Ep 108: Kalishia’s Birth Story – Success with Transabdominal Cerclage

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On today’s episode of the podcast we have a unique birth story episode from Kalishia. Warning: This episode includes pregnancy loss.

Kalishia had a transabdominal cerclage and a successful full term pregnancy after experiencing a miscarriage at 16 weeks and then a stillbirth at 21 weeks. A cerclage is a stitch that is placed around the cervix (the opening to the uterus) which keeps the cervix closed. It’s something we do for women who have a weakened cervix for whatever reason, whether from prior surgery or genetics. It’s not common and happens in 2-3% of pregnancies.  

In this episode, Kalishia walks us through her experience. This episode is a bit longer because you really have to understand her first two pregnancies to understand the 3rd.

In this Episode, You’ll Learn About:

  • What Kalishia experienced losing a pregnancy at 16 weeks
  • What a transvaginal cerclage is and why she received one during her second pregnancy
  • How Kalishia kept a careful eye out for changes and communicated quickly and clearly with her healthcare providers
  • How Kalishia dealt with her second pregnancy being stillborn
  • How difficult it can be to decide what course to take in the wake of pregnancy loss
  • How Kalishia found hope in transabdominal cerclage online forums
  • What made her third pregnancy a “perfect pregnancy”
  • How important it can be to seek therapy or join a support group in response to pregnancy loss
  • Why it isn’t constructive to tell someone who has suffered pregnancy loss what they should have done differently

Links Mentioned in the Episode

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Ep 108: Kalishia’s Birth Story & Success with Transabdominal Cerclage

Nicole: In this birth story episode, you'll hear from Kalishia and her experience with transabdominal cerclage. Warning. This episode does involve pregnancy loss.

Nicole: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankings, a board certified OB GYN, who's been in practice for nearly 15 years. I've had the privilege of helping over 1000 babies into this world, and I'm here to help you be calm, confident, and empowered to have a beautiful pregnancy and birth. Quick note, this podcast is for educational purposes only and is not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now let's get to it.

Nicole: Hello. Welcome to another episode of the podcast. This is episode number 108. Thank you for being here with me today. On today's episode, we have a birth story episode from Kalishia. Kalishia had a transabdominal cerclage and a successful full term pregnancy as a result after experiencing a miscarriage at 16 weeks and then a stillbirth at 21 weeks. A cerclage is a stitch that is placed around the cervix and the cervix is the opening to the uterus. And that stitch helps to keep the cervix closed. It can be placed either through the vagina, which is far more common, and Kalishia actually had that before she had the transabdominal cerclage. Or it can be placed transabdominally. And you'll learn more about that in the episode. A cerclage is something that we do for women who have a weakened cervix, for whatever reason, whether from prior surgery or genetics, it's not common. It happens in roughly two to 3% of pregnancies. So in this episode, Kalishia walks us through her experience with all three of her pregnancies. And this episode is a bit longer because you really have to understand her first two pregnancies in order to understand the third. So without further ado, we are going to hop right into this birth story episode with Kalishia.

Nicole: Thank you so much Kalishia for agreeing to come onto the podcast. You have a really interesting and unique story. Something that a lot of people don't know about. And so I'm really glad that you reached out in order to share your story.

Kalishia: Yay. I'm so glad to be here with you today, and I'm excited to share my story and just bring awareness to incompetent cervix.

Nicole: Yeah. Yeah. So why don't you start off by telling us a little bit about yourself and your family?

Kalishia: Sure. Well, I was born in Alabama. I'm a South Alabama girl, um, went to the University of Alabama and with a degree in psychology, I'm the oldest of three and I'm the only girl. Um, and I got married in 2011 and I recently had a little baby girl in September of 2019 and went through some different ordeals to kind of get there. But, um, that's kind of what my family looks like right now.

Nicole: All right. Yes. And speaking of the ordeal, you know, normally on the podcast, I have people share like their single birth story, but we really have to understand what happened with your other pregnancies in order to get to, you know, and really to understand the full picture.

Kalishia: Yeah let's go through it. So, um, got married in 2011 and then was pretty young 27 and did not want kids at that time. Wanted to kind of just spend some time getting to know my man and just be married. And, um, he did have two children, they were three and seven when we met, but they lived out of town. They were boys. And so, um, got to kind of spend some time with them, but they would go back home. And so when I was 30, in 2014, um, I got pregnant. We weren't really trying at that time I was on the NuvaRing. Um, and I, I think I maybe missed a month or didn't do it right the month. But lo and behold, we became pregnant and were very excited. Um, I was 30 at that time. And so I just went and told the doctor that I had been seeing since I graduated and moved back home, which she was awesome that I was pregnant. And, you know, we just began the normal pregnancy, um, appointments and meetings. I think I went at eight weeks to confirm. And then once I confirm, um, I think we just kind of put different meetings for, um, just to listen to the ultrasound and the heartbeat and all of that stuff and had a really normal pregnancy up until about 16 weeks.

