Happy Hour with Bundle Birth Nurses

#89 Surviving AFE: From Trauma to Survival to Advocacy with The Birth Trauma Mama

• Bundle Birth, A Nursing Corporation • Season 6 • Episode 89

Share episode

In this powerful episode of Happy Hour with Bundle Birth Nurses, Sarah Lavonne and Justine sit down with AFE survivor and trauma therapist Kayleigh Summers, whom you may recognize as @thebirthtraumamama on IG. Kayleigh shares the shocking details of her near-death birth story, the moment everything changed, and the life-saving interventions that brought her back. Now a fierce advocate for trauma-informed care, Kaylee is using her voice to raise awareness about AFE and support survivors. This conversation is raw, emotional, and deeply important for every nurse and birth worker to hear. Thanks for listening and subscribing! 

Send in your question to be featured in Season 7 of the Pod! (90 sec total)

https://www.speakpipe.com/HappyHourwithBundleBirthNurses 

Helpful Links! 

Hi, I am Justine. And I'm Sarah Lavonne. And we are so glad you're here. We believe that your life has the potential to make a deep, meaningful impact on the world around you. You, as a nurse, have the ability to add value to every single person and patient you touch. We wanna inspire you with resources, education, and stories to support you to live your absolute best life, both in and outside of work. But don't expect perfection over here. We're just here to have some conversations about anything—birth, work, and life—trying to add some happy to your hour as we all grow together. By nurses. For nurses. This is Happy Hour with Bundle Birth Nurses.

So I remember when I was training in labor and delivery, I went to an AWHONN conference in California and there was a speaker on AFE. And I'm going through it and I'm taking my notes and I was still in my training and I like, stop. And I'm like, I completely forgot about AFE. Like I learned it in school. We barely go over it because it isn't tested on the NCLEX. And I was like, I had this moment of like, well, I can't do this. I can't do labor and delivery. Like there's a possibility of an AFE. And then I went back to work and I had like, I was on—I remember I was on night shift and I asked one of the nurses that was precepting me—she wasn't my main preceptor—“Tell me what you know about AFE.” And she's like, “Oh, I don't know anything.” And I was like, “Why? Like, how do you not know anything?” And I'll just say this. She's like, “Well, 'cause they all die. There's nothing we can do,” is what she said. And I remember being like, that cannot be the answer. What is happening? Right? And it never sat well with me. Wow. And I always—like I remember asking my educator like, “Do we have an AFE policy? Do we have an AFE protocol?” And she was like, “No, we don't. We just hope it doesn't happen.” That was the answer there.

This is also common, Justine. Like, I can't tell you how many times I've heard this story. This is common. So we are excited to bring our guest on today—Kaylee Summers from The Birth Trauma Mama—who you just heard. She's one of those amazing—and I don’t like saying lucky—but survivors. Do you call yourself a survivor? I do. And I also call myself very lucky. Very lucky survivors of AFE. And I met her—and “met” in quotations—we’re meeting right now for the first time face-to-face, but I met her on Instagram around 2021. We were agreeing on, because I saw her Instagram page and I saw her story and we were able to collaborate and do a Tracing Tuesday. And things I remember still to this day was that it was a long induction. We don’t really agree with the induction, right? Like it was kind of a high blood pressure—and we can talk about that—and then you were induced and then it happened. The event happened while you were still pregnant. The critical care team, like the trauma team, was at a conference on the L&D floor, which is insane to me.

Guys, imagine that. Like, imagine how perfect that lined up and they were able to come immediately to help. And the fact that you then had to go rush to the OR—the fact that you got to the OR so quickly—units of blood, your ABGs, your pH was under a critical threshold, you went on ECMO, you coded multiple times, and you are here today and like changing the world in AFE and making such a difference with not only that but with trauma and birth trauma in general. So we're just so excited to have you and learn from you. It's about time.

