EBB 375 – A Rainbow Baby and Preeclampsia Birth Story with Dr. Sara Ailshire and Dr. Siavash Samei

Dr. Rebecca Dekker – 00:00:00:

Hi everyone on today’s podcast, we’re going to talk with Dr. Sara Ailshire and Dr. Siavash Samei about their preeclampsia birth story. Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker and I’m a nurse with my PhD and the founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details. Hi, everyone, and welcome to today’s episode of the Evidence Based Birth® Podcast. Today, I am so excited to welcome two guests who are going to share their birth story and talk about preeclampsia and how they went through that experience. Dr. Sara Ailshire is a research team member here at Evidence Based Birth®, and she recently completed her PhD in anthropology. Dr. Ailshire’s research focuses on birth professionals, including doulas and reproductive rights in India. Dr. Siavash Samei is an Iranian environmental archaeologist who studies the relationship between climate, environment, and herding and foraging societies in the mountainous landscapes of West and South Asia from the Paleolithic to the present day. Sara and Siavash live in central Kentucky and are the proud parents of their daughter, Ferdous. Ferdous is 15 months old, loves her cat, and enjoys making her parents clap on command. Sara and Siavash, welcome to the Evidence Based Birth® Podcast.

 

Dr. Sara Ailshire – 00:01:39:

Hi, it’s good to be here.

 

Dr. Siavash Samei – 00:01:40:

Thank you for having us.

 

Dr. Rebecca Dekker – 00:01:41:

Before we get into your birth story, I know that Ferdous was your rainbow baby, meaning you were pregnant with her after a prior pregnancy loss, Sara. I was wondering if we could start off by sharing a little bit about your experience with miscarriage and how that shaped your journey.

 

Dr. Sara Ailshire – 00:01:58:

Sure, yeah. We got pregnant for the first time in March of 2023. And it was very exciting and everything seemed to be going normally. We made our treatment. We found out pretty early on, I think about as early as you can find out of a home test. And, you know, I was working at EBB so pretty aware of birth stuff. But never really thought about having a miscarriage, that that could be a risk or anything. So we went and we had a wonderful midwife where we used to live in Ohio, and we saw her and we were having an ultrasound done and… She left. She brought somebody else in and… Yeah, it just turned out to be a missed miscarriage. So that was a bit of a shock.

 

Dr. Siavash Samei – 00:02:45:

Was that our first visit or second visit?

 

Dr. Sara Ailshire – 00:02:47:

It was our first visit. So, it was like, you know, early, like your first scan, dating scan, I guess. So it was a big shock. We thought, okay, I’ll just… If the miscarriage will pass on its own and it wouldn’t and where we lived in Ohio at the time there’s normally two medications you get to help you pass the miscarriage and one of them was illegal because of anti-abortion legislation so it was really difficult to get the other one where we lived like you were at the pharmacy for a while like And we decided that, you know, medical management might be best. And we waited for about a week and nothing was happening. I was just, I was ready for things to be over. You know, it was pretty hard. But yeah, it was tough. It wasn’t what we were expecting. And it was pretty sad.

 

Dr. Siavash Samei – 00:03:32:

I think what made it even sadder and harder for me at these was that when we went to the midwife, she was wonderful. Is that the scanning at the end of the visits. So we had the entire visit where we talk about all manner of birth created things, including our plans and the tests and all this as if everything’s going normally. And then at the end of the visit, that’s when they did the scan.

 

Dr. Sara Ailshire – 00:03:54:

Yeah.

 

Dr. Siavash Samei – 00:03:54:

And I’m like, well, if you’ve done this at the beginning, maybe the pain would have been a little bit less.

 

Dr. Sara Ailshire – 00:03:59:

Yeah.

 

Dr. Siavash Samei – 00:03:59:

Just because, you know, the anticipation had built up by the end of the visit. And yeah, I called the pharmacy. I didn’t go yet. I called the pharmacy. And they put me on hold. And they talked to a manager. And I think they had to call the nurse midwife’s office to make sure that this was a legitimate request. It took a while for them to approve the prescription. And then the day that she was passing, it was a very hard day. I mean, for both of us, certainly for you, I mean, unimaginable.

 

Dr. Sara Ailshire – 00:04:26:

Yeah, it was pretty uncomfortable. I mean, and that was another thing, too. I used to know very much about miscarriage. And, you know, you see it in, like, TV. It’s like, oh, there’s, like, blood. You know what’s happening. In this case, I had no insight into what was happening. And I also had no insight into how uncomfortable it could be to have a medically managed miscarriage. Like, we waited for a week. We went back in because you had to be seen before you could, you know, get the medication. We saw the midwife wasn’t available. She was out of town. So we saw this doctor. And the doctor really didn’t. She didn’t have maybe the same approach to care that the midwifery bottle has. So she wasn’t very informative. And I think I remember asking her about, you know, how it would be. And she’s like, that’s fine. It’s like a period. It was not like a period. At all. It was pretty painful.

 

Dr. Siavash Samei – 00:05:17:

You also passed for pain management medication.

 

Dr. Sara Ailshire – 00:05:20:

Afterwards.

 

Dr. Siavash Samei – 00:05:23:

Just like agile and mostly counter-academic and agile.

 

Dr. Sara Ailshire – 00:05:26:

Yeah, even though ACOG recommends that there’s some type of, you know, attention to the managing pain, I found that later. So yeah, after that, it was really eye-opening. It was really shocking. I knew of one person who had had a miscarriage, but like I was, I’m pretty open talking about it. And what really sort of surprised me was that like so many other people started pouring out of the woodwork in my life who had like experienced miscarriage or experienced pregnancy loss. So it was hard, but I found that like when people were willing to share their stories with me, it made me feel a little bit better and being able to talk about it too, you know, like whatever that pregnancy was, even though, you know, there’s very little record of it in, you know, it still existed and it mattered and like it carries forward when we talk about it.

 

Dr. Siavash Samei – 00:06:09:

Yeah. It was almost a very lonely experience. I mean, you know, we are, we had friends in Ohio, but, but none that either didn’t have children or if they had children, we were not that close with them.

 

Dr. Sara Ailshire – 00:06:20:

Yeah.

 

Dr. Siavash Samei – 00:06:20:

And so from the very beginning until the moment it was done, it was a very lonely experience. There was a very, you know, apartment complex in the rural, Northeastern Ohio. I mean, uh, uh, so to have these stories come out and for people to share their own stories with us was quite, I think, yeah, it made us feel like there’s a whole big community of people out there that has gone through the same thing.

 

Dr. Sara Ailshire – 00:06:39:

Yeah.

 

Dr. Rebecca Dekker – 00:06:41:

Right.

 

Dr. Sara Ailshire – 00:06:41:

It’s good to do.

 

Dr. Rebecca Dekker – 00:06:43:

And I remember thinking at the time, you know, like you said, you were working at EBB back then as well. You were dealing with the loss itself, which was extremely sad. And like you said, lonely and all of these feelings. But then the difficulty with getting care just threw another like insult onto injury. And this was about 10 months after Roe v. Wade was overturned. And you were already, you know, as someone who was having a miscarriage, experiencing the impact of that.

 

Dr. Sara Ailshire – 00:07:13:

Yeah, absolutely. I mean, I remember thinking, I was like, could I even go and get a DNC? Like, what would that look like in this area? And it never occurred to me. Again, it’s just those things that you don’t think about. Like, you think oftentimes about access to abortion as being like, you have a pregnancy, and you do not want to be pregnant. And I very much wanted to be pregnant, but wasn’t anymore, but was in order to have a pregnancy.

 

Dr. Rebecca Dekker – 00:07:35:

You were in limbo.

 

Dr. Sara Ailshire – 00:07:36:

I was in limbo. Like, in order to go before and maybe try to conceive again, like, we had to complete this miscarriage. And… Yeah, it was very frustrating. It was very frustrating-

 

Dr. Rebecca Dekker – 00:07:45:

I wasn’t going to give the best medication option. You had to use the second-best option.

 

Dr. Sara Ailshire – 00:07:50:

Exactly. We talked to the physician about it and she was talking about how there was a way. It was very difficult. It was possible. It was very, very, I mean, oppressively difficult to get licensed to prescribe this medication.

 

Dr. Siavash Samei – 00:08:03:

In the entire state, there were like three or four licensed prescribers of that second medication.

