“Appreciation for my 32-week Twins” – with Sara Roer Benheim

Take a list to this re-drop from High Risk Birth Stories with Sarah Roer Bendheim. After four “uneventful” pregnancies, Sarah had two miscarriages and decided to pursue fertility treatments, including IUI and IVF. Later, she went into labor with her twins at 32 weeks.

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Dr. Fox: Welcome to “High Risk Births Stories,” one of the top 200 health and wellness podcasts in Iceland. I’m joined today by Sarah Roer Bendheim to talk about the delivery of her twins. Many of you might recall that Sarah, who is a psychologist, was a guest on the “Healthful Woman” podcast exactly one year ago this week to talk about eating disorders. Well, today she’s coming back to tell her own birth story and it is a terrific one.
Hey, quick announcement before the podcast. I made the same announcement on Monday on “Healthful Woman.” Thanks to you, this podcast and that podcast continues to grow in popularity. I wanted to let all of you know that if you’re interested in sponsoring either or both podcasts for your business or organization, you can shoot us an email at hrbs@highriskbirthstories.com or at hw@healthfulwoman.com. Both those emails come to me so it doesn’t make a difference which one you choose. All right, have a great day.
Welcome to “High Risk Birth Stories” brought to you by the creators of the “Healthful Woman” podcast. I’m your host, Dr. Nathan Fox. “High Risk Birth Stories” is a podcast designed to give you, the listener, a window into life-changing experiences of pregnancy, fertility, and childbirth. All right, Sarah Roer Bendheim, welcome to “High Risk Birth Stories.” You are already a podcast sensation from your time on the “Healthful Woman” podcast exactly a year ago in the beginning of 2021. And now you’re just, you know, on podcast number two, love it.
Sarah: Thanks for having me back.
Dr. Fox: You’re amongst a short group of people who have been on both podcasts. I know Melka is one of them who has both been on our podcast and told her birth story. And I know there are more, I’ll figure it out along the way, but you’re on a short list, so it’s good.
Sarah: I think Aviva Braida [SP]. Aviva Braida also.
Dr. Fox: Aviva Braida was both, very good. Yeah, Simi [SP] from A Time was one.
Sarah: That’s right.
Dr. Fox: And Shira Billet, who it’s the same podcast, but I dropped it twice on each.
Sarah: As that podcast is worthy of being dropped many times, everyone should listen to that podcast.
Dr. Fox: Yeah, she basically told her birth story before we had the birth stories podcast. And so you know, she told that on the “Healthful Woman,” and I was like, “You know what? This is, like, such an awesome story and so important, so we’re just gonna drop it again. Yeah, I don’t wanna like take up our time to interview her again. So it’s all good. But here you are. I’m so happy you agreed to do this. And fortunately, you guys have many birth stories you can tell. But we’re gonna focus on our time together, which began sort of in 2017 but culminated in the birth of your twin daughters in 2018. And yeah, how are things at home with your crew?
Sarah: Everyone is great, we have six kids. My oldest is 12 and my twins are now 3. It is awesome. I love all my kids, they’re all really super different, which makes it amazing. Each one has its own different personality that they bring to the table. And they all really connect to each other in different ways, which we’re so blessed and fortunate. It’s really…it’s a fun place to be we love being with each other, thank God.
Dr. Fox: It’s amazing.
Sarah: And it’s loud. It’s very loud, it’s very loud.
Dr. Fox: I would imagine. And we were just talking how, you know, we’re in such opposite ends of this, you know, parenting spectrum where your oldest is 12 and my youngest is 15. And you’re getting out of diapers, and I’m getting into marriages.
Sarah: Exactly.
Dr. Fox: And so it’s a whole…we’re like mirror images of each other.
Sarah: Exactly. It’s a whole other different ballgame. But the thing I’ve really come to appreciate probably just from my own, like, psychology experience, like, everybody in whatever it is that they’re going through, like, it feels big and I feel like with each new stage, you appreciate the newness that it has to offer and its complexities, but like really trying to be present and just like enjoy it for what it’s at. And I don’t know, I think like something that I’ve really been able to focus on, at least with my twins is that like, just really enjoying and savoring each stage because like it will go, like, it will go and the next one will be amazing. But like, kind of being able to be present in what that stage was and is.
Dr. Fox: Yeah, I mean, listen, I remember what a big moment it was when our kids moved down from their sippy cups. And it was like, unbelievable, you know, no more sippy cups, greatest day ever. And I have like the same level of excitement over you know, birthdays, and bar and bat mitzvahs, and weddings. Just every milestone is awesome as the kids grow up, and every day that they get older and don’t terrorize you is just another wonderful day.
Sarah: Yeah, it’s a win, total win.
Dr. Fox: So let’s go back to 2017. We sort of knew each other but not as well. And I joined your journey in 2017. At the time, you had four children and you were working on number five. So tell me what’s going on in your life and what was happening at that time.
Sarah: I had four pregnancies, mostly and completely uneventfully. I look back on it and I, like, think back to myself that every child that I had was really wanted. And I was elated every time that pregnancy test came through, but it wasn’t hard. And I think probably if I had to look back on it, I’m sure there was a moment in time in my innocence, as is appropriate, that I probably was like, “Oh, you know, it took me X number of months.” Each pregnancy was really seamless. As my reproductive endocrinologist Dr. Lobello [SP] would tell me, I had four pregnancies, and I treated them as if I was in a car speeding down the highway, they were just like, kind of, not present to me. I just kind of tended to them as, like, not big deals. And then we went and tried to get pregnant with a fifth. And I was having a hard time getting pregnant. And we didn’t think so much about it. I’m an athlete. And so kind of like, “Oh, maybe we’ll just tinker, you know, run a little bit less, and eat a little more ice cream. Like, maybe it’s something related to that.”
And it didn’t really help and then I got pregnant, and then I miscarried. And I remember thinking at the time, like, statistically, people miscarry. And so that’s what happened. It’s not such a big deal. It’s sad, it’s disappointing, but people miscarry. And statistically, it made sense like this was my statistical moment. And then I went on to try to get pregnant again and had a little bit of a hard time, but ultimately got pregnant. And it happened to have been that probably what contributed to some of my angst was my practice that I loved at the time was in the middle of falling apart. They were going through their own transition. And I found myself a little bit like obstetric-homeless, didn’t really have like an OB. And the OB that I was using was basically transitioning out of obstetrics, she was just doing gynecology, and I got pregnant and nobody could figure out what was going on with the pregnancy. It looked like it was not healthy, but nobody was exactly sure. And they wanted to terminate it, but they weren’t actually sure if the dating was off. And I’ve had a history of, kind of, getting pregnant and it looked like it was a slow-to-go pregnancy and then ended up being that the dating was off.