I know. Thank you so much for such a warm introduction. It made me a little teary. I will share that I remember when you reached out to me and I was like, oh my God, I'm obsessed with Tracing Tuesday. I'm also—I don't know if you know this about me—I am, what's the word, a medical hobbyist ever since my event happened. Like I'm just obsessed with medical things, specifically in L&D obviously. And so when you reached out to me, I was like so excited. And then I was excited to share the story. And I remember what was different about it—and I think this is why it was a little bit crazy—was that you had never shared a story where then at the end you were like, “And this is a real patient. Here she is.” And like, there was something about that that was just like wild. And for me and my little tiny baby account—I don't know, you probably don't remember this—but I had like a little over a thousand followers at the time. I was really passionate about what I was doing, but like, you know, I had been doing it for like a year and had like, again, a handful of followers. I felt great about that. But you shared my story and that was the catalyst to the platform that I have today because it went from like that to like thousands in a few weeks because people were hearing my story. Wow.

And so yeah. And so I have you guys to thank for that and I always remember that. And it always is just so impactful, especially given the work that you all do. Like I had already followed you before that 'cause I was so—you were the first account that I found that really combined the idea of physiologic birth with a medical setting. Anywhere else I saw, like, your big thing is like, “You can have this in a hospital.” And everywhere else I saw was either very medicalized birth or, you know, the whole other side of that. And it was like a happy home for me being an AFE survivor because I continued to see all the birth trauma that happened at the hands of medical professionals as well in my community. And so being able to see a place that was educating at the intersection of that was so important to me and really powerful. So thank you both.

We're in it together. I know. I know. It's so great. I love that. I feel like, too, so many of our followers are nurses and I love the testament to our community that they like rushed to you. You know, they're like, “Have to learn more!” Yes. We want to see a patient story. Yes. Yes. I think that's really neat. 'Cause I'm sure you have tons of nurses that follow you, and your message is so powerful too. And so they're learning from you and that’s just awesome. It’s symbiotic. I love it. Yes.

Okay, so today we just want to kind of talk about your story and talk about your work. Yeah, I would love to. I mean, you have the high points of my story. Break it down though. We want to know like the nitty gritty, like even like the medical stuff, if you want to tell us. It's my favorite. Yes. It's my favorite part. Come on. Use your medical hobby to—I'm going to do it. Details. Use my medical hobbyist identity.

Okay. So I had a really normal pregnancy. I had what I now know to be white coat hypertension. I had one like random spike. I was teaching middle school at the time, and I just was like, I'm going to call my OB. And they're like, why don't you come in just to be sure. And of course, when I came in, my blood pressure was even higher. And so I got sent to triage. It normalized within two hours and I got sent home. My labs were fine. Everything was fine. And then I started having these spikes, but only at my OB appointments. So I started documenting my own blood pressure at home, taking it two to three times a day. I had these beautiful spreadsheets and I would show my OB and I was like, “See? It's always fine at home. It's just with you guys.”

And I was doing therapy at the time and my therapist and I were talking about how I was not anxious. I was mad. I felt very angry and like disrespected in these OB appointments. And I now understand that that was like my trauma response to the way that I was being treated. And that anger was coming out in my blood pressure.

Wow. And so fast forward to 39 weeks. I had again had no other signs of preeclampsia. My labs were all fine. I had some sort of discussion at my 39-week OB appointment and the OB decided, “Let's just be safe and induce you.” And this was on a Friday and they scheduled the induction for that Monday. So to me, not an emergency, not medically necessary. I was not told anything about the risk of induction or, you know, that it wasn't truly medically indicated. And so I went in on Monday for my induction, still didn't have any of the symptoms.

They started with Cervidil overnight. I went in, I was like maybe one centimeter, 50% and minus two station. So like not ready for labor. Did Cervidil overnight, Pitocin the next day, had a balloon placed in the afternoon, and then got an epidural in the evening. So all of that was like not a big deal. It was long. It was slow. The balloon fell out around 10 o'clock. I got my epidural and then was able to sleep for a few hours.

Around 2:30 a.m., my water broke spontaneously. And I remember feeling it and I was so excited. Like finally something was happening. It was the middle of the night. My husband was asleep, so I just like let him sleep. And I was like, this is so exciting. I called the nurse. She came in and checked me. I was six centimeters. So like, again, we were progressing. And then she left to go get my epidural bolus and then came back in with the resident who checked my cervix. I don't know why. And then that's where my memory ends.

