72-Bettina Paek-Miscarriage-3 Vaginal Births-eDoula

Description:

In this episode, Bettina discusses the quick and lovely start to her relationship with her husband and the challenges she experienced while conceiving her third child. Even though she conceived her first two children on the quicker side, Bettina experienced three miscarriages prior to experiencing her final full-term pregnancy with her daughter.

birthasweknowitpodcast.com/72

Disclaimer: This podcast is intended for educational purposes only with no intention of giving or replacing any medical advice. I, Kiona Nessenbaum, am not a licensed medical professional. All advice that is given on the podcast is from the personal experience of the storytellers. All medical or health-related questions should be directed to your licensed provider.

Another great episode to check out is episode 7-Mercedes Snyder-Stillbirth-6 Vaginal Births-Something Beautiful Midwifery Care

Resources:

eDoula: https://edoula.com/
The Birth Partner-Penny Simkin
Evidence Based Birth: https://evidencebasedbirth.com/
Perinatal Support of Washington: https://perinatalsupport.org/
Postpartum Support International: https://www.postpartum.net

Definitions:

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Transcription of Episode 72:

Intro 0:08
Welcome to Birth As We Know It, a podcast that is dedicated to recognizing the many different ways that birth unfolds. I am your host, Kiona Nessenbaum. I have experienced birth as a doula, a student midwife, a birth assistant, and as a mother of three amazing children of my own. After attending over 140 births, I’ve realized that each birth experience is truly unique. So make sure you subscribe and join me as we are guided through many different birth experiences through the lens of the storyteller. Please be aware that some of these stories can be triggering to hear. So feel free to pause, take a breath, and come back and listen whenever you’re ready. With that said, let’s prep ourselves to dive deep and get detailed about what really happens in the birth space.

Disclaimer 1:05
As a reminder, this podcast is intended for educational purposes only and has no intention of giving or replacing any medical advice. All advice that is given on the podcast is from the personal experiences of the storytellers. All medical or health related questions should be directed to your license provider.

Kiona 1:25
Hey, I am just stopping in really quick to say thank you so much for tuning into the Birth As We Know It podcast today. I truly love this community that we are building and I would absolutely love for you to be in the conversation with other listeners And the way that you can do that is by going to

birthasweknowitpodcast. com/community that will direct you to the Facebook group that we have. And in that Facebook group we talk about all of the things Every single Friday I ask a question to dig a little bit deeper into your minds to see what you think about birth related topics. So don’t hesitate to join that group because I would love for you to be a part of it. And after you finish this episode, I would love for you to consider also listening to episode seven with Mercedes Snyder. Mercedes Snyder shares her six different birth experiences from a personal perspective, but has become a birth provider. She is currently a certified professional midwife in the Seattle area and she’s amazing. I used her as my personal midwife and I think hearing her stories after listening to this episode will give you a little bit of a perspective as to why people choose birth work. So don’t hesitate to tune in to that one after this episode. All right, friends, let’s turn to this episode today.

Hello everybody, and welcome back to the Birth As We Know It podcast Today I have on Bettina Paek, who is a professional role as a provider OBGYN and focuses on maternal fetal medicine in her work. But today she is here to talk about her three personal birth stories with us because they are all so very different. And she will also be talking to us a little bit about her experience with having some loss between pregnancies as well. So, Bettina, thank you so much for coming on today.

Bettina 3:22
Thank you for having me. I’m a huge fan of your podcast. I think it adds so much for birthing people and women and yeah, just excited to share my story.

Kiona 3:31
Thank you. Thank you so much. Yes. I love this podcast as well, but I’m biased.

But let’s go ahead and just dive right in. So tell me about the time that you first decided that you were going to have a kiddo.

Bettina 3:47
It really started with meeting a very special guy and who’s now my husband. And before that I was thinking I probably would have kids at some point, but it was never really a concrete idea of like, Oh, let’s do this now. And for some reason, just after we met, we both kind of asked each other, What do you think our kids would look like? And this was like on the second or third date. So pretty early on in the process. And I just really thought we would make a great team in raising kids and would have great kids. And yeah, just kind of made that a reality. So it’s a it’s a bit of a crazy story actually, because we got engaged within a week and they got married in two months and then really pursued having a family a few months after that. So it was all pretty much a whirlwind, a little bit crazy looking back on it …

Kiona 4:36
Oh, my gosh. Okay. Yeah. So you just do that in there like it was nothing Like you met your husband and you said you were engaged within a week of meeting each other.

Bettina 4:46
Well, he proposed, I guess. we started dating on a monday. Final four of March Madness went out with a whole group of friends and kind of just, you know, I mean, we knew each other before then, so it’s not like we had just met then. And on the Sunday that same week, he’s like, Hey, what do you think about getting married as soon as possible? And I didn’t say anything because I thought he was just joking. I mean, he was serious about that. And then the next morning he’s like, Hey, you never answered that question. I was serious about that. And I thought about it and I said, Yeah.

Kiona 5:18
Oh, that is so cool. So that’s that’s a really awesome story in itself. Sounds like you guys were very quick to say, hey, yeah, let’s go ahead and start having a family. So what did that look like for you?

Bettina 5:29
I was actually an immigrant, Right. I still am an immigrant, I guess. Right. I was here for a year. I’m originally from Germany, and that’s where I trained as well. And I was here to do research in a lab for supposedly a year. And I was supposed to go home. This was in March, I think. I was supposed to go home in June. And so I think that’s why he was like, Wow, if I don’t lock this in now, she’s going to disappear and I’ll never see her again. And so I had to pretty much switch everything. I had to call my work where I supposed to go and show back up again in July and tell them I wasn’t coming back. I had a grant that I had to renew. Otherwise, I wouldn’t have any income. I had to let my parents know who were expecting me back. I mean, obviously I was an adult, but, you know, that’s sort of still a big deal to have your daughters go abroad for a year and then have her call you and say, like, by the way, not coming back right now. So, I mean, there’s a lot of things that really needed to change. It was a huge leap of faith.

Kiona 6:22
Yeah, it definitely sounds like it for sure. So tell me about the time where you found out you were pregnant. What was that feeling? Where were you? What were your emotions like?

Bettina 6:34
I was super excited because we had thought about having kids pretty much right out of the gate again, a little crazy, and I can’t really explain for why we were so gung ho of getting started, but I guess we were in our late twenties and there’s never a great time, especially when you’re in medical training. I was in the lab. I had to go back to finish my residency. He was also in the lab and was going to go back to do his residency and there’s just not a great time. And if we had waited until we finished both of our training, you know, probably would have been quite old as parents. And we didn’t want to do that. We wanted to have several kids. And as part of the immigration process, I had to redo my MMR vaccine and it’s a live virus, so you’re not supposed to get pregnant for a few months after that. And we did that and then after those three months were like, let’s just go for it. And I got pregnant on the second month. And yeah, I found out at home with, you know, the usual way people find out by just a home pregnancy test. And I was just super excited and should share the good news with them right away.

Kiona 7:34
Hmm. That’s awesome. And so how did he feel? I’m sure he was also excited since both of you were so, ready to start the process.

Bettina 7:40
Yeah. I mean, we were super fresh in love and just it was just, you know, just a wonderful time where when you kind of combine that feeling of a new relationship and being on the same page in terms of your goals for life and, and goals for parenting and then being able to find out that you’re expecting was was just awesome.

Kiona 7:59
That is awesome. So tell me a little bit about how that pregnancy went for you. Did you have a lot of symptoms or were you hiding it for a while? Did you tell everybody that you worked with? You know, like tell me some of the details about how that went for you.

Bettina 8:14
I was pretty nauseated, which I think is pretty common. Not to the point of hyperemesis. I didn’t really have to throw up, b it was just like motion sickness that I had all the time. And of course it got worse when I was actually in motion. So in the car that would be pretty bad. And I really couldn’t tolerate long, long car rides. So just eating small amounts, kind of the classical thing, just snacking on something the entire time was really helpful. And yeah, we were excited to share, but I don’t think we really waited for a specific time point. Phy, I didn’t show for quite a while, so, I totally get the anticipation that people have and is like, Oh my God, when am I finally going to have a little tummy and when am I finally going to show? Because that definitely took quite a while for me.

Kiona 8:54
And everybody’s body is different, you know. And it also depends on like how active you are beforehand, like the tone of your muscles and all of that when it comes to the visual development of a belly. So that’s exciting when you do finally, look pregnant sometimes.

