What Happens when GBS visits your pregnancies repeatedly? Atara's birth story, Part II

In today's episode we hear about the rest of Atara's experience. She talks about managing GBS and its consequences with her newborns, and the importance of nutrition before pregnancy.

We pick up today where we left off last week. Atara is pregnant with her second child and is experiencing a numbness on the left side of her body. She has figured out that she should be in the emergency room and what follows is what she encountered there...

Transcript

 
Music.

Paulette:  0:08  
Welcome to what you didn't expect in fertility, pregnancy and birth, how we think and feel about this enormous transition often lives in the gap between what we expected what we actually experienced. This gap exists in part because of how we tend to talk about and portray these events on all kinds of media in a one dimensional way. Everything was amazing, but it's more often the case that there are beautiful things that happen and at the same time really challenging things that happen. This show shares true experiences, both the easy parts and the difficult parts and how we manage what we didn't expect, the intense things that can happen in the course of this transition can impact how you see yourself, how you see your partner and how you parent. The better we understand what happened to us, the better we can manage all the things that follow. I'm your host, Paulette kamenecka, I'm a writer and an economist and the mother of two girls. I met many, many challenges in this process, none of which I expected. In today's episode, my guest, who's a therapist, shares her experiences of four births in today's episode, we'll pick up where we left off last week. Atari is pregnant with her second child, and is experiencing a numbness on the left side of her body. She's figured out that she should be in the emergency room. And what follows is what she encounters. There.

Atara  1:33  
They go to the emergency room. They, of course, pull me back right away. We can't do the proper spans. We do one pan, not a CT, but something below that. And essentially, they tell me you either have a TIA, which is transient stroke, or you had atypical migraine symptoms. But we can't tell you which one, because we can't do the proper testing. So they shipped me to the stroke war to monitor me overnight, which is hysterical, because I'm the only person under 50 years old in there, and the nurses love me. They're like, Girl, shoot my pregnant lady, and I get released the next day. Point of this is that obviously the device vote you cannot. We can't continue. You can't do a birth center burrow, because you're high risk. Now we don't know if that's going to show up again. So it sounds like at some point at the ER, you get your ability back to speak. I do. I do. I start to come out of it. I'm pretty sure they put in an IV. And what I now know is my mom told me after, oh yeah, that happened to me when I was postpartum. I'm like, Excuse me, you never thought to tell me it wasn't an atypical migraine, and so it's a migraine that looks like stroke symptom. I had fingers firmly crossed for migraines. So this is actually good news. Yes, it's good news. This is good news. But no one could put their finger on that at the time. So essentially, what I think happened, and this has happened a couple times postpartum, is my electrolyte get extremely low, and I get some coconut water and lime and salt in my body, and they go away, yeah, yeah. And I'm thinking it took about two to three hours the first time, because I did not know what was going on. But now, when it's happened a couple times after and helping my sister as well, we know exactly what to do. You need to rest, you need to lie down and get your electrolytes up. Wow, it sounds like in the moment, we can't decipher the two. Do you know before you deliver that it was a migraine? I'm pretty confident, because of my mom's history. I'm like, Okay, I think I know what's going on. So it's frustrating and disappointing to me, but then I go on the search for the OB that will allow me to still have at least as close to the process that I want, which is low intervention. And I find him, and I'm asking him question after question, and he finally goes, Tara, you can birth on your head, as long as the baby's not in distress. And I go, Great, okay, her labor is a completely different experience than my first, who is very slow, wanting to come out. We could say to her, my water breaks at about noon. Nothing happens for a long time. I let my husband know we have dinner as a family. I say, go to bed. Let's get some rent, because going to be a long process. Like last time I lay in my bed for a couple hours watching funny YouTube videos, and it's stormy. It's raining outside, and suddenly I'm like, contractions are real close together. You probably should go probably should have done that a couple hours before, because I then transition in the kitchen. Oh, my God, we're waiting for my mother in law to come. And I could just something changed, and I was like, we need to go now. So we raced down 15 minutes on the freeway to the hospital, and as we're pulling up, I didn't know it, because I never had the urge to push with my first but with him, we're pulling up to the parking lot, and I go, I just, I feel like I need to push, but I'm trying, of course, not to. I'm finding that urge a little bit. What would I know Paulette issue crowding in the parking lot as we're pulling up, who doesn't want a parking lot? Baby, right? I know I have a few friends who had parking lot babies who doesn't want it. The husband, parking lot, baby. We get up there. She is almost she's almost born, right? Then, there's some funny stories there, but they I'm very thankful for that nurse, because she was a minute wife in Iran. Oh, wow, yes. And so she knew what she was doing, but she was a NICU labor delivery nurse here, and so she's panicking because she knows that baby's coming out, but they technically, for hospital policy, need a doctor in the room. There's no doctor available. She delivers the baby as the emergency doctor is walking in. But it was beautiful. It was a flawless birth. It was quick, probably a little too quick for my liking, but she's beautiful and born. Now, what we didn't say was I was GBS positive in both of these pregnancies. Okay, so does that mean you just take the antibiotics before and we're all good you're supposed to, and there's debate around that.

