“Gabrielle’s Story, Part 1: Bad Experiences, Time for a Change” – with Gabrielle Moskovitz LSW, LMSW

Dr. Fox: Welcome to today’s episode of “Healthful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At “Healthful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Hey, Gabrielle, welcome to the podcast. How you doing?

Gabrielle: Good. Thank you so much for having me. It’s such an honor to be on this podcast.

Dr. Fox: Buttering me up at the beginning. I love that.

Gabrielle: You know me. I’m your biggest fan.

Dr. Fox: This has been a long time coming. We’ve been talking about this for a while, I feel. So this is terrific. Thank you for doing it. I really appreciate it. And I know it’s going to be awesome. How are you? How are the kids?

Gabrielle: The kids are psychotic, as usual. Three boys under five and under. It’s always fun in my house. But thank God everyone’s good. Everyone’s good. We’re slowly getting through the summer. All good. All good. Can’t complain.

Dr. Fox: Amazing. So you volunteered to sort of tell your story and also weave in your professional life into this, which is cool. So just for our listeners, what is your professional life? What do you do?

Gabrielle: Sure. So I’m a therapist at a private practice in Bergen County. We’re called Collaborative Mind Psychotherapy. And I specifically work with maternal mental health. So it’s like moms or people trying to be moms, and all kinds of women’s issues like infertility, pregnancy loss, just like motherhood stressors, even like menopause and all that kind of stuff. So anything related to moms or trying to be a mom. And I’m super passionate about it just because of my own journey in motherhood.

Dr. Fox: Going into your career, did you have any expectation that that’s where you would land?

Gabrielle: Absolutely not, to be honest. I actually chose this career later in life, and I can blame my husband for that, and hopefully he’ll listen to the podcast. But he was…

Dr. Fox: Wait, why wouldn’t he? Do you think he’s not going to listen to this podcast? He better.

Gabrielle: He will. He will.

Dr. Fox: Jake, we’re looking at you.

Gabrielle: Exactly. He went to medical school in Israel. So some of my career stuff was kind of put on hold for those four years, and it was an awesome experience. We had a great time, but I didn’t want to do anything graduate school in Israel so that it might not transfer over here. But I always had an interest in psychology. I didn’t even know that maternal mental health was a thing until I was personally going through all of these stressors in my own life. And there was just no resources for women. And so I felt like I needed to do something, and to sort of specialize in that so that I can help other women like myself.

Dr. Fox: So are you saying that you were already interested in psychology, and then this shifted you into that part of therapy, or were you sort of not at all sure what you were going to do and said, “I’m going to do training so I could become specifically a maternal mental health specialist.”

Gabrielle: So it was the first one, actually. I’ve always been interested in psychology. My mom’s a school psychologist. I have a brother with mental illness. Just always thrown up around it. But I always actually thought I would work with children. I always liked working with children or adolescents. And then through my own experiences, I shifted into the maternal mental health field.

Dr. Fox: Love it. And you have to explain to our listeners because you were trying to explain to me over text your handle on Instagram.

Gabrielle: Sorry. So my handle is @thecheftherapist. In addition to being a therapist, I love to bake. I love to cook. So sometimes I’ll throw in recipes in my therapy Instagram. I actually used to sell baked goods when I lived in the city. So just something I’ve always enjoyed doing. And it’s sort of like my own therapy because I feel like it distracts my mind. And when I’m feeling anxious or I just need something, I’ll like just whip up a cake, or a [inaudible 00:04:06] or something just to like distract myself. So I find it a really good coping skill. So I sort of weave in the two in my Instagram account.

Dr. Fox: Wow. So the chef therapist, food, cooking, baking, and therapy.

Gabrielle: Correct.

Dr. Fox: Love it. One-stop shopping for all your comfort needs. All right. So great intro. So let’s start with you. Where are you coming into your first pregnancy? Where are you in life? Where you guys live in? What’s going on?

Gabrielle: We had just moved to the city after my husband graduated medical school in Israel. So we were living on the Upper West Side. And we decided that, as soon as he graduated, we would try to start getting pregnant. And nobody tells you how to get pregnant, to be honest. So I went to my OB, who I’ve seen since I was 18 years old. And I said, like, “Trying to get pregnant, I assume I need to get off my birth control. Like, how do I make this happen?” And she was not helpful, to be honest. But I ended up seeing another OB who said, like, “You have PCOS. So instead of trying to get pregnant for six months to a year, why don’t we just start you on oral clomid to help you ovulate? And then we’ll see what happens.” So it was a very proactive way to conceive my first. So we did one round of clomid, like the lowest dose. Didn’t work. And then we did the second dose with like 100 milligrams and we got pregnant. So it was like a two-month journey to getting pregnant. And even though we took the clomid, it didn’t feel so long because it was proactive. She said, like, “You don’t even have to try for six months before I give you this.” So it was a pretty easy journey getting pregnant, I would say.

Dr. Fox: And how did that pregnancy go?

Gabrielle: Uneventful. It was like my easiest pregnancy. Everything was good. Delivered at 38 weeks. My water broke in the middle of the night, and went to the hospital. He was born 12 hours later, vaginally, and he was pretty big. He was 8.1. But overall, like no complications, pretty seamless delivery and pregnancy.

Dr. Fox: Terrific. All right. So you’re probably thinking, “Piece of cake.”

Gabrielle: Yeah, exactly.

Dr. Fox: “Here we go. Easy peasy. No problems.” All right. So take us through what happened with your next pregnancy.

Gabrielle: So we decided when my son Noah turned one, we’ll start trying for another one. So again, we just went back to that [inaudible 00:06:34] OB and she said, “Here’s the clomid. Like, don’t try again. You know it works for you.” And it was one month, two months, three months. It was like six months later, the clomid wasn’t working. We were very distraught because we were like, “This had worked before. Like, what’s different from now and a year and a half ago?” So she told us she could put us on letrozole, which is another oral medication. We tried that for a few months, didn’t work. And by the time we were like eight months into this process, she recommended that we see an REI, so an infertility doctor.

We went to RNA of New Jersey. That’s where we were living at the time. And we had a consultation and they decided that it was probably because of the PCOS, and that they just wanted to do like one round of clomid plus a trigger shot. And so we would have to come in for observation and all that kind of stuff. So it was really scary, to be honest, to initially make that call to the REI. It’s almost like you’re admitting defeat, like something’s not working and I need extra help. So we went with them, and we were about to start the injection process and I got pregnant naturally. So we were super excited. We actually were… I was over Passover. We were with my family in Florida and we took a pregnancy test in the morning. And I remember just like running into my parents’ room and showing them because they knew we were trying to get pregnant. And so we were all so excited.

And things were pretty uneventful. I went for checkups. And at the time, since I had had a consultation with RNA, I was still able to go there, even though I didn’t do anything with them. So they gave me like ultrasounds twice a week. So it was very reassuring and everything was great. They graduated me at eight weeks to my regular OB. I went to him once for the heartbeat again. Everything was fine. I asked him if I could come back the following week since I was used to getting weekly ultrasounds. And I have a history of anxiety. So I wanted to just check up and make sure everything was going okay. So I went in at nine weeks on my own accord and there was no heartbeat. I was by myself in the room with the OB and the nurse. And I remember him putting the ultrasound probe on me and not saying anything, and then saying he had to check something. And then he did it one more time. And then he said, “I’m so sorry, there’s no heartbeat.”

Dr. Fox: What was that like for you?

Gabrielle: Awful. Terrible. I was by myself, and I remember…it felt like I was in a dream. You know, when something happens to you and you’re kind of like, “Not really happening to me.” So I immediately called my husband and he actually thought I was joking. Like he fully didn’t understand that I was sitting in the office for real, this is happening. And so we went into the OB’s office. Me, I went in, my husband was on speaker, and we were told, “Either, you know, you could wait it out. Naturally, miscarry, you could have a DNC or you can take a pill.” In the end, we decided to do the DNC, which I think was the best option for us. But I have to wait 10 days in between finding out that information and when we could schedule the DNC. So it’s sort of like walking around with old dead fetus, or whatever you want to call it, in my body for 10 days. Those were like the worst 10 days ever. But the DNC was very straightforward. I joke now, only now that it was the best sleep of my life. And I’d like to get propofol every single night so I can sleep well. But it was an easy recovery. Like I didn’t have any pain. I didn’t have any bleeding after. Just emotionally, it was really tough for us.

Dr. Fox: Was it more the loss, or was it sort of like the defeat that you’re not, so to speak, able to get pregnant? You know what I mean? The difference.

Gabrielle: Yes, totally.

Dr. Fox: Is it more the pain of looking back on what you lost or sort of the pain like, “Oh, my God, I had infertility,” or whatever, you know, almost infertility, I guess you would call it, whatever. “And now I’m still not pregnant.” It’s obviously both, but which one dominated?

Gabrielle: I think it was just like not being able to get pregnant, and like admitting that like, “Okay, this didn’t work after nine months. We were about to start some kind of treatment process with RMA. And now we’re going to have to go back to them.” I think that was like the hardest part for me. And so we decided we’re not going to wait. Like, we’re just going to go right back to RMA after as soon as I was cleared to move on with the treatment. And then we actually got pregnant on our own again. So that pregnancy, and that was my second son, was awful in terms of mentally awful. Every single scan, I was waiting for the other shoe to drop. What’s going to happen? Are we going to miscarry again? What are the percentages? I went on a whole rabbit hole of data.