So I was kind of stuck. I was a little…I felt stranded. I was pregnant, something wasn’t right, but it wasn’t wrong either. And I remember just feeling like very overwhelmed, very lost, very sad, very confused, and I had worked with your wife, Michal [SP] at Ramaz [SP], we worked together for a number of years. And everybody like said, “Dr. Fox, Dr. Fox, Dr. Fox.” So I was like, “You know what? I’m gonna do this.” I actually texted Michal, I was like, “I’m in a little bit of a mass and I feel like your husband could help me.” She was like, “We’re on the plane to Bermuda.” I remember, I was like…I remember where it was, I was standing outside Lazy Bean in Teaneck. And she’s like, “We’re getting on the plane to go to Bermuda, but I’m gonna connect you with him.”
And I was like, it felt…I think now knowing everything I know about you, you do this all the time for people. But for me, it was like an act of, like, the greatest kindness that anybody could do for me in that moment. And I look back on it, it’s kind of seared in my brain, it was such a tremendous amount of kindness. You were like, “Yeah, no problem. I’m gonna land in Bermuda in a few hours. And someone’s gonna call you and they’re gonna make an appointment and you’re gonna come in and we’re gonna fix all this up.” And I just felt like such a wave of like, I don’t know where this story is gonna end, but like, I know it’s gonna be okay because I feel like somebody was taking care of me for the first time in this realm.
Dr. Fox: Oh, that’s very sweet. Well, Bermuda is, I mean, frankly, kind of boring. So there wasn’t much going on anyways, you know, it’s lovely there and the beach was nice, but that’s how it is. I mean, that’s, you know, there’s so much to say about healthcare in general in this country, but so much of it is just, I don’t know where to go, right? I don’t know who can help me. It’s not that we don’t have the resources, and it’s not that people can’t get in to see someone, it is that it’s just you feel lost. And you know, it’s one of the reasons I feel very strongly about this idea of having a relationship with your doctor.
And it’s not always the best in the world, and it’s great to have someone who’s, like, awesome., but most of the time, you just need someone who’s available, that’s really it. That they’ll answer your call, they’ll pick up the phone, they’ll see you in the office and sort it out. It’s priceless. I know that for my own doctors. It’s not just about me as a doctor, me as a person, like, you have a problem, you got to talk to somebody, you don’t wanna wait three weeks to get in to see someone. And it’s hard and it’s not that the people who can’t see people quickly are bad doctors, sometimes they’re just not in a good situation, their office has too many people and not enough doctors. Whatever it is, it’s just it’s tough. I hear you. So it was my pleasure, plus Michal says like, “You got to help her.” I was like, “Yes, I will absolutely.”
Sarah: Yeah, we were good kindred spirits in Ramaz. I think also the piece that made it interesting that you mentioned, I think that’s on the patient side, it’s like when you’re dealing with this stuff, like, you don’t wanna sit with a pregnancy that needs to terminate for five days. And sometimes you don’t have a choice, like, it’s just the way that it kind of falls. But I think there was like a sense of like, we’re gonna take care of this in as fast as a time as humanly possible with the amount of flexibility that we have. But it felt like, it wasn’t the scenario where I’m gonna be sitting on this for the next three weeks, and kind of just like, you know, who knows, you know, because it’s an urgency to me because I’m going through it, but it felt like everybody was at least somewhat connected to the fact that like, this is really…this isn’t great, and it’s anxiety-provoking.
Dr. Fox: Yeah. And there’s two reasons to wait in this situation. There’s one reason where you need to wait, like, meaning until we figure out what’s going on, we need to do something, wait a week and do it again, like blood tests, ultrasound, whatever it may be. So that kind of waiting is just your standard anxiety over the results. The what will it be? What if it’s bad news? You know, is it bad news? What are the chances it’s bad news? What am I gonna do if it’s bad news? That type of waiting, which is painful, but sort of just the reality sometimes you don’t know on day one what it is. And then there’s the waiting where I know what it is and we need to do A, B, and C and we can do it in two weeks. And you’re like, “What? What are you talking about, like two weeks? Like I want this done yesterday, this is crazy.” And that’s normal, that’s how it should be, people should want things done right away. Sometimes it’s impossible. But you know, hopefully, it’s you get to it as soon as you can. But that is another difficult source, either to get the appointment, or the follow-up appointment, or whatever it might be. So what ultimately happened from your end?
Sarah: What ended up happening from my end was, we went in, we got a scan, it didn’t look good, it didn’t look terrible. It was kind of like this could really go either way. But overwhelmingly, it didn’t look like this was an overwhelmingly healthy embryo. It’s an interesting piece, like as my own perspective on this has gone in my own experience, and everybody has their own experience. I, you know, subsequent to this, got trained in CBT for infertility, and I do a lot of work in that, do some work in that area, not a ton of work. But I think that one of the things I think is so important is the idea that like, I kind of looking back on it…and ultimately the pregnancy terminated, I miscarried. We recognized that it was a termination. We scheduled a DNC for like a Monday and I actually miscarried on my own at home and was able to have the embryo, the fetus tested. I needed like a small DNC in the office also, just to make sure that there was no, like, leftover fetal tissue.
And so sad, so disappointing, so upsetting, but I also felt, like, relief, like at least I knew what it was and then I could figure out what my next steps were to try to figure out like, why I had these two miscarriages. Was it just two miscarriages? Statistically, people have miscarriages. I’m like, “That is what it is, or is there something else going on?” You were like very much in like…appropriately in the camp of like, “Listen, people, like you’re not young, like I wasn’t old, but I wasn’t young, I must have been probably 37 at the time. Like, statistically, people are gonna miscarry, they’re gonna miscarry once, they’re gonna miscarry twice. You could go on to have healthy children on your own.”
