems to be at my starting point. So I wasn't really inactive later, but my cervix changed a little bit and then they augmented and then they broke my water. And then for, Tormach even you know, I'd also didn't know if he was a boy or girl at this point still I Got an epidural for him. I didn't labor as long with him without the epidural because I was worried about the risk of shoulder dystocia and needy se section or something like this. Is there any benefit to I could see how like you'd have to weigh the risks. I was gonna say like with shoulder dystocia, if there's a risk for it, I could see how you might want to try for an unmedicated birth so you could like get in different positions to like potentially aid the delivery. But then it's like you have to balance like, okay, well then you might have to be put out, put under fully if you don't have time to like get that withdrawal and like. That's a great question. don't, you know, I don't know that. There are so many maneuvers that OBGYNs and midwives can do if there is a shoulder dystocia with maneuvering the shoulders in different directions with reaching for an arm and getting the arm out first. So I don't know that unfortunately changing positions as the mom would significantly help relieve any of those. admittedly don't know. I got my epidural with him maybe around, I don't know, five or six centimeters, it pretty early. And then it was just so long. Labor why why are things that this is not how it was with me I was expecting to go more like Mavs trajectory because once I got to five I had her three hours later, right? was great. Yeah And he just wasn't descending in the pelvis. He was at zero station the whole time. He never came down and so ultimately I got to completely dilated 10 centimeters completely effaced and started pushing and he kept having these cells every time I pushed So yeah switched to having a c-section. so I Got in the best of both worlds, I suppose but because I had labored and push Yeah, the c-section that was more complicated. Yeah, everything's more inflamed for vascular Was there any talk of like just kind of like when you were, when you stopped pushing, was he stable? Yes, he stable. So was there any talk of like just like pausing and like laboring down or like seeing if you could like? We did that. Yeah. So we did all that. We did, we did all the different positions. I had a peanut ball. I did like, just went back. Flipping me. We tried everything to get him down and to get him to descend to the pelvis and he just wasn't coming down. And so then they did the C-section and when he came out, they said they even had trouble getting him out of the hysteria. His trotter is the opening of the uterus. He's so huge. This is why he didn't come out. He was nine pounds, 14 ounces. So he was almost 10 pounds. He was, I can remember, think 23 inches long. He was long too. He was very tall. And this was at 38 weeks. Wow. Oh my God. Can you imagine if you'd gone to full 10 weeks? So yeah, if I'd gone to 39 weeks, we were just going to do the C-section. should have just said it. I have a lot of regret about this, Deloree, but... I hate that. I'm sorry. Yeah, he's here. He's safe. He's huge. Yeah, still. Is he still huge? Is he the biggest of all your kids? is the biggest of all my children. He is 98 percentile for weight or for height and 99 for weight. Oh my gosh. That's amazing. He weighs only three pounds less than his sister who is two years older than he is. That's crazy. And it's so funny because like Heather, your sister has big babies too. And you guys are not big people. Like you're not, you know, particularly tall, like your average height. Heather's husband's kind of tall. Is Brian tall? I mean, a normal height. Y'all just make big babies. Were you guys big babies? I was my mom's smallest. I was seven pounds 11 ounces. So if I'm the smallest, Heather was nine pounds. Oh wow, okay. That is interesting. which is big, constitutionally big babies in our family, for sure. just how we grew up. And then, so what was the difference in recovery like for you having had three vaginal deliveries and then a C-section? You know, it was difficult. It was very important to me not to take any narcotic medications. know if you know this, a week after delivery, I had a small bowel obstruction. I didn't know that. It of explains why the pain was as bad as it was. It kind of reached a pinnacle about a week postpartum. And I was just throwing up my guts all night. Oh my gosh. And then... went to urgent care. did an x-ray. They're like, we see air and fluid in your bowels. I was like, that is a small bowel obstruction. Those are air fluid levels. They're like, no, you're fine. Go home. So I went home. They called me. They're like, the radiologist just read your skin. You have a small bowel obstruction. like, yeah, I know. So that was hard. It's just when you're also a week postpartum, sleep deprived, three other children at home. It was just a lot. And then my milk supply dropped and the kormak lost weight and then was just like a very complicated delivery. Yeah. it was by far the hardest. It was the fourth, which is I feel like very unusual. I know. Was the small bowel obstruction a surgical complication? Yes. Okay. I mean, is a common, or I guess it's not an uncommon complication from any abdominal surgery just because of inflammation and the healing processes. So probably there was some adhesion band from having had the C-section. It was nothing. done wrong on the part of my surgeon. My surgeons were fabulous. They