And we continued to do the weekly ultrasound. And we were just very, very cautious in the pregnancy. Like we didn’t tell people until 20 weeks. We were just very…we didn’t even want to talk about it amongst ourselves because we were so nervous of like what’s going to happen. And so that pregnancy overall was uneventful, I would say, until the delivery part. That was pretty eventful.

Basically, when I was 36 weeks and 5 days, I woke up at night, heavily bleeding. And we were actually at my in-laws’ house over Passover. And we called the OB on call and they said like, “You need to come right away to the hospital,” of course. So we drove to the hospital. It was like 45 minutes from where we were. We got to the hospital. And at that point, I just assumed that like I lost the baby since I was bleeding so much, and I couldn’t feel him moving. But we got into a hospital bed. We were hooked up to a fetal monitor and we heard the heartbeat. And that was like the most amazing sound to hear in that moment, because I really had no idea what the outcome would be there.

And basically, it seemed like I had like a placental abruption. So they told me that, “We need to induce you right away. This baby needs to come out. Otherwise, it can lose oxygen and the baby could die.” Basically, they wanted to induce me, and they induced me. And the baby was not…there was no dilation whatsoever. And so I was sort of coerced into a C-section at the time. And so I ended up having a C-section about like 12 hours after we got to the hospital. And the baby came out. He was 36 weeks and 5 days, but he was 7 pounds and 11 ounces. So it was a pretty big baby. He was healthy, thank God. We were worried like he’s kind of early, didn’t need to have any further intervention, no NICU experience. Thank God. But my recovery was really, really hard from the C-section.

I think, again, physically, it was super hard. And I couldn’t lift my son, who was almost three at the time. I couldn’t drive for a few weeks. I couldn’t cook because I couldn’t lift the ingredients. I couldn’t do anything, basically. But mentally, it was really hard because it was like I had dreamed for this baby for a year and a half, for so long. And then it was sort of like ripped out of me. Like it felt like such a different experience having a C-section versus a vaginal delivery. I felt like I had no control over how the baby came out. And so I think mentally it was really, really tough, too.

Dr. Fox: Yeah, I was going to ask you, you used the term coerced for your C-section. So what do you mean by that? Either what happened or what was the experience for you and how it happened?

Gabrielle: So I went to a practice in New Jersey that I would say, looking back, they’re pretty incompetent, and they were very pro C-section, meaning they don’t do VBACs at this practice. They just more err on the side of caution. So basically, after they had broken my water, the doctor was about to leave. And like 12 hours later, when there was no dilation, he said to me, like, “I’m leaving for the night. So I think you should have a C-section because my colleague’s coming in in the morning,” and happened to be a doctor I didn’t like in the practice. And he also was telling me that because they had broken my water, if I didn’t deliver in 24 hours or less, then their baby can get an infection and you would need to end up in a NICU. So it felt coerced in the sense that I felt scared, like, “I don’t want my baby to be in the NICU.” First of all, he’s premature. So that on top of the infection, it felt like I didn’t have a choice in the moment. But looking back, I feel like I was pressured because the doctor was like, “Hey, look, I can get this baby out in the next 20 minutes.” Like from the time I made the decision to have a C-section, I think it was 18 minutes until the baby was born.

Dr. Fox: And so meaning it wasn’t emergent, but you felt like they were recommending it maybe because it was just like the easier way to go or something.

Gabrielle: Correct, yes.

Dr. Fox: Got it. Okay. Yeah, that leaves a bad taste. I mean, I have no idea whether it’s true or untrue, but that’s what you’re feeling, right? That’s how it’s presented to you. And so that definitely leaves is a bad taste.

Gabrielle: I was also told it wasn’t a placental abruption after all that. So it was also like it made me feel like, “Well, then why did I even do the C-section?” I also did it partially because they were like, “This baby needs to come out.” So the fact that they told me it wasn’t a placental abruption, it made me question why I ended up choosing the C-section in the end.

Dr. Fox: And so how did you afterwards…you know, you’re left with this sort of…you’re recovering physically, which is quite unpleasant. And emotionally, mentally, you’re also sort of…it doesn’t sit right with you. How do you process that? And at the same time, you have a beautiful baby, right? So it’s like, you know, these are very, you know, sort of disparate thoughts at the same time.

Gabrielle: Exactly. I was in therapy since my older son was about four months old. Just to deal with some anxiety, like postpartum anxiety. And so I spoke to my therapist about it. And that is actually when I decided to go into maternal mental health, because I was seeing a male therapist at the time. And no offense to you guys that are males, but he couldn’t fully understand the emotions that I was going through after this birth of my second son. And I just was trying to find resources of, A, some people that went through C-sections, people that went through placental abruption, people that went through quasi infertility. Because I also felt like I was not in one group or the other. Like I didn’t really go through infertility, but I didn’t have this natural experience. And I had this four C-sections. So there were so many different emotions at play. And that’s when I decided… And I was in social work school at the time. And that’s when I decided like, “I’m going to do this. There needs to be more resources for women out there.”

Dr. Fox: Cool. And you think it was because he was male or because he just wasn’t very good at it?

Gabrielle: I think it was a combination because he was an excellent therapist for…I saw him for almost two years. But I think there’s just some things that…if you don’t have female body parts, it’s sometimes harder to understand people. I’m not saying all the time, but it was a combination. Yeah.

Dr. Fox: All right. And so after that, you’re in therapy and you’re deciding you’re going to do this yourself. And you did decide to have more children. And what happened with the next pregnancy?

Gabrielle: So I actually didn’t decide to have more children.

Dr. Fox: Oh, it was decided for you. All right. Fair.

Gabrielle: Because it took us so long to have Caleb, who’s our second, I said to my husband, “I’m never going on birth control again. Like all my pregnancies were clomid or letrozole or something.” So he’s like, “Okay, whatever.” And so when Caleb was four months old, I somehow just…I was like, “I’ve been peeing a lot lately. Like, it’s not normal for me.” So I decided to take a pregnancy test thinking, “There is no chance that this is going to be positive.” And it was positive. And that was actually on Thanksgiving morning when we were going to my in-laws with my parents. So all the families were together. And so we told them the day that we found out because we were just in utter shock. Our kid was four months old and everyone was like…they thought we were joking. I remember my father-in-law was like, “You’re shitting me, right?” “No, no, no, we’re serious.” And at first, I was like super grateful. “This is so cool. This has never happened to me before.” But then the reality started to creep in. “I’m going to have kids 14 or 15 months apart. That’s kind of crazy.” But in the end, I was grateful. The feeling I would say is more gratitude. And so we went to sit back to that same OB who gave me the C-section, which I think was mistake number one.

Dr. Fox: I was going to ask why you did that if they left that bad taste. It was just you didn’t really have time to decide because it sort of came out of nowhere?

Gabrielle: Yeah, exactly. I feel like I didn’t have time to process or decide to see someone else. And to be honest, where we’re from in New Jersey, nobody likes their OB around here. I would ask around and everyone’s like, “You have to go to the city.” And I just was like, “How am I going to go to the city? I have a three-year-old, a four-month-old, and I’m in school, and my husband’s in residency, so he’s never around. How am I going to do this?” So it didn’t even cross my head. And so I went back to that OB, and he was like, “Everything’s fine. We heard the heartbeat.” At that time, when I went in, I was about six or seven weeks pregnant. Again, I said, “I want to come back every single week.” And I did. I heard the heartbeat at seven weeks.

Around eight weeks, I remember exactly where I was. I was in a nail salon and I went to the bathroom and I started spotting. And I was freaking out because I’ve had three other pregnancies and I never spotted before. So I did call that OB, and he told me on the phone that, “Oh, so many pregnant women spot, and you’re spotting because you had a pap smear the day before,” when I went in for the exam. And I started to think to myself, “I didn’t have a pap smear. There’s no way. You could feel when you have a pap smear.” But I’m like, “This is what the OB is telling me. He’s probably right.” So I said, “I want to come in tomorrow just to check.” And he said, “You came in yesterday and there was a heartbeat, you’re fine.” Very, very dismissive. And I said to him, “I’m coming tomorrow. I’m going to show up when the office open.” And he said, like, “Be my guest.”

Dr. Fox: You’re like, “Dude, I am the chef therapist. I’m coming in.”

Gabrielle: Yeah, “I’m coming. I don’t care that yesterday my scan was fine.” So I went in the next morning and I sat in the exam room and he finally came in, and he did an ultrasound and he said, “See, I told you everything’s fine.” And it was, there was a heartbeat. And he said, “I told you, you had a pap smear yesterday.” And I said, “I didn’t.” And there was a nurse in the room and I said, “Can you check my chart?” And she said, “Doctor, she didn’t have a pap smear.” So that’s problem number one, I would say. And he was again, like very dismissive. “I told you everything was fine. Have a good day,” and walk out of the room. And something just didn’t like feel right, I would say. And the spotting continued.