And I think one of the things that I thought was so awesome of you in that moment was you really, like, read that I was, like, on edge, like, I was like, anxious that maybe there was something else going on that I really wanted, that I had felt like the last year was kind of draining on me. And that even though in the scheme of infertility, people go through so much more, so much, much, much more heartache and pain, and somebody would look at me and say, “Hey, you have four kids at home, like, just chill out lady, like, some of us don’t have any kids at home.” Some people have less kids than we had wanted to have at home. But I think the piece that I’ve also come to learn is people who want children, no matter how many kids they have or don’t have already, have like a deep sense of craving. And I think it’s hard to always separate out that from somebody else’s urgency.
And so you just kind of looked at me and was like, “I see that you’re anxious about this. Why don’t you call this doctor?” And I think that like, you totally could have just told me just, “Hang tight,” and you probably would have been right also, like it might…well, I don’t know, who knows, right? It might have been fine. But I think just also giving me the option to kind of address that anxiety that I was having in the moment, like, it felt like relief, for me at least.
Dr. Fox: I wanted you to take our listeners into your head a little bit at that time. You know, you have four children. Thank God, they’re healthy. You have a wonderful family. And, you know, as you said, you’re not old, certainly. In the world of pregnancy, you’re not young, but you’re young, right? You’re young, you have four children, and you’ve had two losses now. What was your motivation moving forward, was it, “I just really want a fifth child, this is like a deep desire?” Were the miscarriages something that maybe discouraged you from that, or was it the opposite that they motivated you even further? I’m just trying to get…because a lot of our listeners are probably wondering…
Sarah: That’s a good question.
Dr. Fox: …what are you thinking at the time in your situation?
Sarah: Yeah, like, “Who’s this crazy lady?”
Dr. Fox: No, not in a “Who’s this crazy lady?” way. Well, I’m just trying to, you know, for people to get what you’re thinking because this is something that not everyone would relate to necessarily. Some are people like, “Four kids,” like, “God, I don’t even want four kids.” And here you are with…like, what’s going on in your head?
Sarah: I think for me, and I think I’ve become very cautious about this when I talk to people, I really am very cautious and sensitive about the fact that for me, it really was a choice. Like, I look at my experience and my choice to go on to do IVF, I ended up having three months of pretty non-invasive fertility treatment. I took Clomid, I did three…then it didn’t work, I did three months of IUI. That’s like where they take the sperm and they kind of give it a little extra boost to get it headed up in the right direction along with, like, timed ovulation, and everything looked like it was working. But I didn’t get pregnant. And so somebody else would not have chosen to do IVF. And the truth of the matter is we had people in our lives who really didn’t get it.
And I really understood from their perspective, like I had, at the time, a very full family. And my house was very busy. And I think we…my husband comes from a very large family. And I think I always had a dream of a very large family, and for many people four people is a large family, but I think we really…we wanted five, six, you know, kids, and I think it was something that I didn’t feel discouraged about, I actually felt, like, sad and scared about, like, in a sense of I really felt like something that I really deeply wanted felt like it was not attainable, and it made me feel very sad. That’s really what it was. It was like something that I really…I think about it often because, you know, for people who don’t know, I actually ended up having…so I ended up actually…subsequent to my twins, actually getting accidentally pregnant and miscarrying.
And I remember sitting there having such a different set of emotions and experiences with that miscarriage, where we had just had our twins, we were actually feeling totally overwhelmed. And it was like a totally different thought process about, “Wow, what would it be like to have a seventh?” And then when the pregnancy miscarried, we had like a real, like, kind of, look at ourselves and be like, “Well, if we were to do this again, will we do it intentionally?” And I think one of the things I tapped into was the idea that me, who I am, I could always have lots of kids, like, I love a busy, bustling house, I thrive in it, it like gives me such deep pleasure and enjoyment. But I know that I would feel complete not having another child. But I really felt like something was missing. I guess that’s the best answer I could possibly give.
Dr. Fox: Everyone’s…it’s like an internal clock, almost, you know, and your internal clock was not set at four, right?
Sarah: Yeah.
Dr. Fox: You did not…I mean, you were you’re obviously very grateful. And you were, you know, joyous over your family, but you didn’t feel complete yet.
Sarah: Totally. Yeah.
Dr. Fox: And it’s hard to, sort of, pinpoint why that might be or it’s hard to, sort of, predict what that might be for somebody, and everyone is different. And you didn’t feel that way with four, and you did feel that way with six, and okay, that’s just it. That’s the reality, right? There’s no explaining it. But it is fascinating. So you decided to do IVF. You’ve obviously never done that before. What was that like for you? Because it’s so different obviously, it’s such a new world. Was that something you found very difficult?
Sarah: So I really…I have to say thank God. I actually felt…again, interestingly, I felt like relief when we decided to do IVF. I was like we did three months of this, as you know, because I was going back and forth. And like, I was almost ready to pull the trigger like a month earlier. And everybody was like, “Just stay the course. You do your three months. If that doesn’t work, you move on to your next treatment.” I did three months. Then I did three months of each treatment and it didn’t work. I actually felt like with IVF, I was like, “Okay, this is a plan, like something is happening.” We don’t know what’s happening. And this seems to be like something that is concrete, actionable. It may work. It may not work, but it felt like it was like it had a direction, it had a course. And I felt, like, very grounded in it. To some degree, I felt very hopeful. I felt very grounded.
And thank God. I think probably because ultimately probably what we realized in our process was that something had turned with some of the embryos, like I needed a ton of embryos for my age and for, you know, all things being equal, but like, less than 50% of them when we tested them were healthy. And so it seems like there must have been something like that genetically just kind of…I don’t know we have been rolling the dice and landing the same unhealthy embryos. It could have been age, it could have been anything, you know, but in some ways, I felt like very relieved by the fact that we ended up going through the IVF process. I didn’t find it, you know, I thought I would never be able to give myself shots. And I think for me at least…and that’s the only way I can speak about it because I think that everyone’s experience is so different with the emotions they bring to the table, the anxiety they bring to the table. I think for me, it was okay because it felt like it had an action plan. And so it was an okay process.
Dr. Fox: You were a great match for Dr. Lobell and she was a great match for you. I mean, it really…because sometimes people go through the IVF process and for better or worse, no one sure who’s driving the bus there. Sometimes, you know, it’s just like a snowball that’s rolling down like an avalanche just keeps going. But I thought that, you know, you and Dr. Lobell are both very good communicators, let’s say. I can imagine being a fly on the wall, the two of you having conversations in there. It’s…
Sarah: Exactly. Those good times. We, like, appreciated, like, just really was like a very positive experience. She’s very, very special. She’s very good at what she does. And she’s very personalized. So I think like that was, like, tremendous, for me at least.