And from what I've been told, that was sort of the beginning of what we think was my AFE. And so I was very quickly showing signs of like respiratory distress. They tried to place oxygen. It wasn't working. They tried to place a non-rebreather mask. That wasn't working. I started to get really like combative and confused. And my OB came in at that point, the attending, and they decided, “Let's just go to the OR. Like, we don't know what's happening, but let's go.”

And so again, very quickly, they transitioned me. They called a code OB. They brought me to the OR and intubated me upon arrival. I went into cardiac arrest and my son was delivered via crash C-section during that arrest. He came out unresponsive. They coded him. They coded me. They got him back. They got me back. And we were both very unstable. We were separated and the next few hours were really, really touch and go.

I had multiple massive hemorrhages. They were calling my time of death. I was unresponsive to CPR and defibrillation and blood products. And the perfusionist came running in and was like, “ECMO, ECMO, ECMO.” And so they got me on ECMO, which is what saved my life. And a little while later, I woke up. I was intubated and restrained, but I was like, alive.

Wow. Wow. You went through all of that, and now you talk about it for a living. You could have, like, not. Like, what made you want to talk about it? It was kind of a slow process. I started by writing. Writing was really helpful for me in my recovery. And then I started an Instagram account. And the whole idea of it was like, I didn't want to be found. Like, I didn't want to talk to anybody. I wanted to have this anonymous account and just write what I was going through.

And that was incredibly healing. And it quickly turned into more than that. And I started connecting with other people. And I was like, wait, this is really powerful. And the first few times I shared my story, I remember thinking, if I can just say it, if I can just say it out loud, then it loses a little bit of the grip it has on me. And so every time I shared, it felt like it had less and less power.

And then I started connecting with other survivors and I was like, oh my gosh, this is really, like, this is really special and important. And I remember reaching out to some of the other AFE survivors that were out there and being like, “Hey, this is a thing we could do together. We could talk about this. We could raise awareness. We could maybe get people to care about it.” And that was, you know, that was a really big motivator for me to keep going.

My husband remembers them saying, “Let's get her to OR one.” And they said, “No, someone's in OR one. We have to get her to OR two.” They asked if I had a pulse. And he thankfully doesn't remember the response to that. So we did have an OR on L&D, which is why they made that decision. Typically, best practice is bedside C-section if there's no resuscitation within four minutes—which I know most people know listening to this, but I want to call that out because my team did not make that decision, and that's okay. I love them. They did an amazing job. They made the decision to take me to the OR, and they were able to deliver my son within six minutes of that code blue call, which is pretty darn good, especially for moving me. Yeah, very fast.

And so my son was unresponsive when he was born, so he did need to be resuscitated. My OB will tell you that he is the heaviest baby she has ever delivered—not only because he was 10 pounds, 14 ounces, but because he also had no muscle tone because he was unresponsive, making him kind of feel even heavier when she delivered him.

So he was able to be resuscitated quite quickly and did really well. If you look at his cord blood gases, they're horrendous. They speak to like, he should be cooled. But his Apgars bounced back so well—he was like, I think a 1 or a 2, and then an 8 and a 9.

So he was taken off to NICU. Very interesting—they explained it… I don't know how true this is, or things kind of get lost in communication and trauma—but my family remembers my OB explaining that there's like a bit of an oxygen reserve for the baby, and so they think that that helped him, along with really quality CPR. Clearly I got very quality CPR, given I'm sitting here talking cognitively intact today.

And so they whisked him off to the NICU. CPR had continued on me until the end of that C-section, and so they were still doing CPR while my OB was sewing me up. And she would have to tell them like, “You gotta pause real quick and throw in a stitch,” and then they would resume as she was doing that.

They did achieve—Yeah, I—sorry, I'll take a breath. I'm used to just like running through my story and telling it, and people are like, deep breaths. It is—I know it. And I'm still just like—yeah. I mean, and we can definitely handle it as well. I know, I know, I know. I think it's just, you know—before you continue, I wanna just say that like, you’re sitting here right now, and so I feel very celebratory hearing this awful story. And that’s not the case for a lot of people when it comes to AFE.