And so that happened on a Wednesday, like that scan. And then by Friday, the spotting was heavier. It was more red in color. And I remember texting my friend at the time who was also pregnant, who actually was at your practice, Dr. Fox. And she said to me, “Reach out to Dr. Fox,” because she said…well, first, “Reach out to your OB.” So I reached out to my OB. I called the office and they wouldn’t even put the doctor on call on the phone. They said to me, “If you’re bleeding and you’re worried, just go to the ER.” Which I don’t think was the right way to handle that situation at all. So I ended up calling you and you were… I’ll never forget the kindness. Like you didn’t know me from anywhere. Okay, you knew…you’re very good friends with my cousin, but you didn’t know me. I wasn’t your patient. And I remember what you said to me on the phone. You said, “Listen, you could be having a miscarriage. You could not. I’m in the city right now. I’m happy to…” It was a Friday afternoon. You’re like, “I’m happy to stay here until like 5:00, 5:30. If you can get here now, I’m happy to scan you. Like, don’t worry about the insurance. We’ll figure it out later. Come if you want.”

And that kindness was incredible to me because my own OB was so, so dismissive. And I remember saying like, “I don’t really want to schlep to the city,” but that was so, so kind of you. So what ended up happening was the bleeding got heavier at the next couple of hours. And I told my husband, like, “I’m going to the ER,” because I just didn’t want to wait around until Monday to get a scan. I needed to know the information. So I left the kids, and it was Shabbat. So I drove on Shabbat, which I had never done before. And I went to the local hospital, and they gave me an ultrasound. And by the time I was at the hospital, there was no fetus even in the ultrasounds. It had past or was about to pass. And the kind ER doctor said to me like, “I’m really sorry, you miscarried.” It was horrible again. This one was worse because I was alone in the ER. They actually didn’t even have a room for me. I was in the hallway, and he sat down with me and said it in a very sweet way.

But when he was talking to me, he got a phone call and he said, “Oh, your doctor’s calling me, your OB.” So I said, “Okay, wow, he’s checking up. That’s shocking.” He checked up, the ER doctor told him, “Your patient miscarried.” And I never heard from him over the weekend. I never heard from him at all.

But I did hear from you, Nathies [SP]. Again, I remember I texted you from the ER on a Friday night saying like, “There’s no heartbeat. There’s no baby anymore. Thank you so much for your kindness.” And you wrote me back such a nice text. But the thing that I’ll never forget is Saturday night after Shabbat, I had a call that said no caller ID. So I assumed, “My OB’s calling. He’s a religious man. So he probably didn’t want to call me on Shabbat, even though he had the information that I miscarried.” But it was actually you calling to check in on me. And at that moment, I was like, “I need to switch to you because the kindness that you showed and just the compassion, I’m not even your patient and my own OB can’t call. He can’t check up on me. Nothing. And actually got worse.”

So I actually went back to my OB on Monday for a scan to make sure like all the fetus was out. And he walked into the room and he said to me, “So how are we doing?” And I said, “Not good.” And he said, “No, no, no, I mean like physically. Are you cramping? Are you bleeding still? Like what’s going on physically for you?” And at that moment, I was obviously appalled, shocked, angry, hurt. I mean, I had been with this OB who did my DNC a year and a half prior, who did my C-section, who knew I miscarried, who dismissed my feelings all week before. And so I actually looked at him and I said, “Are you seriously asking me that?” And he had no words to respond. And I obviously did not go back there. And that was the end of that chapter, I would say.

Dr. Fox: Wow. Not a good interaction. What can I say? It’s not good. I’m sorry to go through that. It’s tough. But I guess the only silver lining is that you and I get to spend a lot more time together.

Gabrielle: Exactly. So I guess we could fast forward a few more months again. I was like, “I’m never going back on birth control.” Not that I wanted to have a kid right then and there, but I’m like, “This natural pregnancy thing only happened to me once. There’s no way it’s going to happen again.” And I should say after that second miscarriage, I experienced…which I never knew about, I experienced postpartum depression, even though I wasn’t…I was pregnant and postpartum depression can occur even if the pregnancy doesn’t last, which I had no idea about even though I was in social work school and learning, I didn’t know this. And so I ended up going to a psychiatrist and I started Zoloft at the time. And it was so, so helpful because after that miscarriage, I could barely get out of bed. I mean, I was functioning, I was going to my internship. I was doing all the things. But I felt like somebody else was doing all the things and I was just…this other identity didn’t feel connected to anything. I couldn’t bond so much with my children. I was not eating as much, my sleep was really bad. And so I decided like, “I need to do something about this.” So I started seeing a new therapist who was excellent and I started the Zoloft. And so I wasn’t thinking about having a third child. And then I unexpectedly got pregnant again. Twice, right?

Dr. Fox: Look at you. You turned into into the most fertile person ever.

Gabrielle: That’s what my husband says every time, like, “You’re so fertile.” Because I never thought that would be me. So it’s just interesting. And I remember calling you, Nady [SP], right away. I remember texting you, “Do you have time to talk?” And you’re like, “Yeah, I have like five minutes.” Like, you’re awesome. And I said to you, “I’m pregnant and I want to be back. What do I do?” And you said to me, “If you want to be back, you have to leave the state of New Jersey.” And I knew you were right, but there was something that I’m like…I’m a fearful driver. I’m like, “How am I going to get to these appointments on the Upper East Side? Like, it’s going to be such a to do. What am I going to do?” And then I just decided, “I have to, I want this to be back more than anything. I want to be in a practice where I feel seen, where I feel heard, where there’s doctors that are compassionate, and also really good at their jobs.” So I remember I came to see you a week later. We had a consultation, and you spent I think like an hour and a half with me and my husband, which is unbelievable. And at that moment, I was like, “This is the right practice for me.”

Dr. Fox: So before we continue with this little infomercial you’re doing for me and my practice, I do have to clarify my statement about the state of New Jersey, because I don’t want people to say like, “Nady Fox says that there’s no VBAC in the state of New Jersey.” So I was saying for you, like you have to leave the state of New Jersey. I mean, there are definitely people who VBAC in New Jersey and there’s several wonderful hospitals in Jersey that do them. But I sort of knew where you were going, what that hospital’s attitude was towards VBAC, where you were sort of emotionally. And you couldn’t stay where you were. That was pretty clear. That’s not really an option for you. And if you’re going to switch, I’m like, “You need to be under our wings, just because we’re going to do everything we can to make sure this happens. We’ve got vested interest in you. Like, this is something that you need to do.”

So I’m not disparaging the state of New Jersey. I live in the state of New Jersey. They’ve been wonderful to me. A lot of good medicine there, but you needed to leave the state of New Jersey. It was the right thing for you. And listen, you’re not a first time mom, right? You have two kids. You had a pretty…it wasn’t even the VBAC part. Honestly, it was also your last pregnancy prior to the miscarriage, it’s a big deal to start bleeding heavily at 36 weeks. I mean, like, it wasn’t just like, “Oh, this is someone who has two kids and wants to VBAC.” This is like if you want to be labeled a high-risk pregnancy, you are. If you don’t, you’re at risk, whatever it is. But there’s stuff going on that we got to follow closely. And I had confidence that we could do it. And I didn’t want to just start randomly picking people that I didn’t know elsewhere in Jersey that you’re going to go to because that would not have worked well, I think for you. And then it wouldn’t have worked well for me because we’d be talking anyways. So I was like, “Just come, we’ll take care of it.” And your husband’s in medicine. “This can’t be done differently.” That’s what I was thinking.

Gabrielle: He was actually working at…he was doing residency at Mount Sinai West at the time. And you guys were planning to switch to deliver at that hospital anyway. So we saw it as a sign also, because it was like, if anything happened, he can meet me at my appointments. He can come to the hospital. So it ended up like working out really, really well.

Dr. Fox: Perfect. So what I want to do is, we’ve covered sort of who you are, and your first four pregnancies, your two children, your two miscarriages, you’re now at the very beginning of your fifth pregnancy and you’re going to start your journey in the big city. So what I want to do is we’re going to put a bow on this here, and we’re going to pick it up again next week with part two of your story, which is gaps in the big city, having a baby.

Gabrielle: Perfect.

Male: Thank you for listening to the “Healthful Woman Podcast.” To learn more about our podcast, please visit our website at www.healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us a hw@healthfulwoman.com. Have a great day. The information discussed in “Healthful Woman” is intended for educational uses only, and does not replace medical care from your physician. “Healthful Woman” is meant to expand your knowledge of women’s health, and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your about specific diagnoses and treatment options for an effective treatment plan.

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Dr. Fox: Welcome to “High Risk Birth Stories.” My guest today, Ruchie Langner, volunteered by proxy to tell her birth story. What happened was her oldest daughter, Suri [SP], is a listener of the podcast, and thought that her mom should tell her story. So she volunteered her. Suri, thanks for listening and thanks for getting your mom to agree to do this. Ruchie and her husband Heshey [SP] have eight children. So thank God she has a lot of birth stories to tell. Today, she’s going to tell the story of the birth of her fifth child, Simi [SP], back in 2002. And as advertised in the title, we are also going to have a surprise mystery guest join us for a portion of this podcast. How’s that for a teaser?