Dr. Fox: Yeah. How surprised were you when you found out it was twins?
Sarah: Okay, so here’s the thing. I will say this, I just have to say, I have to be very transparent. So well, it was very…
Dr. Fox: This is a podcast of transparency, we got all the buzzwords. Yeah.
Sarah: Yeah, exactly. So it happens to be that when I went to put the embryos back…It was actually interesting, first of all, we were back and forth, like, “Well, what will it be, like, when we put back…?” Like, if we get the option, girl, boy, in the end, only my girls were healthy. All my boy embryos had like real genetic stuff going on with those that were tested, that they were tested, it didn’t match. They were unhealthy embryos. So we had kind of a batch of girl embryos. And when I went in, I was kind of like a little bit pushing to put two embryos back thinking that there’s no way that two is gonna go. And the embryologist there was like really not in favor of it. She was very like…I think this was like the tail end of like the tides were turning, they were not putting back two tested embryos as a general rule, like it was really not a go. She was like, “I’m gonna do it.” And I was like…And I actually remember saying, this to her, “Do you think we should put back three just to really cover our bases?” And she looked at me and said, “You are so lucky I’m putting back two, like, you have no idea”. She’s, like, “Don’t even talk to me.” But like, you remember…
Dr. Fox: It’s like, “You know what trouble I’m gonna get in here?”
Sarah: Exactly. She’s like, “You can’t even imagine.” But I just wanna say that for, I think, something that at least I’ve held on to in this process is that you have to find silver linings wherever you go because if you don’t, you’ll just feel like life’s speeding down on you. And I look back and think about the fact that it was so easy and “natural” with my first four kids, you know, like, I never even saw this whole process. It was just like the first time I even had a glimpse of their existence was like that heartbeat on the screen. And before that, with some of my older, like the heartbeat that I heard, I didn’t even see it on the screen. And I think that like, the thing that I thought was amazing was this moment of time where embryo, like, they’re like in air, and like they hit air before they go from that test tube to being transferred. And I think it’s like a very powerful and, for me, it was like a very spiritual moment.
I talk about this actually at my girls’, like, party that we gave after they were born and healthy and had come home, like, this idea that like, you know, I wish all my kids well when they get into school. It’s like a moment in time where I like gave them a little bit of a blessing, like “Be nice to each other, you know, don’t kill each other on the inside,” which did not go well, by the way, like one beat up the other one. That was clearly, like, totally a no-go. But I think it’s a very powerful moment. And so everything has its challenges, but everything has its potential to have its blessing also, and I feel like trying to look at that is, like really, at least helpful for me and maybe helpful for somebody else.
Dr. Fox: Wow. All right, so there were two.
Sarah: So there were two. So when we went back, actually, my blood work came back crazy high and my husband was like a little bit not on…he was on the fence about this idea of two. And I was like, “Don’t worry, it’s not gonna go…like we just had six months of fertility and two miscarriages. Like, I’m sure it’ll just be one.” And then the HCG numbers came back crazy high. He’s like, “I thought you told me it would only be one.” I was like, “I don’t know, like, this is not my field.” And then, sure enough, there were two. We were really excited. I think that like when I look back at it again, you know, I don’t think I totally appreciated, like, the fragility of a twin pregnancy. I was recently listening to the podcast you had on the “Healthful Woman,” and thinking about like all the moving steps, which you told me about twin pregnancy, and most of it’s like not a big deal and then there are pieces of it that are just really different. Like, the nutrition is different, like just certain aspects that like I don’t think I totally internalized. I kind of was just like, “Okay, it’s like a single pregnancy except there’s two of them, like what could go wrong?” Everything.
Dr. Fox: What can possibly go wrong? It’s gonna be great. And then there’s also some interesting give and take regarding your exercising with the twin pregnancy particularly early and you got outed and shamed.
Sarah: Oh, yes. Oh, I got outed and shamed. We had a major clearing. So as you pointed out, me and Dr. Lobell both have very strong personalities, we both have a lot to say on a lot of different issues. You were just being nice. I’ve exercised through all my pregnancies. And my previous doctor was like, “You could stand on your head, you can control pregnancy.” And Dr. Lobell is like very much like, until you are like…I don’t know, she had like 10 weeks or something, you basically are, like, shy of flat on your back, which is like a non-starter for me. I’m, like, an active person. I run half marathons. I’m a big runner. And so somebody spotted me running and, like, kind of added me to my reproductive endocrinologist. She called me screaming at me on the phone. We totally made up. We had…and I then subsequently called you being like, “I know this is fine.” And you’re like, “Just do whatever the heck she says. Just listen to her.” I was like…
Dr. Fox: You’re under her jurisdiction.
Sarah: “You’re under her jurisdiction.” I was like, “Also though, I might have to wear like a baseball hat and go on hiding.”
Dr. Fox: You’re running around [inaudible 00:26:31] with one of those, like, false noses and mustaches and glasses.
Sarah: Exactly.
Dr. Fox: Who’s that? I don’t know. I don’t know, that’s not Sarah. I don’t know. Whoever it is, it’s not her.
Sarah: Yeah, totally not. Like, I just didn’t even appreciate it. Like, I think the day before I gave birth to those twins…so the day before my water broke, I probably ran, what, iike eight…I could look it up, eight, nine miles. And listen, I’m not blaming myself, although I’ve done a lot of that over the years. Because I think that, like, it’s a tendency that moms have to do, just like they’re owning every last step of how their pregnancy goes. And like, it’s a normal thing to do. But like, if I could go back in time, like, I probably would have been a touch, a touch more conservative.
Dr. Fox: I mean, listen, I’m a big fan of exercise in pregnancy, even for twins. I think we didn’t wrestle quite as much as you and Dr. Lobell did, but we, you know, maybe like an arm wrestle, I would say, not so much a cage match. You weren’t doing anything crazy. And I have no idea if your running had anything to do with your water breaking. The answer is probably not, it’s probably unrelated, I would say. But yeah, everyone always feels guilty when something like that happens. Even after…we’ll talk about this, even after your water broke, you were active and it’s not like they fell out of you. It doesn’t work like that. So yeah, so tell us, just in general, other than getting in trouble for exercising too early, how did it go until…as you already said, your water broke. Until that happened, how were things going?
