Miscarriage Sucks

Miscarriage Sucks

Did you know that 1 in 4 women have had a miscarriage? Miscarriage is sort of an enigma in women’s health as it is not talked about often. However, it is unfortunately a common occurrence. I see women in the clinic everyday who have had or are currently going through one. It’s heartbreaking to me when I have to counsel a mother about her concerning symptoms, and I’m thinking she’s probably having a miscarriage, but I inform her that she has to go through blood tests or an ultrasound to confirm it. I have to say my nurse schpeel that these symptoms are concerning and we need to confirm it, which takes time. The time it takes to wait is agonizing for them. They don’t know what to think. They’re worried, anxious, but still hopeful that everything will be ok and they read on Google about stories that women out there have had these same symptoms during their whole pregnancy. What’s going to happen to me? What do I tell my family and co-workers that I’ve already told that I was pregnant? Will this happen when I try again next month? 

These are just a few the thoughts and emotions that women are likely feeling. Just recently I became one of those newly expecting mom’s that unfortunately experienced a miscarriage. 

I’ve gone through a complete roller coaster of emotions and feelings within a span of a week. My husband and I had decided we were ready and wanted to try to have a third child. We love our boys completely and love being parents. We wanted to add to the love in our home. Now we have been pretty fertile in the past so we knew that when we were ready to try, we had to be ready. 

I’m already a very anxious person with an anxiety disorder so the waiting game of trying to conceive and waiting to take that first pregnancy test can drive me crazy. I waited until the tests told me I could take it, which would be 6 days before my period. 

Saturday: Here we go. It’s positive! It’s a very faint line, but it’s positive! My nursing brain tells me that the HCG hormone had to have been detected for the line to show up at all. So, I’m PREGNANT! My husband needed more reassurance, but accepted it after about a half hour. I was pregnant with our third baby and I was happy. However, something didn’t feel right in my gut. 

Sunday: Let’s take another test to make sure. It’s still positive! It’s a bit darker, but still kind of faint. Something still didn’t feel right. Shouldn’t I be more excited? I’m not as happy this time as I was the other 2 times. I also wasn’t feeling as nauseous and fatigued as I had been with my previous 2 pregnancies. It was just a few small waves of nausea. I didn’t think much of it. 

Monday: I took another test. This one was darker. Ok I’ve had 3 positive pregnancy tests. Let’s do this. A part of myself was going through the motions, but another part of myself wasn’t into it. I was still feeling nausea but not a lot. I decided to tell my co-worker that I’m closest with since we she will be with me a lot during this. She was more excited than I was. What’s going on with me?

Tuesday: I’m one to tell everyone around me that I’m pregnant as soon as I found out. I often feel really sick in the beginning so people will find out anyways. I told all my co-workers by giving them donuts. Everyone was very excited. I was, in a way, forcing myself to be more excited than I was. 

Wednesday: Feeling a little more nauseous and tired today. The nausea was reassuring to me but I still felt that something was wrong. I told my husband that I thought if I got really excited that something bad would happen. Of course, he said I was crazy, or at least that what I said he was thinking. He’s smart enough to not actually say these words. 

Wednesday night: I was going to the bathroom and saw it. I saw the streak of blood. Shit. Ok, it’s normal to have a small bit of bleeding sometimes in the beginning. Although, this never happened to me before. It was too late for implantation bleeding. I told my husband, to which he said that we should wait a bit and check again. I went to the bathroom every 20 minutes. More blood every time. It kept coming. I was trying to convince myself that the color was a pink color instead of bright red. But it was red. It was a lot of blood. More than spotting. This was happening. I was having a miscarriage. I didn’t want to confirm it completely or admit it to myself. I just wanted to go to sleep and wake up from this nightmare. 

Thursday morning: More blood. I played the scenario in my head of what I now needed to do medically. I couldn’t take off my nurse hat. I was also trying to explain and console my husband of what was going to happen. I couldn’t stop thinking, “I’m so stupid. Why in the hell did I tell my co-workers? Why did I tell anyone?” I’m a very open person, but right now I didn’t want to talk to anyone about this. I went to work as usual planning to meet my midwife later to check my HCG level. I told my co-workers and didn’t want to talk further about it. I went about my work day, trying to advise other women on their health and concerns. At about 930, I had a big wave of nausea and cramping. This really hurt. This was happening. To me. I didn’t think this would happen to me. Why was God allowing this to happen? Why does he allow this to happen to any woman? This isn’t fair! I started to break down at my desk. I left work, not being able to focus on my job. I needed to process what was happening to me and I couldn’t do that at work. I went to see my midwife. She would call me later with my HCG results. 