As a reminder to our listeners, if you would like to tell your birth story, or throw someone else under the bus and volunteer them, like Suri did, please send us an email at hrbs@highriskbirthstories.com, or you can go to our website and click the link to tell your birth story. Thanks for listening. Have a great day. Have a great weekend. And a heads up, on Monday’s “Helpful Woman Podcast,” Emily Oster returns to talk about COVID, updates to Expecting Better and her new book, “The Family Firm.”

Welcome to today’s episode of “Helpful Woman,” a podcast designed to explore topics in women’s health at all stages of life. I’m your host, Dr. Nathan Fox, an OB-GYN and maternal fetal medicine specialist practicing in New York City. At “Helpful Woman,” I speak with leaders in the field to help you learn more about women’s health, pregnancy, and wellness. All right, Ruchie, thank you so much for coming on the podcast. It’s great to talk to you. I appreciate you taking the time to tell your story.

Ruchie: You’re welcome.

Dr. Fox: So you got roped in by your daughter, right?

Ruchie: I got roped in by my daughter, which is interesting because my daughter kind of lived the story. Her perspective is probably fascinating. I remember about three weeks before I delivered. I don’t know if you’re familiar with the parsha of the week, the weekly Torah portion.

Dr. Fox: Sure.

Ruchie: So it was Parshat Vayechi. It’s the last portion in the Bereshit. What’s Bereshit in English? Genesis.

Dr. Fox: Genesis. Yes. Book one.

Ruchie: So, [inaudible 00:57:36] the matriarch Rachel, she dies in childbirth. I remember Suri saying to me, “Ma, [inaudible 00:57:42] died in childbirth.” I said, “Yes.” She said, “That’s not going to happen to you, right?” I said, “No, Shephelah [SP]. That doesn’t happen anymore today.” She was eight and a half, going on nine. Just the thought that mommy wouldn’t come home just freaked her out. I remember reassuring her, “No, no, that doesn’t happen.” And then after the birth, I was a mess. And she always says that she remembers my husband calling it…you know, it was a girl, and then things fell apart afterwards.

Dr. Fox: So she remembers this?

Ruchie: She remembers that. She remembers my mother-in-law was babysitting, and she got very nervous, and she sat the kids down and they all started saying [foreign 00:58:16]. So she knew something was wrong. I sometimes think the kids knew things were wrong before I did because I was just very weak and kind of out of it.

Dr. Fox: Wow. We’re talking about the birth of your daughter, Simi, in 2002. And so Simi is your fifth child, and Suri’s your oldest.

Ruchie: My fifth child and my youngest daughter. So if anyone remembers what happened that night the clearest, it would probably be Suri.

Dr. Fox: Yeah. So she’s your oldest. So thank thank God you have eight children. And we’re talking…

Ruchie: I have eight children. I’m very, very lucky. And four grandchildren, those are very important.

Dr. Fox: Absolutely. And so Simi was born in December of 2002, and the doctor was Dr. Silverstein, of course, who our listeners know well. He’s been on the podcast, and you obviously know him very well.

Ruchie: He’s great. In a word, he is wonderful. He’s the best.

Dr. Fox: He’s the best. So I want you to take us back to that pregnancy, right? So it’s 2002, or I guess potentially end of 2001. So tell us where are you in life? You’re married to Heshey. And at the time you’re in your 30s, right? Your early 30s.

Ruchie: I was about 33.

Dr. Fox: Right. And you had four children. And how were those pregnancies? Before this pregnancy, what were your pregnancies and deliveries like?

Ruchie: Before Suri was born, I had had two miscarriages. It kind of, sort of, corrected itself after the first pregnancy. I wasn’t making enough progesterone. So I was taking hormones, which back in those days was a very messy business. They were suppositories, you had to pick them up from the pharmacy, they had to be refrigerated. I was picking them up at a pharmacy in Brooklyn, I lived in Lakewood. I was bringing dry ice and a cooler in my car because I was commuting to school. I was going for my master’s in speech. And I was going to school at Brooklyn College. But my husband was in [inaudible 01:00:04] Lakewood. It was just a big mess. These suppositories were the messiest thing ever, you can only get them in certain places, and I was also told to take a baby aspirin. Which Dr. Silverstein still laughs at me about, but I’m a big believer in my baby aspirin. Every pregnancy I took my baby aspirin religiously until my ninth month.

Dr. Fox: Right. And you were not seeing Dr. Silverstein for the earlier pregnancies.

Ruchie: No, no, no.

Dr. Fox: Right, right. Okay, got it. So he didn’t give you the baby aspirin. All right.

Ruchie: I had used the same doctor for the first two pregnancies. And when the second one went wrong, he was like he wasn’t sure. I was devastated. Even as a child, I loved children. For years, I worked as a speech therapist for the zero to three population. I love kids. And kids always liked me back. And I always wanted to have a large family. I was devastated. My mother had a very good friend who was expecting her first child right around when I had the second miscarriage. She was married for 40 something years. And it seems she had been miscarrying her whole married life. She went to this doctor and he said to her, “You can still have a baby.” And she did. Boy’s name is Jonathan and he is a miracle child. You know, you see this child, you make [foreign 01:01:13] on him.

So my mother got… Her name was Renee [SP]. Renee’s doctor. His name was Dr. Sher [SP], Jonathan Sher. Jonathan’s name, the doctor. His practice was…his sub-specialty was miscarriages. And he looked at me and said, “Oh, you’re easy. You’re an easy problem. We can fix this. You can get pregnant. You’re going to have a baby.” So I stayed with them for, Suri, Zipporah [SP]. After Zipporah, the family switched insurance, and I had such aggravation getting my money back from Mount Sinai and the doctors and insurance company after Zipporah. But I figured, okay, Dr. Sher was on his way to retirement. So I figured I’ll use a different practice. So I had used…I think his name was John Snyder and NYU. He came highly recommended and I know I wanted to use a high-risk doctor. Because of the miscarriages, I was always considered high risk.

Dr. Fox: Right. But your actual births, like once you got pregnant, the pregnancy…

Ruchie: My actual births were textbook. Once I got pregnant…okay, I stained a little with Suri, and it was a little awkward because my sister got married, and it was [foreign 01:02:21] and I was staining, and there was no way I was losing this baby. So they told me, “Stay off your feet.” I sat in my seat the whole [foreign 01:02:27] something was wrong. So I wasn’t giving up. I was not losing this baby. And Baruch Hashem, thank God, I didn’t. But other than that, I vomit a lot. But not as badly as my daughter does. You know, I managed to vomit and still gain weight.

Dr. Fox: Okay. After the two miscarriages, you had the four pregnancies again. They were considered high risk, but the actual births were fine.

Ruchie: Everything was pretty [inaudible 01:02:52]

Dr. Fox: Normal births, pretty straightforward recovery for all of them. Your first three were girls and then your son.

Ruchie: Uri he was interesting. I didn’t have a good due date for him. So they were in no rush to induce me. Uri was probably two weeks and change overdue. He was massive. He was an ounce shy of 10 pounds.

Dr. Fox: Okay. So there you are. Now, this is your first pregnancy with Dr. Silverstein, right?

Ruchie: Right. Because after I had used Dr. Snyder, and then my luck, he didn’t wind up delivering any of my kids because with one of them, his father, his whole extended family was going back. His father had served on the Arizona, or had served on one of the ships in Pearl Harbor. And they were taking a trip. His father and his uncle, they were two brothers together on the ship. He kept warning me, “Have your kid on time because two days after your due date, I’m leaving.” And of course, the kid was not interested.

Dr. Fox: Right. Okay.

Ruchie: And then I don’t know why I wanted to switch doctors. I can’t remember. I needed a high-risk doctor. I wanted to stay at NYU. I remember calling one of these doctor referral services. I was a speech therapist. I worked Mondays, Tuesdays, and Thursdays. I needed someone who had office hours on Wednesdays. And that is how I picked Dr. Silverstein because he came very highly recommended. And he had office hours on Wednesdays. So I went to him with Simi and he could tell you, it was a textbook pregnancy. I vomited a lot. I was nauseous a lot. I had heartburn. I don’t gain crazy amounts of weight. My legs didn’t give me too much trouble way back then. My hips hurt. I don’t know. Normal.

Dr. Fox: Yeah. Normal. I mean, normal fifth baby. And so what happened at the time of delivery? You were past your due date, right? You were like a week past, I think.

Ruchie: Uri was the latest and then we started swinging back. So Yoel [SP], I think was born around his due date. Maybe I was early. Simi was still late. It was a Wednesday. I wasn’t feeling well. I had some, you know, family drama in the morning, which didn’t help. And my husband kept saying, “Let’s call the doctor. You’re in labor.” I kept saying, “No, we have to wait for the kids. It’s Wednesday. I picked them up from the school bus,” because I wasn’t home the other days of the week. It meant a lot. “Mommy’s by the bus stuff on Wednesday.”

And Heshey’s like, “No, we’re going to the doctor.” We had an engagement party that night. I was like, “We have to go.” He said, “Ruchie, we’re going to the doctor. We’re going now.” So we went. And you must have seen, you know, orthodox women, you’re going to an appointment. You look like a human being, but you think going to the hospital, you’re not wearing a wig, you’re wearing your glasses. You look like a dish rag. So off we go to see Dr. Silverstein. And he says, “Well, you know, you’re having contractions. You’re in labor, no baby yet.” We’re not having a baby now. So I turned to Heshey, I say, “Good. We missed the bus stop. The kids are going to be upset. Let’s go home. We have this engagement party.” And Dr. Silverstein just said, “No, no, no, I didn’t say we’re not having a baby today. I said we’re not having a baby now.” He says to Heshey, he says, “Take your wife to dinner.” He said, “Take your wife to dinner and then come back.”