Sarah: Totally smooth. I was, like, literally like, “Why are they making me come into this office?”
Dr. Fox: Yeah, you were very annoyed you have to come every two weeks. And I kept telling you, “You’re coming every two weeks, stop complaining.”
Sarah: I was so mad. You got to be kidding me. Yeah, I was like, this is insane. Like, do people expect people to like get other things done with this? Like, it was like really crazy, but they were fine. They were totally fine. They were growing. They were on target. Everything was fine. I had a very normal, easy pregnancy, just like my other four pregnancies. I really didn’t think about it. It wasn’t like it was harder for me. The only, I think, twin hiccup was, like, my iron was low.
Dr. Fox: Okay, fine.
Sarah: That was it. It was like nothing and I didn’t even think twice about it. It was like really smooth sailing.
Dr. Fox: Right. So tell us what happened when your water broke.
Sarah: My kids still talk about this to this day, like my youngest…they’ll be like, “Do you remember when your water broke? ” I’m like, “Thanks, guys.” And they’ll walk through it. It’s like the most fascinating thing, probably because it was scary for them. It happened to have been a Friday night and had just lit Sabbath candles. And I went to the bathroom and I was like, “Oh my God. I think my water broke,” and my husband wasn’t home. And I remember I’ve never been so panicked. Like, my heart sunk. I can remember exactly the feeling I had. And I was 31 weeks.
Dr. Fox: Right, you were 31 weeks, right?
Sarah: I was 31 weeks. And it was a Friday night. I literally remember walking out to the street looking for him and, like, screaming his name. And like, I was hysterical. I was like, in a panic. We called the service and Dr. Malko was on. We went to the hospital and indeed my water had broke, but I wasn’t in labor. So they kind of just watched and I was like, “What do you mean? I was like, I had never heard of this before. Now it’s funny. I hear about this all the time. And in fact, a friend of mine just had this happen to her. And I literally coached her through being stuck in the hospital for a week and then through the NICU, which is something like I’m trying to like get off the ground more like an informal way of trying to like get like a peer NICU mama support group thing going. But I was like, “I don’t understand what you’re talking about, like, my water broke finally.”
They were like, “No, your water didn’t break and we’re actually gonna slow your labor so that you don’t go into labor.” And that’s exactly what happened. We were stuck in Sinai, I didn’t go into labor, they gave me my first dose of steroids for the babies’ lungs. And they measured them and they were doing fine. And they monitored them and they were doing fine. I think I even got magnesium because I was on the cusp. And I don’t actually…I actually didn’t have an adverse reaction to it, even though everybody says it’s awful. But I, for some reason, did not have an adverse reaction to it. I was just so on edge.
Like, I remember the NICU people coming down and kind of giving me a whole lowdown on what to expect for NICU. And I was just kind of like, “What just happened?” Actually, that’s really how I felt I was like, “What just happened?” And then I was stuck in Mount Sinai for a week. So they’re basically like, “You’re gonna be here until you give birth.” And I was like, “I’m sorry, what? I have four kids at home.” My son’s birthday party was on Sunday. And this was before Zoom was, like, cool, but I actually Zoomed into his birthday party.
Dr. Fox: Really? Zoom was even around then?
Sarah: Yes, Zoom was around and I actually Zoomed…even I think it was either Zoom or FaceTime. Now I can’t even remember. I thought it was Zoom, maybe it was FaceTime. And I FaceTimed into his birthday party, and I thank God I had already made his birthday cake. It comes with a little bit of obsessive organization. But I was stuck in Sinai for the following week.
Dr. Fox: Right. It would have been longer.
Sarah: It would have been longer, but here’s the crazy thing.
Dr. Fox: We would have gone up to about 34 weeks probably had you not gone into labor.
Sarah: Yes, I was like staring down the barrel up three weeks. And I wasn’t really contracting, and I wasn’t really…it was kind of like I was doing nothing. Like, everyone was fine. They kept monitoring the babies. My water that was broken was continuing to replenish. And I was actually seeing clients. I would, like, get up and do…I remember having a total panic, I’m going to be very clear. I’m saying this very transparently to share with people. It’s interesting, when you tell people that being stuck in a hospital for however long you’re gonna be there until you give birth is awful, everybody who’s experienced it that I know says it’s awful, but when you tell it to somebody else who’s on the outside, they’re like, “It doesn’t sound so bad. Just like get a book, like enjoy your quiet time.” I’m like, “This is not quiet time, this feels really anxiety-provoking, and like unnerving, and like a loss of freedom, and your like stuck.”
Dr. Fox: Yeah, it’s not a hotel. It’s more similar to a prison than a hotel.
Sarah: It’s more similar to a prison than a hotel. [crosstalk 00:32:32.385]
Dr. Fox: I mean, they’re friendly. You’re not gonna get, you know, beat up in the yard or anything like that. But it’s, yeah, you can’t leave the floor. You have people come in your room all the time. You don’t have…it’s not actually quiet, no real privacy. You’re worried, you know, half the time. It’s not like…you’re not there for any pleasant reason. You’re like, “ugh, I could deliver at any time,” and you got stuff going on at home and people have work and, you know, responsibilities. It’s hard. It’s very, very difficult. Yeah. And yeah, it’s hard.
Sarah: And you’re also, like, toggling…you said it to me so perfectly. The whole week I’m sitting there like, you’re like, “Statistically, if you make it to 24 hours after your water broke, then statistically, you can make it to 48. But you’re not gonna make it longer for a week.” And I remember you came up on Thursday. I’d already been there for almost a week and I had, like, a system for, like, how I kind of survived the week. In retrospect, it kind of reminded me of like a little bit of like quarantine preparation. Like, I was like I would get up, I would like…
Dr. Fox: Hoard toilet paper.
Sarah: Yeah, I was hoarding toilet paper. I would like think of all the activities. Exactly, hoard toilet paper. You never know what else you needed to save back then. I kind of like created, like, a real routine for myself.
Dr. Fox: You were exercising, you were like power walking. People were like, “Who’s that nutjob…?
Sarah: Yeah, I was like, “I’m gonna go crazy.”
Dr. Fox: “Who’s that nutjob doing laps on PP 5?” I was like, “Oh no, that’s Sarah, that’s her. Dr. Lobell’s mad at her.”

