“Short cervix, cerclage, and PPROM” – with Kristin Mayle-Hasson

Dr. Fox: Welcome to “High Risk Birth Stories,” brought to you by the creators of the “Healthful Woman Podcast.” I’m your host, Dr. Nathan Fox. “High Risk Birth Stories” is a podcast designed to give you, the listener, a window into life-changing experiences in pregnancy, fertility, and childbirth. Kristin, welcome to the podcast. How are you doing today?
Kristin: I’m great. Thanks. How are you?
Dr. Fox: I’m wonderful. Thank you for asking. So, you reached out to us to tell your story of your birth last year, in 2020, of your son, Max. What made you think of volunteering?
Kristin: Well, Max was born very early. He was born at 25 weeks and 5 days. And I’ve just found recently that listening to the stories on your podcast, it’s really been helping me. So, I thought sharing my story would be hopefully good for other people as well as kind of cathartic for myself.
Dr. Fox: I think that’s amazing. Thank you so much. And for our listeners out there, Kristin is also pregnant again. How’s that going?
Kristin: Going well. Yeah, that’s part of the reason too, I really kind of needed some therapy during this second pregnancy, so shortly after my first one.
Dr. Fox: Right. I mean, because you’re about 27 weeks now. So, you’re right around the point that you delivered last time?
Kristin: Yeah, actually. So, I just surpassed the 25 and 5 mark, which feels really good. But it’s really interesting to be… I’m trying to…already being a mom and to be enjoying, you know, a part of pregnancy I’ve never experienced before.
Dr. Fox: How did you find the podcast? I’m curious. Because you’re from the Midwest, I mean, you’re from Chicago. Go, Cubs. Amazing.
Kristin: Yep. I actually was listening to… I was picking out new podcasts, and I found the “Informed Pregnancy Podcast,” I heard you on there.
Dr. Fox: Oh, okay. Cool. Yeah, that’s a good podcast. Glad to have you aboard. Thanks for listening and thanks for volunteering. So, take us back to last pregnancy. You delivered in 2020, so at the beginning of that pregnancy, or before you got pregnant, just give a sense to our listeners of, you know, who you are, where you’re from, where you’re living, what’s your family situation at the time, just so we can sort of set up the story.
Kristin: So, I have been living in Chicago for over 17 years. I’m originally from Michigan. My husband and I were living in the northwest neighborhood of the city. And have been trying to get pregnant for about a year, but we found out that we had conceived right around the time of lockdown, during the pandemic. So, I think, almost to the day that we conceived. So, it’s interesting, you know, here we are, in our house that we have been living in for about a year. And the next thing we know, we’re locked down, seeing no one, and expecting a new member of our family.
Dr. Fox: Was that very stressful? I mean, obviously, life was stressful at that time because of the pandemic and the lockdown, and, you know, work and not seeing people. But for the pregnancy specifically, was there any concern either because you wouldn’t be able to, let’s say, see the doctor that you were going to go to? Or were you worried about maybe the virus causing some harm in pregnancy?
Kristin: Definitely. I mean, so much was an unknown at that time too, but the pandemic, I think it really gave us the excuse to just say we’re not going anywhere. Luckily, I had been working from home pre…I was work from home pre-pandemic, but we stayed home. I still was going to the doctor, it was really unfortunate for my husband, he wasn’t allowed to come to any appointments, that was really difficult for him. But otherwise, we just kind of hunkered down and were waiting.
Dr. Fox: And how did you choose a doctor?
Kristin: Once we found out that I was having some complications with my pregnancy, we did change doctors. So, the original OB I was with was…I found through my mother-in-law, actually.
Dr. Fox: Someone who was local or close to where you lived?
Kristin: Yeah. In downtown Chicago.
Dr. Fox: And this was your first pregnancy, yes?
Kristin: Correct.
Dr. Fox: How did the pregnancy go in the early stages, you know, in terms of how were you feeling physically? Other than the pandemic, how were you doing emotionally? Were you very excited?
