Carrying for Others: Cori

In this episode, Katie sits down with Cori — nurse-midwife, gestational carrier, and quite possibly the most interesting person you'll meet this week. Cori has spent her career advocating for better birth experiences after her own traumatic deliveries pushed her away from obstetrics and toward midwifery. But her story doesn't stop at the delivery room door.

Cori opens up about the deeply personal decision to become a gestational carrier and what it's like to navigate that journey when you actually know what all the consent forms mean.  From unpacking the ethics surrounding gestational carrying to the medicine and the emotions behind carrying a pregnancy that is someone else's, Cori keeps this conversation unfiltered and fascinating.  She also shares how her late mother's memory has quietly shown up at every milestone: in a tattooed handprint, a cherished nightgown, and a calling that started long before nursing school. Cori's story is truly one of the most layered conversations this podcast has had.

This episode pairs best with a mango smoothie!

Transcript

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0:01

Welcome back to another episode of my podcast. Mindful Midwifery Presents, the Labor Behind Labor. My name is Katie O'Brien, and I've been a nurse midwife since 2007. Midwives have tremendous pressure to show up to their work every day as their best selves. We must show up despite bad weather, bad days, or bad situations. Midwives are regularly tasked with showing up for their communities and in their personal lives day in and day out. The goal of my podcast is to highlight this challenging world and give listeners an insider's view on what it feels like to be a midwife tasked with being your best self, both professionally and personally. Today I have a guest who honestly keeps surprising me every time I learn something new about them. My guest, Corey, is a nurse midwife whose story covers some profound territory. In this episode, we will cover Cory's motivations to becoming a midwife and how it relates to why Cory became a gestational carrier. What makes our gestational carrier conversation so unique is that Corey brings a clinical lens to an experience that most people navigate without one. This has given Corey a fascinating perspective on the ethical, medical and emotional layers of carrying a child that is not your own. We also get into the story of Corey's late mother who inspired Corey in more ways than one and whose presence Corey has carried close to their heart throughout their whole midwife and gestational carrier journey. This one runs a touch longer than most of my episodes, and I'll tell you right now, it earns every minute. Let's get into it.

Katie 1:31

Okay. So I am really excited to have you here, Corey, because everything I learn about you becomes more interesting. And so when I was thinking about what podcast to do with you, I was like, oh, there's several different topics we could go down. So definitely in another season, maybe I do another topic, but the topic that I found most interesting is your gestational carrier status. So I want, I want this episode mostly to be about that. I think there's a lot of interest around that subject and I think having a midwife. Experience it with all the knowledge that you bring to the table as a midwife is really helpful to hear. There's a lot of ethical considerations and health considerations, and as a midwife, you're gonna be able to walk that world of knowing those things as you're walking through the process. Um, which a lot of people don't have that, so that's really important. So I wanna start though first by talking about why you became a midwife, because I have a feeling there's probably gonna be some crossover with why you ended up deciding you wanted to be a gestational carrier. So let's start with, what about midwifery was appealing to you? Why did you, because you were a nurse, so why did you decide you wanted to be a midwife?

Cori 2:52

I actually had the goal of becoming a midwife in mind prior to even becoming a nurse. I had delivered my two children in a hospital, my two older children in a hospital with an O-B-G-Y-N physician, two different ones. And both of those births were wildly traumatic to me. I initially wanted to be an ob, GYN whenever I was young, so I wanted to be a physician. But then after those births, I was like, we can do better. We can do better for women, I can do better. Not saying that I'm better than anyone, but I, we could just do better for women in general. So. When I started looking into it, I started seeing all different types of midwives and all I had available to me was Google. So you had lay midwives, you had certified professional midwives, and then you had certified nurse midwives. So then I looked into the track to becoming a certified nurse midwife, and when I applied to nursing school, I was still pregnant with my second child. But then the experience after having her, I pushed for four hours and then the physician kept yelling at me the whole time I was pushing. And then at one point he told me to stop being a hero because I was unmedicated and just accept something for pain and I didn't want that so. I don't know. It just became one of those things, I guess.

Katie 4:24

So you were already in nursing school? No,

Cori 4:27

hadn't even started yet. I just gotten my acceptance letter actually.

Katie 4:30

okay. So you had started the process and then that probably solidified the idea that you were on the right

Cori 4:36

It did. It did. So, I mean, I know it's kind of the first birth trauma made me think I need to do something. I need to become a nurse. And I wanted to become a midwife. And then the second one I was like, Nope, I

Katie 4:52

definitely need to do

Cori 4:52

it because this is

Katie 4:54

bad. Yeah. The

Cori 4:55

things that physicians were doing to women, or at least those two particular physicians were doing. And that was my only experience with birth at that time. Three months later, I'd already been accepted to. Nursing school and my friend wanted me to be there for her delivery. She'd been pushing for maybe an hour. And then the physician, which this is a totally different physician than the two that I had, does an unnecessary app episiotomy. And I remember him literally going to my friend, I'm gonna cut this real quick so that baby comes out faster. He does it, he, the head flies out, baby's on the chest. And I'm like, why did that happen? Why did this need to happen? I don't understand. And then I learned more about unnecessary episiotomies, which then talking to women in my family, many of them had had, which as a midwife now I know is not medically necessary until it is actually medically necessary. My mother being one of the people with me having an unnecessary episiotomy unmedicated. Without lidocaine.

Katie 6:03

So then you were in midwifery school and how did midwifery school go for you? How did you feel about it? What was your thoughts? How long did it take you? Where did it take you?

Cori 6:15

It took me the standard two years. It was like a freight train. 'cause you don't have any time off. You don't have the summers off at all. But I loved it. I really did. I went to Georgetown, so,

Katie 6:28

Oh, I went to Georgetown. I didn't realize we were fellow alumni. Were you, was it still in person at Georgetown or is it online? Yeah, we were in person for, for me, one of the things I liked about Georgetown that I think might have changed since in the difference between me and you is we were in person and so we were all there. DC has a really wide variety of midwives, like the type of midwifery care they're giving. And so I saw a lot of different types of midwifery care, which was super cool. That I think a lot of. Midwives don't get that. That experience too, because I went into school and it sounds like you might have gone in similarly without the understanding of what spectrum of midwifery I was gonna fall in. Like I didn't go in saying like, I'm gonna be this type of midwife. I just wanted to be a midwife. And over the course of experiencing a lot of different types of practices, I have realized that I am a philosophically like home birth, birth center world type of midwife. But schedule wise, I fall solidly into like hospital, like shift work. And I do like the high acuity sometimes too. I like the pace. But the point is I kind of took it all in just very objectively at the time. Like, what does this look like across the spectrum? What does this look like to deliver in the hospital? What does this look like to deliver at home? So did you have. Any experiences with that? Like things that you went through in school that you were like, I don't wanna be this type of midwife, or I do wanna be this type of midwife, or This doesn't feel right to me.

Cori 8:02

Yeah, I did. My first clinical site was at an FQHC and it was awful. The midwife I was with was a quote unquote midwife, and throughout my clinical experience with her multiple times, she told me that I had no business trying to become a midwife because I'd never been a labor and delivery nurse and that. I should quit and that I was stupid for thinking I should continue with the path of becoming a midwife. And that was an entire three months with her. It was terrible. Then I learned I didn't wanna be her. I definitely was not gonna be her. And then I went to another midwife after that that was closer to me. I think she was like 40 minutes from my house versus me having to move states to be with a like a preceptor. And I was like, that's who I wanna be as a midwife in the office the way that she did deliveries, because I did some of my clinical rotation at the hospital with her. I was like, that's not who I wanna be in the hospital, but that's definitely who I wanna be in the office. And that's how I want to speak to patients. That's how I want to reassure patients. But my clinical experience at that hospital. Was awful.

Katie 9:20

What was, what was so different about the office setting in the hospital setting?

Cori 9:25

So she actually took time for patients. So she would spend 20 minutes speaking to a patient and reassuring patients and making them feel comfortable. But whenever we got to the hospital, it was very much, everyone with an epidural gets an IUPC and an FSE. This is how we monitor our patients. We do a lot of hands-on pushing. We put our fingers in people's bodies without explaining to them what we're doing. Because our main goal is gonna get this baby outta your body as fast as possible. And that's not something I'm, I'm into. There wasn't much alternative pushing. Positions versus that something that she was talking about all the time while in the office. And I learned that there was a disconnect between what she was advocating for in the office and how she was actually practicing in the hospital. interesting.

Katie 10:18

You bring up indirectly, the possibility that. If midwives have autonomy in one setting versus the other, like more autonomy in one setting versus the other, I think you can get that disconnect where if they're, and it can go either way. Sometimes the lack of autonomy is in the office and sometimes the lack of autonomy is in the hospital. Sometimes it's both, sometimes it's neither. But especially if you don't have the autonomy in the hospital, you can have this provider that looks great in the office when they're able to just be themselves. And then the second they get into the team play with physicians and nurses and, and just the system of the hospital, then suddenly they're not able to do what they wanna do, or they're not in the mindset to want to push against the system. And so it looks very different.