Paulette  6:16  
Okay, let's talk for a second about this debate. According to ACOG, the American College of Obstetricians and Gynecologists, antibiotics are the Go To approach to Group B strep in the pregnant mother, and ideally, these antibiotics are delivered at least four hours before birth. Are there alternatives to antibiotics? Some studies have looked at probiotics, vaginal vitamin C and garlic tablets, but currently, there's no robust scientific evidence that these alternatives will prevent transmission of GBS to the newborn.

Atara  6:52  
You didn't get the antibiotic. And so she is grip strep B positive, and so about a day and a half after she's born, and run her blood work. And she said,
7:08  
as this hospital does not have an issue, so we have to transfer, which is also one of the most horrifying experiences I've been through, because they didn't do it intentionally, but I was trying to feed and comfort her, and they were clearly panicked and went, we need to go now. She transferred now, and essentially rip her off of me and get her ready to transport. They have to put her in the little incubator. Yeah, I cannot touch her, I cannot hold her, and she's screaming, and I also can't go on the ambulance, which is not ideal. Wait, why not? There's no real because their transport team, I think, took up all the seats, and so I have to go separately. So they rushed to discharge me at this hospital, and we drive down to this other hospital that has a NICU, and within a couple hours of being there, they say we have to do a spinal cap on her. And long story short, she was there for a week in the NICU on antibiotics, and she's healthy and beautiful now, but it was quite scary. Yeah, the septic thing is scary. That's a mortality risk for a baby, and it's a pretty fast moving thing.

Paulette  8:28  
So I looked into this, and it is indeed scary, which is likely why the medical team moves so quickly. The mortality risk is 5% that's one in 20 babies can die even with treatment, it's a fast moving issue because the newborn's immune system is still in progress. It can cause severe illness, and of the 25% who develop meningitis could have long, lasting health effects for the baby.

Atara  8:58  
Yeah, yeah. So all of that is very scary, although I guess I'm grateful if they caught it. Yeah, very grateful. And yeah, I was really facing this baby could die. She might die here, and that was getting me emotional, even talking about that, because it was very scary. So that was our experience with her. And then I had a still very small child at home in this baby in the NICU, and clearly leave more therapy around this, because I'm not processed all the way through. There's a lot of emotions still tied in here, and it felt like my heart was constantly ripped in half, because either I could be with her and be present for her, or I could be with my other son. And that also brought up a lot of that guilt and this feeling that I think moms experiences I'm not enough. I can't be enough in this situation, because I can't physically be in two Yeah, at the same time. Yeah. This is why we need to have more than two people involved. The more people that love them, the better. And you clearly can't be in two places at one time, and your daughter in the NICU is probably the first priority, because, right? She needs an advocate, right? But I know that's really hard, and I'm sorry that you went through that and it is, it is stressful, even long after the fact. Yeah, absolutely, absolutely, yeah. I work in trauma. Work a lot. We know that the body holds that. Yeah, I practice brain spotting, yeah, it really helps that process. Yeah. So do you have? And by all rights, we would imagine it's not unusual if you had postpartum anxiety after this one. Or how does that go? Correct? Yep, we're on the same roller coaster, yeah, trauma responses and anxiety, and I think it was a little less intense in the first time around. I also knew how to manage it better, and you were talking about transitions earlier, and I think this was my hardest transition, going from one child to two for me, because I constantly felt like I can't meet everyone's feet. You're going to have to wait, or you're going to have to wait and not being able to always respond to one of the babies. Really both babies still, yeah, really difficult.

