Katie Yin’s Birth Story Part 2: The Pregnancy After a Full-Term Stillbirth

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 OBGYN 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.

Katie, welcome back to the podcast. Nice to see you again, although in real time it’s been six seconds.

Katie: Happy to still be here.

Dr. Fox: Yeah, for our listeners it’s been a week. But you were on the podcast last week, where we talked about your birth story of your first pregnancy with Ellie, which was unfortunately a stillbirth. And we spoke at the time, you know, about what that was, and what that meant, and what you went through. But I wanted to have a separate podcast to talk about your next pregnancy, because that’s also a very important story. It’s a great story, obviously. I mean, you and I know that, and our listeners will know shortly. But it’s just a really important story, again, because what you go through in your next pregnancy is also not easy.

Katie: Right.

Dr. Fox: And I think that this is a chance for you to tell your story, a chance for me to hear your story, and for all our listeners to get some flavor of what someone is going through, and what’s going through their head in the pregnancy after a very difficult pregnancy. So thank you.

Katie: Thank you. You said, I think the first time we met you, you said your next pregnancy is going to be the hardest thing you’ve ever done, except what you just did, which was lose our first.

Dr. Fox: Yeah.

Katie: And that definitely proved to be true.

Dr. Fox: Yeah. I frequently tell people, like, it’s going to be a disaster.

Katie: Yeah. Yeah.

Dr. Fox: But…yeah.

Katie: And it was good to know. I mean, it was good to be prepared that it was going to be as hard as it was.

Dr. Fox: Yeah. So when we finished last week, we were talking about your birth of Ellie, your recovery, and you were already, you know, right away sort of getting in support groups, and trying to hear people’s stories. And my recollection is pretty shortly after your birth, you reached out to me. It was within a month or two, right?

Katie: Yeah. Yeah, it was about a month, I think.

Dr. Fox: Right.

Katie: Yeah. I mean, before I left the hospital, I was already asking, like, can we try again? Are we ever going to be able to do this? How long before we can try again? And there was sort of a lot of open questions about that. So I was really eager to meet with you, to hear your thoughts on what the prognosis looked like for us.

Dr. Fox: Right. Okay. So you reached out, and we met, and I remember the meeting, so…but if you could let our listeners know, sort of what was your prep for that? Or what were your thoughts about that, sort of planning for the next pregnancy, and how did it go on your end? I mean, you know, we got along great, so, you know…

Katie: It went great on my end. Yeah, the rest is history.

Dr. Fox: And you could insult me if you wanted to. It’s no problem.

Katie: No, no.

Dr. Fox: I’m cool with that.

Katie: I mean, so we had actually had a few meetings, I think, at that point with my OB, with our fertility doctor, because we conceived via IVF, and had a few embryos in the freezer, and now we were meeting with you. I sort of had two goals, and one was to see if you could give us any insight on what you thought happened to Ellie, in your opinion, after consulting in our case, if you believed that there was a cause of the stillbirth that we had overlooked. Because we never determined the cause. We still haven’t, and we never will, I guess, determine what happened to Ellie. And then the second was to understand your recommendations for moving forward with our remaining embryos, whether you thought we had a good chance of having a successful pregnancy in the future, whether there was anything we should be concerned about, or a different medical approach that we should pursue.

And I think what was really helpful to both my husband and me was your understanding of what we were experiencing emotionally, and you kind of reflected a lot of that back to us. And that helped us…I don’t know, I think it helped us know that you got it, and that you knew the intensity of the emotion we were experiencing as the backdrop to whatever decisions we were about to make medically. So you sort of reflected that this was the loss of a child, that having a new pregnancy, and another child wasn’t like replacing that child we had just lost. Much like, you know, if, God forbid, you were to lose a brother, you wouldn’t say that’s okay, I have another brother, you know? It’s a horrible thing happened to one child, and hopefully, you’ll have a good outcome with a second child, but it won’t sort of erase the loss that’s happened. That was helpful for us to hear.

And then you also had some reassuring thoughts about how a future pregnancy could go. I think you described what happened to Ellie as getting hit by a bus, which we carried with us for a while, that it was sort of one of these events that was horrible, that can unfortunately happen to almost anybody, but that isn’t necessarily likely to recur in a subsequent pregnancy. So that was comforting to us, although it was hard for me to carry those thoughts through my next pregnancy.

Dr. Fox: Yeah. I mean, sometimes we find a cause, and sometimes those causes are things that can be addressed in the next pregnancy. And for some people, that gives them comfort because there’s something to, like, do, and for other people it brings them horrible pain, because then they say, oh, my God, what if we had done that last pregnancy? And it can go both ways.

Katie: Right.

Dr. Fox: Most of the time we don’t find a cause either because it’s not possible to find a cause, like maybe the tests aren’t available, or because we just don’t understand…and that’s what happens a lot. And again, some people find that comforting, because probably it’s not something that’s going to happen again, and other people find that horrifying, because maybe there’s something lurking, and…you know, it’s always horrifying, obviously.

Katie: Yeah.

Dr. Fox: But I will say that, you know, sadly, I’ve had a lot of these conversations over my career, it’s just the nature of my job, and I would say the amount that I’ve learned or that we’ve advanced medically in the past 15 to 20 years is, like, nothing.