Cori 11:12

Exactly. And I think that's really where she was, which I thought as a preceptor and a midwife, that she was an amazing human being But in that hospital setting, because there was a bunch of different practices there too. It wasn't just her and the physician she was practicing with, it was all different sorts of practices, that she kind of fell into it because sometimes somebody else would be managing her patient before she got there to be able to push and, be able to catch the baby.

Katie 11:41

It's challenging. I'm feeling this right now still where there's this push and pull constantly with the hospital, of, okay, we want midwives, we want. In theory, the midwives to be midwives. But we are subtly putting policies in place all the time that aren't supporting what we really wanna do. And then especially the longer you're in this career, the more you're like, you get tired of fighting. Like if you're just fighting all the time for decades, literal decades, at some point you're like, how much longer can I keep fighting this issue? And is this patient and this is where it gets kind of sad. Is this patient worth the throw down? I remember, I had a student who ended up being a midwife in our practice leader, and she came in as you always are as a student, you know, idealistic. And thank God we have students that are idealistic, like you want people in their idealistic and she's like. I don't agree with this C-section. I don't agree that we need to be doing this right now. And the patient frankly was like A BMI of 60 and had stalled for a really long time and there were just other factors there. And I was like, I totally understand what you're saying completely, but if the patient's not arguing with it, and unfortunately we can't do c-sections ourselves, we are held a little bit to the mercy of the system. And because we're not doing the C-section our ourself, it's not entirely fair. A hundred percent fair for me to look at a physician that is going to have to do this, what will be very difficult surgery and throw down about it, and is it worth doing that for this patient that is not? N like the patient's in agreement with the care. Is it worth doing that right now? Versus you have a patient in an hour and a half with the same provider that is healthy and is not in agreement with this plan of care and you don't feel like this person needs a C-section? Is essentially, sometimes I think it becomes a choosing your battles. Like that person, for me, as I, as I have gotten been in this career longer, it's like this person is the one I'm gonna throw down for. Because to throw down about all, all the things all the time is exhausting. But it is unfortunate because we're in this situation all the time as midwives where we're in these hospital practices where we're still, it's like they're just giving us little trinkets of like, here you're a midwife, but like we're still so far away from embracing the whole culture.

Cori 14:24

think it also depends on which physician we're working with that day. Sure. On how much we can practice as freely as we would otherwise. Because there have been some physicians that I'm like, this isn't worth the fight. But then there's others that I'm like, I know they'll listen to me. I know I've had my patient stalled at eight centimeters for almost for over four hours, but I know I can get this baby out vaginally. I know I can get this bus totall because it's a position issue. This particular patient had ended up being stalled for eight hours before she finally got to 10 centimeters, but she was stalled at eight for eight hours. And the physician I was with that said, baby looks good. Mom looks good. Keep going. Get the baby rotated and show me that you can have a vaginal birth. And I did. But if I had been with any other physician that day, she would've had a C-section.

Katie 15:18

Yeah, that matters a lot. And it's interesting because sometimes the providers that start, we had this one provider that a lot of us that have been on this podcast worked with that loved doing a c-section. But once you gained their trust, they would really let you do your thing. It took, it took a while to gain their trust, but like once they trusted you, they were like, okay, you're, you're, you're doing this essentially. Let me know when I'm needed.

Cori 15:46

Yeah.

Katie 15:47

So some of that is rapport over time, but I can, I can like put myself in the situation of this preceptor that you had of like, wow. The things you're able to do in the office and then you get into the hospital and it's like, oh my God. But I've also been in the other scenario where you actually kinda have more freedom in the hospital and then in the office because of,. Billing confines, like you need to be seeing these patients really quickly because of revenue. So it's not a black and white where it's gonna be the t, the tug and the pool. But anyway, that's a digression. But, so you went through school and then you decided the midwife that you were gonna be. And you correct me if I'm wrong, but you've been kind of open to where you were gonna live after

Cori 16:32

mm-hmm.

Katie 16:33

Midwifery school. Your husband's also a nurse so he could get a job anywhere. Yeah. So what landed you around here

Cori 16:38

because of another preceptor. So I actually only made it three weeks in hospital before I quit, and I told them I was never gonna work in another hospital environment ever again.

Katie 16:49

This actually tracks for me. you are so,

Cori 16:52

so I told Georgetown, I said, if you can't find me a preceptor that's out of hospital, I'm not doing it anymore. So I almost quit. And do you know what Georgetown did? They found me at out of hospital preceptor, like quite literally, it was a home birth practice in Maryland.

Katie 17:10

Okay.

Cori 17:11

So I. Sold my house, bought an rv, and moved to

Katie 17:15

Maryland. And that is how you're here. yep. And so did that, how did that go? 'cause you're not working for home birth right now, so what, where where'd that go? How'd that go?

Cori 17:25

Um, so I absolutely loved the six months that I was with that preceptor. Everything that she said during prenatal appointments was what happened during the birth. I was like, oh, this is who I can be, uh, somebody that's being honest. I know that I'm not gonna have hour long appointments by any means, but I can be honest with what birth looks like in the hospital with my patients, with what it would look like with me, but also knowing how my other. Midwife's practice that it could vary from midwife to midwife, but the primary goal of each of us is to protect you. And to minimize birth trauma while you are in the hospital. But I don't know, I, I think she is such an amazing midwife. So that's really all I can say about is I idolize her still so much today.

Katie 18:18

So she gave you this great example. So it sounds like, and actually I'm just learning so many of our similarities here, Corey, for me, transparency is the most important thing of all as a midwife. Like without question, the single handed most important thing. And it sounds like for you, that was the really big piece was the disconnect you were seeing. Not necessarily the place you were at, but more like is what I'm saying, the words coming outta my mouth, aligning with what's actually gonna happen, through this process and. So what made you decide like not to do home birth and then go back into the hospital?

Cori 18:55

Oh, I'm a HRSA scholarship recipient. Sorry. So I have to work at low income or an FQHC to be able to pay back my loans. Okay.

Katie 19:04

Do you intend on going to home birth after you're done that or have you found like a niche within the hospital that has been enjoyable for you?

Cori 19:12

I think that one day after all my loans are paid off, I would love to have a home birth practice or a bar center. That would be the ultimate goal for me would to be having an out of hospital practice.

Katie 19:25

How much longer do you have on these student loans?

Cori 19:27

In May I would be done, but if I continue to work, the rest of my student loans would be paid off, two years after

Katie 19:35

that. Well, I'm just wondering if it aligns with when I would ever consider, I'm like, oh, maybe we'll start it together. I

Cori 19:41

Delaware's more friendly for out of hospital. Definitely.

Katie 19:44

I would agree with that. Everybody's always like Katie, start a birth center. Start a birth center. And my big reluctance on that is that I don't wanna be the workhorse in the birth center. Me meaning the one actually doing the majority of deliveries. Like from an admin perspective, I'm your girl, let's do it. But I just don't love nights enough anymore

Cori 20:03

I'm the total opposite. Exactly.

Katie 20:05

So this might be a thing Corey later, for us,, okay, so then you were a midwife and. When did you have your third child in relationship to this?

Cori 20:18

So I had her in 2017 at a birth center after I'd already become a nurse.

Katie 20:25

Okay. And how did that birth go for you?

Cori 20:27

It was the most wonderful birth experience ever.

Katie 20:31

So it was probably pretty healing. It,

Cori 20:32

It, it was extremely healing. I didn't realize how much I needed it. Yeah, even though the labor was excruciating, it was only three hours and 30 minutes from the first contraction to the time that she exited my body. And she was in call too with my first, they told me, I'm gonna break your water because it's gonna help your labor. They didn't tell me anything about it. They didn't warn me it was gonna make my pain so much worse. And I was unmedicated, so I was like, oh my gosh, this is excruciating. Why didn't they tell me? I actually had one nurse that blatantly told me, it's gonna make your pain better.

Katie 21:08

I was

Cori 21:08

you lied. I do not tell my patients that ever. I'm like, this will make it worse, just warning you. If you still consent, then you consent, but you do not have to consent to this. With my second, I baked him not to break my water over and over and over again, and he, and he hooked me anyway, while my legs were in stirrups. And I didn't wanna be in the stirrups. I wanted to get up. I wanted to move. I was unmedicated again. With her, I was unmedicated standing and had her standing and she was born in call, which was even better to me, which I know statistically not very common, but she was completely born in call, like midwife, holding her between my legs in call, asking if I wanted a photo. I might've threatened my husband's life about it. I told him not to do that. If he got up away from me to take a photo, he would no longer be an alive man. Looking back on it, I wish I had a photo of it, but the midwife, I don't even remember her name. I don't even remember what she looks like because she was such a small part, but such a healing part of it that you'd think I'd remember more than just the things that she said. But it was only the things that she said. She's like, you can do whatever you want. I say that to patients so often, it's not even funny. And whenever I came to pushing out my placenta, I wasn't told when to push out out my placenta. She was just like, let me know when you have the urge to push again. And I was like, okay, I feel like I gotta push again. And she was like, push my placenta. Came out and I was like, oh, is that how we can do this?