Bettina 9:08
Rather than just looking a little chubbier than your usual self.

Kiona 9:11
Right? during this pregnancy. Did you and Rob take any childbirth education courses to help prepare you for birth, or were you both kind of feeling as though you were already set since you were both in the field?

Bettina 9:27
We had the feeling that we were both pretty set since we were both in the field. And I will be honest, that was a mistake because there is a lot of things that, you know, in hindsight I wish I would have known. Now that’s sort of the non-medical side of childbirth, is how can you support your partner better? How can you support yourself? You know, what non-medical things can you do to cope with early labor or those types of things that I just didn’t know? I didn’t know. So.

Kiona 9:51
Yeah, that’s actually something that’s really interesting to hear because there are other providers that I have interviewed who said they wish that they did put in some extra effort to learn a little bit more about like the physiological side of it or how to mentally prepare for like labor and birth because they were providers and they supported people through pregnancy, labor and birth before. But when it was their turn to be in the hot seat as the patient, it really changed their perspective on how they then supported patients after the fact. would you say that that’s true for you as well?

Bettina 10:29
Oh, absolutely. That’s true, because in medicine we kind of focus more on what’s abnormal and treating what’s abnormal. And I think that’s fair because, you know, that’s obviously a huge need for that as well. But then there’s the and and we can also support what’s normal and we don’t place an equal emphasis on that. And I think that’s just really a gap that the medical care has a little bit of a blind spot to say like, well, that’s important to.

Kiona 10:55
Yeah. Yeah, absolutely. So let’s go ahead and dive into it. The big day for you. What was it when you found out that you were in labor or did you need a little bit of assistance getting into labor? What was that like for you?

Bettina 11:08
Yeah. So I was waiting for labor to start and my due date came and passed. And, I tried being active since that sort of one of the things that has been shown to decrease the risk of needing an induction is remaining physically active in the pregnancy. So, you know I went on long walks. I even went on some hikes towards the end of my pregnancy. Nothing happened. So I went to see my doctor at 41 weeks, and they did a non stress test where they monitor the baby’s heart rate. And his heart rate kind of plummeted and stayed down for a while. So they rushed me over to the hospital and I think it was pretty close to needing an emergency cesarean delivery. But luckily his heart rate recovered and then they’re like, Oh, now it looks pretty good, so maybe we can induce labor after all, rather than having to go the emergency route. so we did cervical ripening overnight. so my cervical exam was not really what you’d want at all. So it was like cervix was long, closed posterior, so really not ready for labor and really a little disappointing. they did something called a cervadil, which is a little insert that you put in the vagina close to the cervix. That is a medication that that helps ripen the cervix. And, you know, I just try to take it as it came to me, right. Rather than having like, oh, I wasn’t planning on that. Just sort of going with the flow. And so my thinking was like, oh, I really need to get a good night’s sleep and really trying to rest in that time where the medication was working. So I sent my husband home so that he could get a good night’s sleep as well, which turned out maybe to be a mistake or not. I’ll see you later. Later in the story, and really did manage to fall asleep and get like a few really good hours of sleep. then I woke up at six in the morning with like a bang or of a contraction. So there really was no lead up to you’re having light contractions and cramping. Am I in labor? Am I not in labor? I’m just literally, like waking up and being run over by a truck. That kind of contraction, really, really intense labor contraction. And that left me kind of speechless. And, you know, I hadn’t taken the kind of coping classes, so I didn’t really have any great tools to suddenly start coping with these massive contractions. I felt I couldn’t even I didn’t have the wherewithal to call for the nurse to say like, hey, something’s really changed in here. I did manage to call my husband and I timed it in between two contractions so I wouldn’t freak him out and panic him, and then he wouldn’t, like, get run over on the way here by just being too nervous and excited. So I try to play casual and say like, Hey, I think things are changing. You should make your way over here Well, it turns out that if you took that, you should make your way over here. Fairly literally, and he stopped off to get coffee and bagels for me. So he rolled in maybe an hour later rather than coming right away. And at that point it was a bit of mayhem. The nurse finally came in and she’s like, Oh my God, Like, because I was huffing and puffing like, you know, that picture of like someone who’s clearly in active labor. How long have the contraction been doing that to you? And I was like, I don’t know, like an hour maybe. A I got my first cervical exam from the nurse, and it was ten centimeters. So I had gone from long closed, nothing to, like, ready to push pretty much in those few hours of contractions. that’s when my husband walked in the door. I was there trying to connect the would the baby’s like spilling fluid on the floor. It is. Everyone’s a little bit this confabulation, because this is just so sudden and kind of overwhelming for everyone. And then, of course, because my placenta didn’t read the memo and didn’t realize it was supposed to last for more than 40 weeks, you know, the placenta obviously hadn’t kept pace with the growth of the baby. And so the baby wasn’t tolerating labor. Great. So the heart rate dropped with every single contraction. And, with my provider, I was kind of looking at it going like, oh, this is not great. I wonder how long you can keep that up. So luckily there was a doctor who was part of the group who was caring for me during that pregnancy, who came in, assessed the situation, said like, look, you know, we got to get this baby out as quickly as possible. Are you okay with the forceps delivery? And I said, like, sure, whatever you need to do to get him out. And so they got the anesthesiologist in there. He gave me an epidural, which in all fairness, didn’t really have time to work. And then they gently pulled him out with the with the forceps. And I’m really grateful for the skill of that doctor to be there and to be able to do that and save me from having an emergency caesarean at that point.

Kiona 15:29
Yeah. Oh, gosh. So. I am so interested in your thought process when you heard that forceps were needed. Because for me, when I think of forceps, that sounds very scary. But you are coming from a provider mindset while in labor, knowing the situation, knowing that baby needs to come out, having your medical background on top of the provider saying, Are you okay with forceps? You seemed comfortable with it. Had you worked with forceps as a provider before?

Bettina 15:56
Yeah. Yeah. I mean, I knew I’d worked with forceps. I know forceps are very safe for the baby. In fact, safer for the baby than a vacuum. And if used skillfully at the risk of tearing for the mom is a little bit higher, but not that much higher. And I knew he needed to come out just based on the heart rate. I was worried about him. And so I think that’s really where having that provider brain was really, really helpful. I think the other part, Maude’s really helpful is that a lot of people find they can’t relax and aren’t comfortable in hospitals, and that’s where they worried about even going into the hospital and oftentimes closed labor down when people come from home and to the hospital. For me, that just you know, I felt very safe there and very much like people there had my best interests at heart. So I’m going to take good care of me and the baby.

Kiona 16:37
Hmm. That’s such a beautiful feeling to have, going into a space where you know that you have to be incredibly vulnerable and really trust the people around you. So I think that’s awesome. And I would say that you having your medical background also contributed to that comfort of the space.

Bettina 16:53
Oh, absolutely. Yeah. And I totally get why people don’t have that if that’s just not their experience. But I had spent so much time there and I knew the group very well who was going to be delivering me and and the doctor. I’d met her a couple of times before that as well.

Kiona 17:06
Nice. Yeah, that’s really awesome. So tell me about what your immediate postpartum was like.

Bettina 17:13
I fell in love with the baby. So he was he was pretty small, kind of consistent with the placenta really having. And there was really no fluid around him anymore either. So. And that can happen if the baby doesn’t really pee as much anymore towards the end of pregnancy, because if the placenta decreases in function, then the baby will sent blood primarily to the brain and the heart, which is really important unless the kidneys and the fluid around the baby decreases. And he really hadn’t grown that much. I mean, he barely hit the 10th percentile for 41 weeks. He was like £6, nine ounces, little shrimp of a baby. So he was kind of small. So which made the glory, of course, a little bit easier as well, I will say. But yeah, I mean, it was just seeing him for the first time and you realize, of course there’s a baby in there and he’d been moving vigorously and I can see him move and I could feel him move and my husband could feel a move. then when the baby actually comes out, you realize that, wow, there’s actually you’ve been growing this person and he’s a combination of you and your partner. It’s pretty magical. And I think that’s what drew me as a professional to obstetrics as well, because it just never gets old. It’s just always beautiful and it’s always a bit of a miracle or a huge miracle.

Kiona 18:21
Yeah. Yeah. I think that is so beautiful to be able to actually just soak in that moment and see this little human that you’ve been creating you’re just so in love with this little being. I think that’s phenomenal. So tell me what it was like when you got home. How was your feeding choices? Did you bottle feed, breastfeed And then also, when did you have to return to work?