Sarah: She’s mad at me. My actual OB who…I ran into my old OB on the floor. She’s like, “What are you doing up?” I was like, “I have clearance. I have not given birth. If I sit in those four walls, I’m going to lose my [inaudible 00:34:05].” I put in a podcast. My husband brought me like hand weights and I would literally put on my sneakers and I power walked down the hall. I made friends with lots of people. Power walked just down the hall. I think I had like a clock. It sounds crazy. And like, I promise you I’m a sane human being but like, I literally was like, “I’m gonna go crazy here.” So like, I have to do something. I actually, if anybody’s ever been on the Sinai antepartum floor, which I don’t wish it on anybody, it’s a dreadful floor, but I had in my head designs of how they could do it better.
Dr. Fox: No, it’s great. It’s like “Back to the Future.” You feel like you’re back in like 1962. You know, like, “Oh, this is what tiles looked like,” it’s the floor they didn’t get a chance to renovate yet. It’s lovely people there, wonderful nurses, everyone’s delightful. It’s just aesthetically, it’s okay, it’s interesting. Yeah.
Sarah: Awful. I remember telling one of the…like, somebody who was there from Sinai who came around. I was Like, “If you need new design ideas, like, I’ve spent a week on the floor, I have some ideas.” I’m like, “I think you could push it out here and like just put a few…” Like, they literally we’re like, “Oh, my God, we can’t handle you for another two weeks, like, God help us.”
Dr. Fox: So you were saying that I came in on Thursday,
Sarah: You came in on Thursday. And like the whole week I was there…and I think this was something interesting, just a friend of mine, I was talking to her about it, you sit there toggling in your brain, “I should stay pregnant because I’m doing go by my twins,” or by my singleton, whatever you have going on. You feel a tremendous amount of pressure as if it’s in your control, which it’s not. But you fantasize that it’s in your control and that if you wish to get the heck out of here and give birth that somehow you’re betraying and not taking care of the baby or babies inside of you and that you’re being selfish to yourself or to your other kids at home. And I think it’s like a very tricky place.
And you came in on Thursday. And I kind of was like in an okay place, I was kind of like feeling like, look, I made it all the way to basically 32 weeks. I was 32 weeks, I think either Thursday or Friday, and that was like a big cut off for twins. And I was like, “I guess I could make it another two weeks.” And you looked at me and said, “But would you want to?” I was like, “What?” You were like, “Would you want to? Do you want…look at your…” Basically you were like, “Look at your existence here. Like, do you want to live like this for another two weeks?” And I was like, “Oh, I don’t think so.” You were like, “Yeah, it’s okay if you don’t.”
It was like such a relief and relief of like responsibility for myself that like, I’m gonna do the best I can but like the fact that this is not…that this is unpleasant and the fact that I’m stuck sharing a bathroom on a 1970s Mount Sinai floor, although I did have a nice park view, like it’s not away from everybody else, like out of routine trying to cobble together losing work time that like I wasn’t planning on taking off yet. Like, it’s okay that this really stinks and that you could want it to end.
Dr. Fox: Yeah, a broker might call it a beautiful pre-war park view studio.
Sarah: Yes. Exactly. Yeah.
Dr. Fox: High ceilings.
Sarah: Exactly, with a shared bathroom. High ceilings. Yeah.
Dr. Fox: It’s good. You have to…
Sarah: I did bring in a plant. I did bring in a plant. I told my husband, I was like, “Get me a plant.”
Dr. Fox: I don’t care what it is, cactus, something.
Sarah: Yeah, something to make this place look alive.
Dr. Fox: No, but it’s true, people feel so much responsibility and guilt, and it’s not in your hands. It’s not your fault your water broke, it’s that you have no control over when you’re going into labor when you’re not. And like you said, yeah, on the one hand, you wish to stay pregnant as long as humanly possible. On the other hand, every part of your brain is like, “Get me the hell out of here. I just wanna go home.” And that’s normal. That’s okay. There’s nothing wrong with that. This is the competing parts of our brain. That happens all the time. And it’s all good and plus, as we said, it’s totally out of your control, and you went into labor the next day.
Sarah: And anyway, then went to labor. But I think the other piece was, by the way, and I often think back on this, is I think there was like a part of me also that was very much like sad and mourning the fact that like this also couldn’t go smooth. I think I kind of had felt like I was like, I had turned to a corner and everything was going easy. And I had a twin pregnancy that was going easy. And I was feeling so lucky and blessed. And like, I know that two twin pregnancies could go south, but I was like, “Mine’s fine.” And then I kind of was just like a really, kind of, wanting and craving for this to just be like smooth. And like, a part of me…even like I look back on it and was like, oh, it’s like sad for me that that was my last labor and delivery experience. Because I was like, it was so crazy. I was so crazed. It was a little traumatic. And I was just like, you know, like, it would have been nice if that could have gone smooth. But then I wouldn’t be here because it would be a really boring story and only a semi-boring story. But like, it happens to people all the time now. I hear people all the time, like, they’ll be, “Oh, my water broke early, like I’m stuck in that awful building in Sinai.”
Dr. Fox: It happens. It happens with twins more commonly, as you would imagine. But how important was a vaginal delivery to you? Which is what you ultimately had, so that’s great.
Sarah: I did, which that I will credit maybe the running too, why not? We got to throw in a bonus, and also I was in really great shape. I delivered them super smooth and easy. You know, I think I really was at a place in my head where I was like, just healthy baby. I think at that point, actually, probably I really didn’t…I was ready for a piece of this to go smooth. So I think that like, probably if I had had a C-section at that point, I could have seen it throwing me over the edge because I was like, “You’ve got to be kidding me.”
Dr. Fox: And it’s also hard because especially you know, when you’re 32 weeks, the babies are likely gonna be in the NICU for some time. And if you’re gonna be going back and forth to see them every day and you’re recovering from a C section, it’s really hard. It’s painful. I mean, it’s hard enough after a birth, but after a cesarean, it’s not pleasant. It’s really hard and you’re gonna be coming every day and then you’re really gonna feel guilty if you can’t come and then you’re in pain and it’s probably a bigger deal at 32 weeks to maybe at 36 or 37 weeks when you’re all home together, I would say.
Sarah: It was like a real blessing. But like I really…in that sense, again, I have great pregnancies, I’m in great shape. And so like giving birth or kind of just like, it’s like an incident for me. And so I just kind of like move on, literally. And so I like to have had to start recovering in a real way would have been…we always joke in our small family like each time my husband looks more tired. I always take a picture of him sleeping after labor and delivery. Like always, like every child, he’s like, “Oh my God, I need a nap.” I’m like, “I know that was really hard work for you.” He’s like, “You don’t know what it’s like to be on the other side.”