Katie 22:38

Because that's awesome. Yeah. I do

Cori 22:40

with my patients that don't have an epidural all the time. Some of them with an epidural will tell me it's time to push. But not all of them have that urge to push with their placenta with an epidural. But almost every single one that's unmedicated does.

Katie 22:53

Yeah, I actually had a patient recently that she did not want me to cut the cord. She wanted the placenta to deliver without cutting the cord. And I was like, this could be difficult. And she also wanted to like, just delay it in general. And so I was like, okay, how am I gonna do this? 'Cause I just hadn't done that. But, she, so she was like, well, I just don't wanna deliver it for a while anyway. I'm like, okay, whatever. Fine. I'm usually in the same camp like, alright, as long as you're not like dying, we're good.

Cori 23:23

Mm-hmm. But

Katie 23:24

anyway. It was so interesting because she had this definitive idea in her head that this was gonna be a while, and then all of a sudden she's like, I, I, I gotta push, I gotta, I, I gotta, I gotta do this. And I'm like, okay, well, can I like help you a little bit? Like, is that, is that something you want? Yes.

Cori 23:39

Get this outta me.

Katie 23:40

I'm like, so sometimes people's opinions change. I just kind of like held the cord with my fingers and like just kind of lightly guided it and pushed it out. And it was, and then we just put the placenta next to the, the baby for a while and then they cut it at half. I think they wanted to cut it at half an hour.

Cori 23:57

And it's actually kind of funny that you say that because whenever I went back to a clinical site that was in hospital again after my six months in home birth. I kept trying to deliver the placenta while still attached. Yeah. And because that's all I'd ever done at that point is I delivered the placenta while still attached to the baby. And they're like, no, you, you gotta cut the cord at one minute. Unless they request for otherwise. So now some of my favorite births are the patients to tell me, don't cut the cord until the placenta's out. And I'm like, girl, you got the right midwife for the job because this is my favorite thing ever

Katie 24:33

Yeah. It went better than I was expecting.

Cori 24:35

Yeah.

Katie 24:36

That's the thing. Most of the time these things are fine.

Cori 24:38

Mm-hmm.

Katie 24:39

It's just like people get hung up on,, like when it's not fine and it's like, well, when it's not fine, then you deal with it then. So you delivered your last at the birth center. That was a great experience. So when did you decide you wanted to be a gestational carrier? I'm, I'm guessing that a good experience birth helped with that. I imagine that that would be hard for people that were still in the trauma mode of birth. But yeah. What was, what did that look like, that decision? Why, why?

Cori 25:10

So, I had started school to become a midwife right after COVID. So my daughter was like three or four years old. And we were learning about IVF gestational carriers, infertility. And I was like, oh man, I could do that. Which I think is kind of silly. But it's something that my mother had always talked about doing whenever she was still alive, but she never ended up having the opportunity to do it. And she was always her BMI was always larger than what was, allowed to be a gestational carrier. So I was still, kind of working through her loss. So whenever I was reading about it, I was like, man, this is another way I could kind of keep my mom's memory alive.

Katie 25:59

Oh, that's cool. Yeah. And she must have been kind of on the early side of that even being an option. It's not like, like I don't remember it being talked about until I got a little bit older. So she, she was like a, wanting to be a trailblazer in that sense. Yeah. So what was the timeline of, your loss of your mother, and then this decision that you made?

Cori 26:23

My mom died actually two months after my daughter was born.

Katie 26:28

So then you were probably processing both of those things and then, so four years later You heard about this in school, and then did you decide to pursue it right then, or did you wait some time?

Cori 26:39

So I actually applied for it and started getting like some of my medical work paperwork to them and everything else from like all of my births so that by the time I was done with school, I could get started on the process of caring for somebody. So in December, 2023, I told them I was ready to actually start the process. In January, 2024, I met the two dads that I was going to carry for. And then in May, 2024, the same month that I started my job as a new midwife, I had transferred, their daughter then went to my graduation at Georgetown. found out I was pregnant with their daughter and then started my job.

Katie 27:22

That is a lot in a short period of time.

Cori 27:24

Yeah.

Katie 27:25

So

Cori 27:25

was a brand stinking new midwife, pregnant with somebody else's baby.

Katie 27:30

That is a heck of a conversation starter,

Cori 27:32

Yeah. Especially when people were finding out I was pregnant and it wasn't mine. Yeah. Lots of

Katie 27:38

up questions.

Cori 27:39

Yes.

Katie 27:39

So I I, I just have so many questions that, uh, yeah. The order of them, I'm like, which one do I ask first? Oh my gosh. So I guess the, the first avenue we'll go down is how did you decide what clinic, or I don't know if you call it clinic organization, that you were going to use? Because you, you have pretty strong views on this now, so how, one, how did you decide that? And then two, I just wanna pause for a second and actually, before you answer that, can you just go over the terms, because recently when we were on, call, people were talking about, oh, the surrogate. The surrogate, and you were like, Nope, it's a gestational carrier. And I was not personally aware of the difference in language and how important that was. So if you can just talk about the language for a second and then, talk about, how you decided, what, what organization do you use?

Cori 28:28

So when surrogacy first really started, there was a lot more traditional surrogacy. So that means that you are using your own genetic material as well as the genetic material of a male individual to be able to become pregnant. Then it became more of a transferring an embryo that was created by the intended parents, whether it be through donor or their own genetic material. More so it's their own genetic material. But surrogacy as a term initially was referring to traditional surrogacy, and then gestational carriers became more of the individuals that are carrying somebody else's genetic material and not involving their own. But a lot of people still use it very in interchangeably.

Katie 29:24

I could see a natural progression of this term changing from a legal standpoint, like the simplicity of it, because I think there was some legal issue when somebody would back out of a surrogacy. It's still like 50% of that person that's carrying the child's genetic material. So then it's like, oh, well that's your child, but in a gestational carrier situation, you're not genetically attached to these, this baby at all. So it's black and white in that sense.

Cori 29:53

Mm-hmm. It's very much so, and throughout my contract that not once is the word surrogate used. The intended parents still use the word surrogacy a lot rather than gestational carrier because it then they would have to explain more whenever they're posting on social media

Katie 30:10

about That. Makes sense. Yeah. The language isn't there yet, which is why I wanted to take a step. A timeout and just, define that because, now I'm much more aware of my own language than that.

Cori 30:20

I try not to use the word surrogate at all. But then still, even in the medical field, a lot of peoples get very confused and just want to use the word surrogate.

Katie 30:31

Well, hopefully they listen to this episode and then they'll stop. Um, okay, so the other part of, okay, how'd you pick your, your organization?

Cori 30:39

I just looked for an ethical one. That's really it. And at the time, I still lived in the Midwest when I was initially looking, so I was looking for an ethical one that was nearby, which ironically I ended up being extremely far away from them whenever we finally ended up transferring. I was their first surrogate in Maryland.

Katie 31:02

Oh, wow. Yeah. Or

Cori 31:04

gestational carrier. But

Katie 31:06

there,

Cori 31:06

So it, they're called Gift of Life Surrogacy. I know they use the name Surrogacy within it, but that's what's well known throughout. Of all of the language. And they still call us, they call us GCs on their social media because we are gestational carriers. Even though the name of the organization is Gift of Life Surrogacy,

Katie 31:25

uh, sometimes you've got a good brand going, you just stick with the name.

Cori 31:29

Don't have that many surrogates or gestational carriers that are active. It's a very small organization. The REI that works with them is actually the husband of the CEO who runs everything. And she's like a little mother hen that is like taking care of all of her little babies, which are her gestational carriers. She's constantly checking up on us, making sure that we're doing well, and that we're not feeling like we're being forgotten and that we're just being used.

Katie 32:04

So you said you picked something that was ethical, but to you at the time, what was unethical? What was ethical? What was unethical? At that

Cori 32:13

at that point, I didn't really know. Other than that, I didn't want to feel like I was being treated like a human trafficking thing. cause a lot of people look at being a gestational carrier as human trafficking and that we are being used and paid for, for a very big job, but not compensated nearly as well as we should be. But that's because compensation in the beginning of surrogacy was like a very low amount.

Katie 32:42

What's in, in your experience, what's like an average, amount now compared to what an average amount was then? When it first started and it was a little more unethical, shall we say.