I looked at him and was like, “Take your wife to dinner? Dr. Silverstein, look at me.” I didn’t say that though. And he’s just like, “Okay, let’s go out to dinner.” We go to this fancy Manhattan restaurant. I’m in my glasses, and my snood, I feel like a complete idiot. And we go to dinner. And in the middle of dinner I said, “Heshey, we need to go back to the hospital. I really don’t feel well.” So, you know, we finish up. I don’t remember eating much of anything. I don’t remember where we went, but I remember it was a place that I’d like to go, it had good food. And we tried to get a cab back to NYU and we cannot. Cab after cab is passing us and they’re all full. And Heshey keeps telling me, “Ruchie, walk.” And then I like to walk. And I guess on a normal day, it wouldn’t have been the end of the world to go to the hospital. And those days I could still walk when I was pregnant. That changed with the last three. But we can’t get a cab.

And some orthodox guy on his way home from 47th Street pokes his head out of the sunroof of a spanking new white Lexus and says to Heshey, “Are you okay? Do you need help?” And Heshey’s like, “My wife’s having a baby, please take us to NYU.” So we climb into the backseat. Turns out I knew these people. Heshey didn’t. They were relatives of my father.

Dr. Fox: Oh, that’s so nice.

Ruchie: I’m sitting in the backseat trying to keep everything together.

Dr. Fox: Try not to break your water on their new Lexus.

Ruchie: See, when I’m in a lot of pain, I [inaudible 01:07:10] a lot. That’s how I deal with life. But when I’m really in pain, I get very quiet. Dr. Silverstein can tell you that too. And as we’re pulling out, you know, he pulls up right in the front of the hospital. Heshey opens the door, he gets out, he helps me out. And after leaving, I say, “Thank you, Mr. Lipschitz [SP].” He says, “Do I know you?” I said, “Sure. I’m [inaudible 01:07:28] daughter, Ruchie.” He says, “Ruchie? Oh, my.” He was about to come to the hospital with us. It was hilarious. It’s like now that he knew us, he couldn’t leave us. I’m like, “No, Mr. Lipschitz, the doctor’s waiting. It’s all good.” I’m thinking, “Great, I’m going to show up with Heshey, this guy’s son, and Mr. Lipschitz.” And he was flipping out. In total, this isn’t going to be pretty. So I convince him he can please go back to Brooklyn. I thank him profusely. To this day, every time Suri’s mother-in-law, one of her best friends is Mr. Lipschitz’s daughter. Her name is Schwartz now. And every time I see her, I tell her, “Your father is a hero in our house. Because otherwise, I would have had Suri on the street.”

Dr. Fox: That would have been bad knowing what we’re going to know soon.

Ruchie: That would have been a disaster. That was a disaster. So we get into the hospital and I’m really not doing well. And I say, “I need an epidural. I needed it like three hours ago.” So you know what it’s like. No one’s in any rush in the hospital with anything. It’s like I’m dying and everyone’s in exquisite slow motion.

Dr. Fox: Right. Was Silverstein there already? Did you see him? Because he’s never in slow motion. He’s consistently in fast forward.

Ruchie: What I love about Dr. Silverstein, you can always tell when he’s around because everybody’s laughing.

Dr. Fox: Yeah, and he’s loud.

Ruchie: No, he’s funny. He likes to make people laugh. He’s also fun because he’s funny. In Hebrew we say [foreign 01:08:46]

Dr. Fox: The joy of life.

Ruchie: Yeah, but it doesn’t sound good in English.

Dr. Fox: Okay. So you’re there. You’re waiting for your epidural. You’re in a lot of pain. Silverstein’s keeping everyone happy.

Ruchie: He met us there. You know, he said he was on that night. So he was there. We come in. They say, okay, so I’m getting my epidural. And I remember this so clearly. They had me curl over like a backwards letter C. He’s holding my shoulders down because I’m just not in good shape. And I kept saying, “The baby’s coming,” in this tone of voice. And of course, no one believes me. “The baby’s coming,” and they tell me, “No, don’t move. They’re almost done with the epidural.” They finally finish and let me collapse [SP]. I keep saying, “The baby’s coming.” And lo and behold the baby was coming. Dr. Silverstein always says, “She says in a whisper, ‘The baby’s coming.’ And lo and behold the baby’s in the bed.” I was like, “I told you.” He’s like, “Yeah, but you know, you didn’t scream or yell.” I said, “What? I was in so much pain. What was I supposed to scream with?”

Dr. Fox: Did you even get any of the joy of the epidural or no?

Ruchie: Afterwards, it’s very good. They put the epidural in because otherwise I would have been in pain. My feet were lacking because they…I had the baby and I don’t know what went wrong, or if they noticed something is wrong right away. But I never got to hold her till way, way, way later. Looking back, I remember saying, “The baby’s coming, the baby’s coming.” And after that, everything’s a little bit of a blur. I remember, it was a girl. We knew it was another girl. Heshey called the kids. So we’re all excited, they wanted to speak to mommy. I don’t remember if I even spoke to them or not. He called his mother who was in my house. He called my parents that it’s another girl. And I remember thinking, “Oh, God, now it’s going to be battle royal. What we’re naming this child?” But that’s a different day’s headache. I’m not sure when things started falling apart, but I think they started falling apart relatively quickly. I’m assuming Dr. Silverstein can tell you.

Dr. Fox: Well, it’s interesting. It’s funny you should mention that, Ruchie, because someone just walked in and I have a surprise guest for you. Say hi to Dr. Silverstein.

Ruchie: Hi.

Dr. Silverstein: How are you?

Ruchie: I am fine. Suri’s making me tell my story.

Dr. Silverstein: I do appreciate that. And there are so many stories. I mean, the stories that you told me in the office about how despite having a house full of kids, you’re making cookies in the shapes of Hebrew letters.

Ruchie: Oh, that was for someone’s birthday. I like to bake.

Dr. Silverstein: How you never came into my office without a pastry. There was babka the last time.

Ruchie: Oh, because it was [inaudible 01:11:15]. I like to bake.

Dr. Silverstein: And when you’re done telling this story about donating some blood to the floor at NYU Medical Center, remember the conversation we had. “That’s it. After this, this is a message from Hashem. I’m not having anymore.” And then you showed up. And, “Oh, well, you know, we thought maybe one more.” I said, “Okay. That’ll be it.”

Ruchie: Three more.

Dr. Silverstein: I know. [crosstalk 01:11:38]

Ruchie: [crosstalk 01:11:38] because I needed a name for my grandfather. You were angry. That was the only time I every heard you angry.

Dr. Silverstein: Was I ever angry with you?

Ruchie: Yes.

Dr. Silverstein: One moment in my life.

Ruchie: Told me my options are a hysterectomy or this interventional radiology thing. And I said, “Oh, let’s do the radiology because I want another baby.” You got angry at me.

Dr. Silverstein: And I’m sure you haven’t gotten to this part of the story yet.

Ruchie: No. You got angry at me. First time in my life I’ve ever seen you angry.

Dr. Silverstein: What happened to us when we were done?

Dr. Fox: I’m here to break up the fight here. So wait, let’s get…

Ruchie: No, no fight. I was saying, I don’t know when things went bad. I said they must have gone bad pretty early on because I never held Simi that night. [inaudible 01:12:15] to radiology.

Dr. Fox: So Mike, what happened?

Dr. Silverstein: It was never a hemorrhage. There was never an excessive amount of bleeding. There’s the amount of bleeding you expect to happen right after a baby comes out. But usually it diminishes after 10 minutes, 20 minutes, 30 minutes, 45 minutes. And it didn’t. It just kept on coming out at a steady flow. So we’re never in a desperate situation, but something had to be done. Now, some people with a large family would say, “Enough is enough. Get rid of the uterus. I don’t want to bleed anymore.” But we opted for, you know, a uterus preserving effort, which turned out to be just fine.

Ruchie: Right. Because I had three little boys who are not so little anymore.

Dr. Fox: Wait, so Ruchie, when this was happening, and you’re being presented with…you know, you’re bleeding, you’re bleeding, was it a frightening moment or was it just a shocking moment? What was it like for you at the time?

Ruchie: I remember being like kind of out of it. My feet were up in the stirrups, and at some point they started cramping. I remember my legs hurting, and I remember the nurse every few minutes saying, “Rachel, Rachel, are you there? Are you okay?” Part of me wanted to strangle her. I was like, “Who is Rachel? There is no Rachel in this room. Ruchie, my name is Ruchie.” But I just said, “Yeah, yeah, I’m here. Where do you think I went?” And I was so weak, I couldn’t open my eyes and they kept trying all sorts of stuff. And I just was like listening with half an ear thinking, “Something really isn’t 100% right. But I’m too out of it to really figure out that something really isn’t right.”