Bettina 18:46
I chose to breastfeed I think we did pretty well. He was a pretty intuitive filter, so I kind of got lucky with that and my milk came in, a few days afterwards, and he didn’t lose too much weight, which given that his starting weight was pretty low, was a big relief. course, my nipples were pretty sore. So I think that was kind of the biggest thing to realize that, wow, this is what people are talking about when. nipples are sore or, you know, the whole engorgement thing. When the milk comes in, you’re like, Oh my God. Within a few hours my bra size just went up like three sizes.

Kiona 19:18
Yeah.

Bettina 19:19
Which, you know, you read about it, but then when it happens, you’re like, Wow, this is impressive.

Kiona 19:23
Yeah.

Bettina 19:23
This is just visually impressive. So I was lucky. I was really, really lucky in that way. There’s nothing. I mean, I had taken the breastfeeding class, I think to be able to learn a little bit about that. But he was just a good father, and he gained weight at a pretty rapid clip. So we were reassured that even though it always felt like I didn’t have any extra milk, I try to pump as well. But, you know,with the pumping, I just wasn’t getting anything. And I think that’s probably just because he was drinking all there was and was very efficient at emptying the breasts. So knowing that he was gaining weight at a good rate, I think was reassuring there. Then in terms of returning to work, I had the luxury of kind of taking very fluidly. I was a research fellow in a lab so I could bring it with me for a little bit. I could work partially from home with a computer. I could just bring him to meetings with me. So it wasn’t like I was working in a warehouse where you have to be gone for your baby from 10 hours and, you know, there’s limited breaks. So I think that was just a real blessing to have that kind of flexible job for him. Initially, we ended up putting him in a daycare that was pretty close to the university where I was working so I could pop over and breastfeed him when it was feeding time. So that was really nice as well.

Kiona 20:33
Yeah, I think that’s awesome to be able to find a resource that’s. Necessary, but also close by to have that option to be able to pop in and feed him. So that one you get the relief because engorgement pain is real. But then also so he’s able to see you and, say, Oh, mom is still here.

Bettina 20:52
And you know, I love breastfeeding because you feel like you’re giving them everything that they need in that one moment. Right. They get cuddles, they get food, they get drink and, you know, they look so blissed out. So it’s just a very rewarding feeling.

Kiona 21:06
Yes, absolutely. On of my favorite feelings while breastfeeding was holding a milk drunk baby afterwards, like just seeing their eyes roll back with milk dribbling down the corner of their mouth. Like that was a very rewarding visual for me. how long did you breastfeed him?

Bettina 21:23
I breastfed him for close to a year until I had to restart residency again. So he was born in July and I had to start residency end of June. And so I breastfed him through that time.

Kiona 21:35
Awesome. And then at what point did you and Rob decide that it was time for a second, kiddo?

Bettina 21:41
We ideally would have wanted them a little bit closer together. But, you know, my first year of residency, there was just absolutely no way we could make that happen. that would have been a good time to start thinking about it again. But this is before the any kind of work, our restrictions on residency. And so I was working over 80 hours a week. So it was just, absolutely would have been crazy to add pregnancy and delivery to that. And it was still it’s bad now for medical care providers and it was even worse back then. It was really frowned upon of having a kid in training. So we waited a couple of years to start trying again and I didn’t get pregnant for six months. And so I became a little frustrated going like, well, what’s going on? You know, I got pregnant so quickly, first time round. I even dragged my husband to an infertility specialist when they kind of hit the six months mark because I’m like, well, I’m 35 at this point. And, you know, it’s been six months, so reasonable to go and see someone. And then, of course, as it turned out, we had just conceived that month and didn’t really need any help but took a little bit longer.

Kiona 22:37
Yeah, that does tend to happen a little bit though, is like when people finally feel like they want that additional support from a fertility clinic. that tends to be when they fall pregnant sometimes, which I think is so interesting. Maybe it’s a mental game or just, your body being like, no, it’s, it’s okay, we can do this.

Bettina 22:56
yeah, I think that in a statistical game is like you just got to try more often and then yeah, mental game when you’re like, okay, I’m going to get some help that you can relax without really thinking it’s all on you. And why is this not working?

Kiona 23:06
Yeah. And during your conception process, did you utilize your cycle tracking at all? Like, did you track your cycle to check with ovulation or was it more of we have time to try now, let’s try now and see what happens.

Bettina 23:20
I mean, I kind of was vaguely aware, but I didn’t use any tracking apps or ovulation predictor kits because, we were seeing each other often enough and having sex often enough to make sure that, you know, it shouldn’t really should have been on the fertile window as well. So.

Kiona 23:34
Yeah, that makes sense. I also feel like when you take away the tracking aspect, it makes it less transactional and it makes it more of, Hey, you want to try wink, wink, you know, like to have a little bit of fun rather than having it be too, focused on the transactions side of consumption.

Bettina 23:52
Yeah. If it has to be like tonight, that can definitely take the fun out of it rather than just having it going like, Well, there’s always the possibility. Could this be the night, as you say, more of a sort of fun aspect to it? So yeah, we try to maintain that.

Kiona 24:03
Yeah. Yeah, tha great. That’s great. So when you found out you were pregnant the second time, were your emotions just as excited? Were you relieved when you were finally pregnant? What was going through your head?

Bettina 24:14
Oh, yeah. I was hugely relieved that I was finally pregnant. I was like, Phew! Because I definitely knew that we wanted more than one kid. So it was just really exciting as well. It was a little bit harder because I was just working so much harder and was working a lot of nights. And when you’re pregnant initially, you’re just so tired, right? It’s like 8:00 rolls around and like got into bed kind of tired. So that was a bit of a challenge to be able to really make that work. But I had an elective where I was able to go and spend some time working in London for a month, working in a lab there. So that allowed me a little bit more freedom. That was right around the time of kind of maximum tiredness,right around from like ten weeks to 14 weeks or so. So that actually worked out really well for me. And I was just like, Oh.

Kiona 24:57
Yeah. Oh, yeah. Cause pregnancy fatigue is no joke. I will say that over and over again.

Bettina 25:03
Yeah, until you’ve experienced it, you’re like, Oh yeah, you’re tired. I’m like, No, this is like a different kind of tired for sure.

Kiona 25:10
absolutely. Like, almost like dragging zombie. Kind of tired. And you’re just. foggy all the time. The days just mend together. It’s a it’s a huge thing. So you had mentioned just briefly that you were 35 at the time you conceived this time around. So did that change how you received care since you were technically advanced, maternal age or like geriatric at that point, quote unquote?

Bettina 25:37
I know it’s not a ridiculous term.

Kiona 25:38
Yeah.

Bettina 25:39
and it really just comes from a historical perspective that people are trying to figure out, who would benefit the most from having genetic testing done. And the 5% of women who were the oldest at the time that the test was conceived, amniocentesis, just 35 was the cutoff. And now, of course, you know, 20, 25% of moms who are pregnant are over 35. So it’s not 5% anymore. So it’s just a much broader piece of the population. And really the risk isn’t that much higher of than if you’re 34. It’s not like something magically happens at 35 and you suddenly become high risk.

Kiona 26:11
Right.

Bettina 26:11
That’s just sort of as an aside. Yeah. So I had a genetic screening test called a nucal translucency test, which was fine, and then some monitoring of the placenta just because of my previous history of having a baby that was borderline small and having a placenta that just sort of at the end decreased in function. So but that was really the only thing that was different.

Kiona 26:30
Okay. you didn’t have to do any extra non stress tests or.

Bettina 26:34
The extra non stress test. Yeah. So when I call it safe paternal monitoring yea the non stress test is what we did weekly starting at 36 weeks or so.

Kiona 26:41
Okay. Okay. Yeah. did you feel different in your body pregnant the second time around? Because at this point, you have a toddler and you’re working different hours. Like, how did this pregnancy feel different compared to the first?

Bettina 26:54
I think physically it’s just a lot harder because in your first pregnancy you can just rest when you’re home from work. In the second pregnancy, you have, as you say, a toddler or a kid to take care of. So your time isn’t entirely your own anymore. So weekends sleeping in just not really an option anymore, at least not for both parts of the couple. So obviously my husband would sometimes get up earlier with our kid, then I wouldn’t he would let me sleep in. But, also more fun because you have the excitement of the other kid to kind of draw on who’s excited about getting a sibling. And, you know, some of the stuff that he said, it’s just like I still hold over his head because, you know, I tend to put on weight, not necessarily on my belly. And he was like, Mom, like, are you sure you’re carrying the baby in your belly because your button is getting really big like. Yes. Kids. Kids and fool speak the truth. Right. So.