Cori 32:54

In the beginning of it, I think it was only around the low tens of thousands and now it's over 50,000. I can't speak for any, all companies, I only know what I've been compensated and what I'm being compensated for with this pregnancy. delicate

Katie 33:12

I'm sure you feel this delicate balance of the people on the other end of this. I can't have children. So there has to be some aspect of this when you go into this that feels like, well, I'm also doing a service and it's coming out of their pocket. And, it feels kind of wrong to make it com so completely unaffordable that you now the only people able to use surrogates are the extremely wealthy. So there's certainly that balance of making sure that your gestational carrier is well paid and well taken care of versus the exploitation that can happen, um, from a payment standpoint on the other end, on the, on the parents that are trying to have a child. So that is a, that's definitely a line. I'm sure

Cori 34:01

there is a huge line for that. My, with our first journey with my intended parents' daughter, my husband didn't take any time off. At all. He would rearrange his schedule so that he would make himself available so that he wouldn't have to need compensation back for the time off that he was taking. I did the same thing. I made sure that I saved up all my PTO so that I could use my PTO for my time off. I also decided that I was gonna go back to work early before my full quote unquote six weeks were up because I didn't want them to end up needing to pay more than what they already have just to bring their daughter around. There was also an insurance issue where their insurance refused to pay for their daughter's birth, but my insurance, because she came out of my body. We're fine paying for it. So I was like, Hey, my, I talked to my insurance company, they're okay paying for her birth, just not for anything after her birth. So like her vaccinations and stuff they would not pay for, but for the birth and the, the stay in the labor room, my insurance was okay paying with for, because she was still in that room with me and they got a big chunk of money paid for, or a big chunk of that, bill paid for. And then they had to pay a small sum versus how much larger it was before that.

Katie 35:33

So as a gestational carrier, you could make like fif, let's say 50, 75 plus thousand, right? Mm-hmm. But what is it costing the families most of the time?

Cori 35:43

way more than that because they actually have to create those embryos and they have to pay the agencies that they're going through. Some places or some individuals or parents decide that they're gonna do, um, they call 'em indie journeys or independent journeys, to where they kind of meet their carriers online and then they have them meet with their clinics to be able to get them to carry their babies, with no middleman or no agency. But it can also make it to where the. Uh, gestational carriers don't get paid. Yeah. Because they don't have that middleman. Making sure that they get compensated and sometimes I feel like those women can get taken advantage of while others feel like they chose such good ips or, Intended parents that they don't get taken advantage of because they are morally sound while other independent journeys don't go that way.

Katie 36:41

Yeah. That seems like a gamble.

Cori 36:42

Yeah.

Katie 36:43

So in your agency, did the parents get to choose you and you get to choose them? It's like a match situation. How does that work?

Cori 36:51

So it is, a match situation. Generally. It's kind of like going through people's profiles. But I was fortunate enough, like I said, the CEO, the individual, the woman that actually runs Gift of Life she has met all of us. She's talked to all of us for extended periods of time, including the parents, and she was like, I have the perfect couple for you. And that's what she texted me. She's like, I, they're, they're perfect. And I'm like, okay, well I guess those are the people I'm gonna meet. I didn't go through any profiles. I just met the people that she thought we would match well, which she was absolutely correct.

Katie 37:32

So she's like a matchmaker.

Cori 37:33

she quite literally is a matchmaker. She knew that my goal was to help same sex couples make a family. Even though heterosexual couples that are dealing with infertility are just as valuable whenever it comes to, you know, making their family grow. I just felt like there is so much. Against a same sex couple that it makes it harder for them to sometimes match because people still are not unbiased whenever it comes to that.

Katie 38:08

I imagine there can be difficulty adopting in certain places too for those couples.

Cori 38:13

And plus everybody deserves the right to have a biological child and in many instances, adoption can be just as expensive if not more expensive than surrogacy.

Katie 38:23

So is it usually the case that you know, the gestational or that the parents know the gestational care carrier pretty well? Is that up to you to like both of parties to decide how well you get to know them and like, how does that all work?

Cori 38:39

So whenever we were initially meeting, that is one of the things that we discussed is what our goals and what our relationship would look like. Which is one of the matching points for many carriers too, intended parents Is what we feel like our relationship would be.

Katie 38:58

And so what or what did you go, what did you all decide together?

Cori 39:02

I told them that whatever they wanted, I would make myself available or less available depending on. them.

Katie 39:09

And

Cori 39:09

I'm laissez-faire about it.

Katie 39:11

but it sounds like they've been pretty involved actually. Like with you.

Cori 39:15

they're extremely involved. They randomly send me things all the time and I'm like, I'm already being compensated very well. You guys don't need to send me stuff. They sent me stuff on my birthday, they send me stuff on holidays and I was like, this is a lot guys. Even after their daughter was born and I was no longer being compensated in any way, they were still sending me stuff on. Holidays.

Katie 39:43

Yeah. When I. first met you, I think it was pretty earlier on, that you were like showing me pictures of them and, uh, their daughter. And so you definitely have stayed in close contact.

Cori 39:53

I kind of feel like a proud aunt now versus like, sometimes I forget I was ever pregnant with her. Like, I'm like, oh, look at my, not niece, but kind of, um, no relation, but very proud of look at look. She's walking.

Katie 40:07

Yeah.

Cori 40:08

Like, now

Katie 40:09

carrying another baby of theirs?

Cori 40:12

Yes. I'm carrying their son this time.

Katie 40:15

And can you explain the, thought process on how genetically they decided they were gonna just 'cause I think it's interesting genetically how their children are in their decision making process there.

Cori 40:27

So they had four viable embryos that could be used and transferred. The first one, which they did not tell me whenever she was transferred, was one of the dad's only embryo. So that makes her like a special, very special to me because she stuck the first time and she decided that she was gonna grow with me and allow me to give birth to her. And then afterwards, they, they finally told me after she was earth side that she was his only, but the other three were all the other dads. And I was like, oh man. That would've been a lot of pressure. Had I known before, like they

Katie 41:11

Yeah, that was probably kind of them.

Cori 41:12

Yes, I was very

Katie 41:13

kind of them

Cori 41:14

because I just, I had no idea that she was his only one. They just told me it was his, and I was like, cool, whatever. Uh, I knew that she was gonna be a little Filipino, beautiful little girl. And that's all I knew until she came out. This time I know that all three of 'em belong to the other dad. It's all his genetic material. I'm still very grateful that his son decided or their son was going to stick the first time, versus me having to go through multiple transfers.

Katie 41:44

Yeah. What does transfer look like? Is that, how intense is that?

Cori 41:47

I mean, you have to have a full bladder. It's one of the worst things ever. Good. People underestimate

Katie 41:52

how uncomfortable that is. Like when you get ultrasounds, for example, that you have to have full bladders and they're just like pressing, pressing, pressing. It's like it's really uncomfortable.

Cori 42:00

Imagine having a speculum placed with a full bladder. It's terrible. With the first transfer, I like, I drank a lot of water 'cause I was dedicated to having that full bladder. And I had to actually do like multiple 32nd releases because I was in so much pain. And the transfer had been set back because other people had been late for their transfers or there was complications with other transfers before they finally got to me. This time I only drank the recommended amount of water and I,

Katie 42:29

that's all I did.

Cori 42:30

I didn't drink more. No, I didn't do it. So it was a lot more comfortable this time. I didn't have to empty any or. Let any of the urine out before the transfer to be able to make myself more comfortable did not, it was way more comfortable this time. Plus the, some places offer, something like Valium to help you relax during the transfer, and there is some research that says if you're more relaxed, you're less likely to have uterine contraction. So the contra, the transfers are more likely to be successful. So I'm with an REI that offers Valium beforehand, so I had Valium and ibuprofen before both of them.

Katie 43:07

And that worked well. Oh yeah.

Cori 43:09

was out of it.

Katie 43:10

So now that you've been in this world of gestational carrying, are there things that you see now because you have this like new eye open, eyes open for this, that concern you? Like when you see a scenario as a midwife, you, you know, we're exposed to this, so we're exposed to patients that are gestational carriers. Do you see things that you're concerned about or you're like, oh, this shouldn't have happened, or, it seems like you have strong thoughts about the ethics behind it that you probably have grown into being a midwife and also a gestational carrier and being able to merge the two and what you think should and should not be happening.

Cori 43:51

Unfortunately, yes.

Katie 43:53

so

Cori 43:54

whenever it comes to like the arms guidelines, they tell you who makes a good candidate for surrogacy and who doesn't. Like if I had ol unresolved trauma from my birth, I would've not been a good candidate. But overall with my psychiatric evaluation that I had to have before I even dove into getting transferred, she said that the trauma that I had has. Overall been resolved and that it was safe for me to continue and carry their baby. And she didn't think that anything would happen from that trauma to be able to make the pregnancy negative for me. So it's protective of me too. But then people that have had multiple c-sections, like more than four C-sections, you're not even supposed to have more than three C-sections to be able to become a carrier. But there are people that are on four or five C-sections and carrying somebody else's baby, Or carriers that are on their, they had two C-sections with their own children and now they're using that surrogacy as a res redemptive process for them to have a toll lack

Katie 45:03

Hmm.

Cori 45:04

with somebody else's baby

Katie 45:06

is

Cori 45:07

not okay. Even though women should be able to birth however they want to. This is somebody else's child. And if you've never labored before and weren't otherwise seen as a good candidate for a tolac with your others, why are you going to tolac now?