Kristin: Pretty easy pregnancy. I was nauseous but not terrible. And, you know, really wasn’t having much more…I didn’t have much more issues in the first trimester there. Nervous, just kind of going with the flow. It was one of those things where, like, we had been trying to get pregnant, we’re excited about it, we’re ready to be parents, but the unknown, you know, [inaudible 00:04:21] it’s your first baby, how do you know?
Dr. Fox: Yeah. Did you know right away whether you were having a boy or girl?
Kristin: Yeah, we did the genetic testing. So, we found out it was a boy very early on.
Dr. Fox: Okay. And then at what point in pregnancy did things start to get a little more complicated?
Kristin: Some at the 20-week anatomy scan, we went and we were very excited, you know, we’re just…both of us… That was the one appointment my husband was allowed to attend because of the pandemic, and we were just so excited to see our little baby on the screen, get all those images, and, you know, after the hour-long anatomy scan, it kind of shuffled us into a room. Our doctor came in and she said she had concerns, my cervix might be short, and she examined me. And she explained that it was short, and they rushed me over to triage.
Dr. Fox: When they said that it was short, were they able to tell using an ultrasound just looking from above, like for your belly? Or did they do a vaginal ultrasound as well to make that diagnosis?
Kristin: No, they did a vaginal ultrasound as well.
Dr. Fox: And is it your understanding that they do it routinely for everybody? Or was there something about either you, your history, your symptoms, or what they noticed from above that led to them checking from below? Because different people do it a little bit differently with a vaginal ultrasound, some do it routinely and some do it only…only if.
Kristin: You know, I don’t know. It felt routine.
Dr. Fox: Got it.
Kristin: So, it seemed to me that they were just…yeah, doing the…at that point, the tech was just doing routine.
Dr. Fox: Right. So, the tech didn’t give it away that he or she had any concerns or there’s any issues and you really only found out when you’re sitting in the office with your doctor?
Kristin: Correct. Yep.
Dr. Fox: Okay. So, they send you to triage in the hospital for what reason?
Kristin: Obviously to explain that there was a potential that my cervix was short and that I might need a cerclage. And so they sent me over there to be examined.
Dr. Fox: And how much did they explain to you at the time? Meaning before you went to triage, in the office, about what are the implications of a short cervix? What are the various treatment options? Or was it pretty quick, “You know, there’s an issue, get out of here, go to the hospital”?
Kristin: No, it was quick. I mean, she made it feel very urgent. She kind of said, “You know, you’ll probably get a cerclage placed. I know a lot of women who have a cerclages placed who didn’t go to full term, but you need to go.” It was very…shoving me out the door.
Dr. Fox: And when you were going to the hospital, was the expectation you’d be seeing one of her partners or one of the specialists who were physically at the hospital?
Kristin: Once I got to the hospital, it was one of the MFM specialists.
Dr. Fox: And what did they tell you? Or how did they evaluate you and counsel you?
Kristin: So, they examined me as well, they indicated that the cervix was short, and then there was discussion of whether or not to place a cerclage. And they weren’t necessarily recommending one way or another. I felt like I was kind of on the edge, right? I wasn’t like, “Oh, yes, you definitely need a cerclage because your cervix is extremely short,” or, “No, you’re fine without it.” It was this real kind of gray area. We had great counseling. They sat with us a long time discussing it but weren’t necessarily recommending one way or the other.
Dr. Fox: So, they weren’t conclusive about what you needed to do. Did you know offhand how short your cervix was at the time Do you remember? Like a number [crosstalk 00:07:44].
Kristin: You know, I don’t know. I don’t. And I actually tried to find out when I was talking to you, but I don’t.
Dr. Fox: And it wasn’t…as far as you know the service wasn’t dilated, it was not open, so it was closed, but short, right?
Kristin: Right.
Dr. Fox: Yeah. I mean, generally, for most people on their first pregnancy, unless there’s some other high-risk issue, if the cervix is closed and short, usually we’re not going to jump to put in a cerclage just because so many women will do fine with either no treatment or something else like progesterone. And I imagine they probably recommended taking a vaginal form of progesterone?
Kristin: Yep.