For those of you wondering, HCG is essentially the pregnancy hormone. It’s important to check the level a few times to make sure it goes down to negative to ensure everything from the pregnancy has left the uterus. 

I spent time in the car driving and talking with a friend. My eyes hurt from all the tears. I got home and got the phone call from the nurse. My HCG level was negative. What? Negative? Already? I was advised by the nurse and the midwife that home pregnancy tests are very sensitive so I was pregnant, but the hormone level didn’t get very high, which is why it didn’t take long for it to go all the way down. Was it even enough to even call this a miscarriage? I can’t imagine what this would be like if I was farther along. I feel like that would break me. This happened so early on, but I was told that this was still a miscarriage. 

The next few days were spent still having waves of nausea, cramping and hormonal crying. Each day got a little better. It’s now two weeks later from when I found out I was pregnant. I have gotten a lot of support from friends and even found out how many more people I know that have had at least one miscarriage. I do have anxiety of this happening again, but this won’t stop us from trying add to our family. 

I now understand why women don’t want to talk about it. It hurts emotionally and physically. It’s confusing. It plays with your emotions like no other. However, I have always felt it’s important to talk about things, especially if it’s uncomfortable. The more people talk about their experiences, the more people will realize they are not alone and have more support. 

If you have never experienced a miscarriage or have ever wondered what do you even say to someone going through this, here are just a few helpful things to say, and NOT to say.

Things that are not helpful to say to someone that have had a miscarriage

·      At least you already have a child.

·      It’s ok, this happens all the time

·      You can always adopt. 

·      You can always have another

·      Your baby is an angel now. 

·      It was in God’s plan

·      At least you can get pregnant

What you should say:

·      I’m so sorry

·      What can I do to help you?

·      I’m here for you

What are your stories? What did you find helpful for support during this difficult time? Leave comments to help support others that may be going through this difficult time.

Epidurals: God's Real Gift to Women

Epidurals are the most common pain medication requested and administered during labor. Most non-healthcare people don’t really even know what an epidural is in regards to a labor patient. They call it an epidural because the medication goes into the epidural space of the spinal cord. An anesthesiologist will be the person performing the epidural and it’s done in your labor room. There’s a lot of preparation that needs to be done before this can happen so be mindful when you think you want to ask for it. If someone knows they eventually want it, I’ll start prepping before they ask for it.

A consent form needs to be signed and risks need to be talked about. This is usually difficult to understand or even care about when you’re in active labor and all you can think about is the squeezing pain of your uterus. I remember one mom who couldn’t stop moving from the pain yelling at me, “I don’t care! Just get the doctor here to give me the medicine!” And then she quickly scribbled gibberish on the form where her signature was to be signed. 

The thing that takes the longest is getting you an IV and starting IV fluids. IV fluids are given to reduce your risk of low blood pressure, which is one of the risks of an epidural. Depending on the facility, you will get about 500ml-1,000ml of before the epidural can be placed. This process can take 30-60 minutes. You also are not allowed to eat anything after getting an epidural. Depending on the facility some clear fluids are allowed. If your blood pressure does go too low then additional medication will be administered in your IV to help bring it back up.

Sitting for an epidural involves curling your body around your belly to curve your back. This helps to open space in your back to assist the doctor in placing the epidural. This can be done while lying down on your side or sitting up depending on the doctor’s preference.

While you’re waiting for the sweet relief, we will be taking your blood pressure, listening to baby’s heart, and monitoring your oxygen levels and heart rate with a probe that goes on your finger or toe. So there are a lot of things hooked up to you.

Prepping your back before the actual procedure will take a couple of minutes. They wipe down your back with antiseptic and put a drape over your back to keep things sterile. This is a sterile procedure, meaning that it’s free from bacteria and nothing that is not sterile can come in contact with it. We tell you to not put your hands behind your back or touch your shoulders, this also includes your partner that is most likely standing in front of you. 