did everything right. I have no doubt in that, but it was simply, there was some sort of adhesive process going on that blocked part of the bowel. It's just one of the risks with any sort of abdominal surgery. The good thing about a small bowel obstruction is sometimes they can resolve on their own. And so mine did. So after I left urgent care and went home, I was able to keep down water and not throw up, which was the first time I'd get done anything in over 12 hours. And so then I said, well, I'm going to keep watching this at home. I'm not going to go to the ER and like expose my baby to viruses and blah, blah, blah. So it was not fun. What would they do to treat it? Like how do you treat it if it doesn't resolve? Surgery. Surgery. gosh. Yeah, last thing you want to go through again. But a lot of times in the hospital, it'll be initially expectantly managed. So they'll give you IV fluids, they'll monitor you. They may place a nasogastric tube to drain the stomach, because you're not having kind of that fluid pass through. And they just give the bowels time to recover. Got it. So how long did it take you to recover just at home? I mean, I was able to eat again. Maybe the next day. I don't think it was long. It's like 24 hours. But, and I mean, you mentioned like your supply dropped. I imagine like, yeah, if you can't eat or drink and you're- 24 hours. And in those early days. Yeah. And it's so important. It was frustrating because it had been going so well. And I had exclusively breastfed Maeve. And then with Mac, I ended up having to supplement with formula. I just never got my supply fully back. But I did breastfeed him until after a year. That's amazing. Still, but he did have to have some- He was big kid. He was huge. And I think I could have kept up with him potentially given what I was able to produce for the twins. But, Babe was always just like a little waif. She never required that much. She would drink like 24 ounces of an A. She was fine. And be fine. But Cormac needed 30 He's a different beast. He needed more. but ultimately three very different stories. But I think it just goes to show that no woman's body, or no delivery, would say, is predictable. You never know. Even the same woman, the same kind of early pregnancy doesn't. It can be so polarly opposite. No matter how favorable prior deliveries were, you never know. There's so many factors. But I'm incredibly grateful that we have modern medicine. I'm incredibly grateful that we have a way to get our babies here safely. If that requires a C-section, great. Induction, great. Exactly. Who does it all? Yeah. Wow. It is wild to start out with twins and have a vaginal twin birth and then need a C-section after laboring for your fourth. I know. That's unusual. It's definitely unusual. But Twyla was so big and he just wasn't coming down. He was asyncletic, so he wasn't rotated the right way into the birth canal. When they got in there and were able to see his position, did they think he was at risk for shoulder dystrophy? Could they sell? because they thought that he was just too big to come into a pelvis at all. They thought it would have been a risky delivery. Well, yeah, that's good. He's here safely. Yeah. He just needed, as I like to tell people, he just needed an abdominal exit procedure. Yes, exactly. So he's fine. And now he'll be... He's two. He's two, okay. Wow. He's two, he's posse. He wanted to walk with me this morning. He very much enjoyed it. All the chatter. He me about his magnetiles. I love it. He's a delight. good. So, yeah, so three boys, one girl. It is, it's wild. It's funny that the only one you find out the gender for is your only girl. Yeah. Another kind of part of why we thought finding out, her sex before she was born was because I didn't want the delivery room to be colored with any disappointment. And I knew I would have another one. Yeah. But I really wanted a girl. Yeah. I know that sounds so superficial. No. But it was, I wanted to, if it was a boy, wanted to be prepared for a boy. Yeah. And be happy. That's so real. I'm honestly really thankful like that you say that because I think a lot of people feel like Guilty or don't want to say like that they have a preference, but that's so real. It's so real and I will say like I Hope my husband doesn't mind me sharing this I think with our so we had surprises with both of ours. They're both boys and in hindsight like I think there was a little like it was a little hard when that second because we really thought second one was gonna be a girl yeah, really thought My husband especially and he really wanted a girl like really did because I mean your time is not up But it is hard when it's a surprise and like you have that moment and then now this baby is here and you have You know time to adjust to the idea. I really wanted to be excited for the delivery. Yeah And if it was going to be another boy, I wanted to be mentally prepared. I was excited for that baby. Yes, for sure. I don't think we're having a third. But if we if we did, I would like strongly consider finding out. Yeah, because like having two boys, it's also fun to do it differently. Yeah. A little bit of. Yeah. A little flavor. Yes, for sure. Certain changes in flavor. Yes. Maybe not all the changes in flavor that could happen. Exactly. Yeah, I you know, it was special. And then we got to do a surprise for MEC. Yeah. So that was really fun. The funny thing about when Cormac arrived is that I was at the house of my husband. I had a rotating cast of characters at my