Dr. Fox: Yeah, that’s a pretty standard thing, and then to follow up again. So I assume they brought you back, they put you on the vaginal progesterone and they were planning to bring you back. That’s what the plan was, I assume?
Kristin: Yep. The plan was to, exactly, put me on the vaginal progesterone and then come back a week later and check to make sure there was no change.
Dr. Fox: Right. So, tell me about that week, I’m really curious. You know, you go home, so they dropped the bomb that you have a short cervix, and they’re telling you that you may have an increased risk of preterm birth, but it may be nothing. We’re gonna try this medication, it might work, it might not. And where are you in your head space? Are you on Google all night? Are you really calm and saying it’s going to be okay? Are you making phone calls? What’s going on in your life over that course of the week?
Kristin: I definitely was trying to play the fine line of the Google game. I was trying to find reputable sources to research cerclage and cerclage efficacy. And, you know, it’s really difficult to with an emergent cerclage versus one placed earlier to find documentation to compare one versus the other. My dad’s a doctor, so he was also trying to find relevant sources. So, I try not to come down too many rabbit holes, but I was definitely trying to take in as much information as I possibly could. And then there was really the concern of, you know, we’re at 20 weeks, what are our outcomes here? So, there’s a lot of concern there. And then there was, you know, do I move? Do I physically stay put? You know, that whole concern. I just…I recall trying to not go up and down the stairs. I’d come down the stairs in the morning and stay on that floor for the rest of the day until I had to go to bed. Things like that.
Dr. Fox: When you spoke to the doctors, did they give you any advice about activity restrictions?
Kristin: The advice was definitely to not do bed rest, like, bed rest was not the recommendation, but to limit my activity level. It was the pandemic, so at the point, my husband and I were [inaudible 00:10:18].
Dr. Fox: What am I doing anyways?
Kristin: Yeah. Well, part of it was that we weren’t seeing anyone. So, our daily activity was going out and riding our bikes or going out for long walks. So, I remember being like, “I can’t ride my bike? What?”
Dr. Fox: All this stuff about activity and bed rest is complex because no one knows the right answer. One of the coincidences is there have been very few studies published on what to do with women with a short cervix about bed rest or not. And actually, the two studies that are out there, one of them was published by our group, by me and my colleagues, and the other one was published by your doctors at Northwestern.
Kristin: Interesting.
Dr. Fox: Ironic, huh?
Kristin: Yep.
Dr. Fox: So, both of them concluded that bed rest is not helpful. So, I’m sure that’s why they gave you that recommendation. How did it feel at the time… You mentioned this idea that they counsel…they spent a lot of time talking with you, they were obviously very conscientious physicians, and they’re explaining what’s going on and what the options are, but that they didn’t give you a solid recommendation one way or another. I’m curious how you feel about that. Because there is a lot of differences in medicine nowadays, where, on the one hand, you know, doctors sometimes feel the need to tell people what to do, and some people don’t like that, they want more options and choice, and what we call patient autonomy to make your own decisions. And on the other hand, some people, some doctors are very much into sort of giving choices and options, and some patients are like, “What the hell am I supposed to do? How am I supposed to decide?” And it’s a tough balance. I’m just curious what you thought about it on the patient side of not having a clear, solid, “You should do this because this is the best option”?
Kristin: It was definitely difficult. I think it would have been easier if the indication was more clear. If it wasn’t such a gray area of factors, I definitely want to be able to, you know, be empowered in my healthcare and the treatments that I’m receiving and considered my thoughts, considered without question, but clear direction would have made me feel a lot more comfortable in that scenario. I think, you know, asking, what are the percentages? What are the chances? Asking all these questions, and there just really aren’t clear answers, either. You know, we were given all of our options, even to terminate the pregnancy at the time. So, it was really difficult. We felt like there were…the options on the table weren’t great options. And I tried asking the doctors what they would do if they were in my situation, things like that. And, I don’t know. Yeah, it was difficult to not have a clear direction [inaudible 00:12:57].
Dr. Fox: Did they answer that question when you said, “What would you do?” Did they say, “Here’s what I would do?” Or did they say, “It’s really not relevant because I’m not you,” that type of thing?