The hardest thing about getting an epidural is when the anesthesiologist is injecting the needle and you have to stay completely still and the more you move the harder it is and the longer it takes. However, this part is usually very short and the only thing getting you through that moment is the fact that you’ll have pain relief very soon. They will put in a needle to find the right space of where to put the medication. This may take another couple of minutes. 

Once they are sure they have the needle in the right place they will insert a small flexible plastic tube and take out the needle. They will do an initial test dose all while analyzing the monitors that are spewing out all the numbers.

They will then tape the long plastic tubing to your back to ensure it stays in place. The tube is connected to a pump that will continuously pump the medication into your back to numb you from the waist down. 

Then once we get you comfortable the nurse will stay with you for a while to continue to monitor everything to make sure there are no complications.

After some time, a catheter will be inserted into your bladder to empty it. I’ve worked in places that have different policies on this. Some will use a temporary catheter and others will use a catheter that will stay in place until closer to delivery.

Now your bottom limbs have a mind of their own and that mind isn’t yours. It’s a weird feeling, like heaviness and having no control where they go. Some people have complete numbness and can’t move at all. Some people are still able to move their legs and even get into different positions. Everyone is different.

So, at this point you have the tubing from the epidural, IV tubing, monitors on your belly and finger/toe, possibly a tube for the catheter and a blood pressure cuff on your arm. This chaos of tubes and wires are a nurse’s nemesis, but we are happy that our patient is comfortable and we try to make it a functional dance.

Just a reminder, you cannot get out of bed with an epidural unless you plan to army crawl your way to delivery.

Mind Blown Moment

When the anesthesiologist puts the catheter in your spine, they are going in blindly. This means that not all epidurals are perfect. Sometimes an epidural will give complete relief from pain and other times you can still feel pain on one side, you could feel pressure but not pain, or you could have pain relief for a certain amount of time. If the epidural isn’t giving adequate relief, the anesthesiologist can give a bolus (extra dose of medication) or replace the epidural all together. 

After all the things are done, we try to get you into a comfortable position and let you rest. Since you have to lay in bed, the baby doesn’t have the movement of the pelvis that it needs to move down. So, we try to put you in different positions. We also will try to what is called a peanut ball between your legs. What did she say? A Peanut ball? Imagine an exercise ball or yoga ball that’s in the shape of a peanut. Google it. I’ll wait….Yep that’s it. Putting this between your legs helps to keep your pelvis open and wide, making a wider road for the baby to drive through. Wide Load Only Lane! 

After this we will rotate your position about every hour and you can rest in between position changes until it’s time to push. You will probably feel it when it’s time to push because you will feel the pressure of the baby’s head coming down. It’s also a possibility that you’ll feel some pain with pushing or close to pushing.TMI:I myself, felt no contractions in my uterus with my 2^ndbirth but I felt pain in my perineum (cooter, vag, va-jay-jay, hoohaa). 

After your baby is born, the epidural pump is stopped and it can take about 30 minutes to 2 hours or more for the medicine to wear off and you can walk like a human again. 

Lots of women love epidurals and wouldn’t give birth without one. Lots of women love giving birth naturally and don’t want an epidural. Neither one of these options is right or wrong. What matters is what YOU want. There’s no shame in epidurals, no matter how much you’ve told yourself that natural birth is best for you. If you suddenly decide that you don’t want to feel pain anymore and whoever decided that giving birth naturally was a good idea is insane, that’s ok. If giving birth naturally is what you want and you’ve done it with all 19 of your children, more power to you sister, seriously. 

Here’s one opinion that I will give you. This is based on my experiences as a nurse. It’s generally best to wait as long as you can tolerate it to get an epidural (but don’t wait until you’re 10cm and crowning to ask for it). Sometimes an epidural can slow down labor or make contractions less effective. Sometimes with an epidural, Pitocin is needed to make contractions stronger and closer together.  Reminder: I’m a nurse and not a doctor or midwife. Talk with your provider about risks vs benefits for your own labor and birth. 

You Say Polenta, I Say Placenta

What the heck is a placenta and why do people eat it?