house taking care of my other three children. Both my sisters came at some point, grandparents. We were very lucky to have a lot of family here. After having had the first three children in Philadelphia, we feel that so strongly. my gosh, the twins were convinced I had a girl baby in my belly, because we didn't know. And they had only experienced having a girl baby brought home to them when they were 20 months old, which they don't remember. Right. they were convinced it was a girl. And so when I was talking to them on FaceTime or something like that while I was still in the hospital, and they ultimately came in to meet the baby, But it was actually my baby sister Andrea had told them, your mom, you want to go and meet your little brother. And they said, what do you mean? You know, your mommy had a little boy. And they said, no, she didn't. She had a girl in her belly. And they were convinced that my sister, their aunt was wrong. Yeah. It's so They were just so sure they were going to have another sister. It's so funny how kids like will be like that. And there's like no telling them that they're wrong. When it gets to that point. Kit, my older son, said it was a boy from the start. I kept being like, don't you think it's a girl? Are you sure? I'd ask him every couple days and see if he changed it. he was always like, it's a boy. I was like, Shoulda known, shoulda known. Yeah. But boys are fun. Boys are great. Little boys growing up together is, oh, it's so sweet. It's very special. It's really, we're still in the thick of like, Ford is, I mean, he's 20 months and so he's still kind of like, you know, just a lunatic, but they're starting to like play together a little and I can see like the future of what it's going to look like and it's so exciting. it's really special. Yeah. I really haven't built anybody. It's great. Exactly. mean, three's a great number. That's what keep telling me. Four might be one too many, but three. Three is great. I'm very happy, to be clear, very satisfied and happy with my four. wouldn't have it any other way. But three is really nice. A lot of logistics change between two and three, and even more between three and four. really? Okay. So, you if you think about it, between two and three children, you go from man-to-man defense to zone defense. going to places like Costco, the carts have two seats, not three seats. You know, a lot of in the basket, but the children want to sit in basket. They're going to a theme park. One parent per kid, if you need to ride with the child on a ride, you know, have to take another grown-up early, but get it home. So a lot of logistics change. Going from three to four, you can't fit in a sedan anymore. That's the thing. The car. Yeah, so you have to have a three row. And what's the difference between the twins and Cormac? Two year, sorry four years. Okay, so yeah, they're still in car seats. We were four... They were the seventh and we were 13 days shy of having four under four. Oh my gosh. When Cormac was I think you can count it. The twins turned four 13 days before Cormac was born. Yeah, so you still have a full car car seats. When they born. But we still have our twins. even now at six in five point harnesses, full back car seats, the ones that you can extend. just, I will look like it's easy. The research is all in favor of it. So we just keep them in the five point as long as until they size out of them. Yeah. As much as they want to ride a booster seat, they are stuck in the five point. Well, for better or for worse, they have a mom who loves to do her research and that's what the research shows. They're stuck there for a while. Yeah. Well I always like to wrap up by asking my guests to describe birth in three words. Okay. I would say the first thing is terrified. Mmm. At times. The unknown. Yeah. The many things that can go wrong. Yeah. A six-minute decel. Yeah. The second, humbling. It's it's humbling to see not kind of two ends of the spectrum how amazing biology is, physiology, how amazing our bodies are as women to be able to. grow a human for nine months and to safely allow that human passage to the outside world, whether it be the natural way or through an abdominal exit procedure. And also humbling to see how far technology has come and has so significantly reduced maternal mortality. Although we have a lot of work to do, especially in the United States, especially in women of lower socioeconomic status, women of color. So there's a lot to be done. I think there's a lot of advocacy there, which is wonderful, but we are far away off. Far away to be, but humbling. And then the third is magical. Yeah, no matter what we get here. know. It's just magical. It is magical. No matter if it's vaginal or abdominal, it's... It's literally the closest thing to magic we have. Literally creating life, bringing it into this world to go from inside of our bodies to breathing in the world externally. It's magic. And then so much of it we still don't know and understand, which I think is kind of cool. There's still some mystery and that I think adds to the magic. It's a beautiful thing. It is. Oh, thank you so much for doing this. Sure. I really appreciate it. I'm sorry. I got weepy on you a couple of times. okay. am. It's to talk about. It is. It is hard to talk about. And it's really, it's really, it's really big. And my husband calls me leaky, so I will never ever judge anyone who cries. Oh, well, thank you again. You've been listening to the Arrivals podcast until next time. All right. Thank you so much. Sure.