Katie: Right.

Dr. Fox: I mean, maybe something, but almost nothing. Whereas what I’ve learned, and I think what a lot of people have learned over the past 10 to 20 years emotionally, psychologically is remarkable. I mean, again, thank God I’ve never gone through a loss like you have, but I have a much better sense of what that means than I did when I started in my career, just from speaking to people, and getting a sense, and you know, hearing people’s stories, and just listening, really. It’s nothing too complicated, it’s really just listening to people.

But it’s so true, it’s just… You know, I always tell people it’s going to be a really hard pregnancy.

Katie: Yeah.

Dr. Fox: And that’s okay, it’s supposed to be a hard pregnancy. Like, if it weren’t hard, like, that would be weird.

Katie: Right.

Dr. Fox: You know? I mean, you lost a child. Like, it’s horrible, I mean, there’s like, no way to process that properly. And then sort of, you know, just from my experience, giving people a heads up, like, what are the things that are going to be triggering, and what are the things that are going to be, you know, potentially helpful, you know, just being around the block…

Katie: Yeah, you said stay in therapy. Yeah. Yeah.

Dr. Fox: Yeah. No, I mean, listen, some people, therapy doesn’t work for them, but for many people it does, obviously. And I know you mentioned on the last podcast how you guys sort of felt like it was the two of you as a team.

Katie: Yeah.

Dr. Fox: It doesn’t always work like that. For some couples, this breaks them apart, an event like this. I mean, many couples get closer because of it, and other couples, they just can’t process that in the relationship for whatever reason, and…

Katie: Yeah, I think it can be really hard. And I think there were parts of the pregnancy that were really hard for us as a couple to sort of communicate on, and we kind of opted out of communicating on some of the things that we went through, that I’m sure we’ll get to as the conversation continues.

Dr. Fox: Yeah.

Katie: But yeah, I think I was really haunted by the fact that we didn’t find a cause of the stillbirth. I felt like…I did feel that sense that there was always something lurking. And something that I sort of uncovered in therapy is the tremendous pressure that a pregnant person has in sort of being the only one who can really watch the baby, you know, who can… I felt solely responsible. Like, I struggled a lot with the guilt of losing Ellie, what did I miss? What did I not, you know, pick up on? Or could I have flagged something, even if it was sort of sub-clinical? Could I have picked up on a difference that could have saved her? So even though we didn’t have a cause, I still sort of wrestled with the what ifs all the time, and still do.

And then, you know, proceeding to a second pregnancy, it just really felt like, well, it’s all on me, you know? I’ve got to watch this kid, you know, 24 hours a day. And so that was a heavy burden, I think, for me.

Dr. Fox: Yeah. Was there any hesitation of getting pregnant again?

Katie: Yeah. I felt worried that it was irresponsible to try to get pregnant again, that there was something wrong with me that would put all our children in danger, you know? These are the sort of non-medically backed thoughts I think that some people have after going through a stillbirth.

And then, I was also concerned that I wasn’t emotionally ready to do it, which may have been true. But I kind of was also…I couldn’t get my mind off it. I was sort of obsessed with it, and I felt like I was living paralyzed in time a little bit. I was supposed to become a mother in three days, you know? We lost Ellie three days before my scheduled induction, and I came home without a baby. So I just really felt like my life can’t move forward until I make this transition I was supposed to make. My life can’t move forward until I’m able to bring home a baby, or until I know that I can’t. The limbo was really difficult for me. So I felt like I’ve just got to do this, and I’ve got to do it ASAP.

To the point that I was talking to my fertility doctor, he said I could do a transfer about three months after my delivery, an embryo transfer. So I was asking him if we could start the medications for the transfer two weeks before, so that I could do the actual transfer on the day, three months after. And he was kind of like, no, you need to slow your roll. You can wait an extra two weeks. Three months and two weeks is not a big deal. Like, I was very wanting to be aggressive.

Dr. Fox: Okay. And so ultimately, you did get pregnant, obviously. And was it… Was the fear and sort of all the emotions, did you find that it hit you right away when you were pregnant? Or did it sort of start off pretty low, because that’s not when you had your issue, and sort of build up?

Katie: I think the latter. I think it was… If anything, it sort of muted the excitement about being pregnant again. It was sort of like, okay, great, but you know, we’ll see how it goes.

Dr. Fox: Right.

Katie: And we were all sort of holding our breath, I think, about how this pregnancy would go. And just unfortunately, in the process of seeking out support, which is so important, and has been one of the best things I’ve been able to do, you hear about everyone’s terrible story, all the many, many things that can go wrong during a pregnancy, all the, you know, early losses, and second trimester emergencies, and then, of course, third trimester events like ours. And so you’re just kind of… The expectation that we were necessarily going to bring home a baby was not really there when we got our positive pregnancy test. But we were hopeful.

Dr. Fox: Right. And then it wasn’t that helpful that we threw you for a loop at the… Was it the first visit in our office?

Katie: Yeah, yeah. So it was just supposed to be…

Dr. Fox: Good job, MFM Associates. Yeah.