 

Dr. Sara Ailshire – 00:08:09:

And yeah, I mean, that’s the thing. You know, access. It’s like a reproductive justice. It’s this issue, right? It doesn’t just affect people who don’t want to be pregnant. It affects people who do. Like access to abortion affects people who maybe would never choose to have an abortion but get pregnant and have a miscarriage. Like these things are so interconnected. And it really surprised me.

 

Dr. Siavash Samei – 00:08:27:

Now I think about this, having this conversation, it’s thinking about when you had the birth. I mean, when Ferdous was born, it was all hands-on deck. Everybody was there. In fact, we had to keep people out of the room, like our aunts, our mothers, you know. And, you know, it was very much a community-oriented process. Well, the miscarriage was the exact opposite. Even though you were giving, in many ways, it’s more difficult than a birth because the body is not naturally ejected.

 

Dr. Rebecca Dekker – 00:08:50:

Oh, because you had to take the Medicaid turn.

 

Dr. Siavash Samei – 00:08:52:

It’s an entirely lonesome process. Either we shun ourselves or somehow, we all just like, what do I do with you? You just do this and you’re at home on your own. It becomes very taboo.

 

Dr. Sara Ailshire – 00:09:02:

Yeah.

 

Dr. Siavash Samei – 00:09:03:

In a way that it would have not easier if we had people there to help.

 

Dr. Sara Ailshire – 00:09:06:

Yeah.

 

Dr. Siavash Samei – 00:09:07:

Maybe in the US. I don’t know.

 

Dr. Sara Ailshire – 00:09:10:

No, I think it’s quite well taken. Yeah.

 

Dr. Rebecca Dekker – 00:09:12:

Were there any resources, Sara, that you found that helped you through the process, like with managing comforts, since the physician didn’t give you any… Help with that.

 

Dr. Sara Ailshire – 00:09:23:

Honestly, I just had to kind of wait it out. I didn’t even think to ask about pain management prior. It was afterwards I was experiencing some pelvic dysfunction. And I basically, I think I just kind of rested and like lived on top of a hot water bottle for a while. It took a lot of that.

 

Dr. Rebecca Dekker – 00:09:39:

And Advil.

 

Dr. Sara Ailshire – 00:09:40:

Yeah, I mean, just trying to find different body postures and ways to be comfortable. Just taking it easy, resting. It was so humbling being so involved with birth work and doing research for EBB and realizing just how much I didn’t know about pregnancy loss. And I mean, what an education. So, yeah.

 

Dr. Rebecca Dekker – 00:09:58:

Yeah, well, we’ll make sure in the show notes to put some links to a few articles I remember we found when you were going through that about managing comfort. Because I think you’re right. It’s just not discussed enough. It’s like, here, take this pill. This will terminate or complete the miscarriage.

 

Dr. Sara Ailshire – 00:10:13:

You’ll finish and you can get back to normal. Yeah.

 

Dr. Rebecca Dekker – 00:10:17:

Yeah. But there’s other things that can be helpful.

 

Dr. Sara Ailshire – 00:10:20:

No, exactly. Yeah.

 

Dr. Rebecca Dekker – 00:10:22:

And what was the medication you ended up taking then?

 

Dr. Sara Ailshire – 00:10:24:

It was misoprostol.

 

Dr. Rebecca Dekker – 00:10:26:

Okay.

 

Dr. Sara Ailshire – 00:10:27:

Yeah, or I guess Cytotec.

 

Dr. Rebecca Dekker – 00:10:29:

Which is still available, although that has been proposed to be limited in some places as well.

 

Dr. Sara Ailshire – 00:10:36:

Yeah.

 

Dr. Rebecca Dekker – 00:10:37:

Yeah. So how did that, you know, shape then your next pregnancy? Tell us about that pregnancy journey.

 

Dr. Sara Ailshire – 00:10:46:

I was practicing a lot of detachment for a while. We didn’t tell anybody. We were pregnant the first time. I think I told my mom, like, almost like straight away, like very soon after. And we didn’t tell anybody, I think, until, what, 12 weeks?

 

Dr. Siavash Samei – 00:11:02:

Yeah, I mean, the first time we had to, we shared with some loved ones and hindsight was not a very good idea because in addition to having to manage our own emotional sort of pain, we also had to provide care for the emotional pain of our loved ones. So, this time, I think we definitely did not tell anybody until we passed the 12th week.

 

Dr. Sara Ailshire – 00:11:19:

Yeah, there’s like a miscarriage calculator that I was obsessed with every day. You can plug it in, check your numbers, and I would fiddle around with it. I’m five foot three and a half. So, I was like, you know, constantly like fiddle with five foot three and five foot four, just… All of these things, like, just to kind of see what the odds are, which is weird because I’m very much not a quant person. And I’m kind of suspicious of quantification. I was trying to quantify everything, but I was like, you know, what’s my risk today? So that was part of it. Detachment. It took a while, I think, to kind of accept this is, like, really going to happen.

 

Dr. Siavash Samei – 00:11:54:

Yeah, I don’t remember much. But if I recall correctly, I think, speaking for myself, even you were very anxious.

 

Dr. Sara Ailshire – 00:12:00:

Yeah.

 

Dr. Siavash Samei – 00:12:00:

Up until, I think, the second or third visit, very anxious.

 

Dr. Sara Ailshire – 00:12:04:

Yeah.

 

Dr. Siavash Samei – 00:12:05:

You know, until the ultrasound essentially cranks up. And whether you hear your heartbeat or not, I mean, it’s just, it’s like a true news box.

 

Dr. Sara Ailshire – 00:12:13:

Yeah.

 

Dr. Siavash Samei – 00:12:13:

You don’t know whether they’re-

 

Dr. Sara Ailshire – 00:12:14:

They would not, look at the screen. I think, I don’t think I felt okay until I could feel movement. And even then, I got, I was very focused on counting the kicks. And, like, if she wasn’t moving, I’m not a juice person. I was, like, drinking juice. I was, like, doing things, like, like, wake up. But I felt bad because she was probably just, like, resting. And I was, like, hello, are you good? I mean, yeah, definitely cast a bit of a pall over the pregnancy. And I’m not saying I wasn’t happy. I was so happy and wonderful. But, you know, you are very aware of, like, what can go wrong. So, definitely. I think that was in the front of our mind until well into like the third trimester, basically. So.

 

Dr. Rebecca Dekker – 00:12:56:

Yeah. And during that time, you moved to Kentucky, and you started making plans for the birth. So, tell us how that process went.

 

Dr. Sara Ailshire – 00:13:04:

Oh, wow. So, I had a good friend in the area, and she recommended a provider in Lexington. I went. And… Again, I have nothing but wonderful things to say about them and what furry care we had there. They were wonderful. But at our second visit, we were talking to our midwife and we’re just asking her, you know, because we would have given birth at Central Baptist Hospital, I think was where they deliver or where people give birth with them. And I was asking her about the C-section rate. And then she was very, I mean, again, like, I think very highly of her, but she was like, yeah, it’s about like, it’s pretty high. You know, it’s like 30, 40%. I was like. Oh. So, and also that’s where we went and did a lot of labs. So, you know, you do your first round of like. Blood testing, all those things. We did our Natera. Yeah, so we were with her. She told us about the highest Cesarean rate at Central Baptist. We went and we were doing all of our blood testing there. And it was just, it was chaos. You know, we were kind of like, it was a sea of people. And it was very difficult to fill that. And we just thought, maybe this isn’t the practice for us. And we were about 16 weeks pregnant at that point.

 

Dr. Rebecca Dekker – 00:14:10:

That’s the busiest labor and delivery unit in the central Kentucky area.

 

Dr. Sara Ailshire – 00:14:15:

So actually, I was looking at EBB because EBB has some information for people in Kentucky about different hospitals and their primary C-section rates. And we live fairly close to Stanford, which has Fort Logan. And they had a very favorable, I think something like 20%, 19%. It was low primary C-section rate. And we decided, okay, well, why don’t we check this out? So, we started going and we saw our midwife, Jamie, who was just wonderful. And it was just nothing negative about the other midwives we saw. They were great. Like they were giving wonderful care. But I think in a system that wasn’t super conducive to the midwifery model, whereas where we went, it was, you know, a mixed practice of doctors and midwives. But it was very much focused on. With three miles of care.

 

Dr. Siavash Samei – 00:15:02:

I think OBs in many ways-

 

Dr. Sara Ailshire – 00:15:03:

Yeah.