Kristin: The one scenario I’m thinking of the doctor very specifically didn’t give me a direct answer, but you could tell by her reaction what her answer was.
Dr. Fox: What was her answer?
Kristin: I mean, that was more in the sense of, you know, proceeding with the pregnancy even. You could tell that she was saying she was not a risk-taker.
Dr. Fox: Oh, she would have terminated it, do you think?
Kristin: I think so. I think that’s what she was saying. Yeah. So, I kind of walked away from that being, like, maybe I don’t ask these questions.
Dr. Fox: That’s unusual for a short cervix. If at the time you were like 2 or 3 centimeters dilated, that’s a much more risky situation. But women with a short service, it’s not quite the same. Obviously, your pregnancy we’ll talk about, you know, which direction it went, but it’s not typically done. People don’t usually terminate a pregnancy for that. Again, it’s a lot different when the situation is when you’re more dilated. Okay. So, you went home, you had that week. And I assume you saw them about a week or so later, a week or two later, how did it go at the follow-up appointment?
Kristin: So, we went back, and I was examined by the same doctor who had examined me when we had gone in the week before. And she had said that there was no change. So, we were thinking that I was going home, and we were not going to place a cerclage. Well, that was not a great assessment. I had fortunately signed up for a study that Northwestern was performing, where they were studying the use of the vaginal progesterone, which I was already on, with the use of a pessary being placed. And so I left that exam room, went to another one to participate in this study, and that doctor who examined me actually physically saw my membranes hanging through my cervix, and, again, quickly rushed me back to triage.
Dr. Fox: Right. So, a week later your cervix was open, in fact?
Kristin: Yes.
Dr. Fox: Do you know how far dilated your cervix was at the time?
Kristin: I don’t.
Dr. Fox: Okay. I mean enough that the membranes are poking through. And so, at this point, you’re 21 weeks, your cervix is open. I assume they told you your best option is to do a cerclage?
Kristin: There was no question at that point. Yeah.
Dr. Fox: Yeah. I mean, it’s really that or nothing, and it’s pretty much all the data points that, at that point, the cerclage is the right thing to do. It’s risky, right? It can have complications but not doing anything is quite risky as well, riskier, in fact. Was it placed the same day, that night, the next day? How would it go logistically from, you know, you go to the office, you rush to the hospital, your cervix is dilated? What was the timing of that and the cerclage being placed?
Kristin: Happened very quickly, I mean, within hours.
Dr. Fox: And did you know the doctor putting in this cerclage, or was it someone new?
Kristin: No, it was someone new.
Dr. Fox: How did it go, procedure-wise? I assume they did a spinal, so you’re awake?
Kristin: Yep. Oh, goodness. I mean, it went pretty smoothly. And the most thing that I wasn’t expecting was that being kind of inverted, almost, like nearly upside down. I know that wasn’t actually true but…
Dr. Fox: Yeah, you’re on, like, a tilt table. Yeah.
Kristin: I was scared, you know, I was nervous. It all was happening very fast. I knew it was the right thing to do, but it went pretty smoothly. And it was a pretty quick procedure.
Dr. Fox: Do you know what kind of cerclage they placed? Did they tell you, McDonald or Shirodkar?
Kristin: I think McDonald. Yeah.
Dr. Fox: Yeah. Like, the one with a farm? Yeah, yeah, yo. It’s the same spelling, or the restaurants. Okay. So, that’s around 21 weeks, you have the cerclage placed. And then they keep you in the hospital long time or they send you home pretty quickly?
Kristin: I spent one night in the hospital.
Dr. Fox: Yeah, that makes sense. And then from that point, when was your next visit?
Kristin: I came back the following week to check, to make sure the cerclage was placed well and it was holding up well.
Dr. Fox: And it was, as far as they could tell?
Kristin: Yeah, everything looks good at that point.
Dr. Fox: All right. So, were you pretty confident at that point, or were your doctors pretty confident that things would go well? Or were they still hesitant to tell you that?