Katie: It was just supposed to be the pregnancy confirmation, hello, you know, here we are, and we’re happy to be here. And I think I was 11 weeks, and so I was just doing a heartbeat confirmation scan, and the tech said, well, do you want to just do your NT scan while you’re here? And I was like, oh, good, get another anxiety off my back. Like, let’s do it, let’s do it all while we’re here. And the next thing I know, Dr. Fox is rushing into the room, and asking to take another look at the scan, which is never what you want to see.

Dr. Fox: No, you never want to see me. That’s bad news. But yeah, that was a little bit of a scare. I…yeah.

Katie: Yeah.

Dr. Fox: I mean, again, it’s…we all knew the situation, you know, on the ground, so to speak, and that this was kind of baseline, you know, not your typical level of anxiety.

Katie: Yeah, exactly.

Dr. Fox: So coming in with anything is not going to be received well.

Katie: Right.

Dr. Fox: So to speak.

Katie: So yeah, so the news that our NT scan was, I guess, abnormal or elevated, that…

Dr. Fox: Yeah. Right. Not definitively bad, but just like, we need to investigate further.

Katie: Yeah. And my husband, you know, unfortunately was running late for the scan, so he wasn’t even there, and then he had this spooky sense that if he misses a scan, we get horrible news.

Dr. Fox: Yeah.

Katie: So he felt, you know, that was his share of the guilt, I think, of what was going to happen.

Dr. Fox: Yeah, okay.

Katie: So you sat us down, and talked to us about the realities that we were facing, which were hard, because it’s, like you said, uncertain.

Dr. Fox: Right.

Katie: We could be looking at a serious issue with the pregnancy, we could be looking at a minor issue with the pregnancy, or no issue, hopefully. But the chances of an issue seemed to be great, or at least significant. And I remember, I… The question that was most on my mind is am I going to come for another scan, and find that there’s not a heartbeat again in another pregnancy, after what we’ve just been through? And like, your very quick response was like, unfortunately, there’s a high chance of that in the next couple of months.

Dr. Fox: Right.

Katie: And that was really difficult for me to sit with. And for my husband, too.

Dr. Fox: Yeah. Yeah, yeah. It’s hard. I mean, you know, what are you going to say? It’s…

Katie: Yeah. No, it was terrible. And you know, the thing with a stillbirth, a pregnancy after stillbirth is like, I feel like a lot of people’s experience is that it gets harder as you go, but this early part of the pregnancy is kind of chill, and that…

Dr. Fox: Yeah. Well, it normally would be.

Katie: Right. So that happened to not be the case for us, and I was really, really worried each week. I think I started coming in for weekly scans because I was so anxious that we were going to have a loss.

Dr. Fox: Yeah. No, I remember…I mean, I remember that day, and the tech coming in and telling me that, you know, one of the patients has a thick nuchal. And I was like, you know, not happy about it, obviously, and I’m like, oh, okay, and then I pull up the images, and I’m like, Katie?

Katie: Yeah.

Dr. Fox: I was like oh, crap. I was like oh, my God…I was like, this is not…I can’t believe, like, this poor thing. I was like, oh, my God…

Katie: Yeah. I know. We felt the same way. We were just like, are we the unluckiest people? Or is there something wrong with us? Like, I was genuinely concerned, is it something with our embryos? Is it something with me? What’s happening?

Dr. Fox: Yeah. Yeah. But the testing was all normal. Thank God everything went okay, and…

Katie: Yeah. So we did a quick CVS, and it took, you know, a month to get the full results back, and then an anatomy scan to prove there weren’t any other defects.

Dr. Fox: Right.

Katie: And that was…like, it was a torturous month or so, six weeks.

Dr. Fox: And then we were already planning at some point around that time, meaning it takes weeks to months to sort of… You never know 100% that everything’s going to be okay with that nuchal situation, but you know mostly. But it takes a while to get that because you have to do the CVS, do the anatomy, an echocardiogram, so you’re talking 20 weeks ’til you sort of can feel that it’s predominantly behind you.

Katie: Right.

Dr. Fox: But that was sort of the time we were going to start picking up visits anyways for you, so you really…we got to see a lot of you.

Katie: Yeah. Yeah. I don’t even know how many visits I had. It felt like I was living here, practically.

Dr. Fox: It was a lot. I was at an event recently, it was a bat mitzvah, and the mother got up and said, you know, my grandmother is here, and she just had…and you know, it’s amazing that she’s here, and she just had a birthday, and I don’t want to tell you how old she is, but it’s three digits.

So I feel like…I counted how many visits you had, and I don’t want to say how many it was…I don’t know if it’s three digits, but we’re getting there.

Katie: Yeah, yeah… Yeah, it wouldn’t surprise me. It was a lot.

Dr. Fox: Right. Right. But you guys are remarkably pleasant, so it’s…you know? It was all good.

Katie: We tried. I didn’t feel so pleasant the whole time, but…

Dr. Fox: No, you weren’t unpleasant, you were worried.

Katie: Yeah. Yeah.

Dr. Fox: You were just…you were anxious. You were worried. You weren’t…you know, you didn’t lash out or anything like that. And even if you did, that’s okay. Like, you can…you know, however you process it, you process it. But you were…no, you guys were just understandably worried.

Katie: Worried, yeah.