Nicole: Yeah. So tell us what happened at 16 weeks.

Kalishia: Yeah. All of my jobs I've kind of traveled with. Um, so sometimes I'd be traveling, but still didn't have any issues, but around 16 weeks I woke up and I was bleeding. I noticed some blood and I was just like, this is not normal, kind of what's going on. It wasn't heavy at the time. It was just some, some spotting. Um, and so I remember calling my sister-in-law cause she had had my nephew by the year before. My mom is no longer with me. Um, she passed when I was 11, so I called her and I was like, Hey, I'm kind of having this. Do you think, you know, in your own Google, I'm trying to figure out like when it may be. And so you see when you're researching that some spotting is normal and I'm like, okay. And then it kinda got heavier throughout the night.

Kalishia: And so I woke up that morning and I called my doctor and I said, Hey, something's not right. You know, I'm having blood, you know, I've done nothing. I haven't fallen. Like nothing's happened. Right. And so I, um, took a shower. I don't know why, but you know, you go into the doctor, you're like, let's take a shower. And as I'm in the shower, there's just blood clots, large clots, just coming out as I'm showering and I'm not knowing what's going on. And I'm just trying to hurry up and just get in the car. Um, at that time my husband was at work. I was by myself. Um, and so I got in the car, I called a couple of friends and I'm like, Hey, this is what's going on. I need you all to pray, just, you know, as I'm driving to the doctor's office.

Kalishia: And so I call, my aunt as well, she's my mom's sister. She met me at the hospital. And so I went in, I remember going in like signing in and they took me to the ultrasound room immediately. And as we got into the ultrasound room, the ultrasound tech told me to sit on the, um, bed or whatever the little table. And she was like trying to go around my stomach for a heartbeat. And so I don't, we didn't hear one. And she just was like, you know, hold on a second, wait a minute. And I think she may have gone to get the doctor. Um, and so she went and got my doctor, cause it's not a small practice, but it's only four doctors. And so you normally can see your doctor. And so when she came in, she let me know there was no heartbeat and I needed to meet her next door.

Kalishia: Um, if, uh, at the hospital there's a hospital next door, um, they said, there's no heartbeat for the baby. We need to meet you next door. And I just, I just kind of froze. I didn't know what to do, had not been in this situation before, this had not happened to anyone in my family that I had known of. Um, you know, it was just crazy. I just couldn't understand. Cause you're like I did everything right. I mean, and so I remember like leaving and going into the waiting room, my aunt was there to meet me and I was kind of telling her, and I'll never forget, like we pushed the doors open, going into the hallway for the elevator. And we both just like fell to the ground, you know, and just bust out crying, just didn't know, didn't understand, um, and proceeded on to the hospital.

Kalishia: And so once I got to the hospital, um, and I don't think my doctor was there that day, it was another doctor because I know someone on call had to come in and talk to me. Um, and so that was within that same group, um, not at the hospital. And so once I got to the hospital and got there, um, they came in and talked to me about, you know, what had happened and that they didn't really know, you know, why it had happened, um, and that they needed to do a DNC, had never heard of that. And, um, I'm a questions girl. So I'm like, what is this? How is this gonna happen? And, um, they're like, we can either do that or you can go home and if you go home, these are the things that can happen. And I remember them saying like, if everything didn't come out, then something, you know, I could have some other, um, medical issues from that going ahead and maybe getting the baby out or any remains that were left out.

Kalishia: And so as I'm thinking and trying to figure out what to do, um, I decided to go that route. And so there was the doctor on call from my doctor's office and my doctor did call me. Um, but that doctor came in, she was nine months pregnant herself. I remember. And she was like, we, we have to do this. And I was like, okay. And so I kind of prepare myself to kind of get ready to do that. Um, and then they did the surgery. I remember losing like two pints of blood within the surgery when they came back and told me, and then they came back and told me that everything had gone well. And I was just like getting myself prepared to, you know, go back home and just understanding what had happened. Um, and I remember them coming with the, they bring the baby and like the pictures at first, they asked me if I wanted to see the baby. And at that time I did not, I know that the baby, I think, did not develop fully maybe the leg or something. Like there was no fully developed part, a part of the body. Um, I do remember my husband at that time wanting to go see the, um, wanting to see the baby. Um, at this point we didn't know what sex the baby was and we couldn't tell, um, based on how the remains did not fully develop.

Nicole: Sure. Yeah. That, that early in pregnancy, you, you, you probably can't tell.