Kristin: I mean, I think that was really where we were just hopeful that this would go as long as possible, hopeful go full term. And this was the same kind of, “Oh, how do I move around the house?” Like, “Can I do anything to change any of this?” And we were kind of on edge. So, I was just very hopeful.
Dr. Fox: And then what actually happened?
Kristin: Three weeks later, and around 24 weeks, I woke up around 6:00 in the morning in a puddle. So, my water had broken.
Dr. Fox: Oh, was it obvious too, right away, that that’s what happened?
Kristin: It was pretty obvious. Yeah. I mean, it was clear that I was very wet. You know, and I woke up, walked downstairs and called the doctor and is pretty sure that that was what had happened.
Dr. Fox: And at that time, what were you thinking? Were you thinking, “Game over. I’m gonna lose the pregnancy”? Are you thinking, “I’m going to deliver prematurely”? Are you thinking, “Everything’s still going to be okay”?
Kristin: I don’t know. You know, I feel like we have the best care. I’m in a situation here where we have the best care we could possibly have. And I was still just really trying to be optimistic and hopeful. So, I called the doctor, I had to call her, I described what had happened. And the one who was on call answered and had said, “Pack a bag. Don’t rush, take time, pack a bag, you’re going to be in the hospital for a while,” and told me to get downtown as quickly as I could. So, I was still just very hopeful that this was all just going to work out.
Dr. Fox: And then what happened when you got to the hospital?
Kristin: They tested to make sure that it was, in fact, amniotic fluid that was leaking. And then they moved me up to a labor and delivery floor. I had the magnesium, put me on magnesium, to the steroid shots. And then we just kind of waited. They weren’t able to sense any contractions or anything like that. And so it’s just kind of determining just kind of a waiting game at that point, really.
Dr. Fox: Did they leave the cerclage in or did they choose to take it out?
Kristin: No, they left the cerclage in.
Dr. Fox: And then how long were you in the hospital?
Kristin: So, I was in the hospital for almost two weeks until Max finally arrived.
Dr. Fox: And what happened that he arrived? Did you go into labor or did you get a fever or something?
Kristin: I went into labor finally.
Dr. Fox: Okay. And so when you went into labor, I assume, you know, you had more contractions and then, at that point, did you need a Cesarean or were they able to take out the cerclage and you could deliver vaginally?
Kristin: No, I delivered vaginally. It was almost two weeks later that I had been in the hospital. And I had clearly started having contractions, they moved me back down to the labor and delivery floor. It was pretty obvious to me I was having contractions, they still were unable to sense them on the monitors. And we decided to take the cerclage out. So, I was in epidural to take the cerclage out. And interestingly enough, actually, they never did sense the contractions on the monitors that day. So, I was contracting still, but I couldn’t feel the contractions anymore because I was on the epidural. They put me on the magnesium again and the steroids again. And what’s interesting is that they had done the whole course of the magnesium, determined that I wasn’t in labor. We thought this was over, I thought they were sending you back up the antepartum. And right as…it’s like 3:00 in the morning, my husband and I are kind of like, “Okay, this is over. We’re kind of like settling in, dozing off a little bit, waiting for the epidural to wear off or to a point where they can move me back upstairs.” And a doctor came in and she said, “We sense something on the monitors, I need to examine you.” Of course, they hadn’t examined me that up until this point because my water was broken.
Dr. Fox: And the head is right there.
Kristin: I was fully dilated. So…
Dr. Fox: Yeah. Probably the heart rate dropped. And they said, “Oh, maybe the head just moved down.” That happens. That’s my guess. During those two weeks in the hospital, how did they, if they did, prepare you for the strong possibility of having a baby that’s born prematurely and in the NICU? Did they give you…like, did you meet with one of the NICU doctors? Did you take a tour? Did they give you something to read? Were you just looking up stuff online? Or was it, you know, not spoken about?
Kristin: The NICU doctors came in regularly, you know, kind of explaining if he was born at this time, potential complications. And I remember saying,” I know we’re gonna be here while, I’m staying here till,” you know, this was in September, “I’m staying here through Halloween.” I’m trying to be very optimistic. They clearly didn’t think that was realistic.