Dr. Fox: And you know, looking for whatever reassurance you can get, and I mean, that’s why we’re here. I’m sure I told you, like, we’re here every day, you know? Whenever, just…you know?

Katie: Right. Right. No, and we felt really supported, and I think that was the best… Well, obviously the superior medical care was the best part of seeing you guys, but…

Dr. Fox: We didn’t…we just watched, basically.

Katie: Yeah.

Dr. Fox: I don’t think we actually did anything.

Katie: Well, I don’t know. Mentally…

Dr. Fox: I mean, we did the CVS, but otherwise…

Katie: Yeah, right.

Dr. Fox: I mean, it’s support, and it’s mostly psychology. You know, visits, talks…

Katie: Yeah, but that’s the big…I don’t know. I mean, it would have been really hard for me to get to the end, if I didn’t feel sort of supported in being able to ask for help, I think, when I needed it.

Dr. Fox: Yeah, I get it. So what, during the pregnancy, other than coming for visits, were you doing for support, you know, on the outside, so to speak?

Katie: Yeah. I was in therapy. I mean, therapy was helpful for me. And I was in…you know, now I’m doing trauma therapy. At the time, it was really just white knuckle, survive the pregnancy, what are you dealing with on a day-to-day basis, and how can we make those symptoms better? After about, I think, 24-ish weeks, it meant medication. So I contacted you and said, I’m really… Like, I sort of hit a little bit of a not unexpected crisis point around fetal movement time. Like when kick counts kind of can become a thing, I really started to lose my mind. Like, I don’t even know if I shared this with you at the time, there was a point in the pregnancy when I didn’t feel like I could sleep lying down. I didn’t feel like I could lie down at all. So I slept kind of propped up, sitting, you know, 90 degrees with pillows, because that was the way I could feel the baby the best. That’s so…

Dr. Fox: I don’t think you told me that. I was actually, literally just about to ask you, my next question was going to be were you able to sleep at night?

Katie: Yeah, no.

Dr. Fox: Yeah, no. Yeah…

Katie: The answer is no. And I have slept infinitely more since having the baby, and having a newborn.

Dr. Fox: Yeah, you’re the only one.

Katie: Yeah, exactly. It’s been a relief. So yeah, I think I didn’t get more than a two-hour stretch of sleep continuously since hitting that 24-week mark, so there was… Obviously, when you’re not sleeping at all, there’s a time when you just start to break down, so I had to let my work know. I also, by the way, I started…I think I was on my third day of work at a new job when I found out I was pregnant, that my transfer had been successful. So in the midst of all this, I’m in a new job, with new bosses who were, luckily, extremely understanding. I had to reach out to them and say, like, look, my pregnancy is going okay, but I’m having a real mental health sort of moment, and you know, I need some time to work on this, and they sort of said, whatever you need.

I took a day off, I reached out to you, and I said, how do we feel about medication? And I think you had mentioned that early on, that it could be a possibility. So I connected with a perinatal psychiatrist, and went on Zoloft, and I think that was helpful in kind of taking the edge off gradually, because, you know…

Dr. Fox: Yeah. It takes some time.

Katie: It takes some time, yeah. And just feeling that I had the support, and knowing that there were things that we could do to help the anxiety, knowing that really nothing would take it away until we delivered a healthy baby.

Dr. Fox: Right. Right. What about family and friends?

Katie: I really…I was just talking to somebody about this. I really kind of withdrew in a major way. I think, I didn’t even tell…If I wasn’t seeing people regularly, I stopped seeing them when I was pregnant, and I didn’t tell anybody that I was pregnant until after Kai was born. So my coworkers knew, so they became, like, actually, like, unusual lifelines, like, more than I think one would normally lean on coworkers, especially in a new job. They became like a major support system for me, so forever grateful to them. And my family knew about the pregnancy, but I had a really hard time talking about it. And the sort of pressure… I felt an irrational sense after losing Ellie that I had let a lot of people down who were really excited about this baby.

Dr. Fox: Wow.

Katie: That was my feeling of guilt. Obviously, it wasn’t my fault, and I didn’t let anyone down. This horrible event happened to everybody. But sort of carrying that through to the next pregnancy, I felt a lot of pressure, that no one was putting on me, to get her here…to get Kai here safely, to get him here safely.

Dr. Fox: Right.

Katie: And I think it was hard for me to feel people’s excitement, to feel people’s optimism and hope that I didn’t necessarily share, because I wasn’t…I was struggling to admit that this pregnancy could go well. And so I really, I wasn’t able to talk about it that much.

Dr. Fox: Yeah. And as you said, you sort of felt that this was all on you.

Katie: Right.

Dr. Fox: That this was like…whether this works or not is somehow under your control.

Katie: Right. Which is flawed, but…

Dr. Fox: It’s natural.

Katie: Yeah.

Dr. Fox: I mean, it’s not, these aren’t… I mean, it’s not that they’re irrational thoughts, but they’re not meant to be rational. It’s emotional, right?

Katie: Right. You’re right.

Dr. Fox: It’s just what you feel. It’s like guilt, right? Like, rationally you have nothing to be guilty about, of course.

Katie: Right.