 

Dr. Siavash Samei – 00:15:03:

It’s a great difference to the-

 

Dr. Sara Ailshire – 00:15:05:

Yeah. So-

 

Dr. Rebecca Dekker – 00:15:07:

Yeah. They have a strong family medicine-

 

Dr. Sara Ailshire – 00:15:09:

Yeah-

 

Dr. Rebecca Dekker – 00:15:09:

And we’re talking about Stanford in Kentucky not Stanford in California a tiny town.

 

Dr. Siavash Samei – 00:15:18:

Yeah-

 

Dr. Rebecca Dekker – 00:15:19:

Yeah. But with a well-regarded small labor and delivery unit

 

Dr. Sara Ailshire – 00:15:25:

Yeah.

 

Dr. Rebecca Dekker – 00:15:26:

Run mostly by family physicians and midwives.

 

Dr. Sara Ailshire – 00:15:29:

Yeah. Correct. No exactly.

 

Dr. Siavash Samei – 00:15:30:

Like local.

 

Dr. Rebecca Dekker – 00:15:32:

Yes.

 

Dr. Siavash Samei – 00:15:32:

In the area-

 

Dr. Rebecca Dekker – 00:15:32:

And local to you.

 

Dr. Siavash Samei – 00:15:34:

Yeah.

 

Dr. Sara Ailshire – 00:15:35:

So yeah, it was great. She was very holistic. Like I’m not a chiropractor person, but she recommended a chiropractor if I was interested. You know, she was very supportive of doulas. She had a list of doulas that she offered to us. Not that worked with the hospital or worked with her, but just that she had encountered in her practice. And it was great. We had a wonderful quality of care there. And she was made a lot of time for us. I mean, we’re nervous, chatty academics. We talk a lot.

 

Dr. Siavash Samei – 00:16:01:

A lot of questions.

 

Dr. Sara Ailshire – 00:16:01:

A lot of questions.

 

Dr. Siavash Samei – 00:16:10:

They made a lot of-

 

Dr. Sara Ailshire – 00:16:10:

Everybody there. This is great. So, we were really happy that we switched. You don’t need to switch. Absolutely.

 

Dr. Rebecca Dekker – 00:16:21:

Yeah.

 

Dr. Sara Ailshire – 00:16:21:

Absolutely. My research and from working at EBB, I’m very much a believer that there’s lots of ways to have a baby that are great. It’s just sort of more like making sure a person’s like needs are met, that their autonomy is respected. So, I really wanted to have a low intervention birth as low as possible. But I, you know, again, like was open to, you know, basically like being flexible as things change. So, you know, I didn’t want to get super invested in like, it has to be this way because, I think birth is like an evolving process. And like, I had that knowledge from working at EBB and for my research. So yeah, so I was very interested in having a low intervention hospital birth. I just thought, you know, there is home birth care in our area. So, when we thought about it, but I thought, you know, it was because it’s my first time. I’m not sure. While we try, we found the hospital that seemed to have, you know, a pretty low intervention approach for a hospital. And we had a great midwife who we knew, like, that was also her, like approach to pregnancy care. And we hired eventually a doula who we thought could help us. So, we thought, okay, like, we’ll do that.

 

Dr. Siavash Samei – 00:17:30:

I think we fired a doula as a bit of a stretch.

 

Dr. Sara Ailshire – 00:17:33:

You hired a doula.

 

Dr. Siavash Samei – 00:17:35:

I think I always took my cue from her. She wanted a low-intervention birth. So, you know, in a very academic sense, she knows what she wants. And she’s done research. Although, as I think she would probably say, when it’s crunch time, the academic knowledge somehow just goes out. And so, I took my cues from her. I knew there was a birth center in Indiana, but it was too far for us. In an ideal world where we had the funds and the money and the energy and the resources, I would have loved her to give birth in India. I’m one of the many birth centers, birth villages that she has done research in. But, I mean, logistically, it was impossible. But also, the fact that legally it was also very challenging. So I think this was, in many ways, the best compromise.

 

Dr. Sara Ailshire – 00:18:11:

Yeah.

 

Dr. Siavash Samei – 00:18:12:

A place that was a hospital that had all the biomedical facilities that we needed, all the while the one else so far, the military model, a low-intervention model that Sara wanted. So, it was perfect.

 

Dr. Rebecca Dekker – 00:18:23:

Yeah, it really did seem like a golden ticket.

 

Dr. Siavash Samei – 00:18:26:

I think what happens to that facility now, because with the new bill and the cuts to Medicaid, a place like that that gets a lot of its funding from Medicaid might be hurt tremendously.

 

Dr. Rebecca Dekker – 00:18:36:

Yeah, its status is in question as a possible birthing location in the future, even though it’s been serving families in that area for many, many years.

 

Dr. Sara Ailshire – 00:18:45:

Yeah. I mean, it’s only six beds in the ward, but it was a full house we were there, you know, so. It was great. I mean, you know, again, hospitals, not a birth center, there’s, you know, you make that distinction. But I think as much as you can have that ethos in a hospital setting, like. That was her coach.

 

Dr. Rebecca Dekker – 00:19:03:

Yeah. So you’re planning to give birth there and you had a doula, and you educated yourself. I know, sorry, you already had some education, but Siavash, like, how did you learn about birth?

 

Dr. Siavash Samei – 00:19:16:

I would say that for somebody who I think likes to read and educate himself and being married to somebody who, again, knows this stuff quite well compared to the average person who is going to have kids. I was not as ready as I should. I, I mean, so I had bought books, and I shared resources with me. Toward the end, as it became more and more real, I definitely began reading a bit. I also had a whole world of my own going on at the same time, just a new job. And, you know, basically five new courses to teach from scratch, to develop design and implement from scratch, new colleagues, new everything. You know, and this is a job where I want to keep this job. Every day for me at work was basically just keeping my head above the water. Keeping myself afloat one wave at a time. And so, it was really hard for me to balance those two. But as it became more and more real, I began reading a bit. But I thought at this point for a number of reasons, including for my own sake and for her sake, we thought that we should hire a doula.

 

Dr. Rebecca Dekker – 00:20:13:

Yeah, I was going to say, it sounds like the doula was a necessity in your situation.

 

Dr. Sara Ailshire – 00:20:17:

Yeah. Like a match made in heaven it couldn’t have turned out better and then you know we took we took the hospital birth class because it was free and i know we had lots of birth classes available to us. Yeah.

 

Dr. Siavash Samei – 00:20:29:

It was not good.

 

Dr. Sara Ailshire – 00:20:31:

Yes. It was not good. Sorry, no offense to the instructor, but-

 

Dr. Siavash Samei – 00:20:36:

I don’t think, they designed the curriculum.

 

Dr. Sara Ailshire – 00:20:38:

It was not their curriculum. Yeah.

 

Dr. Siavash Samei – 00:20:39:

Sitting in a class with a smart kid, where she’s like- And I’m like, I’m taking notes obviously vociferously. But, but also even I knew like this should be a bit more hands-on than it is like it should be a bit more hands-on and then we took the birth class run by-

 

Dr. Sara Ailshire – 00:20:55:

A friend of mine.

 

Dr. Siavash Samei – 00:20:56:

A friend of yours in India. I’m going to the class virtually, and that was, even though it was virtual, it was wonderful.

 

Dr. Sara Ailshire – 00:21:02:

Much better. And we also had access to some of the EBB Birth courses too. So we’re able to kind of, pick and choose some of those videos. You wouldn’t go through the whole thing because time was winding down, but it was really nice to have.

 

Dr. Siavash Samei – 00:21:14:

I was primarily stressing for a doula for a number of reasons, but one of my anxieties was that we’re giving births in a very rural part of the country. I was not sure about my ability to advocate to her if something goes wrong. She’s advocating for whatever it’s simply because of the color of my skin, where I come from, of my name, you know, I’m from Middle Eastern descent, my minister background, and I wasn’t sure if I would be believed, you know, if she needs some kind of big advocate for her, whether I could do it justice. And again, the labor process itself, I knew it wasn’t a lonely process. I mean, you know, it’s lonely to her because she’s the one doing it, but I’m supposed to be there to provide care. If I am not confident in my own ability as a supporting partner to do that, then we need a third person. I mean, financially, we were not in place to hire a doula. And so, my colleagues, our friends here, put together a little baby shower for us and actually put funds to help us hire a doula. And we interviewed a couple of people and finally, yeah, so that was the best choice we ever made.

 

Dr. Rebecca Dekker – 00:22:20:

That’s amazing.

 

Dr. Siavash Samei – 00:22:20:

Picking Stanford, I think it was the best choice we could.