Kiona 27:43
Absolutely. Yeah. No filters on those one.

Bettina 27:46
It’s all stored. Malik is what I told myself. It’s like what you need to draw from those extra few fat stores you really do need to draw from if you’re going to make good breast milk.

Kiona 27:55
Mm hmm. So knowing that you had the experience that you did with your first with needing to get induced, were there any decisions that you made differently the second time around when it came to preparing for what Labor looks like for you?

Bettina 28:08
I showed up, but I was just so busy that I didn’t really think about it that much. And I’m like, now I’m like, I don’t really know what I was thinking. Why did I not prepare better? But, you know, remember, again, I was working like 80 to 100 hours a week and I was just so tired. I just did not have any energy really, to do anything different in terms of preparation, which kind of boggles my mind now, looking back on it. But I was getting up early, I was rounding, I was in the O.R. standing. It was it was tough. And when I finished one of those hour rotations, I just lost £5. Just because water weights, because my legs would be so swollen at the end of the day. And I tried compression stockings, I tried Ace wraps, I tried all sorts of stuff, and nothing was really helpful other than being on my feet just a little bit less.

Kiona 28:47
I can only imagine all of that water weight just going down to your feet and ankles withstanding so much.

Bettina 28:53
Yeah. And then people, you know, there wasn’t a lot of examples of pregnant residents. So some of the attendings would just say, like, interesting things. So one of the attendings would ask me, say, like, is this the second coming? And I’m like, the second coming of what? Like, it’s like, is this your second pregnancy? I guess, Right? You just wanted to be kind of gentle about it. And another I remember one of my MFM attendings who was trying to be very nice and to say, like, you know what? You don’t look a day bigger than 24 weeks. And he would say that continuously throughout the entire pregnancy, pretty much

Kiona 29:20
Yeah.

Bettina 29:20
so.

Kiona 29:22
It’s so interesting how people really do monitor the way that they see things once they’re in the field of birth work. I feel like people outside of birthing providers or birth workers, they don’t have as much of a filter. They’re just like, Dang, you’re so big, you’re about to pop, you know? But when you’re in the fields, there’s more considering with what’s going to be said. But at the same time, there’s this understanding where it’s like, just spit it out. What are you trying to say? You know, like, just tell me like I could take it.

Bettina 29:52
I know, But, you know, we have the saying that you should ask someone whether they’re pregnant or not unless you’re absolutely certain until the baby is crowning. Pretty much. Then maybe you could ask, Are you pregnant?

Kiona 30:02
Are you pregnant at that point? We’re like, Not anymore.

Bettina 30:06
Pretty much.

Kiona 30:07
Yeah. Oh, that’s so funny. So let’s go ahead and talk about the birth of your second kid. What was that like and what things did you do differently?

Bettina 30:16
Well, rat than waiting for 41 weeks with an induction, we decided on induction at 39 weeks, and part of that was because of scheduling, really because of the rotations. It kind of lined up a little bit better with the rotations I was doing and I was going to miss less critical things. Since I had to be induced at 41 weeks anyways. I was like, Well, I know what that’s like. So rather than going into labour when I’m on call myself or taking maternity leave ahead of time and then not being able to use that time for being at home with the baby, it kind of made more sense to actually schedule a delivery date. So that’s kind of what we did right around 39 weeks.

Kiona 30:48
Okay. And was it the same process with, like, cervical ripening

Bettina 30:52
It wasn’t because my cervix was already a little bit more favorable this time. A second pregnancy. So about three centimeters dilated, but still pretty long. So still about 2 to 3 centimetres long, so not 100% favorable. But we didn’t have to do cervical ripening any more. My bishop’s score was good enough to go ahead with Pitocin and then my doctor broke my water and that kind of kickstarted things.

Kiona 31:14
Yeah. So after your water was broken and you had Pitocin in your system, about how long did it take before things really started picking up?

Bettina 31:22
Not long. I mean, I think my body has an on and off switch. It doesn’t have a dial where you dial up labor. It does nothing or it does intense contractions. So fairly soon after my water was broken, the pitocin wasn’t even at really any level that it was causing any contractions. So I think it didn’t really do a whole lot. I started having these super intense contractions again.

Kiona 31:44
And. To the fact that your water had been broken.

Bettina 31:48
Oh, yeah, I think so, because I don’t know what else would have done it. I mean, again, the Pettersen was I was maybe having like a contraction that I could barely feel with the person and the water was broken. And then within 20 minutes, I want to say I had those contractions again that you feel like, Oh my God, did I just get run over by a truck? And after about 45 minutes of those, I got a cervical exam and it was still three centimeters dilated, which was hugely disappointing. But I was now completely effaced. But, you know, I was like, oh, I don’t know if I can do that longer. Maybe I should go for the epidural. I mean, the beautiful thing was that I was really surrounded by friends because I had picked an OBE that was a resident or had been a resident who was a few years ahead of me that I just had worked with and knew really well. My husband was there and one of his friends and anaesthesia attending was sort of on step, might call for me to give him my epidural if I wanted it. So she popped in, did an epidural, and by the time it worked, there was an urge to push. So I can’t say that I ever really got the benefit of the epidural for that, but I can’t really say I did it completely natural either. So that’s kind of it. And so I started pushing and nothing really happened and I was like, Wait, what? I’m like, second birth. Like I should push and It should pop right out. And as it turns out, he was Sunnyside up. So making it a little bit harder. And I will also say that even though my kids are small by weight, they have a big head, which in fact, on the ultrasound had me a bit worried until I went home and measured my head. And my husband said and I’m like, oh, we’re both like 97th percentile. So no wonder our kids have like a 98th percentile head. But then Josi, my doctor, she turned ten, so she was able to turn him. And then literally with one contractions, I was able to push him out

Kiona 33:30
So would you say that the epidural at all, whatever was in your system at that point helped with the sensations that were either felt or not felt when your doctor turned to him, or did you feel all of it?

Bettina 33:43
I mean, it was pretty uncomfortable. So I’m not sure how much the epidural really blunted that. So it definitely didn’t take away the contraction pain because that was absolutely the same. Did help a little bit with the actual birth maybe. Hard to know. I was pretty numb. Afterwards. It kind of started the. Started coming on.

Kiona 34:00
Mm hmm. Also, I did just want to touch on that.I think it’s super awesome that you had the privilege of having the ability to be surrounded by friends who were your providers? You know, like your husband’s friend was the anesthesiologist, and your friend was the OBE. And I just think that that’s awesome because that’s a bonus of working in the field and then birthing in a place that you work.

Bettina 34:23
Oh, yeah. It’s a huge privilege to have that. I realize that. That, you know, that’s just a very unusual circumstance that they were all available. And I guess that’s one of the advantages of having an induction, is that you can plan it a little bit more and it’s not in the middle of the night and no one’s losing sleep over it. And, you know, you can you can be surrounded by your friends or by people that you know, at least.

Kiona 34:42
Right? Yeah. I personally saw a benefit in that too, with my third, because the midwife that I chose was actually a person that I was a student midwife with, but she had graduated and was a full on midwife and it was just so much easier to be comfortable and vulnerable with her because I had seen her in the action of being a midwife prior. From a different lens, you know, So that felt really beneficial. And so I’m assuming that it felt very similarly for you.

Bettina 35:09
And I think having people with you that you trust because you know, you’re not in your rational space, really. So you need someone else that you’re like, okay, if any decision needs to be made, know, that has your back and that can weigh in on your behalf, I think that’s really important.

Kiona 35:22
Yeah, absolutely. And so tell me what the immediate postpartum was like with this kid. Did you decide to breastfeed this one as well? Did you fall in love right away? Tell me all the things.

Bettina 35:33
He was actually not a very cute baby. I will say I mean, I was in love with him, but I was a little disappointed with how he looked and he was just kind of wrinkly. You probably needed to fill out a little bit. Yes, I did. I did breastfeed. And then he plumped up a little bit and turned out to be actually a super cute baby. But, yeah, my initial reaction was like, oh, he looks a little different than my first one. So I had to get to know him a little bit. But for this birth, my mom had actually flown in to take care of our oldest. So it was kind of just nice to have her. And she is an awesome mom. You know, she wasn’t really giving me a ton of parenting advice, but she was just keeping the home front in order. You know, she was doing the cooking, she was cleaning, she was helping take care of the older kids. So really just what you want to mom or mother in law to do.