Dr. Fox: Did you appreciate them coming in and telling you all the bad things that could happen if he was born at that time, or, I mean, some people find that very helpful to sort of know, get an update, “Here’s what’s going on,” and to sort of know who these people are. And other people… you know, we had someone else on the podcast who was like, “Why are these people coming in every day to tell me bad news?” And so I’m wondering what you were thinking about it.
Kristin: I wouldn’t change it. I mean, I think that it was not easy. It was scary, and it was hard to hear but I definitely wanted all the information I could possibly have and kind of understand what could potentially happen. Because, eventually, basically it did, it was helpful to have that information.
Dr. Fox: Did you have the sense that had you said to them, “Listen, I don’t need to hear this every day,” they would have backed off? Meaning they were doing it, sort of, under the assumption, the correct assumption that this was something you wanted to know about.
Kristin: I think so. I mean, I don’t get the sense this was, like, a good time for that neither, a part of their day job, to come down for a woman who’s potentially having a very early child that [inaudible 00:22:43] potentially, so…
Dr. Fox: I mean, it’s one of these things we ask the NICU to talk to the patients who are in similar circumstances. And we usually ask them to come down once, and then get a sense of what each person wants. And some people are like, “I got it, don’t come back again.” And others are like, “I got it. Can you update me every week or two?” You know, everyone’s different, and I think that that’s great. I think people should have the option there. Do they want to hear everything or do they want to just, you know, not think about it, and just, you know, the baby will come and the baby comes and the NICU is obviously good, so we’re happy to be here, but I don’t need to hear this every day? And I don’t know how I would feel in that circumstance, I’ve never been in that circumstance on the patient side, but I know that, you know, from my experience, as a doctor, a lot of women feel differently about that. And some really want it and some really don’t, and everything in between. So, it’s interesting.
Kristin: Yeah, it was very helpful to have them explain what would happen when he did come, like, those actual moments and how they would be prepared for him. Because those teams were on three-week rotations as well. So, it was the same doctors who had come in and explained what would happen when and if he did come that were there when he did arrive. So, it was comforting to see this… You know, because, at the time, there’s just so many people come in the room. So, to see this team of people come in the room and have been prepared that this is what was going to happen and to see those familiar faces as well, it’s kind of understanding, and to expect that level of that amount of people and all that happening was very helpful.
Dr. Fox: That’s great. And for the birth, how was it, ultimately? You know, because it’s a really happy moment, obviously, because you’re delivering your baby, your son, but it’s also very scary moment. Is he going to be okay? What is it gonna be? How was it emotionally for you, again, like, right at the moments of, you know, birth and shortly thereafter?
Kristin: I mean, of course, like I just described, where you’re dilated, your baby’s coming out, that was very scary. And we quickly switched over to, “Okay, this is happening now.” You know, I was amazed at the nurses, the amount of nurses that were with me, that were helping me. I mean, I hadn’t gotten to the point of my reading about labor, you know, we were at 25 weeks, like I hadn’t gotten to that part of the books. I joke, but it was amazing to watch all these people helping me through those moments. So, it felt powerful. It was very, very cool in that way. It was difficult. When he did finally come out, which didn’t take long, he yelled, he cried, which I wasn’t expecting, you know, I was prepared by the doctors that that wouldn’t happen. So, that moment was extremely hopeful and kind of joyous, I could say, just because to hear him…to actually hear him was something we weren’t expecting.
Dr. Fox: Yeah, that is really cool. And you’re right, the labor nurses are awesome. I mean, they’re there for the easiest, so to speak, most calm, uneventful births, and they’re there for the craziest, you know, wildest, most dangerous, and most scary births. And they’re there 24/7, they’re with you, and they’re just awesome. And it’s a really powerful thing to see so many people help someone through a birth. I agree. I mean, I think there are really good moments in medicine, where you see what difference it makes for a team to come together and help someone, and that’s one of those experiences in your time with the labor nurses, your doctors, the NICU team. I mean, there’s a whole group of people there to make this go well, and it’s a good thing. It really is. It’s cool to be a part of it. And how did he do? Obviously, I assume he went to the NICU for a while, right, at 26 weeks?