Dr. Fox: But you’re going to feel guilty because you feel guilty. Like, that’s just…that’s an emotion. It’s like, you know, it’s like sadness, you just…you feel it. You don’t choose to feel it, you just feel it.

Katie: Exactly.

Dr. Fox: And it’s the same way. Yeah, so okay, so the medication started, and took the edge off a little bit were you doing, like, talk therapy as well?

Katie: Talk therapy as well, and so it was cognitive behavioral therapy, so it was a lot of…it’s not like, you know, psychoanalysis, where we talk about your family, and, you know, where…because we know where my pain is coming from yeah.

Dr. Fox: Yeah.

Katie: We were sort of dealing with strategies, you know, breathing exercises, things like that. When I had a panic attack, which happened in the middle of the night frequently, I would get an ice pack and put it on my face, and just sort of calm, you know, quickly calm my nervous system down a little bit, but I don’t think that’s medical, quickly relax my body a little bit.

Dr. Fox: That’s medical.

Katie: Yeah…

Dr. Fox: If it works, it’s medical.

Katie: Okay.

Dr. Fox: Yeah.

Katie: So it was strategies like that to try to…any period of lower fetal movement was likely to trigger, like, panic symptoms in me for the entire, I don’t know, second half of the pregnancy, so…

Dr. Fox: If you’re able to describe, what do you think it was like for Frank going through this? Because you said, you know, last time with the birth, he’s just focused on you. He’s like, I need you to get through this because he’s just, you know…he sees you, and he’s like, oh my God, like, she has to go through all this…

Katie: Yeah.

Dr. Fox: Was it the same? Or was he having his own processing, and you know, guilt, and all these things?

Katie: I think…that’s a good question. We should talk about it more. I think that would probably be a healthy…

Dr. Fox: You and he should talk about it more?

Katie: Yeah. I think that would hopefully, probably be an important exercise to help get ready, yeah.

Dr. Fox: Okay. Frank, here you go. Schedule some time.

Katie: My observation was that he sort of, much like he didn’t want to talk to a lot of people about losing Ellie right away, he kind of threw himself into other things during that pregnancy. And I think that was healthy for him, and that was what…

Dr. Fox: Right.

Katie: You know, there wasn’t much that anyone could say to me or do for me, except support me in what I ended up doing, which was going to labor and delivery all the time. And not pushing back against me on that was probably the most helpful thing he could have done as a supportive partner.

Dr. Fox: Right.

Katie: So besides that, I think he just kind of tried to keep it moving and we were both sort of just trying to hang on until the end. He was a little more optimistic and comforted by statistics than I was. There was pretty much nothing anyone could tell me that would convince me that this was going to end well.

Dr. Fox: Yeah. That was my impression, too.

Katie: Yeah. Yeah.

Dr. Fox: Yeah. I think that the only wise thing that I really did was give you my email, and just say, you know what, just email me.

Katie: Yeah. Which I did.

Dr. Fox: Because I mean, there was no…this is just who you were (indiscernible 00:24:40.094) you know? And you were appropriately not relying on my email for medical decisions, because you know, you’d say, like, we’re on our way to the hospital, just letting you know, and I was like, cool, you know?

Katie: I know. I was saying earlier, before we started this, that there was a period of time when I was like, too embarrassed to email you that I was going to the hospital.

Dr. Fox: I didn’t notice that.

Katie: Yeah, no, I’m sure not.

Dr. Fox: We emailed frequently.

Katie: Yeah.

Dr. Fox: Which is good. Listen, I wouldn’t give it to you if you couldn’t email me, right?

Katie: Right. Right.

Dr. Fox: And so it was good for me to know that you were in the hospital a lot.

Katie: Yeah.

Dr. Fox: Also, it gives me an opportunity to let them know, you know, to give them a heads up, like to call the labor floor and say, Katie’s coming, here’s the story, like, you know…

Katie: Yeah, special situation.

Dr. Fox: Yeah, just so they know. Because otherwise, it’s…you know, they don’t know your backstory. They don’t know what’s going on.

Katie: Right.

Dr. Fox: And they’re going to be like, why…like, she was just here two days ago. Like, what’s the deal?

Katie: Yeah, what’s going on?

Dr. Fox: And so, to give context… And you know, fortunately, with the context, everyone in this world gets it.

Katie: Right.

Dr. Fox: But you need that context.

Katie: Right.

Dr. Fox: But yeah, in addition to all the office visits, it’s the amount of time I got a chance to know you well.

Katie: Yeah, you sure did. I think it must have been once a week or more during my third trimester that… And it was always in the middle… I think there was one time that I went in the evening because I felt a movement that seemed a lot like Ellie’s last movement…

Dr. Fox: Ugh, yeah.

Katie: …and then nothing again, and I was 100% sure that the same thing happened again. They actually didn’t find a heartbeat on the Doppler when I got to the hospital, and that, you know, was horrible. But it was just a Doppler issue, not a…

Dr. Fox: Oh, my God.

Katie: As soon as they put me on a monitor, everything was fine. But that was a horrible day.

Dr. Fox: Did you consider the home Doppler?

Katie: So, a lot of conversation about the home Doppler.

Dr. Fox: Yeah. Because I was going to say, that’s the reason we don’t like the home Doppler, for that exact reason.