The placenta is essentially the organ that connects you to the baby. It gives the baby oxygen, blood and other nutrients to grow in the uterus. The placenta is attached to the uterine wall and the umbilical cord is the pathway from the placenta to the baby. 

A big thing that most people don’t know or think about is after giving birth to your baby, you have to give birth to the placenta too! It can take up to 30 minutes for the placenta to come out and sometimes you have to push it out. For most, it’s not a big deal but some people have said that it hurts like giving birth to another baby. 

Another thing to note is that the umbilical cord can be very short or very long. They may put the baby on your stomach instead of high on your chest because it’s short. So just keep in mind to listen to the people caring for you and don’t pull the baby up higher until the cord is cut. We do this because we don’t want the cord to break on its own. 

Some people believe that consuming the placenta will help the mother somehow in postpartum, usually for the hormonal properties, decrease postpartum depression and it may give you more energy.  I’m not confirming whether these claims are true or not. There’s not a lot of research to support these claims. I don’t really believe that most of these claims are true in my own personal opinion, but you do you. I will advise you though you consult your provider before doing so. 

Some of the more popular ways the placenta is consumed is by encapsulation or eating it raw in a smoothie or drink form. Encapsulation is a process where someone who knows what they are doingdehydrates it, grinds it up, and puts the contents in gel capsules. 

Some cultures have practices where they bury the placenta. Some people like to take pictures of it. Some make art out of it by placing it on a piece of paper to paint on the tree of life. Most people want absolutely nothing to do with it all. They don’t even want to look at it. I don’t blame them. It’s pretty gross, unless you’re fascinated by such a thing like myself. 

Birth Plans/Preferences

Being a L&D nurse I actually like it when patients come in with a birth plan. It shows me that they have put some thought into their wishes and it makes it easier for me to provide care for the mom and partner if I know what they want or are expecting. However, sometimes people come in with very elaborate birth plans and have unrealistic expectations, which can make caring for them more difficult for all parties involved. Most people who write birth plans have realistic wishes that are most likely already going to be done; like putting baby on moms chest right away, waiting for the umbilical cord to stop pulsating, wanting the baby to stay with the parents in their room, or mom wanting to breastfeed, to name a few examples. 

The most crazy unrealistic birth plan I ever saw was…my own. During my first pregnancy I hadn’t been a nurse for very long and I was working in long term care. I thought I had done adequate research on pregnancy and birth, but what I was actually researching was severely biased. With my second pregnancy I was working in L&D and had been for about a year or so. I went back to look at my previous birth plan as reference to make another one and what I saw was shocking. I hadn’t even remembered everything I had put on there and then looking back at it with my new nursing experience made me realize that moms and their partners need more education on pregnancy and especially the birthing process. 

One important thing to note is that no birth plan is going to go the way that it's planned. You can't anticipate everything that's will happen. So, it's good to be mindful that things can change and that what you had in your mind as to how your beautiful birth would go down flexibility and having an open mind is essential. Here’s what is going to be useful in a birth plan/preferences.

·      Your name and your partners name.

·      The name of your doula if you have one.

·      Your doctors name and clinic

·      Your baby doctor and/or clinic

·      The name of people you would like or not like in the room during birth. If the nurses need to kick people out at your request we will. We don’t mind being the bad guy. Realistic Expectation #1: Sometimes people like to have their whole village come to see them in labor or afterwords. If there are too many people in the room in order for the nurses and doctors or midwives to care for mom and baby safely we will ask people to exit the room. But we do want you to have the people around you that you love but as long as we can ensure safety.

·      What do you want to do for pain relief or comfort? Hydrotherapy (laboring in the tub), positioning, counter pressure, music, lighting, aromatherapy (if the hospital allows it), birthing ball, walking, or you may not know. 

·      How do you feel about medications for pain relief? Usually there are two options, if not three. Obviously the most common one is an epidural. Another option available (but may not be available everywhere) is IV pain medication, called fentanyl. A third option has only in recent years become available in the United States, even it’s been available in other countries like the UK for many years. The third option is nitrous oxide; which may not be available everywhere. If you don’t want us to ask you about pain medication in fear that you will ‘cave’ and want it even though pre-labor you doesn’t want it, we should accommodate that. Realistic Expectation #2: I will say that sometimes pain medication is what the mom NEEDS. I only say this because of my own experiences, more specifically my own births. With my second birth, my plan was to have an unmedicated water birth. My anxiety completely took over my mind and I was no longer in control. I believe that I needed it in order to move forward. Sometimes when pain medication is administered, it allows the cervix to relax and is more apt to open up and be less tense. This works for some but not all, because of course not all births are the same. 