Dr. Fox: Right. And he doesn’t get an epidural.
Sarah: So he doesn’t…exactly, that is exactly…
Dr. Fox: He doesn’t get a comfy bed. It’s like a chair, it’s like a folding chair.
Sarah: Exactly, so he definitely needs a nap because it’s really hard work.
Dr. Fox: Yeah, shout-out to the dads, to the partners. It’s not easy.
Sarah: Absolutely.
Dr. Fox: And as I recall for your birth, I think every single doctor from our practice except me was there. Is that right? I think there was like nine hands delivering these babies?
Sarah: I will say that this was like actually crazy. Dr. Silverstein came by in the morning. And he said…it was Saturday, my husband came, we were actually having the loveliest Sabbath because it was like…this was actually lovely. It was really quiet. I had gotten permission actually to go off the floor. As long as I didn’t go for too far. I was like, we were totally having this nice, quiet weekend albeit on…at that point, we would call it like a Central Park suite, although I think it still costs more money. We saw the bill [inaudible 00:41:31] than any hotel on Central Park. And he came by in the morning, Saturday morning, and I was like, “I’m not delivering, go home, like nothing’s happening.”
And we walked over together to the pavilion. And like, I was uncomfortable but I was just like, “Yeah, I’m uncomfortable. I’m 32 weeks pregnant, my waters broken, like I really didn’t pay attention to it. I was like, “I have a high pain threshold.” I really didn’t think twice about it. My husband was like a little concerned. But the funniest part is I got back onto the floor and the nurses who I loved, loved were like, “It’s so weird. You’ve been walking these floors all week, you’ve been clearing eight miles a day on our floors. Like, you’re walking very slow. This is really weird.” And I was like, “I’m not so comfortable.” And they’re like, “We’re calling…” whoever was on call. So they call up Dr. Friedman. Dr. Friedman, God bless her, poor thing, she must have been new-ish to the practice, right?
Dr. Fox: I think she’s new to the earth. I mean, you know, she’s young.
Sarah: She’s young, right? Okay. So, but she’s amazing.
Dr. Fox: Yeah. But in her defense…yeah. In her defense as an obstetrician, she’s amazing and she has little hands. So you’re definitely gonna appreciate her over Silverstein at that time.
Sarah: Yeah, yeah, it was amazing. And she had a lot going on that day. And sure enough, I’m sitting there like…this is the irony. When I asked to go home on Sunday…I think I saw you Sunday or Monday originally when my water broke. I was like, “Just let me go home.” You were like, “You’ll deliver on the side of the road. Like, you don’t understand how fast this goes. And then this will be so bad.” And I remember kind of rolling my eyes. Like, “Yeah, like how fast could it possibly go?”
Dr. Fox: “He’s so full of it, Fox.”
Sarah: Like, he’s so full of it. He’s just trying to keep me here. And sure enough, actually, I’m gonna be the only person who had been on the floor for an entire week, waiting to deliver and only end up delivering in, like, dress clothes. I was literally in, like, a dress and, like, tights. And like, I had like fully, like, whatever. She looks at me, she checks me. She’s like, “Oh my God, you’re 10 centimeters, you’re gonna deliver these children here.” I’m like, “Well, I’m sorry, what?” She said, “Oh…” and then of course, I’m like, “But I haven’t had an epidural.” She’s like, “Also you’re 10 centimeters.” And then at the same time, she gets a page from downstairs that her other…whoever was the other patient was delivering. So poor Dr. Friedman. I mean, she’s like, kind of like, “Don’t go anywhere, but come downstairs.” And she left. And she called Dr. Bender, who I love, he’s amazing.
And Dr. Bender came in, I think it was him who said this, he says, “I just got off with Dr. Fox, he says you have to deliver.” I was like, “Thank you.” “You don’t have a choice you have to deliver,” like, that would seem obvious right at this moment. And then they took me down. And I remember…actually, I was just talking about this with somebody else about the power of nurses. I remember they were scanning me one more time to make sure that the babies were head down before they took me to the OR. And they were attempting to get some form of a small epidural in me, although I did walk into that OR room, and I remember panicking. I remember having this moment and like, I looked at the nurse, I said, “32 weeks is just too early, like, babies aren’t meant to be born at 32 weeks.” And she really calmed me down. She’s like, “They’re gonna be fine. You’re gonna see, they’re gonna be totally fine.” But I remember the panic and like, I was calm up until that moment and I just lost it. I remember really losing it. And she kind of just put me back together. And she was right, they were fine. They really were.
It was like a crazy delivery. Dr. Bender was in there. Dr. Friedman came back. Of course, Dr. Silverstein blows through the room like something out of “Seinfeld.” Okay. Like, literally like a hurricane. “You told me you weren’t gonna deliver.” I was like, “Oh, I’m sorry.” And what was the most fascinating that I actually then learned from your podcast was they delivered baby A super easy because she was head down. And then while they delivered baby A, sure enough, baby B flipped. And so they had to take her out feet first. And I remember Dr. Friedman was doing the second delivery. And they were, like, coaching her through it. Dr. Bender was coaching her through this. And afterwards, any time they were looking at each other, like, were they mansplaining her? Like, she’s a very competent doctor, like why were they…?
Dr. Fox: Mansplaining.
Sarah: We’re like, you have two senior doctors, Dr. Bender and Silverstein, are standing next to this, like, young, very competent, but woman, the OB. I was like, “What the heck is going on here? Like, let her do her job.” Only then did I realize afterwards, like it’s when I was looking at the process, I’m like, “Oh, like, this is legitimately what this practice says because like it’s a very hard maneuver and they’re teaching her how to do it.” And it was very funny, but we were like, “Oh, that’s what was happening.” But it was like…
Dr. Fox: Those jerks.
Sarah: Yeah, I’m like, “What is happening here?” Like, this seems very unprogressive. What is going on? It was like a packed OR. It was like tons of people., we had no idea what was going on. Of course, Dr. Silvestein comes out, he’s like also the photographer because there was really nothing for him to be doing at that point. And they were fine. That’s the truth of it. Like, they were really fine. They were small. They were both like basically 2-pound small babies. They were on CPAP. One of them was like a NICU superstar, like didn’t brady didn’t do anything. She basically, like, came out smiling and pink and stayed that way for the two weeks that she was there. And the second, who was my baby A, was like much more smaller, much more fragile.