Kiona 36:17
Yeah, just that support, you know. And I think that’s a good point to say that she wasn’t there saying, No, no, no, don’t do it this way, Do it this way. you know, trying to subconsciously sometimes it happens on accident when parents are trying to just be supportive, but they’re more of taking away your ability to have agency and parenting decisions. So I think it’s awesome that your mom came and was just doing her role of being a grandma, taking care of the kiddo, and then taking care of you. You know, she’s taking care of her baby that now has two babies of her own at this point, so. Yeah.

Bettina 36:50
Yeah. And then we continued to breastfeed, which was hard. It was harder just because, again, I was working in the hospital and Back then, there weren’t a lot of lactation rooms or there was lactation room. I guess it just wasn’t very convenient. So I was pumping a lot in bathrooms in the O.R., dictating my upload while I was pumping. I’m sure the people in transcription were like, What is that weird noise in the background? But you know, the mom guilt of being away from him so much, I kind of felt that I needed to make up for that with at least feeding him breast milk.

Kiona 37:20
Hmm. And then how soon did you go back to work after this one

Bettina 37:25
After four weeks. And that was just not enough time. And especially, you know, going back to work, working nights. So I was working 12 hour night shifts. And I guess the fringe benefit was that my husband then was tasked with taking care of him at night, and he was a super chill baby. So that was lucky. But after I came back from my month of working nights, he was sleeping through the night because I don’t think guys are quite as attuned to hear every little squeak and whisper of a baby. So he would just wake up when he was really like it was a full throated cry. so he kind of sleep trained him in my absence, which was very different from our first one, where sleep training was just like, Oh my God. It was heartbreaking and just very difficult to get to sleep through night. So he was a lot easier in that respect.

Kiona 38:08
Well pros and cons.

Bettina 38:10
Pros and cons.

Kiona 38:10
of having dad ears.

Bettina 38:12
Yeah.

Kiona 38:13
I imagine that your body felt not ready to go back to work so early. So were there any accommodations that you did for yourself knowing that you were going back so soon?

Bettina 38:23
Not really. I think that’s kind of the problem with when you’re caring for other people in a medical role is you can’t really make accommodations for yourself because when you’re on your on and you know, I was lucky in that my recovery was much more straightforward than from my first birth. Maybe because the first one was a forceps or and also just the first one I was sore for quite a while and had sort of difficulty moving around for a week or so. But after the second one, it was a lot easier to bounce back just because he wasn’t that much bigger either. He was £7, two ounces, so certainly not a big baby.

Kiona 38:52
7 pounds, two ounces. It’s not bad. I had one of those.

Bettina 38:56
And he was the biggest one of the bunch. So My heart just goes out to women who have like these ten, £11 babies. I’m just like, That is amazing. An amazing feat.

Kiona 39:06
Yeah, absolutely. As a birth worker, I have supported people who have birth £10 babies in an adult hospital setting and oh, goodness, it is just I will forever be in awe from like their ability to do it. And let’s just say the pushing phases of those births are a little bit longer and have a little bit more intention behind them, if that makes any sense.

Bettina 39:32
Yeah. No, I mean, it’s definitely a huge a huge feat that they should definitely be given credit for and pat themselves on the back for.

Kiona 39:40
absolutely. so let’s go ahead and fast forward a little bit. You now have two kiddos, you back in the rhythm at work and you kind of have your new normal. At what point do you and your husband decide or do you decide that you want to have more? And if so, what does that look like?

Bettina 39:56
I think about a year after he was born, I felt that our family wasn’t complete yet and I would have loved to have one more kid. My husband was quite happy with the way it was, so he needed a little bit of convincing to add more to our already pretty full plate. But he was on board, and so we started trying sort of in quotes because, you know, I stopped using birth control, I guess. So that was our trying.

Kiona 40:22
Yeah. And, you know, once birth control is out of the way, there’s always that thought in the back of your mind of like, oh, we could be, when it comes to finding out whether or not you’re pregnant, so. what did that look like when you got that first pregnancy test? That was positive.

Bettina 40:36
I was excited again, but I was a little nervous too, because for some reason I was like, Well, I’ve been lucky twice. What’s going to happen? Right? Am I can get lucky every single time that every pregnancy is going to be straightforward or you just kind of roll the dice every time you get pregnant because you just never know what’s going to happen. Maybe I had some kind of a premonition that it wasn’t going to be quite as straightforward as the first two ones.

Kiona 41:00
Yeah. So just like a little bit of intuition or a gut feeling.

Bettina 41:03
I think so. Maybe because I wasn’t feeling quite the same pregnancy symptoms, you know, sore breasts or cramping. I don’t know what it was, but I was a little bit worried that it wasn’t going to be a normal pregnancy.

Kiona 41:15
And at this point, did you think that your age played a part at all in like how confident you were in your pregnancy sticking?

Bettina 41:23
Maybe a little bit as well. I mean, that wasn’t that much older. I was like 37. So it’s not that big of a change.

Kiona 41:30
Yeah. So tell me some details about when you realized that the pregnancy was not sticking.

Bettina 41:39
I started bleeding or spotting. And I remember I was with my sister and my husband. I was for Christmas. I think we were at a ski resort and, you know, kind of just hanging out. And I just knew that things were wrong. And, you know, my sister tried to be empathetic, saying like, oh, you know, lots of people bleed in early pregnancy. You could still be okay. But my pregnancy symptoms had completely resolved.So I was pretty pessimistic about what was going to happen.

Kiona 42:05
Hmm. how how far along were you at that point?

Bettina 42:08
Out pretty early, like six, seven weeks or so.

Kiona 42:10
and then after you had the realization that you did have some bleeding, What were your next steps? Did you decide to be seen by your provider or did you kind of just wait for things to happen on their own?

Bettina 42:21
I think it took a little bit of time to be able to get into my provider just because we were in Canada and I went back home and I think I just ultrasound of myself, to be honest, just to get a quick answer. And could see that there wasn’t a pregnancy in the uterus. And, you know, then I started bleeding like a real period. So I kind of knew that it had just happened on its own.

Kiona 42:42
after you had that miscarriage, what was your thought process with continuing on whether or not to have more kids?

Bettina 42:51
Well, I definitely still wanted to continue to try and have more kids. Again, miscarriages are so common. That I do that statistically. It was just likely to happen at some point. So I didn’t want that to be the defining moment of, Oh, I’m going to give up now. So even though, of course, you know, I was I was pretty disappointed.

Kiona 43:11
And then let’s fast forward a little bit. You and Rob start trying again and then you get another positive pregnancy test. What are your thoughts and feelings at that moment?

Bettina 43:21
It was joy mixed with anticipation that we were going to have another miscarriage again. So it was kind of like cautiously optimistic, but not really buying into the idea that we were fully pregnant again. just because I think I wanted to protect myself from being super disappointed. I was just telling myself, okay, well, we’ll have to see how things go.

Kiona 43:42
And did you still share your information with friends and family around you, or did you wait?

Bettina 43:48
No, we waited. We waited. It was just the two of us. I don’t think I talked to anyone. And my sister wasn’t around. So she lives in London. So she lives far away,

Kiona 43:57
about how long after your first miscarriage did you end up getting pregnant again?

Bettina 44:01
It was about five months or so.

Kiona 44:05
Okay. And then you get pregnant again. You keep it to yourself. And how is your body feeling? And what are you watching for this time?

Bettina 44:14
Kind of the same thing. It’s just watching pregnancy symptoms, watching for bleeding. And it unfolded pretty much the same as the first one did. Pretty undramatic in terms of the magnitude of the bleeding and how early it was, right around six or seven weeks, so fairly soon after a positive pregnancy test.

Kiona 44:31
Mm hmm. And so what was going through your and Rob’s head at this moment, knowing that a second miscarriage was happening Did it waver your desire a little bit to have a third?