 

Dr. Rebecca Dekker – 00:22:22:

I think we’ll get more into that advocacy part and some of the discrimination later in your story. But Sara, when did you first realize something might not be going as expected in your pregnancy as you got towards the end of pregnancy?

 

Dr. Sara Ailshire – 00:22:37:

I think around maybe the 30-week mark or so, we would gone in for like, just like a regular appointment that you do. And. I think I had like a little bit of elevated like protein in my urine, like not a lot. Like I was in the normal range, but that was the first time I ever heard that comment made. And then, you know, the following appointment I went in, it was a little bit higher. And then at the 36-week appointment, we went in and they were like, okay, this is high, but I had no other symptoms, like no blood pressure symptoms, anything like that. They sent me home with a big jug of pee that you pee in. And I set it up, you know, like you have to keep it cool. So, like you have to set up this whole apparatus. Again, they don’t give you a lot of instructions because I picked it up. It wasn’t like handed to me in the appointment. I just like collected it and lots of good resources on the internet about how to keep your urine collection drug cool. So I, you know, I did that for 24 hours. Sent it back in and then at the following appointment about 37 weeks they were like okay like you have probably have pre-eclampsia like you need to be taking your blood pressure and I think it was the first time I ever had an elevated blood pressure reading was at that appointment too like I was always in the 110s 100s like lower I’ve always had kind of like lower blood pressure um and that was the first time I ever spiked like I think like 120 something- It was high. It was high for me too, which I think was more important. They were like, this is not the usual. So they said, why don’t you get a blood pressure monitor, monitor yourself at home. I think it’s a 36-week appointment. That’s when I had that first bit of a higher blood pressure. So we got it out and… I think this is after we had returned the jug for testing. And I think we put it on and it kept like saying like 140, 145. I’m like, oh, this is wrong. Like-

 

Dr. Siavash Samei – 00:24:25:

Yeah, I bought this. I bought this-

 

Dr. Sara Ailshire – 00:24:27:

I bought one a Kroger or something.

 

Dr. Rebecca Dekker – 00:24:29:

Yeah. It’s malfunctioning.

 

Dr. Sara Ailshire – 00:24:31:

It’s malfunctioning. And like, I was like, obviously, like, I’m silly. I don’t know how you feel.

 

Dr. Siavash Samei – 00:24:34:

Because, you felt well. You mean you felt fine.

 

Dr. Sara Ailshire – 00:24:36:

I just felt totally normal. I felt a-okay. So we’re like, oh, whatever. And then I was like, okay. I’m like, I watched, you know, I went online and like made sure I knew what I was using at Crackly and like did everything you’re supposed to do. You know, like. Like, I think I, like, sat for a while and, like, I got it on my arm the right way and, like, got a little table out. So, like, put it on the table correctly. Just, I was like, I’m going to do this as, like. To the book as possible. And was still reading high. And it’s like, this is broken. Like.

 

Dr. Siavash Samei – 00:25:08:

Just 140 over something.

 

Dr. Sara Ailshire – 00:25:10:

140 or something. I was like, this is not real. So, but I was starting to worry. I was like, okay, like, maybe something’s going on, like we should just make sure we’re getting this done correctly. And I think, in retrospect it’s like really ridiculous. I’m like obviously, I had high blood pressure. But. Well, I mean we’ve all had, yeah.

 

Dr. Rebecca Dekker – 00:25:25:

This is where the blood pressure cup, you know, maybe isn’t working.

 

Dr. Siavash Samei – 00:25:28:

She also comes with other symptoms, and she did, she had more-

 

Dr. Rebecca Dekker – 00:25:32:

Yeah. It’s like, your numbers were starting to show, there was something, before you were starting to have any physical symptoms.

 

Dr. Sara Ailshire – 00:25:38:

Yeah.

 

Dr. Rebecca Dekker – 00:25:40:

Yeah. Which means, you’re catching it early, hopefully.

 

Dr. Sara Ailshire – 00:25:42:

Yeah. No absolutely, I think, they were very much. Keeping an eye on things and like the moment, you know, and I think there’s, there’s a degree of range. It can be normal. So, but like the moment that like, there is this real clear trend developing, you’re like, okay, let’s just test and make sure you’re good. And my mother had great dementia. So I knew that that could be a risk factor. You know, if she’d had it, I might be likely to have it. So we went to a CVS. There’s a CVS close to our home. And we went to the blood pressure machine there. Because I’m just like, this is probably calibrated to be like, fairly user friendly, you know. And I’m not saying it’s like super accurate. But I’m like, this is probably, you know, if there’s something wrong with our home machine, this one might be better. Let’s just try it and see what it says. If two machines say it’s high, then, you know, then it’s not user error. I think at that one.

 

Dr. Siavash Samei – 00:26:32:

Do you remember what it was?

 

Dr. Sara Ailshire – 00:26:34:

It was like, you said.

 

Dr. Siavash Samei – 00:26:35:

It was 177.

 

Dr. Rebecca Dekker – 00:26:37:

Oh, no.

 

Dr. Sara Ailshire – 00:26:38:

We walked there. I felt fine. I didn’t have a hit. I felt totally okay. And we go back home. I’m like, we have to go to the hospital. Like, that’s really high. Like, we have to go to labor and delivery and, like, get checked out.

 

Dr. Siavash Samei – 00:26:53:

Which, luckily for us, is right across the street from CVS. I mean, from our house, the CVS hospital is a kid. Three, four minutes.

 

Dr. Sara Ailshire – 00:26:59:

I wasn’t sure. I was like, me. I’m like, I don’t know how long we’ll be there. So. let’s go home and, like, you know, get it back just in case. You never know at that point in pregnancy. So we went, and we didn’t go to Stanford. There’s two hospitals, like, in the same network. And we went to the one in Danville because I’m just like, if it’s just, like, super high, I don’t want to. A pop a blood vessel 20-minute drive when there’s a hospital right here, they brought us in-

 

Dr. Siavash Samei – 00:27:26:

They’re wonderful.

 

Dr. Sara Ailshire – 00:27:26:

They’re wonderful, and they put me on blood pressure medication They gave me an IV and then they also prescribed me medication they keep taking. I don’t remember what it was called now. That’s so silly.

 

Dr. Rebecca Dekker – 00:27:36:

Maybe a beta blocker.

 

Dr. Sara Ailshire – 00:27:38:

Something. Yeah.

 

Dr. Rebecca Dekker – 00:27:39:

It was sounding in, oh, all.

 

Dr. Sara Ailshire – 00:27:41:

Yes. Yeah. Yeah. So, yeah, and then, you know, we went back and we kind of knew at that point that it was preeclampsia.

 

Dr. Siavash Samei – 00:27:50:

Well, the thing that night was that- My question was for them is, are we going to be delivering the baby today? Are we going to go home? And they’re not sure until they saw the results.

 

Dr. Sara Ailshire – 00:28:02:

If the blood pressure went down.

 

Dr. Siavash Samei – 00:28:03:

If we’re going to go down, then we can go back home until we see Jamie, our midwife. If not, then they would have to discuss the possibility of having an induction.

 

Dr. Sara Ailshire – 00:28:12:

Having an induction. Early.

 

Dr. Siavash Samei – 00:28:13:

Okay. And luckily for us that date, the numbers went down. So, we were able to go home.

 

Dr. Rebecca Dekker – 00:28:20:

Yeah. Okay. And then you followed up with your midwife?

 

Dr. Sara Ailshire – 00:28:24:

Mm-hmm.

 

Dr. Rebecca Dekker – 00:28:25:

Okay.

 

Dr. Sara Ailshire – 00:28:25:

So, we followed up with her, and I don’t think she was happy about us being on this medication. I think she might have made a different choice as a provider. I was happy to be on her medication. I felt like, for my own self, the risk-benefit made sense.

 

Dr. Siavash Samei – 00:28:40:

Nor was she happy to be on this other hospital.

 

Dr. Sara Ailshire – 00:28:42:

I think she would prefer we had gone to Stanford because, you know, she would have had more awareness of what was going on. And but, you know, we talked about it and she was just saying, you know, we probably will need that. You’ll probably be induced, which was not what I wanted. But it was also very early. Like we just kind of passed the 37-week mark. And I was like, I asked her, like, can I stay pregnant if I keep on this medication and like I’m taking my blood pressure every day? And, you know, if everything is okay, like, is it possible for us to stay pregnant at least till 38 weeks? Or, you know, what’s the possibility here? Like, do we have any. Leeway or is this like really serious and she said you know she’s like If you want to, we can try it, but you have to come in for non-stress tests and take your blood pressure. So that’s what we did for about a week.