Kalishia: Can't tell. So we didn't know. And I remember getting the pictures though, and I did look at the pictures and they put them in the keepsake box and I remember them asking what we wanted to do with the remains. And I didn't really want to have a big funeral, or I didn't want to be so sad because I had dealt with loss, losing my mom at a young age. And I just I've gotten better with dealing with death because it's inevitable. But, um, it was just hard to kind of grasp my mind around it. And so we decided to, um, get the baby cremated. Um, we had a family member that owned a funeral home. So they came and picked up the baby and we got the remains, um, cremated so that we could do something special later, um, which we eventually did something at the beach that was just he and I, and did something just special, wrote a letter to the baby and put it in a, um, a glass jar and sealed it with the remains and kind of put it in the sea, which was a sweet, um, kind of memory to do together.

Kalishia: Um, and so after that, we just kinda, we talked about it some and some of my family members and it was a hurt that I just definitely didn't understand. I'm a Christian. So I definitely pray about like, maybe why did it happen? But based on the pregnancy, how it went, um, and I had no prior issues of any other type of, um, body issues or female issues.

Nicole: Right. No surgeries or anything with your cervix nothing?

Kalishia: No. No. We could not understand that. So going back for like, follow-up, you know, we talking to my doctor just kind of did not understand why this happened. And I do remember her wanting to do a test. I don't remember what kind of test at that time. Um, but just to, I know before I got the other surgery, we did a fallopian tube tests, but at this early stage, I don't remember what the test was, but just wanting to make sure there was nothing kind of causing this, that she knew of immediately, but she was really good at that. My she's recently retired with this last baby. I was, my little baby was one of the last ones. Cause I wouldn't let her not deliver her because she had been through just this whole process with me. And so that was the first loss, um, 16 weeks not understanding why it was an actual miscarriage, um, healthy pregnancy, no morning sickness, no issues, no pain. Um, that was the only time that I had saw any type of discharge was that night.

Nicole: Got it, got it. So then you come to, I guess, how did you make the decision to decide that you're going to try and get pregnant again? And I know that during this pregnancy, you ended up having something called a cerclage. And for, um, for the listeners, a cerclage is basically a stitch that keeps the cervix closed. So how did you decide, like, we're going to try for this again and then how did it come to the decision of you're going to get the cerclage?

Kalishia: Yeah. So the next two pregnancies were planned. Um, we talked about it and decided that we were ready. I was about 33 at this point. Um, maybe 32. I know the, um, pregnancy was in 2017. And so we decided that we'd start trying. So I started kind of working out more. I never had an issue like getting pregnant. So if I decided like we're going to start and we'll start eating better and working out within three to four months, I can, you know, I've been, my history has been able to get pregnant. And so within a short amount of time found out that we were pregnant, excited called the doctor. Um, and she had me coming in, I think it's six to eight weeks at this time. And we kinda talk about a plan because, um, like I said, at the beginning, I'm, I'm the questions person.

Kalishia: I'm like, Hey, we know what we've had gone on before. What kind of, what can we do? How can we really make sure that we're going to be on top of this? And like I said, I had a great medical team. That's something that I really emphasize to people, someone that I trusted that I've seen her work with me throughout the years. And I know that she cared for me, um, in my family. And so she said that, you know, I don't really know what happened, but as we look at, you know, your paperwork and all that, and then it was perfect. She said, I think you may have something called incompetent cervix, but I'm not sure because we can't diagnose it unless you're pregnant. And I was like, incompetent, sorry. I was like, I hate that word. And

Kalishia: I'm like, why am I at my, is my cervix incompetent? And what is this thing? Right. And so she began to kind of explain what it was. And I was like, okay. And she said, I'm going to want you to go to this high risk doctor. And so I'm in Mobile, Alabama. There's a hospital called USA, which is combined with the University of South Alabama. And so they have like the high risk doctors, the people that really research additional things that she's not, it's not her specialty. And so she said, I'm going to work hand in hand with this person. And I'm sending you now to this other doctor. His name was Dr. Bolcano. My doctor is Dr. McGrath. And so he was the guy and she said, you're going to go see him. And we're going to just measure this cervix weekly. And so at eight weeks I started to go over there.

Kalishia: I met him and he kind of told me the process and he basically laid it all out, which I liked. He was like, Hey, um, I've looked at your chart. Don't really know what happened. Can you tell me? And I'm like, no, it was normal. I had nothing, you know, crazy going on. That would make me say, Hey, I need to go to the doctor. And he said, well, this is the plan he said, we're gonna measure you weekly. He said, a normal cervix is this length, I think in pregnancy, what, two and a half to maybe five centimeters. And so he said, if at anytime you get below that I'm going to want to do a surgery. So we can do, what's called a TVC, a T yeah. A trans vaginal cerclage. And it's a stage, it's an in-house surgery and that's going to kind of hold the, um, cervix to kind of keep it from expanding.