Bettina 44:46
I was just really disappointed. You know, it’s like when you get pregnant, you start thinking immediately about the future that you’re going to have and about the baby and what the baby might be like. And you start kind of dreaming about that. And even though it’s pretty early, that’s all kind of dashed when you miscarry. So I knew it was a possibility. Again, of course. But on the other hand, I kind of just took it as like, well, t just the way the cookie crumbles. Just got to try again. human reproduction is a system that is not very well designed. I guess that kind of keeps me in business, But it is really something that’s a bit of a legacy system where there’s just so many loss rates, a pregnancy and the whole birthing the way the birth canal works is just, not really well suited to deliver babies the size that we deliver with the heads that babies have. And I guess when you when we look at other species, they have pretty high loss rates, too, in terms of, you know, how many eggs of the turtle and how many of them survive anyways, when it’s in your body, it’s a little bit different. And it’s hard. It’s hard. I get why people struggle

Kiona 45:48
Yeah. And then also, just like you were mentioning, even just the psychological ups and downs that happens when you get pregnant. And when you do,you realize, oh, I’m miscarrying So after this miscarriage. Is there anything that you and Rob do differently? Do you decide to kind of slow down on trying or do you just kind of keep pushing forward?

Bettina 46:14
I think we kind of doubled down, or at least I did. I don’t really know if he felt the same way or not,if he wanted to give up or not, But he didn’t say that he did. So I’m just like, okay, we’ll just keep trying. So I got pregnant again fairly quickly after a month or two, I want to say. And got a little bit further in that pregnancy, but also when the pregnancy symptoms started to decrease.

Yeah, I was just heartbroken. It was hard the third time when you kind of feel like, is it ever going to happen? You kind of start to lose hope a little bit.

Kiona 46:45
Yeah. I mean, if you think about it, based off what you’re telling me, this is a year full of losses

Bettina 46:52
It was. It was every few months, pretty much.

Kiona 46:55
Yeah, and that just sounds incredibly challenging emotionally. And then, I’m assuming that age played a factor in this with like just continuing to try rather than waiting because, at this point you’re 37, 38. And as a health care provider, you know, like risk does go higher and like the older you get and then the possibility of conceiving naturally could get a little bit more challenging the older you get. So I am so curious as to what you did after this third loss. Was there anything that you did differently? Because when it comes to miscarriages, there’s a saying out there and I’m not sure if I’m going to say it correctly, but it’s something along the lines of the first is common. The second is a warning, and then the third is when you need some help, something like that. Do you know what saying I’m talking about?

Bettina 47:53
Yeah. So, you know, that’s when we started offering investigations and offering, you know, blood testing and things like that to see if there’s kind of a reason for that. And I kind of had checked off some of those things myself as well. It’s kind of one of the benefits if you have access to ultrasound. You know, I had ultrasound myself to see if there are any fibroids, you know, anything that would hinder with implantation. I think I had also gotten a formal ultrasound with that third miscarriage just because I was further along and actually needed to take medication to finish the miscarriage. And that’s how I ended up bleeding quite a bit as well. And then ended up with the DNC, which was different than my previous miscarriage experiences. And then, yes, you can do bloodwork to see if either partner is carrying a genetic rearrangement that makes them more likely to miscarry. sort of IVF. There’s really not a lot that we can do differently other than try again. So I chose not to do that blood work because I was like, Well, we can’t really afford IVF. This was before IVF was a little bit more commonly covered and now it is a little bit more of a covered benefit for many employers, which I think is great. So we chose to not go down that route, but it would have been a very reasonable thing to do, especially for someone who’s not in the medical field who wants answers.

Kiona 49:01
Yeah, absolutely. let’s rewind just the tiniest bit, because in your guest request form, you did mention that with your third loss, you actually ended up bleeding while at work. So what was that like? Because you are a provider on the labor and delivery floor, so. What was going on.

Bettina 49:19
It was not a fun experience at all. I mean, yes, I’m on labor and delivery. I’m caring for women giving birth. So it’s not kind of easy to just run out of a room. And I was starting to bleed through my scrubs and, you know, I had to borrow those postpartum pads like the big ones that we give immediate postpartum moms and those wonderful mesh panties. Luckily, at least I had access to lots of pads and extra scrubs and extra panties. But it’s just hard when you’re helping women have a beautiful baby and at the same time you’re experiencing a loss. And you know, it’s so visible as well and you can’t step away to care for yourself at all in that moment.

Kiona 49:56
Yeah. So, man, I can’t even imagine the thought process that you have to go through for that because, there’s those emotions that I imagine are torn because you’re here supporting someone as they bring their baby into the world, literally being there, touching these babies as they come out of their parent. And just all in the middle of that, you are losing your baby. And I think it’s amazing that you had access to all of the things that you needed, like the mesh panties and the pads. But emotionally, did you access any kind of resource afterwards when it came to like therapy or even just talking to coworkers or friends about it?

Bettina 50:39
Definitely talking to co-workers and friends about it. I probably should have reached out to a therapist to kind of have some more professional guide me through that. but I didn’t. And again, you know, now I probably would make use of that resource, But yeah, I mean, just talking to other people and normalizing it and having other people empathize and say like, yeah, this is hard and, be able to process those emotions because as you say, right, there’s the joyful emotion of being able to support someone in their pregnancy and in their birth and, you know, sharing in that joy of them having a wonderful baby and then your own loss and you kind of vacillate between the two and pretty rapid succession. So it is a bit of whiplash trying to navigate that at the same time.

Kiona 51:18
Yeah. Oh, that just sounds like such a heavy experience in itself, to just be in that place. So as you realize that you are losing this baby. How soon were you able to get that medication in order to help you in making sure that everything was happening properly?

Bettina 51:38
I was able to get the medication fairly quickly, but the medication didn’t work. It just caused more bleeding so than I was. I had to get a D and C, and so for that I had to go to the clinic and get a preoperative visit and started bleeding again. And the nurse there was really nice and trying to be sympathetic. And she’s like, I’ll have really heavy periods too. And I didn’t say anything, but of course I wanted to sort of scream like, No, it’s not just have your period, I’m losing my baby. But that’s not really what she needed to hear either. She was trying to help me and be nice and stuff, but then. But at least I was able to get in for a D and C next day. And then my coworkers covered my clinic for the day after. I was kind of expecting to show up to work the day after my D and C and I didn’t have to. And that was just really nice and thoughtful because physically it wouldn’t have been that hard. But mentally and emotionally it would have been hard. And I think they realized that and kind of just created that space for me to be able to lick my wounds and be at home and hug the kids I did have, which was great.

Kiona 52:33
Yeah, it’s great to be able to work with people that can support you in that way as much as possible. But it sounds like you still had to return to work pretty quickly after. So maybe just one day to be in your emotions and love on the kiddos that were present with you and then to flip that switch and go back to work.

Bettina 52:52
Yeah, well, I had a weekend too, so it was three days, in all fairness. So. But yes, I mean, pretty quickly it wasn’t like I was able to take weeks off.

Kiona 52:59
Yeah. So After this loss, you and Rob are just, I’m sure, experiencing fluctuations of up and down emotions. What next step do you take after this? are you still doubling down, trying to have another baby, or did you guys decide to take a break at this point? what decision did you guys make

Bettina 53:20
We took a relatively short break, maybe a few months or so, but not a long break. And maybe it was just me. I’m just like, I can be pretty determined. So I was just like, I’m not give it up this quickly. So even though obviously it wasn’t that quickly, so kind of forged ahead again after a few months and got lucky.

Kiona 53:41
So you did get pregnant again after a few months. What were your emotions at that point?

Bettina 53:45
Well, again, you’re just worried. Right. It’s happened three times. You’re like, is this going to be the same again? And if it’s the same again, can I deal with it? Am I never going to have another kid again? Am I going to have to be happy with the family that I have? And, you know, I kind of starting to go down that road as well and say like, well, what if you know, what if if this doesn’t work out? Again, I was really trying to find a place where I was going to be at peace with the family that we had created. And I think I would have been as well. So I really try to be a little bit more detached and not really go down that path of imagining like, Oh, what if this could be a girl? You know, we’d had two boys. And so I was excited about the prospect of seeing what a different gender would be like and how parenting a different gender would be like. It’s hard to be in that sort of space of hopeful and not hopeful at the same time.

Kiona 54:35
Yeah. And so when you did surpass that week of gestation where you had experienced your losses, what were your thoughts?

Bettina 54:45
I was allowed myself to be hopeful again. because gotten past the 1012 week mark and things look good, the new translucency look good. I was actually told it was probably going to be another boy. So which turned out to be inaccurate. So can’t trust the first trimester number theory necessarily. And so, yeah,once we got past that point, I was really excited about the pregnancy.