 

Dr. Rebecca Dekker – 00:29:34:

So, from about 37 to 38 weeks, you were doing regular non-stress tests and blood pressure checks?

 

Dr. Sara Ailshire – 00:29:40:

Every other day, basically. So, every other day for a non-stress test and like multiple times a day for blood pressure. And it was good. Like everything was great. We had no problems with the non-stress tests. And I’m very lucky. I work from home. I have a very flexible schedule. So. That was great. I mean, it made it, we were in a good position. We had a lot of flexibility that made it easy to navigate all these.

 

Dr. Siavash Samei – 00:30:05:

Were your cooking counts going down or were they going up?

 

Dr. Sara Ailshire – 00:30:08:

I think it was just kind of high. Never really said anything if they went down or up. Yeah, 38 weeks. So, we went back in to see Jamie and, you know, I was like, can we keep doing this? And she was like, I’m not super comfortable. Like, she’s like, this is fine. There’s nothing I’m worried about but, you know, your preeclampsia. We should probably like, you know, we’ve got you to 38 weeks. That’s great. But I think it’s probably time to start seriously talking about an induction.

 

Dr. Siavash Samei – 00:30:33:

This was a Tuesday, I think.

 

Dr. Rebecca Dekker – 00:30:36:

Yeah, okay.

 

Dr. Siavash Samei – 00:30:37:

And then I was asking her, do you think we can… Go until Monday. Just because that was the last full week of my classes. Monday or Wednesday would have been the last day of the class. So basically, that week would have been the end of the semester. So, it wouldn’t be a full week. I was like, can we just go until Monday? And Jamie was like, it’s up to you, but I would say no.

 

Dr. Sara Ailshire – 00:30:56:

Yeah, and that was something that was really important to us, was that you know… She gave her perspective as the expert, as a provider, as a midwife. And I knew that, you know, she wasn’t coming to us from a, like, we have to like to manage you, manage you. Like you have to do things my way or the highway. Like you have to fit into this mold. Like she was very much willing to meet us where we were at. And if we wanted to, we could have kept going. But like, I trusted her. Like she had created an environment where like, she’d always listened to us. She had always like taken us seriously. Like we had this really beautiful, I think. Relationship with her as our midwife and when she said I just don’t feel like she’s like you can but I’m not sure that was like okay like I trust her judgment she’s never steered us wrong. And she was right. no, I mean I think, I’m really glad that you know we were induced, and I wasn’t sure either and like, that was a thing like if she, had said we kind of went into that appointment thinking like, we want to know what she has to say. Like, we’re not sure if this is new. Like everything seems like it’s going fine, but yeah, we’ve crossed the 38 week mark. So we’re like, early term, but still term. So I’m feeling, I feel happy about that. And like, if that’s as far as we go, that’s as far as we go. And kind of back to the point about, I wanted a low intervention birth, but not at my expense of my health, at the expense of anything else. I was like, you can also have a low intervention birth and be induced. So I was like, if that’s going to happen, it’s going to happen here. So let’s go for it. So.

 

Dr. Siavash Samei – 00:32:24:

And I think she was right because, up until now, as far as I could see, and you could see, you know, you were looking for physical symptoms of the cancer and they were not really there.

 

Dr. Rebecca Dekker – 00:32:35:

We still hadn’t had any.

 

Dr. Siavash Samei – 00:32:36:

No, but I think that Wednesday or Thursday, we went to the hospital.

 

Dr. Sara Ailshire – 00:32:39:

Yeah, I went to Thursday, but Wednesday I started to get the beat.

 

Dr. Siavash Samei – 00:32:41:

On Thursday, we took our last photos before we go to the hospital. And on the photos, you could see.

 

Dr. Sara Ailshire – 00:32:46:

Yeah.

 

Dr. Siavash Samei – 00:32:47:

You could see that the symptoms had very suddenly appeared.

 

Dr. Sara Ailshire – 00:32:49:

Yeah.

 

Dr. Rebecca Dekker – 00:32:50:

And what were your symptoms, Sara?

 

Dr. Sara Ailshire – 00:32:52:

I never had headaches or vision changes. I was very aware of that. Because I have migraines and migraines of aura. So I feel like I’m pretty sensitive to that. And that wasn’t happening. I didn’t have pitting edema necessarily. But my fingers and my feet were definitely puffy.

 

Dr. Siavash Samei – 00:33:07:

Your ankles.

 

Dr. Sara Ailshire – 00:33:08:

Yeah, my ankles were puffy too. And I just thought, I was like, okay, we’re on the road. That’s a normal thing that people experience in pregnancy. But for my pregnancy, I hadn’t really experienced that type of swelling.

 

Dr. Rebecca Dekker – 00:33:20:

And it was sudden and you already knew you had preeclampsia.

 

Dr. Siavash Samei – 00:33:23:

You compared the photos of the day we went to the hospital to two or three days before.

 

Dr. Sara Ailshire – 00:33:27:

Yeah.

 

Dr. Siavash Samei – 00:33:27:

I mean, day and night.

 

Dr. Sara Ailshire – 00:33:29:

I was also, yeah, I mean, in my face. So, like, it was kind of like a little bit of, like, the frog in the boiling water. I was like, okay, like, this is a change. And it’s subtle, but it’s enough where we can see it. Yeah, that was really physical symptom that I ever had preeclampsia, like no headache. No vision changes, no spots. If I hadn’t known, if I hadn’t been testing, I would have been testing.

 

Dr. Rebecca Dekker – 00:33:50:

Your blood pressure and your protein, you wouldn’t have known. You might have just said, oh, this is normal swelling.

 

Dr. Sara Ailshire – 00:33:56:

Yeah, exactly. Exactly. Because there’s lots of things that… You know, it can kind of like, it can be normal, or it can be a symptom. And like, you have to have those other context clues to know when, what is what. So.

 

Dr. Rebecca Dekker – 00:34:08:

Right.

 

Dr. Sara Ailshire – 00:34:09:

Yeah.

 

Dr. Rebecca Dekker – 00:34:10:

Yeah. Okay. So, and at this point you were 38 and a half weeks ish?

 

Dr. Sara Ailshire – 00:34:16:

I think 38 is three.

 

Dr. Rebecca Dekker – 00:34:17:

Okay. And so you went to the hospital to be induced.

 

Dr. Sara Ailshire – 00:34:22:

Yes.

 

Dr. Rebecca Dekker – 00:34:22:

Okay. And how did that process go?

 

Dr. Sara Ailshire – 00:34:26:

I would say, you know, the worst part about the induction for me was the IV. I really didn’t want the IV. I don’t care for it. I find it really uncomfortable. I’m not afraid of needles, but it’s not pleasant to have the saline log. And I kind of knew that that was coming. But that was the worst part. We were given, or again, Cytotec, which was a weird kind of callback to like pregnancy loss. But now it’s, you know, the same medication for a very different purpose. We started with cervical ripening, which was Cytotec. And I would say the worst part, aside from that IV, was just that we went in overnight. And the way it works when you’re in a hospital being induced is that, you know, they keep coming every few hours. You know, they’re checking your blood pressure. They’re giving you the Cytotec because you have to take, you know, small doses every few hours. And it was really hard for me to get rest. And I felt like I paid for that a little bit later in the next day when I was actually having the baby. Another thing, too, I had done before I went in was, like, I tried to calculate my own Bishop score based on, like, what I knew from, you know, because I had been open not to every cervical check under the sun, but I had been open to a cervical check. During our last appointment, just because like, I’m going to be induced. This is information I want to know. And like, I’m informed. I know the risk benefit here. And I think I’d prefer to have a check just because I don’t have a sense of what’s going on. I felt like, you know, again, like calculating yourself at home is a grain of salt. But I feel confident though, because I had like a decent score. It suggested that an induction might go well. I already had, like some cerebral dilation, like, so, yeah. It was fine, and then the next morning, I didn’t really sleep super well you, you didn’t sleep super great either, but-

 

Dr. Siavash Samei – 00:36:01:

Better than you, every few hours and she had to wear I mean the silence function was, uncomfortable from the beginning to the end, but also you have to wear, the ultrasound and the pressure.

 

Dr. Sara Ailshire – 00:36:15:

And the monitor.