Kalishia: And he was like, and I'm just letting you know that if that this is going to be immediate, you know, and I'm like, okay, all right. You know? And so I'm just going along and everything's like, it was the first time. Perfect. Just going great. And I'm going in at this time now I'm going in every week, eight weeks, nine weeks, 10 weeks. And I go in on my lunch break and Hey, and they listened to the baby's heartbeat and give me a picture and check the cervix. And it's like four and a half five, I mean, just doing great. Great, great. Okay. So by this time, you know, I'm still keeping up my other doctor's appointment with my, um, what do y'all call it? Maternal feat, maternal fetal medicine. The MFM, Dr. McGrath and she's like, Oh, I'm connected with Dr. Bolcano. Everything's going great.

Kalishia: And I'm like, yay. And so by, I guess, about 17 or 18 weeks, maybe 19, I don't remember, but because I'm going so often, I think I got to know the sex a little earlier than most people would, because it would be kind of further out. And so got to know the sex and wanting to do a gender reveal. And I was like, Oh, put them in an envelope. We're going to do a gender reveal at the house. And so, um, of course I'm not letting people know I'm pregnant just because of what's happened. And so unless you're seeing me at work or at church people don't know. And so I did a private Facebook group to do a reveal where people could come in and view it. And so we did balloons. I gave a friend the card or my hus he wanted to know, but I didn't want to know.

Kalishia: So he knew, and I gave her the card. Then she went and got the balloon that had whatever color. And we did just like light snacks and decorated the living room with, you know, pink and blue and balloons. And it was cool. I still have this footage. So it's nice to kind of go back to, from time to time. And we did the reveal. And so I popped the balloon. It's a girl with just what I wanted, because I'm surrounded by boys. If you heard earlier, I'm like, and so that's probably around 17, 18 weeks. And I'm just still in the back of my mind kind of worried because even with that, and I'm like, do I do the gender reveal? Do you know, I'm getting these people all involved in this. And I guess it's about maybe 20, 21 weeks.

Nicole: Let me ask, were are you feeling better? Because you had gotten further along than you had with the first pregnancy?

Kalishia: Yes. I was feeling better, but it was still like, but what is a little bit of a, yeah, like, man, I've just done this reveal. What if, you know? Um, and that really think that was about 17 to 18 weeks, when would be that, um, and I remember going on, I'm still going to the, um, um, I'm still going to the weekly cervical checks and they're checking in every week and it's like an hour bill that, you know, so it's kind of in and out, not long. Um, and so that's going on, and viability, I think is 24 weeks. So around like maybe 22 ish, 23 ish. Um, I went somewhere, Oh. And at this time my doctor is telling me, because we don't know if it's incompetent cerviz and she's like, Oh Lord. She's like, Kalishia. I need you to sit down somewhere. And I'm like, okay, but what do you mean sit down?

Kalishia: Um, you know, I do this, I do that and it's not on bed rest yet. And so she's just like, what are you doing? I'm like, well, I'm going to work, but I can work from home most times. And then sometimes I would travel and she's like, no, I don't want you traveling. And I'm like, okay. So I stopped doing that. I'm like, but can I go to the grocery store? She's like, no, I'm like, can I go to the church? She's like, no, you need to do what's absolutely necessary, if it's not necessary, don't go. And I'm just like, man, I gotta be in this house. Can't do anything. You know, like that's not my life. Definitely wasn't used to that. And so I ended up, um, definitely was listening, doing better, not traveling, but that one night I think I ended up going to dinner somewhere.

Kalishia: And, um, when I went to the restroom to just wipe myself, I noticed a little white discharge, so nothing crazy. And I'm like, okay. They said previously, they also tell me if anything changes, if you see anything come in. And so that little white discharge I was fine, well, this is something. I've not seen this before. I'm going in. So I call my husband. I'm like, Hey, I'm going to the hospital. You need to meet me. It's probably about eight something on some night. So I had to go through the emergency room at the other hospital where the high risk folks are. And so I go in and, um, had never really gone to that hospital. And this is one, I think that they will just see all types of patients. And so when I went in, I remember them asking the questions like separating me and my husband. And then like, are you going through this? Are you going through that? And I'm like, no, I'm not going through all this stuff. Um, not knowing why they're asking and I'll find out later, just because of some women are in situations where they need some help, you know.

Nicole: Yeah, we have to ask separately. Yeah.

Kalishia: And so again, they get me in the room and so basically they do an ultrasound or maybe check me with the hand or something. Then they're like the, this is what the Palm P P um, so basically the mucus was coming out. All of the mucus was just coming out. Um, and leaving around the baby, the baby still has really high heart rate though. And so they're like, okay, this mucus is coming. We can't really stop it. The heart rate is good. But, um, they're trying to figure out a way to kind of slow down this mucus plug. Is what I'm thinking of. I'm trying to kind of just stop coming out, all that water that surrounds the baby.