Kiona 55:08
And did you embrace your symptoms differently, knowing that you were kind of pushing forward with a viable pregnancy?

Bettina 55:15
Yeah, of course. I was super excited about feeling nauseated because I’m like, Yes, it means and again, I did not have hyperemesis by any stretch. So and that is just such a miserable disorder that I feel for anyone who has anything close to that. So I had mild nausea, but yeah, I was really excited. But all the pregnancy symptoms because it just meant I was still pregnant. And then I was very relieved once I could start feeling her move. I think that’s such a big moment in a pregnancy when you’re like, Oh, I feel a flutter. So you know that you get this message and reassurance every day that they’re moving in there, they’re okay. And pregnancies going forward normally.

Kiona 55:53
Oh, that’s great. That’s so beautiful that you got to experience those layers of excitement again, let’s go ahead and chug forward into more of this pregnancy experience. Did you decide to do anything differently this time or did you still kind of just push forward with the experiences and knowledge that you had?

Bettina 56:13
You would think that I would have done things differently. But I guess I still didn’t know what I didn’t know and that there were so many things that I could have learned to make the birth a little bit easier. So I didn’t. And again, in hindsight, I’m like, that was such a missed opportunity that I really wish I would have taken advantage of now. You know, my birth was still beautiful and it was great and it was amazing. But it would just be nice to have an unmedicated birth by choice, rather than it being sort of by happenstance. Right. And kind of being sort of overwhelmed by the whole process.

Kiona 56:47
Yeah, that’s a really good point to be able to, like, make that decision for yourself rather than it just happening when you’re wanting something else, because things are just moving along too quickly at that point. So tell me about how her birth went.

Bettina 57:01
We decided on a 39 week induction again, since overall, medically, that had been sort of an easy delivery in terms of the whole process of it. And I was a little worried given how quickly my labors had progressed, that if I were to start labouring at home, I would have the baby in the car or definitely not have a chance to have an epidural early, which this time around I’m like just out of professional interest. I want to see what a work patrol looks like. I could have also had a professional interest chosen to say like, I want to see what an intentionally unmedicated birth looks like. I guess those are my two choices. And I picked the like, Well, I really want to see what an actual epidural feels like. And again, kind of constraints with scheduling and not wanting to go into labor. While I was working on labor and delivery myself and then having to call someone in like we didn’t really have a great backup system or we didn’t have any backup system that was formal in place. So if you’re on labor delivery and you suddenly couldn’t function anymore, you kind of everyone was out of luck. I mean, they’d have to call people who weren’t on call. It wasn’t like a Jeopardy call system or anything. Which Has changed to now just because Yeah. People could get sick or can have things happen So you had decided on a 39 week induction decided to get my epidural before the breaking of the water. I called the morning of the induction and they said like, sorry it’s too full. You can’t come in yet. And of course, that’s sort of a common thing in terms of having to triage who’s most urgent to need their induction, rather who’s. Well, it’d be nice if we get to them.

Kiona 58:26
Ye, that’s always a little bit tricky when it comes to induction and like scheduling because, people are always having babies and some people go into labor unexpectedly like two, three, four or five, six weeks early. And the numbers that pop up in the space, like you don’t have any room for someone else.

Bettina 58:46
Yeah. So I chose to. That evening, I think my mom had come again to take care of the kids, so I went and got a pedicure. It was really nice to actually have a day where I wasn’t having a baby and I wasn’t scheduled to work to just really take care of myself. So I think that would be another thing that I wish I would have done for the earlier birth as well, to at least have a day just to kind of recharge and just be fussed over a little bit.

Kiona 59:10
Yeah. Get a little bit of love. A little TLC for yourself.

Bettina 59:13
Yes.

Kiona 59:15
you spend some time with yourself, get a pedicure, and then you go in for your induction. What does it look like when you go in for your induction this time? How’s your cervix? Did it need ripening this time around or was it.

Bettina 59:27
No, it was it didn’t need ripening. It was three centimeters again, maybe 3 to 4 even, and not quite as long. So I was anticipating is hopefully going to be another relatively quick induction again. So, yeah, I got my epidural again. My husband’s friend did my epidural, so that was great. Again, you just having a familiar face. I will say that the nurse that they gave me, I wasn’t super in love with. I guess I just didn’t mesh all that well with her. But I guess I just had to make do with that. And then now I know what an epidural actually feels like when it works. You know, I’ve always envy those women who are like, Oh, and then they woke me up to push. Or I’m like, Oh, my God, you slept through your contractions. Seriously? That is possible. So, yeah, So they did have to you know, the contractions were getting pretty intense. So I broke my water and then the contractions were getting pretty intense again very quickly. She dosed up my epidural a little bit, and then it just worked perfectly. It was like I could feel a twinge of pressure. That was it. So it wasn’t painful, but I could still feel it. it really ended up working perfectly. And about an hour and a half after my water was broken, I got a cervical exam and I was ten centimeters. And it happened to be right at 5:00 so my doctor could make it there from clinic. She showed up. I pushed like twice and had a baby. So in terms of that, it was as far as physical exertion. It was very straightforward.

Kiona 1:00:46
that sounds ideal. And honestly, for you to experience such a smooth labor after having such a hard time with getting pregnant probably felt really nice

Bettina 1:00:58
Right in that your body is working. You know, when you have miscarriages, several miscarriages, one after the other, you kind of start to question yourself, Is my body working? Is I am I do something wrong? Is there something wrong with me? And it was just nice having such an uncomplicated pregnancy and a birth that was so. I don’t usually describe birth as easy because it never really is, but it was really it felt like cheating a little bit like this should be harder.

Kiona 1:01:21
It was more straightforward. You know, things kind of just worked out. And you intentionally knew that you wanted to have an epidural this time around. So I really thought about the timing and placement of that, and I think that’s awesome. I think that’s really awesome. So did you decide to breastfeed with your daughter as well?

Bettina 1:01:38
Yes, we did just because it had gone well the other two times, there really wasn’t a reason to switch gears. Now, the wonderful hiccup that we had with her is that she got diagnosed with hip dysplasia soon after birth on her screening. So she had to wear a harness, which, as all new moms, probably I was a little bit more emotional. So for me, that was sort of a bigger deal than it turned out to be, But you’re like my precious baby. And now they’re telling me there’s something not perfect with her. What are you speaking of?

Kiona 1:02:05
Yeah. Yeah. How long did she have to wear her harness for?

Bettina 1:02:09
only six weeks. So they decided to give her the harness fairly early. They advised me saying like, look, we could wait a little bit longer to make absolutely sure she has hip dysplasia because, you know, it could be that she could do fine without a harness. it could be a little bit more of a prophylactic measure. But if we wait and then she does have to wear a harness, she’s going to have to wear it way longer or you can do it really starting quite early. And then she’s going to be out of it by six weeks.

Kiona 1:02:33
Nice. So seems like it was a good precautionary choice to make to just go ahead and go with the harness then.

Bettina 1:02:39
it was it was still because, you know, again, you know, she was a girl and, you know, had all these cute outfits for her. And they look kind of weird because she was wearing this harness. So I was a little disappointed. But I did get over that fairly quickly.

Kiona 1:02:54
Yeah, well, that’s beautiful. Oh, that is beautiful. And you have three healthy babies. And how much did she weigh?

Bettina 1:03:02
She weighed 613 So she was. Right there in the middle.

Kiona 1:03:06
That’s awesome. And Did you experience any, like, postpartum mood disorders with any of your kiddos?

Bettina 1:03:12
Not to the point that other people do. I think, you know, there’s always a period of adjustment where you’re like, wow, trying to find your footing as a new parent. And I think probably with the first one’s more than the other one’s. Just adjusting to a completely new role for numbers two and three. I was I was pretty lucky in that I had a sense of what my purpose was and I was going back to work fairly quickly again. And I think for some people and I would put myself in that category actually having that routine of work and being able to go back to that kind of provides a sense of continuity and security rather than your whole life feeling like it’s being upended. And you have to completely reinvent yourself as a person.

Kiona 1:03:55
Going back to familiarity makes a big difference in how your mental health adjusts after having children for sure. I think that’s why some people who are really active during their pregnancies decide to be active really quickly after they have a baby. for example, runners, there are runners that will run throughout their pregnancy and then they’re like day two postpartum going on a long hike with my husband. You know, I think that that kind of desire of getting out and giving back to what is familiar to them can kind of impact the healing process and how quickly they get back out there.