Paulette 11:14  
Yeah, yeah. I don't know whether it's because we expect too much of ourselves or imagine that our reach is critical, right? You can see in your tubers, you don't have control over any of it. You can't control the migraine. You can't control the that whole process. So it's a tricky spot to be in. I wish we had a different frame or perspective on what you should be responsible for, not, okay, I want to take up a should, what you can imagine you're responsible for and what you can release, because, you know, realistic. Yes, it is so unrealistic. And one thing kids will teach you is the limit of your reach. And you're getting that lesson day one four, day minus 20, or whatever the migraine was, you get her home, and then how is it after that, we do okay. We do okay. I'm settling in even more so into this identity as stay at home mom, which is not when I ever saw myself. I always say, Yeah, I'm a career woman. But the reality is, when you're holding these babies, right, that are yours, there is a new reality. And that really hit me and so really shifting into that mindset of my first shot is to be present for you and be what I can for this responsibility right here. So that was a pretty smooth process, so smooth that about nine months in, my husband turns to me and goes, What do you think I he and the phrase came, I think it came from him. I think we have more love to get. Is what he said. And they went, Yeah, I agree. I agree. I didn't expect that month. What was going to be the month that we had more left to get? Let's not, yeah, let's not get it right now, right now. I got pregnant again that that first month, and here comes baby number three, and that child was almost identical to the first part of but His birth was I finally got my beautiful, peaceful birth center. Birth I unintentionally. I didn't mean to get birth in the in the tub, but I was in there, and I said, this is where it's happening. Y'all, I'm not getting out of here. This is noon, and I will say this too, that my water did not break with Him until the very end. And I had the opposite experience with the first two and that was a game changer for labor. So if you can keep your waters intact for as long as possible. Do it because it was like a cushion between him and me when the contractions would happen, and it felt much more manageable. And so that got me through to the end, until my last kind of few pushes to get him out. And then the water broke there. And it was beautiful. It was wonderful. They did some monitoring before to send us home. We're about two hours plus part after birth, and they take his temperature, and they go, that's reading a little low for us. I think he's at 9796 they're like,

Atara  14:17  
let's wait a little bit. Let's take it again. They take it again. Keep at 94 and that was the first time I saw my midwife on her face. She went, we need to transfer now. And we called the hospital, and it was the same NICU that my first was at, and we transferred to the hospital, and we're in the same NICU and about the same amount of time, about three days in there, he was also GPS positive, like my second. But I knew for a fact we will get the antibiotics because of our experience with our second. And I thought, Oh, we'll get that and we'll be fine. So we went in earlier, and we did get the antibiotics, and we don't fully know what happened, but they are suspicious that it actually still with the GBS, and this is the problem, and what we need to figure out as a society, that GBS can still impact baby with antibiotics or without. And so I know my case is probably pretty rare. Antibiotics do often take care of the issue, but not all the time.

Paulette  15:28  
So the medical literature is in agreement with the Tara here. Antibiotics do significantly reduce the risk of transmission of GBS between mother and newborn, but they don't eliminate the risk. What can go wrong again, as I just mentioned, we're dealing with biology here, so nothing is 100% that drugs can reduce the risk, but they can't eliminate it. The rate of effectiveness that I saw was 80% so some colonization by bacteria could persist despite the antibiotics. And timing of the administration of the antibiotics matters in terms of effectiveness, and in the case of GBS, as with other bacteria, there could be antibiotic resistance strains, so transmission can occur even when you follow all of ACOG guidance on this.

Atara  16:18  
So what is happening? What's our root cause here that is causing this bacterial growth that we need? Then how can we address it? There's some good information out there. Not enough. We need to have some really solid answers, in my opinion, yeah, that's a big surprise if your water didn't break for this third one, what brought you to the birth center? Contractions. So my contractions were happening steadily, but I had that underlying anxiety of, I have to get the antibiotic. So we probably could have waited at home longer, but I knew I I wanted that antibiotic to prevent any NICU stay, and so we went in a lot earlier than I normally would have, so that we can get that going. And then we had about so his labor total was 24 hours, and I would say about 20 of that were at the birth center. Oh, wow. So for GVS positive, you're only getting the antibiotics right before delivery. Is that how it works? Correct? Okay, so that's tricky to time it is. Yeah, it's tricky. I'm glad you were in the birth center, even if you didn't stay so he's in the NICU. And how do you feel about it this time? I feel like that would give you some reflection on both your daughter's birth and on your sons before that, because now you've ostensibly, quote, done everything right, and you're still in the same place. I'm still here. I was done. I was done. I had joked about it that one of those half serious jokes of, if this baby is in the NICU, we're done. That's it. I'm not ever doing this again. It's too much. And so that was my stamp at that point. I was like, All right, that's my last baby. So I hope everybody's happy with that. And yeah, a lot of again, yeah, these questions of, what am I doing? Of course, as if I could do something to change or create a new situation. And there are things I learned which were beautiful and so redeeming that produce healthy pregnancy will get through in a sec, but that's essentially where I was at after he was born. Wait, so do we let younger ATAR off the hook? Because now we know even if she had taken the antibiotics and went out of work we do, we have moved through that self shaving place. And really, I think I came to the term, I use it with clients as radical, acceptable, yeah. And I think time also gives perspective, okay, that was horrible and painful and not ideal, and it taught me a lot and inspired my heart for mamas, especially making mamas or people who experience birth trauma, and I believe in God, in a higher power, so I had this understanding of everything that I experience in life serves a purpose. And so I really wouldn't have been able to walk away with that is radical acceptance. A shout out to Tara Brock, or is that from somewhere else? Ooh, I don't know. Has Tara Brock Paulette, she wrote a book called radical acceptance? Oh, yes, then yes, I have it on my list. It's on my list to read. But yes, for sure. Okay, cool, excellent. One is the third postpartum life. Overwhelming, three. So my oldest was three years old,