Nicole: So did they think your water had broken?

Kalishia: They thought it had broken, I guess. Yeah.

Nicole: Okay.

Kalishia: Eventually, it it. Oh, let me go back. Okay. Let's go back. So before the dinner, um, so at 17 weeks, so we did the gender reveal and all that good stuff. At 17 weeks at one of these, um, cervical weekly, um, checks, they saw that the cervix was shrinking.

Nicole: Got it. Okay.

Kalishia: And so at 17 weeks. He comes in Dr. Bolcano and he's like, Hey, we had this conversation. We're going to need to do this surgery I was telling about. And I was like, Oh gosh. Okay. And it was about noon. I said, well, when do you need to do? And he was like, tomorrow, I'm saying tomorrow, like I can't cause I need time to process. And that's not a lot of time. And he's like, yeah, tomorrow. He was like, do you want me to do it? Or Dr. McGrath? And I was like, gosh. And so I was like, well, I want her to do it. You know, I trust her. Not that I don't trust you, but you know, I want her to do it. I just feel more comfortable with her. And so I had to come in and do an in-office or outpatient surgery, um, had to get a epidural in my back to get this, you know, it was serious, even though outpatient is just like, just so scary. I had never had surgery, never gotten a shot in my back before, um, to numb me from down there. Um, and she came in, she did the surgery, everything went great. So she was able to put that stitch.

Nicole: Did she, did they say how short your cervix is?

Kalishia: By that time? I think it was maybe 1.7 or may have been something around there.

Kalishia: It was less than a 2.5. It may have been closer to five, but I don't know if they could have done it at five. I don't realize at first. And so I remember when they told me I had the incompetent cervix doing some research and I saw that that affected about maybe 20 to 30% of women. It's not a lot of people. Okay. And so then as we're talking about the, um, the stitch, now I'm asking, Hey, well, what's the success rate of this? How is this, how many have you done? Do you have anybody currently on the stitch? How are they doing? You know, just asking those questions. And they're like, well, it's about 60% success rate with this. And I'm like, okay. Um, you know, we've got it at a good enough time. We think you'll be okay. But really now you got to sit down. And so definitely, um, started, didn't go to church, didn't go to the garden. Didn't do any of this stuff.

Nicole: Got it. So that's when she was telling you, like you needed to back down with all the activities and everything. Okay. And then you get to the point where, um, you, then you have this mucus discharge, and they're like, you need to F if anything happens, you need to come in. And that's when you went in.

Kalishia: That's when I went in, sorry, I skipped that. So then when I went in and they're checking and they see that this mucus discharge, um, they're trying to decide whether I remember to cut the stitch or leave and they're not knowing like, do we need to cut the stitch? Does she need to go into delivery? What are we gonna do?

Nicole: Yeah. Cause sometimes we worry, it's an FA is there some sort of infection developing? Um, so that may have been one of the concerns. Did they mention anything about that at all that you remember?

Kalishia: I don't remember. I just remember them trying to figure it out until like maybe my doctor got there and one of the doctors could really check me. I think those were like nurses at the time I was on the maternal unit. They sent me up,and so when my doctor Dr. McGrath or one of them came in, they saw that, that mucus was kinda just coming out. Baby's heart rate, they're checking that all the time. Cause they have the, um, what is the thing called where they put over your belly to listen?

Nicole: And check the heart rate, monitor and everything.

Kalishia: And so that's going strong the whole time and they're like, okay. So they come in and they're like, okay, Kalishia, you know, the mucus is coming. We're going to try to put you in this position where they kind of lean the bed back and my feet are up and they're going to try to see if that will help any mucus kind of go back inside or keep the mucus from coming out. And I think it was like on a Friday because that happened on a Thursday night. And she's like, you know, we're going to try this over the weekend. And we're going to really try to see if this will help. And she's like, Oh, we got to have some tough conversations. And I'm like, okay. And she's like, if this doesn't happen, we're going to have to go into labor because we can't. Um, this is when we start talking about infections.

Kalishia: If this continues to happen, something can be detrimental for you. And so we know that we can't save the baby. We want to be able to save you. And so when I come back on Monday, um, if such and such hasn't happened, this is what we're going to need to do. And I'm like, okay, I'm just listening. I'm like, Oh my gosh, calling, everybody texting ike my family, my dad I'm really close with him and my brothers. And I'm just like, this is what's going on. Need everybody to be on the prayer chain. This is what's happening. Not understanding kind of all of it. And I remember I had this nurse, Lord bless her heart. She just was, I guess in her mind, she had already figured out what was going to happen because maybe she'd seen this before. And so her spirit was just kind of down in the dumps and I'm just like half glass, half full person.