·      Do you have thoughts when the time to push comes? Do you want to be able to move around? Do you want to have a water birth? Do you want to be in bed? Do you want to have a mirror so you can see your pushing progress (trust me it works)? Do you want the Lion King soundtrack playing in the background?

·      Are you going to breast feed, formula feed, both, or exclusively pump?

·      Medications to give your baby. There are typically 3 kinds of medications given to the baby after delivery. There is an antibiotic eye ointment, the first of the Hepatitis B vaccine series (this is a shot, which can be done later at the clinic depending on your provider), and a vitamin K shot. Realistic Expectation #3: PLEASE PLEASE PLEASEgive your baby the vitamin K shot! I will do another post about these 3 medications, but it is my professional opinion to encourage parents to give their baby vitamin K after birth. Babies are born with a limited amount of vitamin K and this is necessary for blood clotting and can prevent brain bleeds. 

·      Are you ok with testing? Typically 24 hours after delivery there are some tests that are performed on the baby. These include:

o  A hearing screen

o  Checking baby’s heart rate and oxygen levels together to screen for possible heart defects. 

o  A bilirubin screen. Bilirubin is the product of red blood cell breakdown, which is normal. Eventually, bilirubin is passed through the liver and leaves the body. When there’s a high build up of bilirubin, it can cause jaundice. This is when the skin and eyes will turn an orange/yellow color. When the bilirubin level is higher typically the treatment is bili lights or phototherapy. 

o  There’s also a small blood sample taken to test for congenital diseases. 

·      Realistic Expectation #4: Sometimes people come in and either don’t want to be on the fetal monitor or only intermittent monitoring. I’m 150% an advocate of natural birth and doing less monitoring, IF it’s safe for mom and baby. If the nurse or provider wants to check on the baby, it’s because they are concerned for you and your baby. I want you to be an advocate for yourself, but also realize that we all want a healthy and happy mom and baby at the end of the day. 

·      Do you have plans for your placenta? I know what you’re thinking: What would one do with a placenta and why would I have plans? Some people ahead of time have made plans to consume it in some form, bury it for cultural practices, take a picture of it or whatever your heart desires I suppose. I can do another post on this topic if people would like. 

·      Are you doing cord blood banking? This is not commonly done, however if this is something you want to do you need to let us know beforehand.

·      Do you have specific desires about your baby’s first bath. Most people don’t care when this is done and will have it done within a couple hours after birth. Some choose to wait 24 hours and others wait until they are home. Some want the staff to do it and others prefer to do it themselves. If you’re a first time parent, demonstration of the first bath and education is very helpful and necessary. Some people choose to wait because some believe that the vernix is good for the baby’s skin among other reasons. 

·      If you’re having a boy, do you want a circumcision? If so, do you want it done in the hospital before you leave or in the clinic? PS…It’s usually cheaper if you do it in the clinic. 

There are other things you can add to your birth plan of course if there’s something that is really important to you. I highly encourage everyone to take their birth plan to their appointments to have their provider read it. This sets you up for realistic expectations for your birth and have questions or misunderstandings answered.

Doctors vs Midwives

So you’re pregnant and now you have to choose where to get your prenatal care. Do you choose an doctor or a midwife? I, myself, have gone to midwives for most of my adult life. This isn’t because I don’t like doctors. I actually love most of the doctors I’ve worked with and think they’re awesome and I’m so thankful that we have them. I’m just more comfortable with my midwives and their philosophy for my own care. There’s a lot of misconceptions about what these types of providers can and can’t do. There’s not a whole lot of differences but here is how they compare.

 

An OB/GYN is a medical doctor or a doctor of osteopathic medicine in the specialty of obstetrics and gynecology. Another doctor that can take care of you during pregnancy is your family practice (FP) or primary care doctor! I didn't figure this out until I worked in OB. I had no clue. A CNM or a certified nurse midwife is a registered nurse who has a maters or doctorate degree in midwifery medicine. An OB doctor went to medical school after their undergraduate degree, then did 4 years of residency. A CNM most likely has an undergraduate degree in nursing and then did another 3-4 years for their midwifery program. There are some midwifery programs where they don’t need to be a nurse first. This is called a CPM, certified professional midwife.