Dr. Silverstein: When you’ve left half of your blood supply on the floor of the labor room, it does leave you a little bit less than alert and a little bit less than aware. So I believe we all were trying to make sure that a very important part of your body, your brain was not deprived of oxygen. And so that’s why we kept on talking to you like that.

Dr. Fox: What does Heshey say about all this? What does he tell you that he remembers from this event?

Ruchie: I say, “Heshey, it must have been a bit of a roller coaster. You have a new beautiful baby, everything’s great.” And I don’t think he realized things were wrong. They sort of told him to leave because I guess the bleeding wasn’t stopping. I don’t think he realized something was very not right until you, Dr. Silverstein, came to speak to him.

Dr. Fox: Right. And when did your mom got involved in this, right?

Ruchie: Heshey figured that if I’m bleeding out on the table, maybe my parents have a right to know something’s not right.

Dr. Silverstein: And the most remarkable part for me was when we finally get down to invasive radiology, we’re inside a room that’s inside a suite, that’s inside a locked up part of the hospital, that’s like the inner sanctum of invasive radiology. And we’re getting all set to do the procedure. And I look up and said, “Who’s that woman? And how did she get in here?” “Oh, that’s my mother.”

Ruchie: My mother was fearless. My mother was fearless and she never ever took no for an answer, ever.

Dr. Fox: She burrowed through the concrete walls to find…

Ruchie: No, she just probably just strolled through it and everyone figured she must belong here and no one bothered her. The hospital’s…you know, it’s different today. Everyone’s much more security conscious than they were 18 and a half years ago.

Dr. Fox: That’s what mothers are for. That’s what they do. So ultimately, as far as I understand it, a decision had to be made whether to do a hysterectomy or whether to try other things. And you wanted to try something other than hysterectomy.

Ruchie: I didn’t want a hysterectomy. I remember two things. First of all, I remember Dr. Antoine. I remember Dr. Silverstein, you’re always calm and cool and collected, but you must have been trying a lot of stuff that didn’t work. I remember you asking someone, “Who else is on the floor tonight?” And someone said, “Dr. Antoine’s here.” I remember thinking, “Oh, Dr. Antoine, I want to see him,” because a lot of people in the neighborhood used him as a doctor and thought he walked on water and he was incredible, including my sister-in-law and her twin sister and a number of their other siblings. And I realized something is really wrong with me. When he came into the room, I couldn’t get my eyes to open. I remember thinking, “I really want to see this guy. Ruchie, open your eyes.” And I couldn’t. At that point, I realized something’s really not good.

Dr. Fox: And so, ultimately, you all decided to do the uterine artery embolization by the interventional radiologists?

Ruchie: Yeah, because I was not going to consider having a hysterectomy. And what’s interesting is I told the doctor something and Heshey said, “You can’t tell this to my wife because she’s going to say whatever.” And we actually said the same things. From when I was pregnant with my first child, I wanted a little boy to name for my maternal grandfather. I may have had a crazy relationship with my mother, but I was exceptionally close to her parents. They were amazing people. And for whatever reason, my oldest… In Ashkenazic families, every person has their own tradition. So the first name goes to the girl side, the second name goes to the boy side. And then somehow it peters out depending on how easy or not easy the in-laws on both sides are. My parents were the opposite of easy. So for whatever reason, I never wound up naming a boy for my grandfather until my sixth child. So when they tell us, so Dr. Silverstein is laying my options out for me, one of which is a hysterectomy. I said, “No, you can’t do that. I need a boy to name for my grandfather.” That’s when you got angry at me. You said, “Look at me.” I could barely get my eyes open. He said, “Look at me.” And I managed to sort of open my eyes and look at him. He said, “I just delivered a little girl here tonight. My job is to send you home to raise her. Forget about the next kid.” I’m like, “No, but I don’t want to.”

Dr. Fox: Wow.

Ruchie: The only time I’ve ever seen Dr. Silverstein upset.

Dr. Fox: Mike, what do you remember about that?

Ruchie: I guess you were right. It made such an impression on me because, hey, you know, I need to raise my children. And that’s the most important thing. Forget about, you know, the theoretical children down the line.

Dr. Silverstein: It’s all about what we tell our patients is that our goal at the end of your pregnancy is to get to the hospital in one healthy piece and leave in two healthy pieces. And at that point in the bleeding process, it was a very difficult decision to make about whether a conservative approach would be successful at keeping you alive and well and healthy to go home. And so I thought that the more prudent thing to do would be to put an abrupt stop to the bleeding. But since it was never, as we said before, a hemorrhage, it was certainly reasonable to try the conservative thing that we did. And we did that and it worked and you came back and then you came back and then you came back.

Ruchie: Yeah, I came back again. But what’s interesting, you’re not mentioning the part where the guy who showed up, his name is Hillel Brick [SP]. He was not on call that night.

Dr. Silverstein: And your community got in touch with him to make him come in?

Ruchie: No, he said you did.

Dr. Silverstein: Oh, I have more connections than I’m even aware of.

Ruchie: I heard that from… The nurses are terrible gossips. I went back to labor and delivery after this. Remember? And the nurse says, she says, “Oh, you were the plane crash.” I’m like, “Excuse me.” And you had pumped me full of all kinds of fluid to make the bleeding stop. I could barely open my eyes and look at her because my eyelids were swollen. She said, “Last night we had a car crash, a train wreck, and a plane crash. And you, honey, were the plane crash.” I’m like, “Oh, that’s nice. I guess that’s how they rank things in… I remember thinking, “Who are you? Aren’t you supposed to be a nurse? Get off the transportation…you know, the National Transportation Board. We’re in a hospital for heaven’s sake.” And then she proceeded to tell me the hospital version of what went on. She said the clerk was calling these radiologists in and whoever was on call didn’t want to come in. And then she called the next two people on the list and they said, “We’re not on call. What do you want from us?” She said, “Dr. Silverstein himself picked up the phone and said to these guys, ‘One of you better come in because otherwise this woman’s going to sue the pants off of you.’”

Dr. Fox: This is great. I’m having so much joy hearing this story.

Ruchie: Like I said, nurses are terrible gossips.

Dr. Fox: I get to see Mike’s facial expressions while…

Ruchie: What’s he doing?

Dr. Fox: He’s very…wonderful memories, just wonderful memories, but it worked.

Ruchie: I’m sure, but he must’ve been pretty freaked out. It’s like, “This is what we want to do.” And whoever’s supposed to show isn’t showing. Now with a name like Hillel, you realize he was Orthodox Jewish. He came, he said, “I’m on call next week because I’m the only Jewish person in the practice. And I don’t care about working over Christmas.” He came anyway. He came in this puffered down jacket and high top sneakers. And from far away, he looked like a kid.

Dr. Fox: I’ll tell you, from the doctor’s side, number one, it’s very stressful when your patient’s bleeding like that and you’re trying to make these decisions. “Do I do a hysterectomy? Do I not? Like she doesn’t want it, but obviously we don’t want anything to happen to you. Fine.” And then it’s also very stressful when you have a plan that we made.

Ruchie: And it’s not working.

Dr. Fox: Not that it’s not… Yeah. It’s not working logistically.

Ruchie: It’s not working because the guy won’t show up.

Dr. Fox: Right. Whatever it is, the elevator is too slow or the bed doesn’t move or you can’t find this medication or this person’s not there or that person runs away. It can be very, very stressful. It’s almost always in the middle of the night. These things never happen at noon. They always happen at some crazy time at night. So thank God it happened. Was it pretty clear pretty quickly that it worked? I mean, Mike, was it something like, “We’re done, it’s good.”

Dr. Silverstein: Well, we did keep running [crosstalk 01:21:59] overnight.

Ruchie: I got a blood transfusion.

Dr. Fox: Yeah. You got a blood transfusion, that I know. But in terms of the bleeding slowed down pretty quickly.

Dr. Silverstein: It was very impressive response. I was very glad to hear that. I’m very glad to see that.

Dr. Fox: Ruchie, what was your recovery like after that? I mean, was it much longer than typical? Were you like kind of beat up from that experience?

Ruchie: I remember when Dr. Silverstein discharged me from the hospital, he asked me how many flights of steps are there in my house? I remember looking like, “Why do you want to know?” He said to me, “You have to take the steps from the bedroom floor to the main floor.” God, I sound like I live in a palace. It’s Brooklyn. Houses are small, but they’re…you know, I have a lot of floors.

Dr. Fox: They’re vertical.

Ruchie: They’re vertical. Like we have to go from basement to the attic.

Dr. Fox: Right. It’s like you take like a shipping container and turn it on its side. You know?

Ruchie: Exactly. And then you carve up as many bedrooms and every last inch gets used for closet space, no matter how irregularly shaped or out of the way it might be. Doctor, he just said, “Do the steps once a day.” And I was like, okay. Coming home…I was the expression in Hebrew is [foreign 01:23:03] I was like a limp wash rag. I just had no energy. I mean, these days, I’m pretty much [foreign 01:23:13] but back in those days, I was very energetic.

Dr. Fox: Ruchie, say goodbye to Dr. Silverstein. He’s going to go back and see patients, and we’re going to finish up you and me. So what do you…

Ruchie: Thank you so much for coming by and thank you so much for being my doctor.