Kristin: Yes.
Dr. Fox: Does he bark very loudly or you have a dog?
Kristin: I was hopeful you couldn’t hear that.
Dr. Fox: No, it’s good. Max is a barker. He doesn’t really speak much. He likes to bark a lot, but it’s okay. You know, we scratch him behind the ears and he’s happy.
Kristin: Yeah. That’s our other child.
Dr. Fox: No problem. Well, the dog is welcome to the show also. It’s a family affair.
Kristin: Yes, yes. These are the joys of work from home. This is all how my conference calls go.
Dr. Fox: Yeah.
Kristin: Well, he was shockingly breathing on his own, you know, came out…they were very impressed with how he was doing at that time. He was, you know, quickly taken up to the NICU. So, he was on a CPAP respirator initially, and then that didn’t last long. I think within the first 24 hours, he was intubated. So, overall, he was in the NICU for 97 days.
Dr. Fox: Wow. That’s a long time. You really become regulars there?
Kristin: Yes. Yes.
Dr. Fox: Make a few friends during those three to four months?
Kristin: Yeah. I mean, you talk about nurses and doctors who are amazing. I mean, those people changed our lives, not only saving our son but they helped us my husband and I through every moment of it. And, yeah. We have people we still keep in contact with. They’re just amazing people, that’s for sure.
Dr. Fox: The NICU is awesome. And it really is crazy if you think about it, pick your number of years, whether it’s, you know, 30, 40, 50,100, whatever years ago, you break your water 24 weeks, you’re not going to have a living child, right? It essentially is unheard of. I mean, there were probably reports of it and, “miracles that happened.” But, you know, the idea that the steroids, the antibiotics and magnesium, the NICU care, all these things, they changed… It’s a whole life, it’s literally difference between life and death for your son. And it doesn’t always work out well at 26 weeks, sometimes even with the best care. Children either don’t survive or survive with really long-term complications, but you have a real, reasonable chance that everything’s going to work out okay, and that circumstances, despite how risky it is, and that’s just…it’s just awesome. And, you know, how’s he doing now?
Kristin: Max is doing great. So, he’s just 14 months yesterday.
Dr. Fox: Fourteen months by his birth date, so he’s…I guess, they adjust for that. So, that makes him, like, you know, 10, 11 months or whatever it is?
Kristin: Yeah. Eleven months, because he was three months early. Yeah.
Dr. Fox: Right. Okay. So, he’s doing his thing for 11 months?
Kristin: Yes, he’s hitting those milestones for 11 months. He’s doing great. You know, other than that three-month adjustment, you wouldn’t know he was born so early. He’s healthy, happy, little kid. Yeah.
Dr. Fox: That’s so amazing. The fact that you’re pregnant again, obviously, indicates that you are willing to do this again. Did you have a lot of trepidation about that? Or did you say, “You know what? We want to have more kids and we don’t want to wait.” I mean, how did that decision come about?
Kristin: Well, it’s interesting because, you know, I listen to your podcast and I listen to other things. And I think a lot of us don’t talk about kind of these as many…especially in our “High Risk Birth Stories,” these accidental pregnancies as well. And I say that because it wasn’t easy for me. We wanted Max to have a sibling, without question, but I don’t know that I was prepared to do it so quickly after what we went through with Max. So, it was hard for me, actually, the first many weeks of this pregnancy. I’m at a point now, we’re at 27 weeks, some of the fears have subsided, you know, we passed where Max was born, to really excited, and I’m feeling great about it, but that was not how I felt initially.
Dr. Fox: Yeah, it’s pretty terrifying. I mean, because you don’t…you know, if you knew, let’s say, if you could tell the future and say, “All right, A, B, and C is going to happen, but I’m gonna have a healthy child,” all right, whatever, you can wrap your head around that, but you don’t know what’s going to happen. And you can’t be guaranteed that. I mean, I assume you spoke to your doctors, and they came up with a plan of what to do this pregnancy to sort of prevent what happened last pregnancy. Obviously, something’s working, I guess, if you’re more pregnant now than you were then. What did they do primarily to try to prevent it from happening again?