Katie 45:25

Yeah.

Cori 45:26

And then women that have with history of preeclampsia that then become surrogates or gestational carriers, which there's an increased risk for preeclampsia with IVF pregnancies and pregnancies that are not carrying a child that is genetically related to you. So if you look at the research, carrying somebody else's genetic material that has no relation to you whatsoever increases the risk of preeclampsia.

Katie 45:53

Well, yeah, because we don't know a whole lot about preeclampsia really. But we do think that it has something to do with the genetic component of your body, recognizing it as foreign, which is why you see less preeclampsia in people that have the same partners in future pregnancies because the body's kind of like gotten used to that genetic material. But yeah, in this case, and even in your case right now, it's not really, it's not even the same father. So is the same,

Cori 46:19

Egg donor.

Katie 46:20

That's helpful. I'm hoping. I'm hoping

Cori 46:22

hoping, I'm hoping to, but I didn't have preeclampsia with the previous pregnancy, which automatically reduces my risk whenever it comes to carrying a non-genetic relation. But whenever you look at the research, if you were caring for your sister, your aunt, or somebody else that was genetically related to you on that side, or even carrying your brothers with his wife's genetic material, it would automatically reduce your risk of preeclampsia development. If you look at the research associated with it.

Katie 46:50

Right. So it is concerning when you have preeclampsia in a genetically related pregnancy. Yeah. And then now we're going into an un genetically related pregnancy.

Cori 47:02

Absolutely.

Katie 47:03

And unfortunately, especially preeclampsia, I think people often devalue how catastrophic that can be.

Cori 47:11

can be. Yeah. And now you're, say you end up with severe preeclampsia and now you're delivering at premature times to where baby's gonna end up with a NICU stay. You are putting more financial responsibility on those parents that otherwise would've had a potentially much better pregnancy with somebody that didn't have that risk factor and would've ended up with a full term baby.

Katie 47:37

When you bring up, here's another example of how it's a balance between the gestational carriers and the parents because

Cori 47:43

mm-hmm.

Katie 47:44

it's, it's easy to just, for me, it's easy to just think of all the health consequences that you personally can have because that can, can be out of control, like the health consequences that, the gestational carrier could be put into as a result. But also, like you said, there's this, these parents on the other side that are putting out all this money and also potentially time, if you have a NICU baby stay, like that's no longer the gestational carrier's problem,

Cori 48:13

Mm-hmm. Like

Katie 48:14

If the baby's in the NICU for six weeks, they're not, they're not dealing with that at all, but these new parents are. So it definitely brings up, ethical concerns on both

Cori 48:26

Mm-hmm. But most of the time it's not the parents that are reviewing this, gestational carrier's health history. It's the clinics that are moving forward with the transfer.

Katie 48:37

You're blowing my mind right now because I've always been like thinking about, oh, the gestational carrier, like the safety risk of the gestational carrier. And I just didn't even think about this flip side of these parents being taken advantage of too.

Cori 48:51

Yeah. So, and ultimately, like to me, I think it is the clinic's responsibility to choose the safest option for a gestational carrier, for the individuals that are choosing to move forward with family planning. Using a carrier like those clinics hold so much responsibility. Like decline all of them. If they do not bring forward an option that is good enough. Like don't choose somebody that could put a potential future child in danger. Because this, the carriers typically, they don't know that they shouldn't have been a good candidate. They just go with, oh, I've been approved, so I must've been a good candidate.

Katie 49:37

Right. And especially, especially if they've had a baby in the past, in their head, whatever uncomplicated looks like in their own version. Right. Because you and I both know that we have patients all the time that come in and your, your whole obstetric team is praying to God, you're alive at the end of this scenario. And they're like. Oh, I'm gonna have six more babies. And you're like, oh my God. Right. So sometimes people are, they don't have a lot of self-awareness about what uncomplicated actually is. Um, and so in their minds, I can totally see it. You know, you go to a, a clinic and somebody tells you, Hey, you're great, you're good. And, and of course you're gonna think you're great and you're good.

Cori 50:16

Mm-hmm. But those agencies or those, clinics, they're their problem because they're not doing the ethical thing. They're not following the guidelines of an uncomplicated pregnancy. Now they've expanded the guidelines just a little bit. Like I had a history of gestational diabetes that was completely diet controlled with my first pregnancy. Never reoccurred with any of the other ones. I happened to be a teenager at the time. So that increased my risk of development of gestational diabetes, but then had never reoccurred, which the history of gestational diabetes means that I could get it again. I just haven't, and the fact that it was well controlled and did not need medication meant that it made me a better candidate. Had I been insulin or on an oral medication, then I no longer would've been a good candidate.

Katie 51:07

Mm-hmm.

Cori 51:07

And I would've just been like, well, there goes that dream. I guess I'll do something else Instead.

Katie 51:12

How many pregnancies are, recommended? Maybe not pregnancies. How many deliveries are, is there a max for how many? You can do five. Five. And is then that includes like total, not just gestational carrying or

Cori 51:27

five at that point of applying. okay. So then you could have a sixth, if I'm not mistaken.

Katie 51:35

So six total

Cori 51:37

more than five Uncomplicated.

Katie 51:40

Mm-hmm. but then

Cori 51:41

I think it's three. Um, cesareans.

Katie 51:45

Mm-hmm.

Cori 51:45

So no more than three. So if somebody had two cesareans and then multiple VBACs and they're going in as four pregnancies, two cesarean and two VBACs, then they could,

Katie 51:58

in theory have two more vaginal deliveries? Yes. Okay.

Cori 52:01

If I'm not mistaken, I'm pretty sure it's five.

Katie 52:04

There is a limit though, is also part of the point.

Cori 52:07

Yes, there is a limit. However, some are unethical again, and I do know one that had given birth five times to her own keepers is what they're called. So babies that were yours and then. Gave birth to five surrogacy babies, or Surro babes or whatever you want to call 'em, or babies for other families. Oh. So that means that she's on multiple, but she, every time that she had a transfer, every single baby stuck. So somebody thought, Hey, you're really good at this. You've never hemorrhaged, you've never had any adverse pregnancy outcomes. I know that you're over what is recommended, but we're gonna keep you and we're gonna do this. Just like there are now people that are over the age of 43 that are 46, 47 and carrying.

Katie 53:01

Yeah, that's an interesting one right there. Mm-hmm.

Cori 53:05

Mm-hmm.

Katie 53:06

I remember going to this reproductive conference, by one of the re, well, it wasn't a conference, it was actually a dinner where they were telling us about the perfect h to, harvest your eggs, for yourself or later. And they were saying, you know, we can, we can put an embryo in anyone like. And it doesn't matter because your uterus is going to do the job, but that doesn't mean we should.

Cori 53:30

Um, but then the people that are doing it that know they're over what the guidelines say will fiercely defend it.

Katie 53:42

It is a little of the wild west when it comes to reproductive stuff in general. I do think there's a lot more conversation now that's happening and restrictions and it does feel a little more figured out than it did 15 years ago where I feel like anybody was doing anything. Now I do think there are practices that are kind of gray but are still frowned on. So people are, are. A little bit more likely to be like, Hmm, that's not okay. But we're still seeing some very questionable surrogate situations or gestational caring situations.

Cori 54:21

Oh yeah, we are. I don't think I've seen a single one since I've been a midwife that was truly like ethical other than maybe myself. cause I am, I think I've only cared for a couple, but still all of those, I'm like, how, how did you get clearance? To carry somebody else's baby.

Katie 54:46

Yeah. Yeah. Once again, it's always interesting to me when you have. Patients that just have no self-awareness about some of the stuff.

Cori 54:54

Yeah. And you can't blame 'em either. No. Like you literally can't.

Katie 54:57

No,

Cori 54:58

Um,

Katie 54:58

But that's why there need to be some parameters. Do you have any personal parameters for how many you're willing to carry? Like how

Cori 55:10

this is probably gonna be my last one.

Katie 55:12

Yeah. Do they want more children?

Cori 55:14

No, not that I know of. I think if they asked me to carry again, I would, if I were to carry for somebody, again, it would probably be somebody that is completely known to me. It would be altruistic. So it would be, as in they know that they're only responsible for the medical bills associated with me carrying and that. I am doing it just to give them a child without any comp, you know, compensation whatsoever.

Katie 55:42

Right. But

Cori 55:43

don't wanna be responsible for the medical bills of carrying somebody else's child either.

Katie 55:47

No. No. Um, and good that you have insurance that has not fought with, uh, no. The pregnancy stuff so far,

Cori 55:54

very friendly towards that. And that's one of the requirements. Well, not requirement. If I was not on a friendly insurance plan, then the parents would be responsible for paying for a plan. That was, the first time we did this, they paid for my insurance the whole time, even though I ended up getting on an insurance plan that was friendly and I was able to use both of them. At the end of the day. We had, he, they had no medical bills whatsoever. Once I started with that job. This time all of my meds had been paid for and last time they ended up paying for some of the meds. One of the very expensive meds, Lupron was paid for by my insurance company this time.