 

Dr. Siavash Samei – 00:36:16:

And the monitor would just keep coming off because you’re trying to sleep. And so even the slightest movement on your part would dislodge it. And so it just started beeping. And it was not a good night.

 

Dr. Sara Ailshire – 00:36:25:

It wasn’t restful, which is a real shame because you need your rest before, you know, if you have the opportunity to rest before you get for it, it’s so important. The next day, things seemed like they were going well. Jamie, my midwife, came to check on us-

 

Dr. Siavash Samei – 00:36:39:

Is attending.

 

Dr. Sara Ailshire – 00:36:40:

But then again, I was interested in this. Like I was like, check my cervix again, my request. And I was like, could you do a membrane sweep? Because I was just like, I would really like to avoid Pitocin. I would really like to have as low of an intervention birth as possible. I’m already here. I’m already having this side attack to be induced. I’m like, can we? But it seems like things might be happening. Can we get this show on the road? Can we try it? And she was like, sure. This is not something that she had pushed. It’s not something she said, you should do this. It was my wish to say, let’s see if this can maybe help. My body’s on this road, it seems like already. Maybe this is just one more push it needs. So she did a membrane sweep. And then I went into labor pretty shortly after, so.

 

Dr. Rebecca Dekker – 00:37:20:

That’s amazing.

 

Dr. Sara Ailshire – 00:37:21:

It was great. I feel like we had a wonderful, wonderful induction experience.

 

Dr. Rebecca Dekker – 00:37:26:

And when did your doula arrive then?

 

Dr. Sara Ailshire – 00:37:28:

Did she get there, I was kind of in labor land at that point.

 

Dr. Siavash Samei – 00:37:31:

Yeah. I think, Jamie came around 10 o’clock. I think, I was talking 10 in the morning.

 

Dr. Sara Ailshire – 00:37:35:

Yeah.

 

Dr. Siavash Samei – 00:37:35:

I was saying, Elaine. I was texting with her regularly, about her progress. And as her labors became more, I think contractions became more and more intense. I was trying to help her, uh, various poses, breathing and poses and, at some point, I felt like, because, you were in tremendous comfort, I wasn’t able to be the best sport that I could, well, I think, the doula came at my request. She was like, you know, she was hands on deck she was like now I’ll come whenever you want, I think around four o’clock.

 

Dr. Rebecca Dekker – 00:38:06:

Okay. So by four or five you were, working pretty hard and you needed the doula there.

 

Dr. Sara Ailshire – 00:38:10:

Yeah.

 

Dr. Rebecca Dekker – 00:38:11:

And how did you- Yeah, how did you labor with the doula? What did you do?

 

Dr. Sara Ailshire – 00:38:16:

Oh, wow. I mean, I was off the bed as much as possible. I didn’t want to lay down. I was on my hands and knees a lot. I was in the shower. It was another thing that was really great about this hospital. This birth, what do they call it? It has like a little tagline of birth something.

 

Dr. Rebecca Dekker – 00:38:31:

The birthing spa.

 

Dr. Siavash Samei – 00:38:32:

Right. I mean, it does feel like it’s fine in many ways.

 

Dr. Sara Ailshire – 00:38:35:

Yeah, the big tub. So I was in the tub. I was in the shower moving around. Just, you know, there was a ball. I think I was on the ball for a while.

 

Dr. Siavash Samei – 00:38:45:

There’s a little yard there that you can go walking in the yard. So we have to.

 

Dr. Rebecca Dekker – 00:38:49:

Like there’s a green space. Yeah.

 

Dr. Sara Ailshire – 00:38:51:

She brought a TENS machine. So she’s put the TENS machine on me. And I think it helped a bit. I think maybe if we had had the forethought to bring- It might have been more helpful earlier in labor, but it was helpful. It really did, you know. And, yeah, so she came and, you know, I think she was also just, she was tagging him out because he had been, you know, doing counter pressure and kind of like helping me through it. It just gave him a chance to like. Breathe. And I think it’s really interesting is that you know a lot of people go inside of themselves during labor I think I very much just it’s where I run when she came is when I really started to go inside it’s like I know she was there, but it’s hard for me to like, always articulate what she was doing necessarily. I felt like, it was kind of like, very much like turned inward at that point. Yeah, but I mean, he’s doing-

 

Dr. Rebecca Dekker – 00:39:40:

All this without Pitocin. So, yeah, gotten Labor Star with Cytotec and the membrane sweep. And then what happened next?

 

Dr. Sara Ailshire – 00:39:48:

So labor’s progressing. And at one point, I think I was really starting to like throughout all of it. I mean, I was definitely a lot of discomfort, you know, but I was like breathing through it and I felt okay. I was like, I felt like I had kind of a grip. And then, what time was it? Around 8? 8 o’clock. I was starting to feel out of control a little bit. Like, feel very overwhelmed with, like, the surges of, like, the contractions. I was in the shower. I did not want to talk to anybody. Like, the lights were out. I was very much like, just leave me alone, you know. And everyone was, like, protecting my space. And Siavash and Elaine were kind of, you know, as the nurses were coming in to check, they were just like, we’re good. Kind of helping me like maintain my like. Bathroom of solitude. But I was also, I was really starting to feel kind of hopeless at that point. I was just like, oh man, maybe I want epidural.

 

Dr. Siavash Samei – 00:40:40:

Because your contractions were increasing in intensity, but there was no other movement.

 

Dr. Sara Ailshire – 00:40:45:

No, and I was also having, experiencing some back labor at this point too, which is tough, you know. And again, that’s just kind of like where everything I knew and read and like thought about like pregnancy and birth, and it was starting to kind of just like slip away. And I was just like, I could have that epidural and lie down. We got the nitrous oxide, which was kind of funny because I was like one of the first things I ever did for EBB was like, right, help us update our work on nitrous. So I had nitrous and that was so helpful. But then I needed to kind of get away from the machine and go back to the bathroom. And at that point, I was like, you know, I think I’m just done. I’m not going to hold myself like prisoner to what I thought I needed. I’m just like, I need the epidural. I just need it. I’m done. I’m done. I’m done.

 

Dr. Siavash Samei – 00:41:28:

9 o’clock. After 9 o’clock at night.

 

Dr. Sara Ailshire – 00:41:30:

Yeah. And then my water broke. And then I was at 10 centimeters, it was time to have the baby. So I think that’s something that happens to a lot of people during transition. And I think outside, I think I was very surprised by… Just how much knowing wasn’t a preparation for feeling. Which sounds really obvious, but you don’t know what you don’t know. You haven’t felt what you haven’t felt. So. And then, I mean, I was ready to have this baby. I was starting to feel the ejection impulse. And, you know, I was thinking, I was like, I’m going to like have this baby on my hands and knees. I’m going to be upright. I’m going to like, you know, standing up. Like, I was just like, so like thinking all the postures I’ll have this baby. And I was just like, I was well laid down. At least put me in lithotomy. I don’t care. Which is so, I thought it was really funny afterwards.

 

Dr. Siavash Samei – 00:42:19:

You were exhausted.

 

Dr. Rebecca Dekker – 00:42:20:

I was tired. I’ve been working really hard.

 

Dr. Sara Ailshire – 00:42:25:

I was really tired and that’s what my body wanted. And it was great. Elaine got the, there was these bars so she was able to help me kind of like position myself. Yeah. And then we had Ferdows. Like she came pretty quick.

 

Dr. Siavash Samei – 00:42:43:

It was a very quick.

 

Dr. Sara Ailshire – 00:42:44:

I think it pushed like a couple of times.

 

Dr. Siavash Samei – 00:42:47:

The midwife was not there because my wife was not expecting the baby to come that night.

 

Dr. Rebecca Dekker – 00:42:51:

Yeah, they’re like first time mom, Sara in that room. Like she won’t be having the baby.

 

Dr. Siavash Samei – 00:42:56:

And his wife finally came and within, I think, two pushes. Two or three pushes. The wife came and the baby just came out.

 

Dr. Sara Ailshire – 00:43:03:

The first time I was experiencing like the ejection like, reflex. So like I could feel her moving down. I wasn’t doing anything. I was just like, this is great.

 

Dr. Rebecca Dekker – 00:43:09:

Like she’s coming out.

 

Dr. Sara Ailshire – 00:43:11:

And I was like, I’m just going to like let it roll. And I feel like, no, you should probably be, you can push. I’m like, I can’t and, I was like, okay, I guess I’ll do it. I think, I pushed twice, like it was very-

 

Dr. Siavash Samei – 00:43:22:

You pushed twice, and then they’re like, you’re not breathing, I think correctly with it. So, one of the, one of the nurses came, and told you what to do exactly-

 

Dr. Sara Ailshire – 00:43:29:

Yeah.