Katie: Yeah, exactly. Exactly. So actually, I haven’t even admitted this to her yet, but a friend in my support group just went ahead and mailed me her Doppler at some point during the pregnancy, and it’s still sitting untouched in my closet. I couldn’t bring myself to use it. Because I think some people use Dopplers because they want reassurance that things were not okay, I was fully convinced every time I went to the hospital that things were not okay. So I didn’t want to be the one to figure out that things were not okay, I wanted to hand that off to somebody else.

Dr. Fox: Right. Wow.

Katie: So, too hard for me to use the Doppler.

Dr. Fox: I mean, you’re describing such a…I mean, such a painful pregnancy, that every day, every week, every whatever you feel like you lost a baby again.

Katie: Yeah. Yeah, absolutely.

Dr. Fox: And you’re basically going through that trauma that you had with Ellie daily, weekly, whatever it is for a short amount of time. That’s… Oh, my God. You poor thing.

Katie: It was really hard. It was really hard.

Dr. Fox: Yeah.

Katie: And I’ve talked about the second pregnancy as sort of its own little trauma in a way, even though it ended as happily as could possibly be.

Dr. Fox: Yeah. So let’s get to that, because it’s…you know, we have to.

Katie: Yeah.

Dr. Fox: So tell me about that last week.

Katie: So this was… And I’m probably going to give you more context now than maybe you had at the time, too, so…but maybe not. Maybe I shared all this. We were looking forward to a 37-week induction, 37-plus zero.

Dr. Fox: Right.

Katie: It was scheduled for Wednesday, April 6th, at midnight. My induction with Ellie had also been…it was for 39 weeks, but Wednesday at midnight, same deal. And we lost her Monday morning.

Dr. Fox: Right. Right.

Katie: Or that was when we found out we didn’t have a heartbeat. So…

Dr. Fox: For the record, I remember every single one of these details.

Katie: Okay, got it. Thank you.

Dr. Fox: Just so you know. Yeah, to the…

Katie: I wasn’t even sure…

Dr. Fox: To the minute, to the date, to the day of the week, like yesterday.

Katie: Got it. Okay. Okay, so I did hear it all, I guess. Okay.

Dr. Fox: So yeah, so this is for our listeners. Yes.

Katie: So I knew that that Monday before the Wednesday was going to be really hard, because even though it wasn’t the same gestational age, it just felt like a similar circumstance.

Dr. Fox: Harrowing.

Katie: Yeah. I loaded myself up with distractions, I made an appointment for a biophysical, which we had had twice a week leading up to this point, and I think I scheduled one for every day that week, so for the Monday, the Tuesday, and maybe even the Wednesday before I was admitted. And so I had a breakfast scheduled with a friend, then I was supposed to go straight to a therapy appointment, like a well-timed therapy appointment on that day, and then my COVID test for my induction, and my biophysical. So I went to the breakfast, and I’m sitting at the breakfast, and I’m not feeling the baby move, and I’m panicking. And I’m trying to say, okay, this is just the day, like, you knew this was going to be hard, just talk to your friend and get through it. And so I tried to distract myself. I tried to not be poking the baby every five seconds. I ordered an orange juice. I felt the baby move occasionally, so I knew it wasn’t, you know, the worst, but I was very, very anxious. I got in the taxi to go to my therapy appointment, and I just couldn’t take it anymore, so I told the taxi to turn around, and go to 90th and Madison, and called you guys while I was on the way, and said, like, something’s really wrong. I can’t stand this.

And I think I was standing on the corner outside your office at the time, and they said, okay, like, how soon can you be here? And I was like, well, I live right around the corner. Like, I was trying not to confess that I was already waiting outside for them to tell me to come in right now. But they basically said, you can come in right now. The very nice doctor did not one, but two biophysicals back to back to make sure we really hit all the criteria for a healthy baby and healthy pregnancy, everything was okay. So I kind of took a deep breath, and went to my COVID test, and I just…everything was just off. Like, I could not shake that the baby didn’t feel right, I didn’t feel well, movements were really, really off. Like, I wasn’t feeling any spontaneous movements. Like, I could kind of feel him when I poked him, he would sort of poke back… But it was really, really different to where I was like, okay, I know I’m crazy, and call the time, but like, this is a real one.

Dr. Fox: Right.

Katie: Like, I know that this is really different than usual. And so I went, and I think I had…I wanted to keep the original biophysical appointment I had. So I went, and I walked down the block to Mount Sinai, got my COVID test, and basically came back to the office and said I’m just going to sit here in the waiting room until my scheduled appointment today, and they said that was totally fine. I think they thought that…you know, what’s wrong with this person who’s camped out in our waiting room?

Dr. Fox: No one thought that, but yeah.

Katie: And at some point, I mean, I was just…I’m sure it was not helpful that I was just sitting there assessing fetal movement constantly, but I just was only focused on the baby, and how the baby was moving, and at a certain point, I just started to cry in the waiting room. And I haven’t cried…like, I’m not a crier. I didn’t cry when we found out we lost Ellie, like, until I think after I held her, I didn’t cry after the NT scan, I didn’t cry when my husband proposed to me, or during our wedding… Like, that’s not usually my reaction, I just kind of couldn’t keep it in anymore. I was doing everything that I could do, and nothing was making me feel better, or getting rid of this emergency sense that something was wrong with this baby.