Katie 56:42

Oh, nice. Yeah. Lupron is, that, so that helps you get pregnant or is keeping you pregnant?

Cori 56:49

I mean, it, it's a GNA antagonist, so it keeps me from ovulating, puts me in a me medical menopause. So yeah.

Katie 56:55

So how long were, are you or were you on that for?

Cori 56:58

I only took it before the cycle started and it was a one month, depo.

Katie 57:03

Yeah. They're using that I believe for, transitions and it's extremely expensive.

Cori 57:09

Extremely. So what ended up happening is they put me into that chemical menopause one week before me starting anything. And I start was on the birth control pills. And I took it on a Wednesday until that Saturday. And then I took the last birth control pill, and then I was nothing other than that depo. And then I had a light period, and then I started on that following Wednesday, the estrogen, to be able to mimic my body going through the follicular phase,

Katie 57:42

Mm-hmm.

Cori 57:42

which I think is the craziest thing about all of this, is I know exactly what they're doing

Katie 57:48

well, and that's the angle, the, the piece of this that I really found so interesting about having you do a podcast is yeah, you, you're gonna know more about what's happening and then it's gonna make you curious about what you're going through that'll bleed into midwifery. Actually, I'm sure a lot of this has bled into how you care for people or what you think.

Cori 58:11

I think it makes me a little bit more protective over IVF pregnancies in general as well. Not just, pregnancies that are with a gestational carrier, but all IVF pregnancies in general, because a lot of people forget that IVF is a risk factor for, preeclampsia and why it's a risk factor for preeclampsia. Whether it's a natural cycle, a modified natural cycle or if it's a completely medicated cycle can change the difference on how much IVF changes there as a risk factor. And then even like reciprocal IVF patients, like. Those women don't realize that they actually put themselves at more risk carrying their partner's child because there's no genetic relation. When they do that, and I've talked to my same sex couples that do reciprocal IBF and tell them, Hey, this does re increase your risk for preeclampsia. You might not have any other risk factors other than IVF pregnancy and first pregnancy, but this also is an increased risk.

Katie 59:17

I just realized

Cori 59:18

baby aspirin?

Katie 59:19

what you meant with reciprocal. You're talking about, same-sex couples that are carrying their partner's genetic, right, baby. Okay. Mm-hmm. Yes. So they don't, they're carrying no genetic matchup.

Cori 59:32

Yes. As their first pregnancies. Within a non-genetic donor that they've never been exposed to Whenever it comes to semen.

Katie 59:42

Well, it's when they go to decide who's carrying, I'm sure some of that falls into one who wants to carry out of the two of them, but also perhaps who looks like a better medical case for carrying. Mm-hmm. Um, so to your point, you could be like, well, I'm the healthier one and I want to carry, mm-hmm.

Cori 1:00:04

Mm-hmm.

Katie 1:00:05

But once again, you, you're maybe underestimating that you're not genetically linked. So yes, you're healthier, but it's still gonna be less healthy for you to do this than carry a, a genetically matched child. Mm-hmm. And

Cori 1:00:20

there is enough research on it that you can look at it and know that it does actually overall affect the pregnancy. And it's not something that I really thought about before becoming a gestational carrier. I never really would've looked at the research before then, but I started looking at the research after. me

Katie 1:00:42

because I did not know this. Tell me more about what you were saying about the cycles of when you do the IVF and how that alters your chance of, or how, how you do the IVF and how that alters your chance of preeclampsia as well.

Cori 1:00:54

So if you don't have a corpus lium, that increases the risk of preeclampsia because, the American Heart Association did some research on it and they realized that individuals who did like natural cycles, they actually ovulated how to corpus lium from ovulating were less likely to develop preeclampsia versus the individuals that did not ovulate.

Katie 1:01:18

I'm not in the world of IVF, which a lot of us aren't. So my understanding of what you just said is that you can Put somebody medically into the ability to be able to get pregnant with an embryo that's implanted just at any point, like any day. But it's healthier if maybe your body's kind of already thinking that's a possibility to happen, as opposed to, Hey, just a random Tuesday that we decided to do this.

Cori 1:01:44

Even though we are tricking the body with even a medicated cycle, to think that an ovulation occurred that didn't because, you know, the corpus lium or the yellow body is creating all that progesterone until the placenta takes over. But with a medicated cycle, fully medicated cycle, you are being given that progesterone in a suppository or in a very uncomfortable shot in your butt, that is taking o or doing the job until the placenta takes over.

Katie 1:02:17

So the least risk is if your body is doing it anyway.

Cori 1:02:21

Yes. Whenever it comes to risk factors associated with break claims. Yeah.

Katie 1:02:25

And then the most risk would be if you are doing it medicated or, yes. Yeah.

Cori 1:02:32

Which most cycles because the most successful cycles are medicated cycles. Mm-hmm. And that's why I would be a great candidate because I don't have my tubes tied, um, for a natural cycle or a modified natural cycle. And that's what the REI told me. But then being who I am, I had the choice between that or a medicated cycle. Even though it's a little bit more expensive, it also increases the likelihood of implantation. So I chose what would've been best for the family I was caring for, even though they were letting me make that choice, because I looked at the research beforehand, which it could have been just as successful. Um, but I'll never know. I would rather give my a slightly increased risk of preeclampsia than. make it to where the embryo wouldn't stick or have the likelihood of less likely to implant.

Katie 1:03:32

But if you had a history of preeclampsia, which you don't, but if you did, maybe you would make a different decision.

Cori 1:03:37

Oh, I most definitely would've made a different decision, but I never should have, would've been able to be considered a candidate had I had the history of preeclampsia, but my mom had preeclampsia. So that overall increases my risk. It gives me a moderate risk factor. Ding, I'm gonna be 35 with this pregnancy. That gives me a moderate risk factor. Ding, I'm, it's an IVF pregnancy already a moderate risk factor. Ding, my BMI is almost 30. Moderate risk factor, ding, like I have mul multiple moderate risk factors for it, that I went into it knowing that it was a risk factor. It also means I'm gonna be much better at taking my baby aspirin.

Katie 1:04:15

Do you feel though, if you weren't a midwife that you would. Have known this, like were you counseled in a sense that, so being on the other side of this, I'm sure you believe more counseling should probably happen about this particular piece. I'm

Cori 1:04:31

I am constantly counseling patients on the importance of baby aspirin,

Katie 1:04:36

Yeah.

Cori 1:04:36

especially whenever it comes to that. And I also talked to, like I said, with our same sex couples that do reciprocal IVF, the importance of baby aspirin with those moderate risk factors. Being there and that risk of preeclampsia, because the last thing we wanna do is increase that risk.

Katie 1:04:54

I firmly believe that most of the patients that people deem as difficult patients, like people that are not doing what the providers want them to do, and they, they're, they're labeled them as non-compliant, is that most of the time we just haven't met them with where they're at. We just haven't individualized our conversation enough for them to say, this applies to me and this is why it applies to me. And so for you to be able to go to somebody that has IVF or reciprocal, and say like, this is why, it's not just because I'm telling you like this is literally the reason for you personally, I think that hits on a different level.

Cori 1:05:40

Yeah. There's been multiple instances that I can remember where like our practice is. It, it is good at getting people on baby aspirin. That should be, but it could be much better. Especially whenever it comes to IVF pregnancies and those other risk factors that go along with IVF pregnancies. 'cause I feel like some of them just completely forget that IVF is a risk factor in itself.

Katie 1:06:05

You're making me think that, reproductive technology needs midwives.

Cori 1:06:09

I think they do. I really think they do.

Katie 1:06:12

Yeah. They need, they need midwives in there. Helping bridge these, these gaps of, of patient education actually.

Cori 1:06:20

Yeah. Because another thing that goes with IVF pregnancies, sticky placenta. Placenta, that implant weird. But how many. Gestational carriers go into it knowing not that many, so they can end up with a manual removal that they never knew was gonna be needed and a hemorrhage that they didn't know was gonna happen because of that placenta. And ultimately it could take some gestational carriers lives.

Katie 1:06:46

Oh, that's scary. Do you know the statistics on that? Like how much riskier it is to be a gestational carrier?

Cori 1:06:52

I really don't know. I try not to, I try to stay away from it because I already know that it is a risk and if I look and know the actual statistics while actively pregnant, I'm just gonna be anxious the rest of the time.

Katie 1:07:04

I think that's a good plan. Also, I don't know if our statistics probably are great yet. We probably are just now coming to the time of having enough years behind us, but also, I don't know that. Even if we are say, 30 years deep into research, the changes that have happened from the start of this versus how we're doing gestational carrying right this minute technology wise are probably very different. They've probably evolved quite a bit. So hopefully it's getting safer to be a gestational carrier compared to 30 years ago or however long we've been doing it. 'cause it's, it's not been that long.