 

Stereotypically, women who want more personal care empathy choose a midwife. Midwives are also known for doing more natural births, including water births. In my own experience working at the hospital midwives will be more hands on and do more cares with the mother compared to OB doctors. However, there are many OBs who prefer to be more hands on and stay through the labor process. All providers are different on how they give care. Some are OBs, some are CNMs. Some are hands on, some are hands off. Some like pizza, some like kung pao chicken. This is also why it’s important to find a provider that works well with you and has good chemistry with you.

 

A CNM can do most of what an OB/GYN can do. If a women needs more care during her pregnancy because she’s high risk she may need to be under the care of an OB depending on the policies of the facility and the providers’ experience. Also, an OB can do surgery whereas a CNM can’t.

 

Now, here's the differences between a FP and OB/GYN doctors. Not all family practice doctors do prenatal care. Some choose to make it a part of their practice and others don't I've worked in a hospital where it was quite uncommon for a FP doctor to be there delivering babies and most of the time it felt as if they didn't know what they were doing. This isn't because they aren't good at what they do. They just didn't deliver babies often enough. If I suddenly were asked to go to the ICU or behavioral health, I'd fall flat on my face, but that wouldn't make me a bad nurse.

 

I've also worked in a hospital where seeing a FP would be the norm. Approximately 50% of the providers there would be FP and sometimes I'd forget which one they were because that's how often they were there. One thing I loved about working with them is how well they knew their patients. This is because they are their care provider for everything, from well visits and annual check ups to OB/GYN related matters. However, they are not surgeons, so if their patient is requiring surgery or a c-section they can assist but an OB/GYN doctor will be the one actually performing the surgery.

 

These are a lot of options to consider. So, if you find yourself not knowing where to go, start asking your friends. If your friends have good/bad experiences with someone, this is a good starting point in your search. Either way make sure you have good chemistry with them and feel like they'll support you.

Welcome Friends!

Hi!

My name is Catie. I’m a nurse, wife and a mother to 2 amazing and energetic boys. 


I’ve thought about staring this blog journey for a very long time but never had the guts or enough ideas to start it. I finally came up with what I felt like a great idea and there is a need for right now and something I’m very passionate about. I want this blog to be all about pregnancy, birth, postpartum and being a parent. 

I’ve been a nurse for about 8 years now and I have 3 ½ years of labor and delivery and postpartum experience. Being an OB nurse has truly been in the top 3 best experiences of my life. I’m currently a triage nurse at an OB/GYN clinic. This is something different for me with a slower pace but I’m learning about new things every day. Which brings me to how this blog idea came about. 

I left my bedside RN job as a L&D nurse and working nights to have a steady day job so I could be home more with my husband and kids. However, my sacrifice led me to a stage of grieving a loss in my life that I didn’t know I would feel. For weeks I was depressed because I missed my job so much and my wonderful co-workers. Even though it was very difficult and stressful and most of the time I was sleep deprived, I loved it and I felt like it was one of my purposes in life. So, I decided to start a new endeavor in my “free time” to write about what I’m passionate about and hopefully help people. 

One thing I always saw with parents, especially new parents, or parents who had less resources is that most people are uneducated about pregnancy, birth, and being a parent. There’s A LOT of classes out there, but most cost money and are usually out of people’s budget. There’s also too much information on the internet for people to research through and know what’s accurate and unbiased. Your healthcare provider is a great resource for a lot of questions; however, they have a very limited amount of time with you. 

So why are there such limited resources? I’m not entirely sure; and there’s many answers. I do know that when I talk to my patients, I try to give them any advice and resource I can to help them in their situation because I want everyone to succeed and feel supported in this crazy life. I know this because I’m a parent! It’s HARD! Nothing in my life has been harder and more rewarding than being a parent. So why not give advice and knowledge that I have to others who are looking for it. And if you don’t want it or like it, that’s okay too. I’m far from being an expert in my field but I know a lot and what I do know I’m willing to share.