Exactly. You know, it’s sort of like balancing that somber respect—Exactly—for the various people that actually don’t make it, while also celebrating your life. And this is a really hard balance for me as an AFE survivor, and something that I find really important for us to acknowledge and balance in a way is that I do have survivor’s guilt. I live with that. I live with the fact that I lived when others didn’t, and I also really feel called to share the story because I believe that it can help.

And I do think that the very fast turnaround I made had to do with that—with them implementing skin-to-skin, and my baby being with me as soon as I could wake up. My family being there. Them putting me in a space that reminded me that I had a baby and I had a reason to be here. And all of those things mattered.

So eventually, I woke up. I was intubated and restrained. And I don’t remember much from that time, but it was about a day and a half on ECMO. And then I started to stabilize. And I was extubated about four days later. And I was holding my baby five days after the event. Wow. And breastfeeding. And breastfeeding. Yeah. He latched like a champ. I love that for him. He’s so chunky and beautiful.

And so—yeah. That’s my story. And now you’re here changing lives. We are so grateful for your story and the way that you tell it. You’ve given voice and words and context to something that most people only fear or never understand. And now, nurses get to feel more prepared. Patients feel seen. And there’s hope even after trauma. Thank you for being with us. Thank you for having me.

Okay, so let’s talk about what you do now. Yeah. So now I am a trauma therapist and birth trauma advocate. I run a private practice that specializes in trauma therapy and perinatal mental health, and I run The Birth Trauma Mama community and podcast and platform. And so I do that work really to sort of support survivors who are in this community. I didn’t have that. I didn’t have a place to go where people knew what I was talking about. And now, thankfully, there are a few more places like that, but it still isn’t enough.

And I love this idea of being able to be a part of building a trauma-informed world in maternity care. Like that’s what I want to do. I want to do that from the inside and the outside. So I work with clinicians. I work with nurses. I work with birth workers. I work with survivors. And the idea being that if we can understand trauma, if we can learn how to support people after trauma and prevent trauma in the first place, we can really shift the whole system. And so I feel very called to that work. I love that.

I think sometimes trauma feels so overwhelming, or like this kind of vague, heavy word, and it feels like you’re not qualified to deal with it unless you’re a therapist. And it’s like, that’s not true. If you’re in a birthing space, you are dealing with trauma every day—whether it’s yours, your coworker’s, or the patient’s. Yeah. And that’s one of my big things. Like if you work in perinatal care, you are working in trauma care.

Yes. That’s just it. That’s the line. And so being able to then say, “Okay, I work in trauma care. What does that mean for how I show up?” That’s really powerful. And I think it gives us a lot of control over something that often feels really out of control. That’s so good. I think it also like puts a name to the emotional toll that we take on in L&D, especially, because so much happens so fast and so big. And we’re supposed to be, you know, this steady force through it all, and that’s just not human.

Right. And especially if you don’t have the support or the language to process that or to reflect on what just happened. I mean, one of the things that I tell people all the time—nurses, doctors, survivors—is that your body keeps the score. Your body holds the trauma. You don’t have to say anything. You don’t have to acknowledge it. You don’t have to remember it. Your body knows what happened. And so being able to access that and support that—mind, body, soul—is so important.

Yeah. It shows up whether you like it or not. It shows up. That’s what I always say. I'm like, it's going to show up. So let’s help it show up in a way that feels good and safe and okay. It makes me think too—like I’m a huge advocate for debriefing after events, and like, we don’t do that. We don’t take the time. We don’t pause. And sometimes, I know it’s shift change or it’s chaos or something else is happening or you have four patients, but the ripple effect of not pausing has such an impact not only on how we care, but like our longevity in this career.

Yes. It’s a huge factor in burnout. Like it’s probably one of the biggest factors. I just—if there’s one thing I could change, I would give people 10 minutes after every birth. That’s it. Just 10 minutes. Like what would that look like? What would it look like if we all just like were able to stop and be like, “What just happened? How are you? How am I? What do we need?” and move on. That’s it. But we don’t do that.