But I will say this to everybody and anybody, the NICU team, all my doctors told me that over and over again, “A healthy, uninfected 32-week-old is better than an infected 34-week-old.” And like, I’m so blessed that I delivered at 32 weeks, not just because I had to get out of there, but also because they really were. Like, they weren’t infected. They were still healthy. They were on CPAP for a little bit of time which helped them kind of like blow air in their lungs to give them a little bit of extra lung support so they weren’t working so hard. And they were awesome. They were great. It was an amazing NICU. It is an amazing NICU, the doctors are amazing. And we were…like, they came home by 35 weeks. One was really ready to come home, to be honest. And we look back at pictures now of my baby A who, ironically, her name is [inaudible 00:47:54] there’s like a subconscious thing about baby As, naming their kids with an A name. Like, it’s like a thing I was reading about afterwards, like you don’t even recognize it. And she totally needed a few more days in that NICU. Like, I can’t believe they let us take her out, but they did.
Dr. fox: Right, my baby A is Noam [SP] with an N, so yeah, there goes that.
Sarah: Okay, so no, sorry. There goes that.
Dr. Fox: Looking back, they’re 3 years old now. Thank God you have…you know, they’re well. As you said, big family, six kids. What do you think about all this in hindsight?
Sarah: You know, it’s funny, I look back on it and it was like a crazy…I don’t think we’ll ever feel as tired or as scared but also as amazed and grateful as I was those days when I was traveling back and forth in the NICU. And I had a tremendous amount of guilt. Like, I really did, like questioning, “Should I have put back to two embryos? Should I just…?” Like I didn’t need two. I could have had one and then transferred another embryo and please God, it would have worked, you know, just as well as the first time and then I would have had the same family without all of this drama. So I have a tremendous amount of guilt around pushing for that.
But then I look at them and I look at their special bond and their special relationship. They couldn’t be different, more different, and they just started school for the first time. And from their personalities, their look, they’re two totally different kids, they fall into different parts of my family, but they have a very special bond. And when I walked them walk into that school building, kind of holding hands, like, there’s nothing like it. And I watched the way all the other kids take them in. It’s amazing. And it’s funny now one of my younger kids was like, “When are you gonna have another set of two?” I was like, “Guys, I think like…” They’re like, “And when you do, can we get a boy in there?” You know, like, my kids kind of have like a different mindset around some of this. But my kids also know, like, we talk about a little bit…like, one of…my oldest daughter definitely remembers, like a time when I was, like, fatter and so she, like, is tuned into it.
And I think we’re very sensitive much more in the family. The fact that not everybody has babies easily or as many as they want. And the way that we talk about it is different and being very appreciative to the family we have. So I think we’re very mindful. You know, I think some people look at us are like,” Oh, my God, what car are you gonna get next?” And I’m just like, thank God, thank God we have, you know, a car problem. I never take it, ever take it for granted. Even when we get our tuition bill. It’s like, it’s a blessing. I think that’s for me, like, that’s nothing else to say for it.
The best thing I could possibly think about it and I do acknowledge the fact that these last two probably, in a different way, have a different place in my, like, being just because of maybe the way I perceive them as fragile. On the first day of school, I was like, a basket case, I was like literally crying. And the principal said to me, “You know we’re giving them back to you at the end of the day. Like, you know we’re not keeping them forever.” But I did, I felt like I was really dropping them off. And they have a piece…there’s a piece for me that they just feel a little more fragile and a little more sensitive, and they’re not, but it’s my perception of it.
So it’s something that kind of stays with me. And I think it’s like, yeah, it’s something I think about, like when I think back on that time, I can really put myself back there because I think I thrived in it, I did well in it, but I think it was hard at the time, which is why I’m gonna make a plug for this in a second is that I’m really trying to…I was really fortunate, a friend of mine, actually, the same thing happened to her. Her water broke a week after me and she was 31 weeks with twins and we became fast friends, like, and I remember kind of like coaching her through that and through the NICU.
And my sister-in-law had premie, really early premie twins. And they’re like, in like the 20-week-ish, like I think they were 28 weeks, 27 weeks. And I remember her coaching me through some of the NICU stuff. And I think that like for anybody who thinks that they’re gonna have a NICU stay, like reach out for a mom who’s gone through the NICU because I think like their insight’s invaluable, even if it’s just somebody who understands you who gets what’s going on and, like, who can make you feel like whatever you’re feeling, it’s like a reasonable, legitimate thing. It’s exhausting. It’s tiring. Like, I was living off of that, like, bodega coffee at the corner outside of the Sinai Hospital, which was excellent coffee, or just is my memory that it was excellent. But feel like that’s just like an important piece that I would plug for anybody listening who ever thinks they would go through that or has gone through it, if you hear somebody to connect with them because I think it’s, like, invaluable support that like you’re part of a community of NICU moms that you didn’t ask to be a part of, but now it’s an opportunity.
Dr. Fox: Amazing. Sarah, thank you so much for coming on the podcast again.
Sarah: Thanks for having me.
Dr. Fox: Thanks for talking your birth story. I love talking to.
Sarah: Thanks for being an awesome doctor. Your team is the best. I always say like one of the saddest parts about not having, as far as I know, any more kids is that I don’t get…I would have more kids just to hang out with all the doctors in your office. They’re all amazing, and fun, and awesome, but we’d have to get a new car.
Dr. Fox: Thank you for listening to “High Risk Birth Stories,” brought to you by the creators of the “Healthful woman” podcast. If you’re interested in telling your birth story on our podcast, please go to our partner website at www.healthfulwoman.com and click the link for sharing your story. You can also email us directly at hrbs@highriskbirthstories.com. If you like today’s podcast, please be sure to check out our “Healthful Woman” podcast as well, where I speak with the leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Have a great day.
The information discussed in “High Risk Birth Stories” is intended for information and entertainment only and does not replace medical care from your physician. The stories and experiences discussed in our podcasts are unique to each guest and are not intended to be representative of any standard of care or expected outcomes. As always, we encourage you to speak with your own doctor about specific diagnoses and treatment options for an effective treatment plan. Guests on “High Risk Birth Stories” have given their permission for us to share their personal health information.