Dr. Silverstein: Honored to and honored to keep being your doctor. Regards to Heshey and the kids and the grandkids. And it’s always a pleasure to see them coming through the office. Thank you so much for sending them.

Ruchie: Thank you.

Dr. Silverstein: Take care.

Ruchie: Have a great day, and a nice and a happy and healthy summer.

Dr. Fox: What a nice surprise. So your recovery, your home, your…

Ruchie: So I came home and they kept me in a hospital an extra day. Simi was born. It was a Wednesday night. I stayed in the hospital over Shalva. So it’s a little crazy because Heshey tried to manage on his own with the kids and they were a little freaked. They come to visit me back in labor delivery, which was odd. Why was I put back in labor delivery?

Dr. Fox: I assume so you can be monitored closer. There’s more nursing and labor and delivery. You know, each nurse has one patient or two patients, whereas in the postpartum, each nurse has six patients or seven patients or something like that.

Ruchie: So the kids came there and my face must have been pretty swollen. And I couldn’t close my hands. So they left the hospital more freaked out than anything else. I didn’t come home for Shabbos saying, “Mommy’s going to be in hospital two days.” Suri’s very smart and very together. And when I didn’t come home Friday, it was a problem. So we kept preparing them. “Mommy is going to be home after Shabbos. I don’t remember if I came home Saturday night or Sunday morning, but I do remember it was Sunday morning. I have a sister, she lives in Montreal now, and she lived in Israel. It was hard to get ahold of people in the hospital and the whole family was worried. It was Sunday. The baby nurse was with the baby and she was resting. The kids were out. I don’t remember who took them. And Heshey just was so wiped out. So he just crashed.

I remember thinking I was hungry or thirsty. I was going to go downstairs and get myself something to eat. I walked down the steps. The kitchen is the back of the house. The steps are towards the front. I barely managed to drag myself into the living room. I just dumped myself on the couch. It was like, “Oh my God, this is terrible.” And that’s when my sister calls me. So I picked up the phone and I can’t catch my breath. And she’s like, “Ruchie, what’s wrong?” I’m like, “I don’t know. I was hungry. I wanted to get myself something to eat. So I came downstairs and this is me.” She hung up the phone and called Heshey, who of course turned his cell phone off, frantic that I need to go back to the hospital because I sound terrible. That’s when I realized they asked me how many flights of steps in the house. I couldn’t move.

Dr. Fox: Smart guy.

Ruchie: He told me once a day. And oh my God, the first month, he wasn’t kidding. I couldn’t do anything. It was awful.

Dr. Fox: Did you have any difficulty emotionally? Was it the fact that it was scary? The fact that you almost had a hysterectomy? The fact you could have died? All of these things, or was it just like, “I’m home, I’m okay.” And that was behind you?

Ruchie: I remember being so grateful. Thinking that I’m so lucky. [inaudible 01:26:16] is like, “Oh my God, had I been born in a different century, I would be dead. Someone else would be raising my children.” And the fact that I didn’t have a hysterectomy, I didn’t realize at the time how grateful I should be for that also because we all swap crazy birth stories. Get enough of us together. I’ve heard two other stories like mine, but both of them gave birth in Maimonides here locally. And there was no interventional radiologist to do anything. And both of them never had children afterwards because they both had hysterectomies. I just remember being so grateful thinking that God has been so good to me because I could have died and I didn’t. And I now have five beautiful children. I don’t know. I remember thinking like I’m a new person almost. And then I should just realize how much I have to be grateful for. Sounds sappy, you know? But that’s kind of how I felt. I was overwhelmed somehow.

Dr. Fox: It’s not sappy, you went through…I mean, you went through an event that you almost lost your life and you got out of it okay. And not only did you get out of it okay, but you have this beautiful, healthy baby at the same time. And sure. I mean, you’re thankful. Listen, you’re glad to be alive.

Ruchie: I remember thinking that I’m so lucky that I had a great doctor. I was in a good hospital and then I’m here to raise my family. It was horrible being very weak. I said in my letter, you know, in that little missive I sent you. It was pretty horrible to be in bed after the delivery. I don’t know anyone who’s done that. And I was in bed for months. I was a completely non-functional human being. I mean, to the point where the kids had homework and they had school. We did everything from mommy’s bed. I had like pencils and crayons and erasers and anything you needed, scissors and glue, and anything you needed, that the kids needed for schoolwork was brought up, you know, in my night table.

Dr. Fox: Right. How long until you felt yourself? How many months did it take?

Ruchie: I always joke. I came out of bed to make Passover, to make [inaudible 01:28:18] for the first time.

Dr. Fox: So it’s like three months.

Ruchie: About three months. Yeah.

Dr. Fox: Wow. And do your kids all know this story? Like have you told this to the family, you know, now that…obviously, at the time, most of them were very young, and obviously you’ve had kids since then, but is this something you’ve told, you know, at the Shabbos table or around? So they all know this story?

Ruchie: I don’t know if they know all the details, but they know that…

Dr. Fox: They do know.

Ruchie: …something went terribly… Oh, well, they will if they listen to this. They’ll know something went terribly wrong having Simi because my husband at some point woke up and realized, oh my God, he’s got four daughters. That means four son-in-laws. Four son-in-laws [inaudible 01:28:54] he’s going to say. Right. And there’s no way his daughters are…most of the young couples in our neighborhood tend to live in Lakewood. And there used to be this really fifth rate little hospital within Lakewood proper. I never was there because I… It was called Paul Kimball. From what I understand, the hospital closed, but a lot of people were delivering there, and God help you if something went wrong. And then she’s like, “Oh my God, my son-in-law’s are going to want to live in Paul Kimball. I’m not letting it.” So I said, “Well, [inaudible 01:29:27] on your daughters.” So she was adamant, drilling into the kids, “You need to go to a good doctor in a good hospital.”

When I was pregnant with Simi, it was my fifth kid, right? The other four deliveries were really textbook. A couple of women in our school were pregnant at the same time as me. And I remember…where was I sitting? And she says to me, “Oh, you’re still going to the city.” I said, “Yeah, I’m considered high risk. Everything’s been fine. But I’m just nervous.” She said, “Oh man, been there, done that. I don’t have the time. It just takes too long.” And she was right, because between the school buses and the kids’ homework and Wednesday was my one day free, I could see why she wouldn’t have want to go to the city anymore. And I’m very grateful that Hashem, the God put into my head that I’m nervous that I still want to go to the city because had I had my baby [inaudible 01:30:19] there’d be no Yoel, no Yehuda, and no Sharni.

Dr. Fox: Wow. What was it like in the next three pregnancies? Were you much more nervous than in the prior pregnancies because of what happened, at least during pregnancy, during delivery? Or were you confident that it would be okay because, again, you had the same team?

Ruchie: Well, I desperately wanted a little boy for my grandfather. So I was going to have at least one other child. And God should be merciful and should be a boy for everybody’s nerves. Dr. Silverstein once said something to Suri, she came home and said, “Mom, he has a family completely backwards.” I said, “Well, what did he say?” “He said that you’re out to lunch and [inaudible 01:30:55] is the one with his feet on the ground.” I said, “Okay, I’m not really out to lunch.” Although when you see me, I have so many balls up in the air and juggling so many things, I look [inaudible 01:31:05]. I always look a little flustered, like I have so many things to do. But I can tell you exactly where everything is. [inaudible 01:31:12] supposed to happen with it.

Dr. Fox: Right.

Ruchie: I don’t know. I guess because I wanted to have another baby, I just decide I’m having another baby and I really don’t care. Heshey was very, very, very, very nervous. Really nervous. And then we were sitting in traffic going to have Yoel, Heshey was like, “Let’s fly down an ambulance. Let’s call 911.” And I said to Heshey, “And where are they coming? The place is a parking lot. No one’s moving. Should have been calling a helicopter down. We’re not getting to the hospital any faster if you call an ambulance.” He was very nervous. But Yoel went okay. He was a little less nervous with Yehuda. I mean, if it were up to Heshey, we’d probably have two kids. Given the fact that Uri wasn’t a boy till kid number four, after Uri, he would have been done. He’s one of three.

Dr. Fox: Yeah. Okay. You’re one of how many?

Ruchie: Four.

Dr. Fox: Okay. So yes, he’s one of three. You’re one of four. So of course, you have eight.

Ruchie: Yeah. Doesn’t that make sense for you?

Dr. Fox: Yeah. Well, you add them together and one for good luck.

Ruchie: Yeah. Okay. I never thought of it that way.

Dr. Fox: Yeah, that’s a good thing. So looking back now, you know, thank God you said you have eight kids, and you said four grandkids?

Ruchie: Four grandchildren.

Dr. Fox: Beautiful. What’s it like being a grandmother?

Ruchie: Oh, it is the best thing in the known universe. Being a babi is the best thing ever. I love being a grandmother.

Dr. Fox: It’s amazing.

Ruchie: I love it.

Dr. Fox: You were talking about sitting around telling stories. Do you and your friends tell your war story, so to speak? You tell your stories of your births?