 

Dr. Siavash Samei – 00:43:30:

Breathing- The third time, the baby just came out.

 

Dr. Sara Ailshire – 00:43:31:

Yeah. She was born. It was wonderful. I mean, again, like it was once my water broke and we were pushing, like, I know pushing can be uncomfortable for a lot of people. I think my experience with transition, like everything after that, I was like, it felt like. It felt great. I felt really good. I felt in control again, I felt like, I was like, kind of back up in myself and it was good.

 

Dr. Rebecca Dekker – 00:43:52:

And no things changed though, right? At some point. So what happened next?

 

Dr. Sara Ailshire – 00:43:57:

So, fair does this warm, to the very, very short chord. Very short. I think less than six inches. It was really short. And, so I couldn’t even bring her up to my chest at first, um, then they you know, we waited, and then we once, you know, her quarters- I’ll say, it’d be like a couple of minutes, saying we’re able to cut it, and bring her up. And we’re waiting, for my, you know, to placenta to pass, at this point they said, you know, do you want Pitocin? I was like sure. Because, I think, again, my response that was like, this is fine for- Yes maybe, I wanted during labor, but I was like you know, I’ve given birth, this might be helpful for, you drink productions, getting the placenta out, I was like, okay, sure. And we waited, and waited, and I never felt an urge to push, nothing else happened, and my placenta just like was not budging. They came after some time, they tried traction, to see if it would help encourage it to slip away, you know, skinless you know, Ferdous, so it was wonderful. I was so happy, that I wasn’t really even worrying about the placenta, and other than I wanted to see it. I very much wanted to see my placenta, and like, look at it in the dish, and- That’s such an important you know, organs, like, it’s done this amazing thing. And then, you know, it’s probably time for us to remove the placenta, and like we can put you under, because it might not be very comfortable. So it’s like, I felt fine with that. I was a little bit concerned at that point, I guess, when they were like, oh, like, this is, we need to maybe get your mean here.

 

Dr. Rebecca Dekker – 00:45:38:

How long it had been since the placenta had not detached?

 

Dr. Sara Ailshire – 00:45:41:

I think it had been about, like, 30 minutes, and by the time I was under, it was about 45 minutes. And, like, I mean, there had been nothing. Like, no further contractions, like… It was just like holding on pretty tight. So yeah, you took a fair dose and-

 

Dr. Siavash Samei – 00:45:56:

Yeah, and then they just performed the… Invisc as an operation.

 

Dr. Sara Ailshire – 00:46:01:

I wasn’t there.

 

Dr. Siavash Samei – 00:46:02:

Yeah. Yeah. So I took shadows. I think.

 

Dr. Sara Ailshire – 00:46:06:

Your turn is getting to skin with her.

 

Dr. Siavash Samei – 00:46:07:

I was getting to skin with her. I think I was sitting in one place. I think the doula, the name was sitting between me and the bed. And she had to take one eye on me, one eye on the bed. I was out of it a little bit because I had a migraine, but also I had the baby. So I was like, my focus was on the baby. At the same time, I was very anxious about what was happening. I think the doula was just telling me, giving me updates about what was happening. But it was fairly short. I think maybe the whole thing took place an hour. I don’t. Time at that point was quite, I had most of time, maybe half an hour.

 

Dr. Sara Ailshire – 00:46:38:

Yeah.

 

Dr. Siavash Samei – 00:46:39:

75 minutes at most. Yeah.

 

Dr. Sara Ailshire – 00:46:41:

And it turned out, I guess I have a heart-shaped uterus. So I don’t have a full septum, but it’s like partially have like a little septum. And what had happened, so the family practice physician came in to assist Jamie with this removal of the placenta. And also, Ferdous was very small when she was born. She’s like six pounds, three ounces. The placenta was really small. And they said, basically, it was like tucked up in the lobe of your uterus.

 

Dr. Rebecca Dekker – 00:47:05:

Oh, wow.

 

Dr. Sara Ailshire – 00:47:06:

So it was like kind of way up there. And that was the first time I heard.

 

Dr. Rebecca Dekker – 00:47:09:

Did you know you had that type of uterus? Yeah.

 

Dr. Sara Ailshire – 00:47:12:

No, I guess it doesn’t. It’s not something that always… Comes out like even on ultrasound it was like well when they’ve caught this and I guess it’s something that you don’t always see on ultrasound either, so.

 

Dr. Siavash Samei – 00:47:22:

So the baby was in one mode, and then-

 

Dr. Sara Ailshire – 00:47:25:

It was all tucked up in like the one side. So, but yeah, it came out, I think fairly cleanly. I think they had to take out in pieces though, and I woke up, I was like well where is it? But yes, I mean, I think it went a while as it could have gone.

 

Dr. Rebecca Dekker – 00:47:41:

And it’s like one of those examples of an intervention that could be potentially life saving, the fact that they were able to, you know, put you under to remove the placenta safely.

 

Dr. Sara Ailshire – 00:47:52:

Absolutely. Yeah. And I think too, because preeclampsia, a lot of times it’s like a problem with how your placenta is connected to your uterus. So like it could have just been like really Velcroed in there.

 

Dr. Rebecca Dekker – 00:48:03:

So you didn’t have any further complications, like no postpartum hemorrhage or anything like that, because I know both preeclampsia and placental separation issues can cause that.

 

Dr. Sara Ailshire – 00:48:12:

No, I mean, they were very wary of that. I got a lot of fundal massage, you know, just to help me bring it down. But there’s no indication of a hemorrhage. Like my once placenta was out. Things were, you know, kind of nicely pressing down. One thing that kind of surprised me was that they didn’t have a Jada device. It’s like an inflatable balloon that you can put. It’s a low tech device that can, you know, prevent hemorrhage. I think it’s great. And I know the hospital in Danville here has one. And I asked about it. I was like, well, do you guys have it? And they’re like, oh, no, we just do other things if you have a hemorrhage. And I was like, oh. It’s kind of a shame that you don’t have that. But, you know, there was a need for it. They were able to bring me down. And things could return to normal pretty quick. Once I was out of the woods, like, I was cared for and, like, checked in on. But I didn’t feel like all of a sudden I became this, like, high risk. Like, we have to be on top.

 

Dr. Rebecca Dekker – 00:49:08:

It’s like they did everything, but there was no panic around it.

 

Dr. Sara Ailshire – 00:49:11:

No. Yeah.

 

Dr. Rebecca Dekker – 00:49:12:

Yeah.

 

Dr. Sara Ailshire – 00:49:12:

They were very, I think because they were very calm. And, you know, never really treated me like a high risk case. Like I felt fine. Like I never felt afraid or anything like, yeah, I had preeclampsia, but I didn’t have to wear a monitor the whole time I was laboring. You know, yeah, I need to be induced, but they were willing, you know, I didn’t have to have a whole adduction.

 

Dr. Rebecca Dekker – 00:49:34:

They were flexible with which methods you got to use.

 

Dr. Sara Ailshire – 00:49:37:

Yeah. I was able to labor in the bath, in the shower, move around. Like I was never kind of like those horror stories you hear people who are like kept to the bed and, you know-

 

Dr. Rebecca Dekker – 00:49:46:

And then you lose all control over your birth experience.

 

Dr. Sara Ailshire – 00:49:49:

Yeah. I had a lot of, I had a lot of autonomy and I felt really respected the entire time.

 

Dr. Rebecca Dekker – 00:49:54:

Siavash, one of your, you know, hopes for hiring a doula is that in case you needed additional advocacy, you know, with discrimination, did any need come up for that at all?

 

Dr. Siavash Samei – 00:50:05:

Yes and no. I mean, the fact that they had to put her under for the, to, to, to, to deliver the placenta, I think at that moment, at like a lucid moment, I was exhausted. I was like, okay, this is what I needed the doula for just in case that something like this goes wrong. Or this goes in a way that’s unexpected. I mean, we initially hired the doula, I think in my insistence, primarily for that reason, in a way to advocate, not necessarily for the birthing person here, but advocate for the advocate, advocate for the supporting. And in practice, primarily, I think the doula, they was able to, as Sara said, I think, be a relief pitcher, you know, just give me a moment to rest, to get ready to have a sip of water. I would say the anxiety that I had initially of discrimination did not really materialize in a way that would require the doula to help me as a patient. There were two instances where, where I think that something relevant happened. One is that the nurses were phenomenal. They were wonderful. I mean, they were really, really, really, really wonderful. There was one particular nurse there who, for reasons that I don’t know, would not make eye contact. And when I would want to ask a question, like sometimes, you know, I was, they had a fridge there, we had the colostrum stored. So every now and then I would just go and get a vial of colostrum to feed for those. And when I would go to the nurse’s station during that specific person’s shift, when I would ask them, they would not make eye contact with me. If I had one or two questions, they would usually, usually it’s somebody else’s answer. And it felt somewhat discriminatory. I can’t say for sure. It felt like a racialized microaggression.