Kalishia: Sure. Optimistically. That's just my personality naturally. And I remember kind of, and I needed that to kind of be going on to just keep me sane in the situation because I didn't want to go crazy. And so I remember telling her, I was like, Hey, we're going to have to get this, get it together. I'm going to have to get someone else in here because I can't have you walking around like it's already over because it's not. And so I'm just hoping that this is happening. And so, um, I remember maybe that Sunday. Oh. And they were saying that if I got a fever, I remember they were like, if you get a fever of any of these things happen. And so I ended up, I was doing good. I was like, Oh, Friday. Yes. Came through Saturday. Yes. And I think it was like, Sunday, I ended up getting this fever. I did get some kind of fever. I threw up, I remember throwing up and it was just like, oh man.

Nicole: Yeah, at that point. Yeah. Cause then it's, it's, you're getting sick essentially. It's an infection hass developed and it's spread spread throughout your body. And then the only way to fix that unfortunately is to end the pregnancy. Yeah.

Kalishia: Um, I remember that's what they said. And so I think Monday morning, the nurse comes in and she's like, here's your medicine. And I'm like, what medicine I need to know. And she's like, this is the Pitocin. Is that right? And I was like, what's that? She was like, well, it's going to start the delivery process. And I said, no, I don't want it. And she's like, Dr. McGrath ordered this. I said, I don't care. I don't want it. I said, I want to talk to NICU. And she's like, well, you know, the NICU doesn't come until 24 weeks, blah, blah, blah. And I'm like, that's great. I don't want this Pitocin. I want to talk to NICU. The nurse goes back out and she was like discouraged. She's like, Oh Lord. And then my phone rings and it's Dr. McGrath. She's like Kalishia. And I'm like, yeah, when she's talking through all the stuff and what we've gone over and Dr.

Kalishia: Bolcano was coming in and checking too, from this time the high risk doctor. And, um, and I said, yeah, I understand that. And I don't, I want to talk to the NICU. And I'm sure now she's probably putting on the clothes. Cause she's like, okay, this girl. And she knows me. So she's like, okay. And so they go in and they try to see if I can talk to NICU and they come back in and they're like, NICU, you know, you have to be 24 weeks. You're only 22 point something weeks. Um, like I said, I don't care. I want to talk to the NICU. I want to see if there's because the heartbeat this whole time is so strong. It's still strong. The heartbeat still going. And as a mom, as a fighter, as a strong woman, I'm not wanting to give up on my baby, you know?

Kalishia: And so I just kept pushing to the surgeon of NICU, ended up coming to my room. Um, I remember my husband being like, why are you giving these people a hard time? They're trying to help you. And I'm like, I don't care about these people. That's great. Their job is to help me. I need to know if something can be done. And so the surgeon of NICU comes in the room and he's like, Hey, I'm like, hi. He's like, we're going through things. And he was so nice because he really sat, he listened as I was telling him, like my times he got them to go back and look at my chart to make sure that I was really this many weeks. Cause I was measuring a little bit off. And by the time I finished talking to him, he had agreed to have NICU in there when I delivered.

Kalishia: And I didn't know if that was going to help, but I did know that as a mama, I tried my best. Sure. And so, um, when Dr. McGraff came in, um, I told them that I would take the Pitocin now because I got NICU in and I'm ready to go. And so they gave me the Pitocin and we began to kind of go through labor, you know, having contractions, all that good stuff. And, um, at a certain point I had to deliver the baby and so deliver the baby. Um, she was still born. Um, NICU was in there. They immediately got her, tried to work on and try to see what they could do. But unfortunately there was nothing they could do, but I was thankful that they tried and they were in there, but I wouldn't have said anything. And I know normally they're not, they wouldn't have been in there.

Kalishia: Um, but I know that I did all I could. And so even after delivering the baby, I had to deliver the afterbirth the placenta, which was hard, you know? And so I'm there. I remember she had one leg, he had one leg and I'm just pushing and crying and just, I'm like, man, this is something, you know. And so after I delivered the baby, I did get the look at the baby. I wanted the baby this time. Um, and so my husband and I sat there and we just looked, we talked to her, prayed. Um, and then they took her, um, so that they could get her ready for whichever way we wanted to take her body home. And they came back with the pictures and all of that good stuff. And, um, I remember my doctor just crying with me. She was like, Kalishia, you know, I'm just so sorry for you.