And I don’t think it would take away from productivity. I think we’d be more efficient if we did that. I do too. We’d make less mistakes. Yeah. Because we’d be regulated. Because you’re not running on fumes. Yes. And you’re not traumatized. You’re not dissociating. You’re not shut down. Yeah. Because what we see is when people are in those states, that’s when the trauma happens.

Yes. That’s when the mistakes happen. That’s when the ruptures happen. That’s when people feel unseen, unheard. That’s when we stop caring. That’s when we stop caring. That’s what I hear the most from survivors. Like, “They just didn’t care.” And I’m like, you know what? I bet they did. I bet they did, and they couldn’t show it. Or they were so dysregulated themselves that they couldn’t access that part of themselves. I always say that nobody becomes a nurse to cause harm.

Absolutely. That’s not why we enter this field. And so when we do, it’s usually because of these systemic factors and a lack of support and a lack of education. And so I think those are the things we can change. Like we can’t change everything, but we can change those. It makes me think about trauma stewardship and this idea of how do we stay in this field for the long run while carrying the weight of what we do and the privilege of what we do? That’s trauma stewardship. It’s showing up with presence and care and regulation and boundaries. And that’s really hard, especially in a broken system.

It’s possible, though. I’ve seen it. It is. And it’s contagious when it happens. It is. It really is. Like I always say, “Regulation is contagious. So is dysregulation.” Yes. It spreads like wildfire. And so you decide what you want to be contagious. Like, I tell nurses, I tell providers, like, “You’re going to walk into a room. You’re going to set the tone. You just are.” You are the energetic force in the room when you walk in.

And so you decide what you want that tone to be. You don’t have to be perfect. You don’t have to be happy and peppy all the time. You just have to be regulated and connected. That’s it. That’s it. That’s beautiful. I love that. What are you seeing from patients who have had traumatic births that you think nurses might not realize is happening on their end?

Yeah. So a few things. I think the biggest one is that it’s usually not what happened. It’s how they were made to feel. And so what I see the most is, you know, when we’re thinking about diagnostic criteria for trauma, it’s not that a traumatic event occurred. That’s not the criteria. The criteria is that the nervous system responded to a perceived threat. That’s it. It doesn’t even have to be real. It doesn’t even have to be happening in the moment. And so what we see is people were scared and people were alone.

And what happens when you’re scared and alone is you become traumatized. And I just want nurses to know that the little things that you do matter so much more than you know. The sitting with someone, the holding their hand, the looking them in the eye, the offering presence when you don’t know what to say, that matters. It is the antidote to trauma. Like, it’s the antidote. We can’t prevent all trauma, but we can buffer it. We can hold people through it. And that’s what matters.

So that’s the first one. The second one is that a lot of times, I’ll hear from nurses, like, “They had a healthy baby.” And I get that. That’s a protective thing. It’s like, “I want to believe this went well.” And so they had a healthy baby. But there’s so much loss that happens for survivors. And I say this all the time, like, loss is more than death. And so when we talk about the loss of a vision, the loss of control, the loss of dignity, the loss of safety, the loss of a future family—because people aren’t going to have kids again after their traumatic birth—those things are real.

And so being able to acknowledge those things and hold those things and not dismiss them because “they had a healthy baby,” is so important. And then the third thing is just listen. Like, people want to be heard. People want to tell their story. I can’t tell you how many survivors come to me and say, “Nobody ever asked me what happened.” Wow. “Nobody ever asked me if I was okay.” We don’t do follow-up in postpartum in the same way we do in other types of medicine. And so people are left on their own with very little support and understanding.

And they just want to tell someone. They just want someone to say, “That was a lot. I see why you're feeling the way you're feeling.” Like, that validation goes such a long way. And so just being able to be that person for someone, even if it's for a minute, is so powerful.

It makes me think—like, one of the things I try to teach is when someone says something like, “This is scary,” or “I’m afraid,” or “I don’t know what’s happening,” the answer isn’t to say, “It’s okay,” because that’s not what they’re asking. The answer is to say, “Tell me more,” or “That makes sense,” or “I hear you.” Yes. Or even just nodding. Like sometimes it’s just like, “Yeah. Yeah, that’s a lot.” And that’s enough. That’s enough. And people feel that. People feel when they’re seen and heard. They feel that.