So a very nice receptionist kind of said, is everything okay? Like, is there anything we can do for you? And I was quickly whisked back into, like, an NST machine, and still everything looked fine. But you and a couple of the other doctors who were there said, look, we’re talking… I mean, you will have better insight into this, but kind of the message I got was, we just talked about it, and what do you think about going to the hospital to, like, start the process now, instead of two days from now?

Dr. Fox: Yeah. Yeah, basically I pulled rank. I said, this is it, she’s…

Katie: Was calling it. Yeah.

Dr. Fox: This is the end of the rope. I said, we are…I mean, I was like, we’re going to lose you. Like, you’re just going to…you know?

Katie: Yeah.

Dr. Fox: I mean, there’s only so much one human being can handle, and you were a real trooper.

Katie: Can take.

Dr. Fox: Listen, I don’t know if I told you this, but I, in a million years, I never expected you to get to that Thursday to be induced.

Katie: Yeah.

Dr. Fox: I was like, I thought it was almost a miracle that we got you to 36-plus weeks.

Katie: Yeah.

Dr. Fox: Because, you know, we don’t want to deliver at 34 weeks. Then you’re really like, you know, a premature baby, this or that, so we were hoping for 37.

Katie: Right.

Dr. Fox: But I was pretty confident… And especially just knowing that this concept of having a finish line, and losing a baby a few days before the finish line was not going to go well.

Katie: Right. Right.

Dr. Fox: And so when it’s Monday, and they’re like, Katie is losing it, she’s just breaking down, and I was like, yeah, that seems about right.

Katie: Yeah. Yeah.

Dr. Fox: Like, that timing seems perfect, and I was like, that’s it. Like, what are we doing, three days, two days here? I said, like, that’s it. Go to the hospital. Like…you know?

Katie: Yeah. Yeah.

Dr. Fox: Because once you’re there, and the baby’s being monitored continuously, it’s like, all right, this is happening, you know? I’m going to have a baby, right?

Katie: Right. And that’s…like, that was what I needed, was the monitor.

Dr. Fox: Right. Right. The alternative is if we could have literally just parked you in the hospital for three straight days, and I said, like, well, she’s not going to be able to sleep, she’s not going to take a shower…

Katie: Yeah.

Dr. Fox: I said, like, that’s not going to work.

Katie: Right.

Dr. Fox: Because if that were going to work, sending her home would also work.

Katie: Right. Exactly.

Dr. Fox: Right? So I said, that’s it. Like, there’s just no way we can get past this.

Katie: Right.

Dr. Fox: And so we’re like, that’s it, you know? Whatever, we’re inducing.

Katie: Let’s do it, yeah. Which I’ve never been more grateful. I read… You and I exchanged emails when I was on my way in, and you were basically like, “You did it. You’re going to have a baby,” and I was like, I don’t know… And much like I couldn’t process the pain of learning that we’d lost Ellie, it was really difficult for me to process the joy. But it was there.

Dr. Fox: Yeah. So how did the labor go?

Katie: Great. I mean, another Ellie gift, as I call them, is learning about the early epidural. So I did that again.

Dr. Fox: Yeah. Yeah.

Katie: I started the epidural before we did anything.

Dr. Fox: Right.

Katie: And it was good. I mean…

Dr. Fox: It was pretty quick.

Katie: It was like the hard part was sort of getting to there.

Dr. Fox: Yeah.

Katie: And so once I could be in the hospital with a monitor on… I mean, I was staring at the monitor every second that we were…yeah.

Dr. Fox: Sure. That’s why it’s there, continuous feedback. Yeah.

Katie: Yep. And by the way, like, Kai did fine during that. There was no sign that there was actually anything wrong with him.

Dr. Fox: Nope. Nope.

Katie: So I don’t know what that was. I mean, it was just trauma that I was feeling.

Dr. Fox: You know, but listen, I always say this, we don’t know everything from everything. When stillbirths are unexplained, we assume that it’s for reasons that are not going to recur, but we don’t know that. I mean, look, we don’t know 100%.

Katie: Right.

Dr. Fox: And so part of the reason we deliver early is just, again for like, you know, just have pity on you, like, because it’s just so painful to go…

Katie: (crosstalk 00:35:42.443)

Dr. Fox: And again, in a real way, it’s so painful go through it, and part of it is because, honestly, we don’t know. Like, I can’t tell someone 100% that it was a fluke. I mean, I think that’s what it was, but how confident do I have to be, 99%? I mean, like, that’s still not perfect. And so, I don’t know. Like, maybe there was something going on there. There’s no way to know, obviously.

I mean, I can tell you…I know this is your birth story, but that birth was one of the best of my life.

Katie: Ohh…

Dr. Fox: No, I mean, I was like… And I remember saying there’s no way I’m missing this birth. There’s like, no chance. Like…yeah.

Katie: I was talking, I had a doula with me for the labor, which was great.

Dr. Fox: Sure, sure, sure. I remember.

Katie: Yeah? And she was the best. And I was talking, like…

Dr. Fox: Yeah. That was also a good suggestion.