Paulette  19:34  
so basically taking care of himself. 

Atara: 
My middle is a year and a half, and then my youngest is born, and then my oldest did turn four A month later, so now that was great. Now driving to work by himself, yeah, it's totally self sufficient. So it was a lot. It was a lot. It was a lot of overwhelm. It was a lot of constant chaos and just managing a lot of okay, we're just gonna make it through today, and that's the goal today. And at the same time, my heart was so full, right? There was just so much love around me. And so really, these polar extremes, right on, on opposite ends of extreme stress and overwhelm, and, yeah, extreme emotions, and also these other extremes of so much love and so much joy, and that is parenting, isn't it? Yeah, yeah, higher highs and lower lows than anything else, yes. So how do we get to a fourth what happens there? Yeah, so great question. Long time I was like, Nope, never doing this again. Never do this again. And we moved to Montana, so that happened in between, and something started to ship within me. And we joke that even numbers, I don't know, it feels like a better idea, for some reason. And so then we were like, Okay, we'll have a forest. And it's a little thought out, but it was a little spur of the moment at the end, okay, yeah, we'll do this. And then I got pregnant with my number four, and in that time period, what I really discovered was the importance of minerals for our body, and re mineralizing my body, and having some really great changes with that, including being tested for GPS again by my midwife, because we're going to have a home birth, and it's showing up negative. Oh, that's great. Wow, yeah, yeah, being so incredibly grateful that there was still some fear, and my midwife could sense it, and she was amazing. She came probably 12 hours after birth to make sure there was no symptoms, and 24 and a couple days later, because she knew I was really concerned about that, so he kept a really close eye on in GBS symptoms. But it was a absolutely wonderful home birth. So let's slow down about this birth. So what have we learned in the other three pregnancies that we're bringing to this one, no matter what happens, that we are going to be okay, and that was within myself, but also within my marriage, with my partner, and you talked about support earlier, and knowing that I have that within him, but with an extended family, and that there's this beautiful thing that was blossoming, and that, being my family, and this, this culture we were creating in the home, was inspiring, I guess is the word I'd use. And so all of that really played into this decision to go for a number four. And yes, my physical health was shifting greatly as well, from being extremely fatigued, anxious, angry, irritable, tired, to getting my minerals on board. Helps help my mental health. Big time. It really switched everything. And magnesium was the first thing that I really got on board, and we know that magnesium is responsible for over 3000 and enzyme processes in the body, and I didn't have that right, that was absent for me. And so getting that even on board helped me stay calm, or I could go on and on about the changes. So did you happen upon these things because you went to a doctor who told you that, or, like, how do we find this out? No, so I mentioned the earlier health crash, yeah, before babies. And that's when I went to my allopathic doctor and testing. I was like, well, excited. Oh, great. We're gonna figure out what's wrong. And he went, Wait, your labs are good. I don't know what to tell you. And that's what started me into the holistic world and deep diving, and it's 11 years ago now, and figuring out my own health and that whole food eating and getting things like bone broth in your diet or lots of good, nutritious food from the earth that started the shift. And I was already on board with that through these first three babies. But then what happened between the third and the fourth was the discovery of I already have all of those things in place, but there's still something missing because I'm not healthy and my babies aren't healthy. What's happening? And that's when I was not really exposed to the concept of micronutrients, minerals are very important as well for all of these processes to happen healthfully in your body. And that's when I started incorporating that, and saw those big changes, really obvious changes. Of course, I felt better eating whole foods, eating less sugar, all of that. But then the minerals were like this missing key piece that when it was placed in, boom, life changed. Okay, cool. And so that sounds like it's self investigation, not something else, yeah, not any professional education at that point. And this was all digging deep into all the resources available online. Okay, okay, awesome. And so for this birth, we're imagining a home birth, and then how does that play out? How do you know today's the day? What does it look like? Yes, so with her, it's pretty funny. My water actually broke at my midwife appointment, and I think we're about five days to a week after the quote, unquote due date. But at this point I know better. I know after the first you're gonna