And we don’t always know how to fix things, and we don’t always have to. No. You just have to be with them in it. That’s all. So what advice would you give a nurse who maybe has just seen or experienced a really traumatic event at work? Like, what do they do with that?

I would say the first thing is to pause. Just pause. Take a breath. And ask yourself, “What do I need right now?” And if you don’t know the answer, that’s okay. That’s okay. Just sit with that. And then I would say, find someone you trust to talk to. Find someone who can hold space for you. And that might be a friend, that might be a therapist, that might be a coworker, but just find someone.

And then give yourself time. Give yourself time. You don’t have to bounce back. You don’t have to pretend like it didn’t happen. You get to be impacted by the things you go through. That doesn’t make you weak. That makes you human. I think we forget that sometimes in healthcare. We do. We do. We’re not robots. And we’re not supposed to be. No. And so that’s what I would say.

And also just knowing the nervous system, it will re-regulate. It will. It’s built to. That’s its job. That’s its job. But it has to be safe to do that. And if we don’t feel safe—if we don’t give ourselves space—we won’t be able to re-regulate. And we get stuck. And that’s when it becomes trauma. That’s the thing. The definition of trauma is not just what happened. It’s what happened without the resources to process it. That’s it. So when you give yourself resources and space and time, you’re processing it. You’re not becoming traumatized.

That’s really powerful. It gives you a lot of hope. It does. It does. It gives you control. And that’s what I want for survivors. That’s what I want for nurses. I want you to feel like you have control again. It doesn’t mean we can control everything that happens, but we can control what we do with it. And we can support each other through it. Yeah. And I think, too, like, having a culture that allows that. I think that’s the hard part, is like, we can do our own work, but then we go to work and our coworkers are checked out or burned out or whatever.

And I just think, like, if we all do the little things, like if we all regulate a little bit more, if we all say, “That was hard,” or “Are you okay?” or “Do you want to debrief that with me?”—it changes the culture. And we can be the culture changers. Like that’s the thing. You don’t have to be a manager. You don’t have to be in charge. You can be the culture shifter on your unit.

That’s such a good reminder. I think we forget our influence sometimes. Totally. Especially when you’re new or when you feel like you’re drowning. Yeah. Or you feel like you’re not heard. But it matters. It really does. It really does. And you never know who’s watching or who’s listening or who’s being impacted. So thank you for sharing your wisdom with us today. You’re welcome. Thank you for having me.

We are so grateful. You’re welcome. I’m so happy to be here. And thank you for all that you do. Thank you. You’re changing the world. We’re doing it together. We are.

So if you want to learn more, where can people find you? Yes. So I am on Instagram @thebirthtraumamama. I also have a podcast called The Birth Trauma Mama Podcast. And then I have a website, thebirthtraumamama.com. You can also email me at hello@thebirthtraumamama.com. I love that. And you’ve been like doing keynotes and you’ve been speaking and presenting and all the things. I have. I have. It’s been a wild ride. And I really just feel like if I can share what I’ve learned, I want to.

And if I can support people through this, I want to. And so I love being able to connect with people, especially nurses. It’s one of my favorite things to do. You’re a safe space. Thank you. It’s felt. You are too. Thank you. So much. Thank you so much. Thank you. All right, well, we’ll link all the things in the show notes so that you can find Kaylee and connect with her more.

And for all of you nurses listening, we’re just so grateful that you’re here and that you care enough to want to keep learning and to hear these stories. And we hope that it’s impacting the way that you care and also the way that you care for yourself. So thank you for doing what you do. And we’ll see you next time.

Thanks for spending your time with us during this episode of Happy Hour with Bundle Birth Nurses. If you liked what you heard, it helps us both if you subscribe, rate, leave a raving review, and share this episode with a friend. If you want more from us, head to bundlebirthnurses.com or follow us on Instagram.

Now it’s your turn to go and help bring the humanity back to healthcare.