Kalishia: She's like, I've worked with so many different women and you've done this stuff the right way. You've done this. And it's just disheartening. When you see someone who's tried to do it the right way. Um, versus people that, you know, may have not taken the best care of themselves may have been taking certain drugs and that, you know, during pregnancy and have a perfect pregnancy. And I remember her just kind of breaking down, not, not unprofessionally aware, but just, you know, like just sharing that moment with me. And, um, this was also like around my birthday. It was like two days before my birthday that year. Oh my God. Yeah. It was just a hard time. Um, and so after delivering the baby, I remember my dad wanted to come see me, my family, because they, we just rally around each other. And I remember my husband, like, no, y'all just, we gotta have this moment, give her this time.

Kalishia: And I remember my doctor coming in and I was, um, the high-risk doctor at this time. Cause he's around during the whole time. And he said, Kalishia, who said, I know, um, that you may not want to hear this, but if you do want to, um, if you're ever thinking about doing this again, there's one other option that I want you to consider. And I was like, okay, what is he talking about? Cause I'm not ever doing this again. And he said, it's called the TAC. And I said, okay. And I just kind of put that in the back of my head. And I was like, okay. And he kind of left it alone. And so, um, we went home, uh, before I went home, I remember Dr. McGraff coming in and I say, is there any type of group? I said, this is hard.

Kalishia: I said, I've just lost my second baby. I'm only 33 years. I don't have any prior issues. Like what local groups do we have that deal with this. Your husband doesn't understand if your family hadn't gone through it, they don't understand. And then we have people that say crazy things, not realizing they're crazy, you know? Well, if you didn't have on those types of shoes, if you didn't have, you know, just certain things that don't even have to deal with, that, that places guilt on the mom, which that's just not okay. When you already feeling guilty that your body can't do what a woman's body is supposed to do and carry a baby. Right. And so she gives me the name of this organization. I'll write it down, kind of tuck it in and prepare to go home. And so, um, I remember going home and just feeling just mad.

Kalishia: I was really upset. I was like, God, I don't understand what's going on. I don't know why this is happening to me. And about day three being at home, my husband's gone back to work. He, he dealt with it, but then it's like, I gotta get to work. I gotta put it out of my mind. And I remember just crying in the shower, just like being so mad, just frustrated and crying. And I remember that day three on the couch and I'm like, God, okay. I've told you I'm mad, but now what do you want me to do with this? That was like a question I had. And I was just like, just put it out there. What am I going to do with this? What am I going to do with this hurt this pain? And I began looking at that TAC. I was like, let me see what Dr Bolcano was talking about. So I started looking it up transabdominal cerclage, and I'm just Googling.

Nicole: So wait, I'm sorry. Let me say like before, so you, you've had now two second trimester pregnancy losses, and now you've, you're, you're thinking like my body has failed me. Hasn't done what it's supposed to do. Um, and I forgot to ask that it either time, did you have any pain or was it always these sort of

Kalishia: That's I think was another thing. They didn't know the first time. And they were like, well, you know, we're gonna say it's this, but we don't know. No, never pain. Just these discharges.

Nicole: Gotcha. So you've had these two losses and then just a few days after the second loss, you start looking at the, the transabdominal cerclage?

Kalishia: I'm sitting on the couch, I'm at home by myself. Now I wasn't ready at that time for it. I'm like, what is this? And so I, um, that same March, I find this YouTube video. I don't even remember who it was, this girl talking about it. And she's like, I got this. And I had had this many losses and after getting this, um, I had this successful pregnancy, here's the baby, blah, blah, blah. And you're seeing the baby. I'm like, okay. And so then she put like two resource groups on there. One was on Facebook and it's called Abby Loopers rainbow kids, or Abby loopers. And so I go to that page and now I see hundreds to thousands of women that have gotten this surgery and they have babies. They have rainbow babies, never heard of that term. And they have one rainbow babies, two rainbow, but twins, some of them have had two losses, three, four multiple losses.

Kalishia: And they're all over the country. And they're talking about, um, this, these doctors that do this all over the world and there were four like top doctors names that kept coming up. I mean, women from India, women from all over the world, just in this group talking about, um, their situations and now showing these babies. So they had the one group for Abby Loopers and then they had a separate group that were the same Abby Loopers with the rainbow babies. And then they also had a website that kind of broke down the doctors that did transabdominal cerclages in your state. So you could go to that website, like get some information. Um, the lady that started it like years ago had a set of twins through, um, an abdominal cerclage. And so now it's all this information and I'm like, cool. And so I'm looking and looking and from time to time, I kind of would look back and kind of see what they were talking about.

Kalishia: And I remember, um, there was one name that kind of kept coming up and there was Dr. Haney, Arthur Haney. He was in Chicago and he was like the top of the top. So was those four ones, but that he was like the top name that people kept coming to. And so I remember probably that was in March. I remember kind of April talking to my husband about it and was like, Hey, you know, how are you feeling? And he was like, I'm good. You know, not really. And I said, well, I know you don't want to talk about this. Um, I said, but in about six months, we're going to talk about this because I may want to do this one more time. And then I said, if I do, I only have one more time in me, but, um, let's, let's just put, spend some time to kind of do some other stuff.