Bettina 1:04:28
Yeah, and I think it’s helpful. And I think it’s helpful to have a summer baby, too, especially when you live in the Northwest like we do. So being able to be outside with the baby rather than cooped up inside. Yeah, I remember we went home pretty early from the hospital with her and I had to read like five in the evening. We went home probably at 11 or so in the morning and stopped by Green Lake and walked around Green Lake with, you know, the middle one was on his little bike, you know, one of those pedal less bikes kind of roaming around. And we just my mom was there. It was just great to be outside and to really soak up that moment of having her visible on the outside and having my family with me. So that’s always been a treasured memory of mine, is really that walk around Green Lake on the way home.

Kiona 1:05:09
So you walked around Green Lake, on your way home from the hospital right after having her.

Bettina 1:05:12
Right.

Kiona 1:05:13
Wow. Yeah, that’s a lot of effort, but it also shows your level of comfort in your body at that point. And, you know, just kind of embracing the moment of you are now a family of five,

Bettina 1:05:24
And again, you know, that literally just felt like I was cheating. It felt too easy with the epidural. So I was felt a little bit guilty about that. I guess.

Kiona 1:05:33
No need to feel guilty. It’s a decision people make consciously most of the time. So I’m glad you got to make the decision and then experience what that decision was like. I think that’s great. Well, Bettina, I am so happy to have heard these stories and I find so much value in your stories because coming from a place where you are knowledgeable on all of this information prior to getting pregnant, but then also realizing now that there’s still so much that that you wish you knew when you were pregnant, even as a provider who’s actively working in this field. So I really appreciate you and thank you for sharing your stories. I just have three final closing questions for you and then we can wrap up on this interview. the first question I have for you is what is one piece of advice that you would give to all pregnant people to prepare for labor, birth and postpartum?

Bettina 1:06:29
I think it’s to learn something every day. You know, something to break it down into bite sized pieces to say like, look, you know, it’s not just, oh, this big task that I have at the end of the pregnancy to take a childbirth education class and drag my husband along and practice all these things, you know, when it’s crunch time, but really start relatively early, maybe buying a book or, you know, I’ve created a resource called E Dula that kind of does that too. It’s kind of something that I created that I wish I would have had myself, because as you mentioned, you know, after all of this, I got to meet Penny Simkin and become friends with her and learn from her. And there’s another whole world of Labor support and techniques and mindfulness techniques that are helpful for the birth, but they’re also helpful for life in general that I just wish I would have dipped my toe or my foot or myself into a little bit more. I mean, I knew about the medical side of things, but birth is so many different things. It’s like a social event. It’s, you know, you’re transforming your life from being a person to a parent and a couple to a family and a child to siblings. There’s so many different things that go on there, but it’s also reliant on letting the process unfold normally. And at the same time, it’s a complicated medical process that definitely has a chance to go off the rails a little bit. And, you know, that’s kind of what we do, of course, is to see that and kind of nudge it back on again. But I just wish I’d pay a little bit more attention to those first two aspects.

Kiona 1:07:52
Yeah. So just learning little things along the way for sure. That’s a great piece of advice. my next question is what is one resource that I can share with the listeners on your behalf? And I will absolutely be sharing the E-doula app for them to check out. And we had talked previously to recording it about your app. And I think it’s amazing because it’s not just for birthing people, but it’s also for providers. So it gives the providers and the birthing people the option to look at the same information, but absorb it in a way that makes sense to them when it comes to even the just the different ways that they search things in the search bar, like a person that’s pregnant could be how to make my baby get into the right position. But as a provider, you could look up ways to resolve an asynclitic, baby. You know, it’s more of a medical term and you will be funneled down into the same information. So I think that’s absolutely great. Do you have an additional resource that you want to share or do you think the app is going to be your source?

Bettina 1:08:50
I think the app is my source. But, you know, sort of just to get back to the basics, I think, the birth partner Penny Simkin’s kind of classic as I think is another good sort of reference volume to kind of peruse and kind of just dip in and out of. So it’s certainly one of my favorite books as well.

Kiona 1:09:06
Yeah, I love the birth partner. I think it’s really inclusive and very informative as well.

Bettina 1:09:11
I think evidence based birth is another, great resource, though, especially if you have kind of questions about things that you may talk to your provider about or sometimes it’s just, you know, what does the evidence say about how to induce labor naturally, right? This is a great resource for things that are medical or sort of tangentially or partially medical. Kind of pulling together what studies there are. So you kind of know, not just based on what Facebook says and what your friends say, but really what has been studied. What hasn’t been studied? What do we know? And I think it’s easily digestible and is a podcast as well. But I think there’s also a lot of written material. So I think that’s another great resource.

Kiona 1:09:50
Yeah, t what I love about evidence based birth is that they have multiple ways of absorbing their information. And so they do have a podcast that comes in video and audio form as well as their website, where you can look up all of the written information as well as like actual studies that have been performed and done. And what the stats and outcomes of those studies are. So I think that is a great resource as well. And the last question I have for you is if you could describe each of your births with one word, what would it be?

Bettina 1:10:19
I think the first one would be powerful or overwhelming or like a combination of those two. I think it felt like being in surf, like in a big wave kind of biz being topsy turvy. So that kind of just happened to me. At the same time, my body was doing these amazing things without really my doing anything to control it. So I don’t know if there’s a good word that kind of combines powerful with a little bit of sense of like you’re just abandoning yourself to the forces of nature. my second one was very social. I think I already mentioned that I had people around me that I loved and part of it was my husband kind of chatting with my O.B. while I was just laboring in the corner there. And, you know, Even though they weren’t necessarily paying attention to me, it provided such a backdrop of normalcy and of calmness that I think just really allowed the labor to go quickly as well. And then the third one was, yeah, Easy’s probably the best way I could describe it.

Kiona 1:11:21
Oh, I love all of those words. And I can definitely understand that first combination of words of powerful and overwhelming for your first. And I feel like a lot of people who experienced their first pregnancies can relate to that as well, like the first pregnancy and labor experience, because it is very powerful because you’re like, Oh my gosh, my body is doing this amazing thing. And then you’re like, also in that moment of like, holy crap, like my body is doing this thing and I can’t control it. Like, what do I do? And so there’s that mix of overwhelm and power. So yeah, I love that. So Bettina, thank you so much for sharing your stories with me. I truly appreciate your perspective on what birth is like, especially with you sharing your personal experiences because it makes such a huge difference when you’re learning through other people’s stories. So thank you so much.

Bettina 1:12:09
You’re welcome. Thank you for having me on. I really, really enjoy your podcast. That is also another great resource because I think stories are so powerful to help people realize that what they’re going through, they’re not alone, right? There’s little bits and pieces that I think you can relate to in many of the stories that your podcast guests tell.

Kiona 1:12:26
Yeah, absolutely. I mean, I agree. I think that there’s a lot of similarities between all of these stories and there’s also a lot of differences, but there are ways that you can connect with someone else who is in a completely different space than you, whether it’s across the world or across the street. So, Awesome.

Outro 1:12:55
During this interview with Bettina, she brought forth some really important information. And the thing that I love most is that she brought it up from both a personal and professional perspective. And I want to say, Bettina, thank you so much for telling us your birth stories, as well as being vulnerable with us and sharing your miscarriage experiences. Now, for anybody that’s listening that has experienced a miscarriage, please know that you are not alone. It is an extremely common situation. But that doesn’t mean that it’s not painful and it doesn’t mean that it doesn’t impact you. So if you want to connect with others, please feel free to reach out. You are also welcome to join the birth as we Know it Podcast Facebook Group. You can do that by going to

birthasweknowitpodcast. com/community. And in that community there will be people that you can connect with and you can also connect with people just to have a conversation about parenting or birth or anything in between. And if you’re listening now, I just want to say thank you for being part of the Baha’i community. I appreciate you. If you enjoyed the knowledge that was shared during this episode, I again highly encourage you to check out episode seven with Mercedes Snyder. In that episode, she talks about her six birth experiences where her first is a stillbirth experience. But she goes on to talk about how having that first experience impacts how she prepares for the labours of her subsequent pregnancies. And if you want to check out the show notes for this specific episode and look at some pictures of Bettina family, you can go to

birthasweknowitpodcast. com/72. All right friends thank you so much for sticking around for this long. I totally appreciate you and I look forward to talking to you again soon. Bye for now.

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