Ruchie: Sometimes. Well, you know what? My friends all knew when something happened because I was laid up in bed for weeks. I couldn’t cook for myself. I couldn’t run my house. I mean, I was able to do it over the phone. And I’m a killer with a telephone. People who know me joke, “Hand Ruchie a telephone, get the computer. Hand Ruchie a telephone.” And I can just run the world. But other than the telephone, I was useless. People were bringing me supper for months. People were sending chavas for months. And that was the thing I liked the least about the whole business afterwards was that I’ve been very fortunate that I’ve never been on the taking end of things. I’m always one who was packing up, you know, [inaudible 01:33:30] has a child or a friend has a child. You bring supper. It’s a lot of fun. You send like a 15 course meal. So there should be enough leftovers for two days. And you bring something, you know, for the kids for dessert, and you bring cut up fruit that might be snack, and you bring soup that someone can warm up for lunch tomorrow. And somewhat being on the receiving end of all that, it’s very humbling.

Dr. Fox: Yeah. It’s a strange experience to get something from someone else.

Ruchie: It’s a weird experience and constantly. This went on for almost three months. They didn’t want to do the second blood… I had one blood transfusion in the delivery room. And my husband was surprised with how fast it was because his father had an anemia condition. I don’t remember what exactly his father had. He used to get blood transfusion. They take hours.

Dr. Fox: Right. When you’re getting it for like a chronic issue, they give it very, very slowly to lower the chance of getting a reaction. But when you’re getting it because you just bled a lot, they have to give it quicker.

Ruchie: And after I had the blood transfusion before I went to radiology, it was actually the first time I held Simi that whole night. I remember thinking, “Poor baby, everyone’s ignoring you. This is awful.”

Dr. Fox: Wow. So I have two questions for you looking back. The first question is looking back on all this, this delivery amongst your eight, looking back at your family, looking back at this birth. What do you take away from all this?

Ruchie: I’m lucky. I’m Hasidic. I come from a Hasidic family. I’m very into the concept of [foreign 01:34:59], the merit of your grandparents. My mother’s a Teitelbaum. I don’t know if that means anything to you.

Dr. Fox: Sure.

Ruchie: But my mother is related to every rabbinical dynasty you can name with the exception of Ger because Ger was in Poland. So I just look at it that my grandparents were watching out for me. I can’t say that I deserve this in my own merit. It was a miracle. I came home, I got to raise my child. I got to have three more children afterwards. This whole story, and every time I think about it, and I see it now, how overwhelmingly grateful I am that I was in a good hospital, that I was in the hands of a fantastic doctor. I’m a very, very fortunate person.

Dr. Fox: The second question I want to ask you is, now that you’ve gone through the experience of being on a podcast, how do you feel now about Suri volunteering you to do this?

Ruchie: It wasn’t as bad as she made it out. She said, “Mommy, it’s going to be very painless. You have a very interesting story to tell.” She loves these podcasts. Suri works from home. And she’s a graphic artist, so she’s constantly on her computer. So she’ll put stuff on in the background. And Suri got into this a little because…what’s this morning sickness on steroids? What’s it really called?

Dr. Fox: Hyperemesis gravidarum, fancy word for throwing up a lot.

Ruchie: So ever since…she’s been trying to research that, you know, so she’s looking in all sorts of interesting places, different ways to handle it. She found some kind of, I don’t know, coconut extract, supplement she was taking with the last pregnancy that seemed to have helped. So she got into researching, you know, women’s pregnancy issues, and she tripped over your podcast and she finds it fascinating. She told me, “Mommy, you should tell your story. People should hear it.” I’m not quite sure why. But I guess everyone likes listening to horror stories and thinking, “Yay, that wasn’t me.”

Dr. Fox: I’m not sure that’s it. Maybe that’s it, “Woo. I’m not the one who bled.” Listen, I could tell you why I do this. Why I enjoy listening to these stories. Why I’m really excited about letting others listen to them. First of all, they’re just so interesting. These stories are fascinating. You learn about people. You learn about emotions. You learn about families. You learn about relationships. You learn about fear. You learn about joy. I mean, there’s so much you learn about, number one. Number two, everyone’s a personality. Everyone has got their, you know, take on it. And you get to hear sort of different people’s perspective. But also all these lessons that we learned. So just, you know, from today, from your story, this idea about, you know, gratitude and about this idea that, you know, your grandparents, your ancestors are watching over you. And that resonates with a lot of people. A lot of people feel that way.

Ruchie: Well, anyone Hasidic. [inaudible 01:37:46] and it’s a big one.

Dr. Fox: Yeah, they feel that way. Or just this idea that, you know, you can go through a very difficult experience in life. And when you come out on the other side, how do you cope with that? And some people, you know, cope with it in a way that they become more cautious. Other people cope with it that they become more grateful. Like sort of what you’re describing. Other people cope with it that become the opposite. They become more daring because they want to do more because life is short. And just to hear how people process these things and is that how I would do it? What would I do? What would my family do? Do I have something like this? People love hearing this. It’s fascinating. I love hearing it. And, you know, we’re having more and more people listening. It’s not just women. It’s not just women who have babies. It’s everybody who hears these finds them really, really fascinating.

Ruchie: Well, I guess the women without children maybe shouldn’t listen to all these horror stories. They’re going to say never.

Dr. Fox: They’re not all bad. A lot of these stories are good. A lot of the stories are good. Yeah.

Ruchie: Oh, my story is good too.

Dr. Fox: Yeah, exactly.

Ruchie: Simi is this beautiful 18 and a half year old. I have three more children after that. I’m here to tell my story. So my story is good. It’s a little hair raising, I guess. Heshey… I think it was more…you asked me what my husband felt like. I think it was much more of a racking for my husband.

Dr. Fox: That’s common. That happens a lot. It’s not unusual for it to be more difficult on the people watching it than the people experiencing it. And that happens a lot. So I’m not surprised.

Ruchie: You know, he kept saying that they threw him out of the room at some point. And he kept trying to come back. And they kept telling him, “No, come back later.” And he realized something has to be really wrong because that never happened before.

Dr. Fox: Yeah. Yeah. Wow. Well, Ruchie, thank you so much for taking the time and telling your story.

Ruchie: It’s my pleasure. Like I said, I hope this story…if anyone walks away from my story with one thing, I want them to realize that, you know, we’re very lucky we take for granted people…you know, you go to give birth, you come home, you’re a relatively healthy mother, depending on how the baby got here, and a healthy baby. But that wasn’t the norm for many, many, many years. And I have friends who do home births. I think they lost their minds, honestly. It’s like, you want to play Russian roulette with your baby? You’re nuts. I think people should realize that having a baby, it’s a gift. God is entrusting you with a life. And you have to do your best to make sure this life actually gets here. You need to use a capable doctor. And go someplace where something is going to go wrong, you can be helped.

Dr. Fox: Wow. Thank you so much.

Ruchie: I sound preachy, don’t I? I’m sorry. But that’s what I really believe.

Dr. Fox: Hey, first of all, you’re a grandmother. You could be preachy. That’s your job on Earth now.

Ruchie: No, I can’t. No, I can’t. Grandmothers [inaudible 01:40:31]

Dr. Fox: You give advice.

Ruchie: …to spoil their… No, you’re only allowed to give advice once you’re asked. You know, there’s a cute saying in Yiddish that when you become an [inaudible 01:40:38] parent, you’re supposed to keep your mouth shut and your pocketbook open.

Dr. Fox: Yes, I know that rule. It’s a good rule. It is a good rule.

Ruchie: Yeah. So I’ve learned that I cannot give advice unless asked. And just because you are asked doesn’t mean they’re going to listen.

Dr. Fox: Right. Well, I asked you, so it’s good. This is different forum. Well, thank you for coming on. This was amazing. I’m glad we spoke. I’m glad we got to get Dr. Silverstein here as well.

Ruchie: Pleasure is mine. It was actually… Well, that was the nice…that was the best part. It was actually pretty painless.

Dr. Fox: Pretty painless.

Ruchie: And I guess when Suri actually listen to this, she’ll let me know if I made a complete fool out of myself or not.

Dr. Fox: No chance. All right, Ruchie. Thank you so much.

Ruchie: Thank you.

Dr. Fox: I had such a blast recording that podcast. First, Ruchie is awesome. She’s a terrific storyteller. And she also threw in some pretty important life lessons for us about being grateful for all of the blessings we have in life. Second, getting to see and hear Ruchie and Mike go back and forth about her delivery, which was almost 20 years ago, and talk about it like it was 3 weeks ago, was a lot of fun. Ruchie and Mike met during that pregnancy, and she has been a patient of his ever since. One of the most rewarding parts about being at OB-GYN is the relationships we build with our patients and their families. These develop over a lot of happy times during pregnancy and deliveries, and also sometimes during difficult times. And then over the course of the years, when they return for more pregnancies or for general care afterwards. The longer I practice, the more I appreciate it. Thank you all for listening. Have a great day. Have a great weekend.

Thank you for listening to the “Healthful Woman Podcast.” To learn more about our podcast, please visit our website at www.healthfulwoman.com. If you have any questions about this podcast or any other topic you would like us to address, please feel free to email us at hw@healthfulwoman.com. Have a great day. The information discussed in “Healthful Woman” is intended for educational uses only, and does not replace medical care from your regular physician. “Healthful Woman” is meant to expand your knowledge of women’s health and does not replace ongoing care from your regular physician or gynecologist. We encourage you to speak with your about specific diagnoses and treatment options for an effective treatment plan.