Cori 1:07:39

Well, there's more PGT testing too now than there was before. More people are opting for it so that they know that they're transferring good tested embryos into people or into themselves. And the area that they take from is where the placenta would be growing. So I think that some of that does contribute to why the placenta are different with some of the IVF pregnancies versus other IVF pregnancies.

Katie 1:08:09

So it sounds like it will continuously, hopefully, get safer. Also, we're doing more genetic testing, able to do more genetic testing on people, like the preeclampsia test that's come out. That's still kind of in its infancy actually, but, hopefully that'll be able to help us determine things too, like who's actually a good gestational carrier.

Cori 1:08:29

Oh, that would be fantastic.

Katie 1:08:32

Yeah.

Cori 1:08:33

Mm-hmm.

Katie 1:08:33

Are there any other ways that you have used this experience in, in your midwife career that you can think of?

Cori 1:08:42

I mean, I think it just makes me more empathetic because I forget how bad this first trimester is until I meant it. But like, every pregnancy is different. Like, I had never experienced rib pain until the, until the last pregnancy with, the baby I carried. She, I had such bad rib pain with her and I was like, I was in tears because of how bad it was. And then I realized kinesiology tape is godsend and you can just tape your ropes in place and go on with your day.

Katie 1:09:15

day. Oh, I have not suggested that to a patient. I'll have keep that one in mind.

Cori 1:09:18

I literally took

Katie 1:09:19

it's like a belly band for your ribs.

Cori 1:09:21

God. It, it was life changing to be able to just tape my ribs in place.

Katie 1:09:28

I imagine it also gives you empathy in a kind of strange way for people that come into pregnancy detached. There is this cultural. Bias we've created that the second you get pregnant, you should be overjoyed. You should be overjoyed throughout the whole pregnancy. You should never worry that you're going to die. You know, you should like all of these, like happy all the time kind of things. And lots of people don't have that.

Cori 1:09:56

Mm-hmm.

Katie 1:09:56

I actually, personally, I tell people all the time, but you know, but in our in office visits, I'm like, first of all, it's evolutionarily natural for you to think you're going to die because for a very long time, this was a very real possibility. Number one. Number two, I think it's healthy to some level for most people that are having detachment, to have detachment. I, I think it's protective of your sanity because once again, evolutionarily, if you are not in a place that outcomes are good. It is better for you not to get so attached to this. A baby that's growing that you don't have a promise is going to to survive this process. Mm-hmm. Um, and you still see that in some cultures. Like you still see this distance, this arm length distance of accepting this as like the way we do here, where we embroider everything with the names and we announce the, sex of the baby at 10 weeks. Like that's very unfathomable for other cultures. But here that has been a norm. So I'm guessing this gives you this like other angle too, of how to go through a pregnancy, um, that you're not a attached to. In the same sense

Cori 1:11:14

with my other children, I really didn't have the same attachment either. I mean, I knew they were mine versus this one. I went into it knowing these babies do not belong to me. I will. Not feel the same for them as I did for my children. Once they were finally born, I felt an attachment to my children. But when they were inside of me, I just thought they were little parasites, which would maybe be the opposite of what most people experience, or it might be very similar and nobody else wants to say it. But my mom with my first pregnancy, she actually had me write a living will, telling me that even though you're 19, pregnancy and birth can kill you. And she made it very well known to me that not in a mean way, she did it in a very loving, motherly way. That pregnancy is in all rainbows and butterflies, and you're putting yourself through process that could very well kill you at the end of the day, or your baby.

Katie 1:12:06

I think the United States steps away from that because we are able to now, um. So unfortunately for black women in this country, they have not had that same reassurance that other, ethnic backgrounds have been able to have here. So I think they're, they're not able to go through pregnancy with that, frankly, very unrealistic expectation that somebody promised you that everything would be okay, like, because nobody's promised that. I, but I think that that is frowned upon sometimes that you would have these concerns. And,

Cori 1:12:41

mm-hmm.

Katie 1:12:42

Oh, how, how do your children feel about this? Because that's an interesting piece too. They're old enough to have, to be able to have some opinions on this.

Cori 1:12:53

So my son, he

Katie 1:12:55

15.

Cori 1:12:56

Yes. Or turning 15 in July. So he's, he's almost there. He. He doesn't care. He didn't care at all. But I will tell you, he does some of the best like belly lifts, like ever,

Katie 1:13:09

Like,

Cori 1:13:10

and he was, I guess 13, turning 14 whenever I was pregnant last time. So. That child, he would get behind me and just be like, Lift up my belly. And I was like, child, like, I'll pay you

Katie 1:13:24

I need to,

Cori 1:13:24

This is the best thing ever. But then, my almost 13-year-old, so she was 11, turning 12 with the last one. She thought it was creepy, and it solidified for her that she never wants to be pregnant because that should not happen. You should not have another thing moving inside of you. Once she was out, she was like, most cute thing ever. Let me touch her. Let me hold her. Um, I love seeing pictures of her, but I'm so glad she doesn't live with us.

Katie 1:13:55

And so are your kids, because you do get these pictures and these updates constantly from the parents. Um, are your kids, do they like seeing this? Do they, like I know you and you've met them at times too, right? Like you've, you meet up sometimes.

Cori 1:14:11

Yes. So, my middle child, so my almost 13-year-old, she went to Michigan with me for the transfer this time. And she went and hung out with the dads with me. Well, one of the dads because the other dad actually had COVID, so he couldn't make it for the transfer, and he was sick. Um, but she came, she was so happy to see, the baby again. And she thought it was so much fun to see her, even though, the baby wanted absolutely nothing to do with my daughter and kept crying every time she looked at her, which made my daughter sad. But she, she just loves babies. She doesn't like the process of babies, but she loves babies. And then my youngest, I thought she would be the one that was most attached. She was the most detached after the baby was born. While I was pregnant, though, she loved laying on my belly. She loved being kicked by the baby. She loved asking the baby questions and if the baby moved, and that meant the answer was yes. If the baby didn't move, the answer was no. She would ask her. About her favorite movie. She would ask her about her favorite color. She would ask her all sorts of things. And then when she was born, she was like, cute. Um, can I go

Katie 1:15:15

do so?

Cori 1:15:15

else now?

Katie 1:15:16

That's funny.

Cori 1:15:17

That's funny. So it was like complete opposite whenever it came to my two daughters. Yeah. One daughter thought it was creepy. The other thought I thought it was cool. And then vice versa, once the baby was actually physically out of my body.

Katie 1:15:30

So who, who has been in the delivery room and and where, where have you, where did you deliver the first one?

Cori 1:15:36

The hospital that I work at in Maryland is where I delivered her with one of my co midwives. Um, and

Katie 1:15:41

that went well.

Cori 1:15:42

It went very well. One of the dads, which was something that was a matching point for me is that. One of the parents would be interested in helping their child come earth side and be the first hands that ever touched their child, which that's how I'm as a midwife. I try to get everybody to catch their own babies. 'cause I'm like, come on, be the first person to touch your child. Don't make it be me, be you. But it was gonna be the dad whose genetic material was not used. And then the other one was just gonna watch and cut the cord. But then it ended up completely flipping before she was even coming out, he, The dad whose genetic material was used, he ended up helping catch his daughter. There was a birth photographer in the room. I might have shown you pictures. I show everybody pictures, that ask anyway. I'm not trying to show everybody pictures of me giving birth, but that moment that he. Saw his daughter start to crown, he started crying. And you see the midwife that was assisting in the delivery, like look over at him, like, are you okay? And you can just see him just bawling because he can see his daughter is coming. And then he helped catch her with happy tears in his eyes. And once she was out and she was on the bed, they didn't break the bed down or anything and I delivered on my side. They were both touching her after she was born and she was still attached. They wanted to do delayed cord clamping, and they were telling me, thank you over and over and over and over again. So I start bawling because all I hear is them saying, thank you for giving us our daughter and. Like, that's something I didn't even expect to happen. And then there was my husband, he was there too, but he was just trying to keep me from biting him the whole time he was being, he was very supportive.

Katie 1:17:36

but

Cori 1:17:36

but he, my husband, I bit him when our daughter was born, so it was very important for him this time not to be bit, which did not happen even though he kept telling me You're a little too close.

Katie 1:17:49

But

Cori 1:17:50

like very grateful for my husband as a support person. But the only people that I really, really remember being there are the dads. They were the most central part to that delivery for me. So

Katie 1:18:01

So you're planning that it would be the, the same way this time

Cori 1:18:04

I'm hoping that one of them will catch again. Yes.

Katie 1:18:10

Awesome.

Cori 1:18:11

Um,

Katie 1:18:12

And I back to kind of your family's experience with this. I think you told me that you have used the money to go on vacation. A kind of a, Hey, this is something that I'm kind of gifting my family for this process. That we kind of all went to through together to some extent.

Cori 1:18:30

Yeah, we did. We went on Disney cruise and then, we actually, put a, we did a lot of stuff towards my husband going back to school, so it was helping further his education. Again.