Kristin: A cerclage was placed at 14 weeks.
Dr. Fox: So, you did that earlier? Okay.
Kristin: Yes, I did that earlier. Obviously, it has a better outcome. And then I’m also getting weekly progesterone injections.
Dr. Fox: The progesterone?
Kristin: Yeah.
Dr. Fox: Great. And right now all indications, other things are going well?
Kristin: Yeah. Yep. Everything looks good thus far.
Dr. Fox: It’s amazing. Amazing. So, looking back on all this, right, so you’re 27 weeks in your second pregnancy, you have your son who’s 14 months old, born 3 months early, a little bit before this time of pregnancy last year, looking back now compared to a year and a half ago, right, I mean, how different is your life from before your first pregnancy? It’s like crazy.
Kristin: It’s dramatic. Yeah. And what’s even funnier is that the state of the world in the last 18 months, I haven’t seen most people in my life. So, in the last year and a half, I’ve not only gotten pregnant, had a child, now I’m pregnant again with my second. So, our lives have changed quite a bit.
Dr. Fox: What do you wish you knew before your first pregnancy that you know now? I mean, if you could go back in time and talk to yourself, pre-pregnancy, first time around, and you can’t say anything about COVID, like, you know, don’t go to Wuhan, stay out of Wuhan, what would you say to yourself now? What now would you say to yourself, then?
Kristin: For one thing, you can’t plan how your pregnancy is going to go. You know, I think believing and that just… You know, we really kept a positive outlook through this whole thing. And luckily, we were fortunate enough that we had a positive outcome. I think…because I’ve always tried to stay as positive as I can, I think that is something I would be proud of myself for. But, you know, I think this idea that we… I think the birth plan, telling…you know, we all are advised or it’s suggested to put together a birth plan, I think, is the wrong terminology. I feel like it should something like birth preferences or something because you just don’t know how it’s gonna go, you just can’t plan. So, I think being able to just be hopeful and understand that life is going to take you in directions that you can’t always anticipate, and relying on the people around you is really what’s most important.
Dr. Fox: Anything else you want our listeners to take away from your story and your pregnancy that you haven’t mentioned yet?
Kristin: I think I’ve said it already. I mean, just the nurses and the doctors, just being really appreciative of all the care that’s out there. And, you know, from what I’ve said, you know, it didn’t all go smoothly. We had frustrations throughout the entire process, but these people are doing great things and really are kind of gems in the world.
Dr. Fox: Kristin, thank you so much for volunteering your time and volunteering your story. It’s a scary one, obviously, fortunately, for you and for your family. It went well, and, you know, you’re on the train again, and the ride is going on all thus far. I agree. I just think it’s important for people to hear these stories because there’s so much that could happen in pregnancy, things that could happen good, things that could happen bad, things unexpected, things you never heard about. And just to hear others go through it, like you said, might be helpful for someone to listen. And I do think for people telling the story could be cathartic. How do you feel after telling the story?
Kristin: No, I feel good. I thank you for having me on. I really appreciate being a part of your podcast.
Dr. Fox: Thank you for listening to “High Risk Birth Stories,” brought to you by the creators of the “Healthful Woman Podcast.” If you’re interested in telling your birth story on our podcast, please go to our partner website at www.healthfulwoman.com and click the link for sharing your story. You can also email us directly at hrbs@highriskbirthstories.com. If you liked today’s podcast, please be sure to check out our “Healthful Woman Podcast” as well, where I speak with the leaders in the field to help you learn more about women’s health, pregnancy, and wellness. Have a great day. The information discussed in “High Risk Birth Stories” is intended for information and entertainment only and does not replace medical care from your physician. The stories and experiences discussed in our podcasts are unique to each guest and are not intended to be representative of any standard of care or expected outcomes. As always, we encourage you to speak with your own doctor about specific diagnoses and treatment options for an effective treatment plan. Guests on “High Risk Birth Stories” have given them permission for us to share their personal health information.