 

Dr. Rebecca Dekker – 00:51:34:

Right. That sounds like it.

 

Dr. Sara Ailshire – 00:51:36:

That same nurse later came in and did some stuff with me. And it was very different with me and my mother. My mother had come and joined us at that point.

 

Dr. Siavash Samei – 00:51:42:

That’s true.

 

Dr. Sara Ailshire – 00:51:43:

You had gone to the house to like- Pick something up or do something. Like you were, oh yeah, yeah, we sent you home. And yeah, we had a very, like just night and day, very different encounter.

 

Dr. Siavash Samei – 00:51:55:

Yeah.

 

Dr. Sara Ailshire – 00:51:56:

Yeah.

 

Dr. Siavash Samei – 00:51:56:

And the other moment where I think I called on Elaine to help me was that after they delivered the placenta, you know, she was in discomfort. She was in some pain, I would say, even. And we were asking, you know, I think you had at the moment asked for some sort of medication for what you had asked for.

 

Dr. Sara Ailshire – 00:52:13:

They were giving me Advil and Motrin. I was like, is there something that’s stronger that’s breastfeeding safe? Because I had a manual placenta extraction, so someone’s arm had been inside my body. Had a second degree tear but I didn’t feel at all when I was having the baby I felt great when I was having her and I was like I’m in some pain I had been catheterized. And I just I felt, I was in a lot of discomfort. What I was being offered wasn’t really helping. I was like, is there something that is breastfeeding safe that you can offer me? Because this isn’t even touching it.

 

Dr. Siavash Samei – 00:52:44:

Like what you offer to people who have C-sections.

 

Dr. Sara Ailshire – 00:52:47:

It was like, is there something?

 

Dr. Rebecca Dekker – 00:52:49:

You had just been in the operating room having this procedure done.

 

Dr. Sara Ailshire – 00:52:52:

Yeah, it was.

 

Dr. Rebecca Dekker – 00:52:53:

Essentially, yeah.

 

Dr. Sara Ailshire – 00:52:55:

And I was just kind of blown off a little bit. And Elaine kind of strategized with you for us to find a way.

 

Dr. Siavash Samei – 00:53:01:

Yeah, so I spoke with her. By then, she had gone home. This is really after-

 

Dr. Sara Ailshire – 00:53:06:

Yes, of course, yeah.

 

Dr. Siavash Samei – 00:53:06:

So I was speaking with her over the phone to try to strategize to try to get better care for her at that moment. I think you had decided that you just went off that moment that you were doing okay. She just did not want to shoot the same trigger. And so we sort of dropped it. I think that was the one moment where the initial intention of finding a Duola became, for me, became sort of necessary.

 

Dr. Sara Ailshire – 00:53:26:

Yeah, the brainstorm.

 

Dr. Siavash Samei – 00:53:27:

Exactly.

 

Dr. Rebecca Dekker – 00:53:28:

Brainstorm advocacy.

 

Dr. Sara Ailshire – 00:53:30:

She can’t, you know. She’s not like magic. She’s not a superhero. Like, she can’t do everything for us. But, like, she has so much wisdom. From attending some of the perks and can help us find ways to ask or approach or re-approach a situation.

 

Dr. Rebecca Dekker – 00:53:44:

Yeah, ideas or options, things like that.

 

Dr. Siavash Samei – 00:53:46:

If, for example, discrimination is a factor here that they have a hard time hearing me out or listening to me or taking me seriously, then my ability to advocate for her is reduced. And so at that moment, Duola can help me brainstorm how to phrase things, how to say things to sort of get them the best possible care for them.

 

Dr. Rebecca Dekker – 00:54:07:

Amazing. Yeah. I just love how. You know, your doula did all the doula things, but also provided that peace of mind for you as well.

 

Dr. Sara Ailshire – 00:54:16:

In that area, for sure.

 

Dr. Rebecca Dekker – 00:54:17:

Before we go, is there anything else you would want to share for listeners who are entering birth or parenthood soon?

 

Dr. Siavash Samei – 00:54:23:

Hire a doula.

 

Dr. Sara Ailshire – 00:54:25:

Yeah. I don’t know, if-

 

Dr. Rebecca Dekker – 00:54:27:

Yeah, if I had a dollar for every parent partner who said that.

 

Dr. Sara Ailshire – 00:54:31:

Right. Now, I have preeclampsia, which is high risk. And I was still able to have a very… As low of an intervention birth as was possible. You know, just because you have to be induced doesn’t mean that, like… Everything flies out the window. Like you still have a say, you know, there’s like courses you can take. And, you know, I think we were very supported. Like we were never made to feel like we need to panic and this is like the world is ending. Cause there’s a lot of research that’s already done and there’s lots of ways that we know to take care of people who are experiencing preeclampsia. And, you know, I think they’re calm, let me be calm and let us, you know, make sure that like we had the space to consider our options and we had the space to, you know, make sure that we were moving forward in a way that felt was both informed by the evidence, but also felt right. You know, and that we felt totally confident. Like we weren’t being pushed. We weren’t being pressured. We weren’t being rushed. Like, you know. We felt really good. And I think that helped, helped a lot. And yeah, I mean, I think it’s exciting. Like being parents to a little person, it’s really fun. They’re so interesting. I think people always say, well, just wait, just wait. And like, there’s lots of just waits. Like just wait until they talk. Just wait until they start singing. You know, there’s lots of, I think, pleasure and joy. Even in- The parts that aren’t super glamorous or exciting and you know it’s hard I’m not saying it’s not hard but you know I think that, throughout all of it, there’s been just a lot. That’s wonderful that we’re grateful for. And either way, I think too, like it kind of brought us full circle, like maybe more in the last pregnancy, a little bit more considering like what that pregnancy could have become. Having gone through it, but also, you know, I kind of felt not grateful for having it happen. It was awful. I wish I hadn’t, but I felt like it prepared me a lot for, in a way, labor. I think it gave me some knowledge and some insight that made the earlier stages of labor a lot more, like, manageable. So, yeah, I’m sorry, I was kind of rambling.

 

Dr. Siavash Samei – 00:56:33:

I’m going to say, for me, at some point, her memory of that evening, so it became hazier and hazier and hazier, and then she didn’t remember much. But I was there, I think, to this day, I cannot find it proper words right now. Really ever. I have never witnessed firsthand something as wonderful as what happened from the moment that she sort of went into contraction until the moment. I mean, I think I teach human evolution. I talk about, you know, the fact that in the process of human evolution and primate evolution, there’s nothing as important as a mother-infant bond. And again, very theoretical, very academic. And witnessing firsthand what was happening, what was unfolding before my very eyes really made me understand. To the extent that any non-mother can, tell that bond is formed. And it was just awesome in the very definition.

 

Dr. Rebecca Dekker – 00:57:25:

Incredible. And with that, I thank you both for joining us and sharing your story. We really appreciate you both.

 

Dr. Sara Ailshire – 00:57:32:

Of course. Thank you. Thanks for having us. This is really fun to talk about.

 

Dr. Rebecca Dekker – 00:57:37:

And for our listeners, I also want to encourage you to visit preeclampsia.org if you’d like to learn more about the symptoms, warning signs, treatment, prevention, all of those things. So we’ll put that link in the show notes as well. Thanks, everyone. And I’ll see you next week. Bye. This podcast episode was brought to you by the Babies Are Not Pizzas: They’re Born, Not Delivered! Babies Are Not Pizzas is a memoir that tells the story of how I navigated a broken healthcare system and uncovered how I could still receive evidence-based care. In this book, you’ll learn about the history of childbirth and midwifery, the evidence on a variety of birth topics, and how we can prevent preventable trauma in childbirth. Babies Are Not Pizzas is available on Amazon as a Kindle, paperback, hardcover, and Audible book. Your copy today and make sure to email me after you read it to let me know your thoughts.