Katie 1:18:44

That's a great use. Okay, so you have the baby. Mm-hmm. And then there's the, after having the baby, what does that look like for both you and them as the parents? And is that, is that determined ahead of time through the agency? Is it kind of a, let's see how this goes. What does that look like?

Cori 1:19:06

So for the dads, they wanted to have more closure than what I did actually. They wanted my children to meet her. And I really wasn't interested in my children meeting her at all by the time that she was born. I finally came around to the idea, because I wasn't sure if my children would feel that like it was actually closure or if it would push them to make me want to have like another child for them, and that's not something I was down for. And they met her. They were like, oh, this baby's cute. And then they didn't wanna go back because she was loud and she cried and it was not the thing for them. But my middle one, who I said loves babies, she likes looking at babies, but she doesn't wanna bring home one, one home with her. She would come with me every time that I would drop off breast milk for them. 'cause they stayed in the area for a week after she was born. ended up

Katie 1:20:05

pumping for a while for them?

Cori 1:20:07

Yep. I ended up being three months.

Katie 1:20:10

How did you ship that?

Cori 1:20:11

Very well packed inside of a freezer box that was insulated. It was

Katie 1:20:17

so it was probably quite expensive on their part

Cori 1:20:19

week. But one of the things, because providing that to them the same way I provided for my own children was very important to me. A lot of gestational carriers choose to be compensated weekly for pumping. They were willing to compensate me on the first contract we had drawn up for that pregnancy. They put in there, they wanted to compensate me, pay for all the shipping, all the handling, everything that, the bags, everything that had to do with breastfeeding. I had them take out the compensation portion, but they could pay for the shipping, the bags, the pumps, everything else that I needed, which that's already expensive, but I didn't feel like I needed paid for my time, even though it was most definitely a full-time job pumping for her. But it was also probably one of the most rewarding things I've done because they would send me updates on how much she weighed. All the time. And I was like, oh my gosh,

Katie 1:21:20

you're still supporting a life.

Cori 1:21:21

Exactly. And plus, whenever you look at the research again, 'cause I love research infants that were provided any amount of breast milk had a reduced risk of, SIDS or sudden infant death syndrome. So that to me was again, hi helped in bringing this baby to this world. I want to increase the chances that she will stay in it, which was very important to me. And then also ended up being very important to them because they believed that it helped with all of her development and it made her so much smarter. And I was like, well, thank you. If my breast milk did that then everybody should get my breast milk. But, but it was still something that, because they. They were just so grateful that they would say anything really to be able to make me feel good about giving them something without anything and really return for it. Yeah. It was just their praise that I got in return, which was more than enough.

Katie 1:22:17

Yeah. So,

Cori 1:22:18

So,

Katie 1:22:19

so how was it recovering, from a delivery and without a baby that you have to care for? I'm, I'm guessing there were some pros there in the recovery sense. I

Cori 1:22:31

I mean, I woke up to an alarm instead of screaming,

Katie 1:22:33

Yeah.

Cori 1:22:34

which was really, really, I don't know which one I would prefer. they're sending me pictures of it right

Katie 1:22:39

my God, it's so cute. like

Cori 1:22:41

first couple months, she had like no hair on the

Katie 1:22:44

top. Oh, she's, I was just about to say, she got a lot of

Cori 1:22:46

It was all right here. It was gone. It was the funniest freaking thing ever.

Katie 1:22:50

So you were saying that the, the, you don't know what's worse, the, recovery from the alarm or, I'm being woken up by an alarm or a baby.

Cori 1:22:57

Yeah. Oh, ultimately I would rather be woken up by an alarm that I can set a, an hour later

Katie 1:23:04

that you can mute, snooze.

Cori 1:23:06

But I was pumping every two to three hours to be able to maintain supply. So.

Katie 1:23:11

so you were still very much in like recovery mode?

Cori 1:23:15

Yeah, I still chose to go back to work at 13 days though.

Katie 1:23:19

13 days,

Cori 1:23:20

Yep. 13 days postpartum. I went back to work.

Katie 1:23:23

Did you feel like you were healed enough to go back to work after you did it?

Cori 1:23:26

Yeah, I have a very, nice labors and deliveries. I don't tear, I haven't torn since my first, which even then it was just a labial laceration and I healed very fast from that. I think I went back to walking every day after I was two weeks postpartum with him, even though I didn't realize I wasn't supposed to not do that. But with all of 'em, I would went back to doing everything I shouldn't, which is very western of me if we, we don't allow ourselves to heal postpartum the way that other cultures do, which is a fault for the US in general. But I didn't, I felt like I was going crazy at home. If I didn't go back to work, I was going to lose my mind. I needed to go back to work.

Katie 1:24:13

It is a balance. Going back to work. I think when you have a baby that tips the scales of like too much to, but if you're healing well and your mind is like, oh my god, for some people work is kind of a sanctuary.

Cori 1:24:30

Yes. And it is for me. I love working. I love my job.

Katie 1:24:34

Yeah. So if you're like kind of battling that hormonal change and everything else going on, then yeah. As long as your work's accommodating, you're pumping and you're not just standing for 12 hours at one time,

Cori 1:24:47

Yes.

Katie 1:24:48

cause that would be hard on a newly postpartum body.

Cori 1:24:51

Plus one of the things that. Was very beneficial to me being postpartum is my sister was pregnant at the time and she delivered my niece on March 14th. I was able to provide my sister with over 200 ounces of milk from me that my sister was able to use towards her daughter, Who had a little bit of issues gaining weight initially. Even though she was also breastfeeding, planning on breastfeeding. It just took a little bit of time for her to get into the groove of it. So when she supplemented, she supplemented with my breast milk, which I thought was like the most amazing special thing ever. I was there when my niece was born, so I was pretty still fresh postpartum. I wasn't even fully three months postpartum. And then I went and visited my sister for two weeks during, after my niece was born to help her take care of. Her daughter, which really rounded out my entire journey is I was pumping for somebody else, but also still providing for my blood related family member and giving her things that I wasn't giving to a different baby. Yeah,

Katie 1:26:07

And also, kind of back to that piece with it probably whether consciously or subconsciously felt you connected to your mother too, because your mother wasn't able to be at that delivery for your sister. So yeah,

Cori 1:26:21

that's one of the reasons I went. I actually wore one of my mom's nightgowns during my delivery. Aw.

Katie 1:26:28

Aw.

Cori 1:26:28

Yeah. And then I gave my sister, one of my mom's nightgowns whenever I went and visited her because my mom, my granny gave us the nightgowns whenever I was pregnant and I went to visit. She's like, Hey, I found a bunch of your mom's nightgowns. Do you want these? And I was like, heck yeah. Which I probably looked quite silly wearing this outfit with a two can on it

Katie 1:26:50

to bring the delivery.

Cori 1:26:52

but like, it was nobody's business why I was wearing it. But to me it felt like she was there.

Katie 1:26:59

Yeah. That's special. You've really done a good job of, incorporating all of this together and, having it be meaningful to you on a lot of levels.

Cori 1:27:08

My mom was one of the best people you would've ever met.

Katie 1:27:12

Oh, it certainly sounds like you're honoring her Corey day in and day out, so,, I could be miscalculating this timeline. Were you a midwife before she died? No. Did she know you were gonna becoming a midwife? Yeah,

Cori 1:27:27

so she knew that I was applying for midwifery school eventually after Hunter was old enough to, like basically my goal was when she started pre-K I would apply right before then, which is exactly what I did. I applied in, 2021 and then started in August, 2021. But she passed away in 2017, but she knew my ultimate goal and I always thought that she would be there.

Katie 1:27:57

I can imagine she'd be super proud of you right now.

Cori 1:28:01

This is her hand print. I got it tattooed before I started clinicals.

Katie 1:28:04

And then you have your babies tattooed too? Yeah. The footprints

Cori 1:28:07

of their footprints,

Katie 1:28:08

yes. Oh, well that's a nice, closing place. Corey. This, this episode is gonna be probably a good 30 minutes longer than any of my others. But they say with podcasting the episode should be as long as it is with good content. So

Cori 1:28:23

as

Katie 1:28:23

as it needs to be. So, thank you so much for sharing

Cori 1:28:27

No problem. And

Katie 1:28:28

I'm sure, like I said, what, like I referenced at the start of this, I am sure there'll be a season two Corey episode because once again, everything I find out about you just makes me more interested in learning more so.

Cori 1:28:41

Yeah.

1:28:42

Thank you for listening to this episode of Mindful Midwifery Presents, the Labor Behind Labor with my guest. Corey, I hope you have new insight on the world of gestational carriers. I certainly did. After talking with Corey in two weeks, I will introduce you to Angela, a Venezuelan born midwife who is one of the only Latina midwives practicing in Delaware. Angela shares her remarkable journey from arriving in the us. As an undocumented immigrant to having a community college teacher help her find, a path to legal status to ultimately becoming a certified nurse midwife. Given what our country is going through right now, this conversation brings humanity into focus, and I hope you enjoy it as much as I did recording it. I can't wait to reconnect with you in two weeks.