go over your due date, because you have every time and just be patient and don't be okay. And so we're having our appointment. How you feeling? Blah, blah, blah. And I, I said, I need to use the restroom. I like feels wet. That's weird. And sure enough, my water had partially broken, and then she'll go home get some rest. You have three kids in tow right when we drive home, and as I get out of the car, maybe to grab the mail or something, the sidewalk, my water completely breaks like that big gust, right? Talking about, I was like, Oh no, okay, we're definitely doing this soon. I text my midwife that was at about 11 noon, man. So mind you, 32 hour labor, 24 hour 12 hour labor, 24 hour labor. So again, I think we're maybe tomorrow morning we'll have this baby. So I tell my husband, stay at work. It's fine, whatever. Tell the midwife, nothing major happening yet. We go home, let the kids hang out, prepping dinner, just what I've heard, and it really works, real for me, is keep going with your life. Just keep going with your day of what you would normally do. And that's what I did. So at about five, 530 the contractions start to get closer. I text my husband. I'm like, Yeah, you should come home just in case, and go, I'm sorry. It was earlier than that. It was probably about, like, three, 330 and I'm like, I'm gonna get in the shower, because I don't my water broke all this gunk that really sped things up. Paulette, I get out of the warm shower, and I'm like, we should probably call the midwives now and we get her over, and that's about 435 and by 536 my fourth baby is born. Man, that's fast. Wow. Five hours start to finish. Really fast. Amazing. And were the kids a part of the birth? Or, how did that all work? Sort of, I am a very focused Don't touch me. Don't talk to me. Person. And I want to do my contraction. I want to get it through by myself. If I'm not too any yet, I'll come out of it and be like, hey, joke, let's talk, let's tell stories. And then go through contraction again. But at the end, it was very obvious when that shift happened, and then I remember standing there and saying, I could feel her, she's coming. And I had a friend there, and I said, get the midwife. And I was very thankful, because Sure enough, the next contraction, she is halfway out. Wow. They almost missed it. Everyone almost missed it. My kiddos were home, but they were watching a movie, and so they're pretty clueless as to what, what's going on in us, which is surprising. I think I'm allowed to during labor, so they were there, but not in the room. Yeah, yeah. They're all still pretty young at this point. Who knows if they could make sense of that or but within 30 minutes of her being born, I got settled in the bed, and they were able to come in and meet her. So yeah, that's lovely. Yeah, that's really nice. And then you were saying, The midwife did special checks to make sure there's no GBS and yes. So she knew I was pretty anxious. So we kept a good eye on the temperature. You look for signs, really fatigued, baby doesn't seem responsive, doesn't want to eat, really lethargic. And then we did the blood work right away, too, because she knew we just wanted to keep an eye on that, and baby was healthy, and it was a beautiful experience. Excellent. So lovely. And then is that postpartum easier because you've done it before, or harder, because now there are 17 people in your house? It was really easy. And I chalk that up to two things. I chalk that up to being experienced mom at this point, and knowing the those ups and downs are going to come doesn't mean anything about you. The other resource I'll plug is the Wonder weeks. So a wonderful resource for moms to know to say, oh, okay, it's a wonder week. They're going to be extra clean, they're going to be crying a lot, and this is also what they're learning, and what we'll see on the other side is really relieving for me as a new mom. But I knew all of that at this point, and also my mental health was a lot more stable again because of the minerals, and so I was a lot more I was just chill. I wasn't panicked by things. I wasn't paralyzed by decision making, is how I'll say it. That was really an indicator in the first couple of births that something's not right here. So that's amazing, and I'm guessing, although you should correct me and expand on this, if you had to give advice to younger Atara, one would be nutrition, yeah, yes, absolutely. One would be get your minerals on board with the practitioner. I don't think we're talking about doing it backwards, right, doing like postpartum backwards, and offering support, prepare your body, even for conception, if that's what you want. And I will give credit to that natural doctor that I saw. She did say to me, we don't typically want babies when our body isn't doing well. And that was really solid advice too. Get your own health really solid, and then go for it on a number of levels. It can also impact your mental capacity, yeah, that makes sense. 
Paulette: 
ATara, thanks so much for sharing your story. It's an amazing learning curve. 

Atara: Yeah, yeah, quite, quite a journey. Definitely. Thanks so much for talking this morning. Thank you. I appreciate your time.