Dr. Fox: Yeah. Well…

Dr. Fox: Yeah, she was…she’s a rock star. Yeah.

Katie: Yes, she was amazing. She was your suggestion, and she was incredible.

Dr. Fox: Yeah.

Katie: So she and I were talking, and I think I was…I think you had probably told me that for my scheduled induction date, like, oh, shoot, I’m not the one who’s on, you know? I’m not going to be there, but whichever doctor is going to deliver you, you’ll be fine. And so I said, okay, you know, we’ll miss you, but great.

Dr. Fox: Yeah.

Katie: And so I was like…

Dr. Fox: Yeah, I was pretty much lying to you, because…you know?

Katie: Right. Right. So the moment you walked into the hospital room, I was having a conversation with Julie where I was like, Dr. Fox can’t be here, and you know, I’m kind of bummed about it, but it’s fine…and then in you strolled, a nice surprise. And you were kind of like, let’s have a baby, and I was like, no, no, I’m hours away from that. And then I think you lifted the gown and said, well, there’s the head, so let’s get going.

Dr. Fox: Yeah, no, I remember Spiegelman was there, and I said to her, I said you better call me in. I was like, I’m coming from anywhere, you know?

Katie: Aww…

Dr. Fox: It’s like, that’s…there’s… I mean, please I invested a lot of time and effort into this pregnancy, you know?

Katie: Right. You’ve got to…

Dr. Fox: It’s not just hard for you…

Katie: I’ll say.

Dr. Fox: So, no, but it was… I mean, and now that I told my story, what was that moment like? I mean, do you… Was it a fog? Or was it clear?

Katie: It was a fog. I just…I know Frank and I kept looking at each other, and saying, like, it’s so different from last time, which is like a ridiculous thing to say, because of course in every way it was different… But it was just, like, the joyfulness, the noise… Like, the absence of sound was a very haunting part of our first delivery, and…but you know, it was appropriate. And…

Dr. Fox: Yeah, right. I’m full of sound.

Katie: Yeah. Yeah. And so having, you know…and there were teeny things with the baby we were a little bit worried about, but like, your attitude was just so positive, and like, this is great! The best thing happened! It’s going to be fine. Enjoy this moment, was what we were able to kind of live in, which was a gift. So it was… I think I pushed, what, one-and-a-half times or something?

Dr. Fox: Maybe. I mean, on my end it was like, the easiest birth ever, you know? It was like a dream come true for me.

Katie: Yeah, no, it was great. I mean, as childbirth goes, I think it was great. And we got to spend a while with Kai, and eventually he was taken to the NICU because he had some mild transition issues.

Dr. Fox: Yeah.

Katie: But honestly, for a stillbirth mom, the NICU is like, the best thing…

Dr. Fox: Yeah. Yeah.

Katie: I mean, not to minimize, because obviously, people are in the NICU for horrifying reasons.

Dr. Fox: Yeah. No, you’re like, my kids being watched like a hawk. Yeah.

Katie: By someone other than me for the first time, you know? Like, two years I’ve been monitoring babies all by my-…you know, not all by myself, but like, you know what I mean.

Dr. Fox: Yeah.

Katie: So to be able to send him somewhere where they’re monitoring every breath and heartbeat was fine. I was not upset about the brief NICU visit, so…

Dr. Fox: That’s amazing. So looking back now, what are your thoughts at all this?

Katie: I mean, I think what we’ve been through has changed me in every way. I think it’s made me a more patient parent to Kai. I think it’s made me more understanding of, like, human pain, honestly, the knowledge that everyone has a story, everyone’s story is hard, and deserves sort of patient support and attention. I have a closer look at my mental health and mental health care than I think I’ve ever had before in my life, and I know how important that is as part of a medical picture, too, I think, to make mental health a priority. And I think that was one of the most important parts of the treatment plan that we worked out, that, you know, mental health was at the forefront in terms of pursuing therapy, and pursuing medication, but also, like, allowing these reassurance visits and biophysicals and things like that that just helped me to get from one milestone to the next, with some kind of…I wouldn’t say sanity, but functioning.

Dr. Fox: Yeah. Yeah. And how is Kai doing now?

Katie: He’s great. He’s probably tearing up my apartment as we speak. He just learned to crawl yesterday.

Dr. Fox: Wow.

Katie: He’s just, like, in every way…I know every parent says this, but in every way the best part of our lives, and you know, we are so… We feel so privileged, even in the middle of the night, you know, even during a cold or a diaper blowout, like, we are so grateful in every moment that we have him and that he’s here.

Dr. Fox: That’s amazing. Thank you so much for telling your story, your stories to podcasts. Really, it’s…I said it last time, I’m so… It’s not easy to do, and it’s so valuable to me and to our listeners, just to hear your thoughts on going through those two pregnancies. And it’s really helpful, and I just really appreciate you taking the time to do it. I know it’s not easy.

Katie: I thank you for having me. It’s healing to talk about, and you know, again, to debrief with your own doctor, that’s a privilege. Thank you.

Dr. Fox: Thank you for listening to the “Healthful Woman” podcast. To learn more about our podcast, please visit our website at www.healthfulwoman.com. That’s 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 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 doctor about specific diagnoses and treatment options for an effective treatment plan.

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