Kalishia: And then let's talk about it later. And I remember that May we went to Disney World on Mother's Day and it was like one of the best, um, Mother's Days, because usually I would deal with the loss of my mom not having her. And now I'm grieving two babies as well. And so, um, and people don't think that, you know, if you've lost babies, you've carried babies. Even if you've delivered a baby that you're not a mama. And I'm like, no, I'm a mama. You know, carry the baby with the living heartbeat in me twice, I'm a mother, my babies are just in Heaven. And so, um, we went to Disney World, had a great time. It was like the best Mother's Day that I probably have ever had since this one with my rainbow baby. And just kind of tried to kind of get out of our heads about, you know, all that we had gone through, um, in the midst of all of that.

Kalishia: And so maybe around that summer, I had decided that if I did this, it would be Dr. Haney. He just was the top person. And I had just gone through too much hurt to, to just not. And so I remember talking to my doctor Dr. McGrath and saying, Hey, I think I want to do this other surgery. I said, Dr. Bolcano talked to me about it. Um, when we were in the hospital and what do you know about it? And she's like, well, I have maybe I think at the time maybe she had one person that she was, um, that was in her care that, um, had had it and they were doing okay. She couldn't tell me the name, you know, that they were pregnant at the time. And I was like, okay. And I said, well, I really want to do this. And she was like, okay.

Kalishia: I said, um, and she said I think Dr. Bolcano does it. And that's it. Okay. So, um, I remember going and talking to him about it and he was like, I do do it. And I'm like, how many have you done? What's the success rate and all of that stuff. And I think at that time he had only done four or maybe six. And I was like, okay. I looked it up myself. I saw the success rate was like 80 to 90% versus the 60% with the TVC and, uh, um, continue to do my research. And I started seeing doctor Haney's name on that group start seeing these women, how they were being able to have the success rate, how he was doing multiple bands and how it was just doing after also doing some research on the tech to kind of trying to figure out what's the difference? How does this now work? Um, and so that TAG where the trans vaginal cerclage, they just tie the bottom of the cervix with a stitch that they just cut open. It's like, well, it's probably thicker than a thread, but it looks like to me, um, that trans abdominal cerclage, they actually cut open your abdomen and they go in like a C-section and they tie the top of the cervix with these banks that are thicker, like shoe strings. You can explain to them.

Nicole: No, no, no. You're describing it perfectly as though, like, that's exactly what happens. It's a much more involved procedure. You do it in not very many people in the country know how to do it. Um, I've practiced for 15 years. I've never seen it done. So it's just not something that is very common. It's really, you have to go to a specialized person. And it sounds like in your case, you decided that you were definitely going to do it. It was just a matter of who was going to do it.

Kalishia: Yeah. Of who? Um, after, I mean, after I kind of did the research, and so once I talked to Dr Bolcano, I said, well, no offense, I love you, but I'm going to have to go to someone that just has a little bit more experience in this area. I've never been cut open like that before, you know, um, even though it's similar to a C-section I had never had one of those either. And so he said, okay, I understand, I'll go back to Dr. McGrath. I said, I want to do this. And she says, okay, before you do this, let me, um, rule out everything else. Cause that's how she is. That's why I love her. And she was like, because I want to make sure that that's your only, let's do this fallopian tube test to make sure both of your fallopian tubes are working.

Kalishia: Right. Let's do this dye test. Let's do this. So I said, well, let's do your stuff before I make this appointment with him. And so we did the dye fallopian tube test. She was able to see that everything was flowing. Right. And I'm able to see that as far as she knew, I had no other issues. And so I remember calling doctors Haney's office that summer and was like, Hey, I want to, you know, have a consultation. And so he does them over the phone. And so he gets on the phone with me, asked me my history. I kind of give him a brief history. And I remember those first words of I can help you. And I was just like, Oh my God. He was like, I can help you. This will work for you. And so he asked me to get my doctors to send over, um, all my medical charts, which they did.

Kalishia: And so we made an appointment, I think for December of 2018 or 2017. Yeah. Yeah. Um, and so made the appointment had to go through insurance. So here we go, insurance wants to deny because they say that it's not necessary. This is an elective surgery. It's not necessary for you to have. Um, and I remember some lady saying that in the group. So of course I went back to my doctors. I'm like, however, y'all gotta write this up. It needs to be necessary because it can be like a 30 to 50,000. It's an expensive surgery. Um, and so I definitely wanted my insurance to cover whatever it could cover. Of course it wasn't going to cover travel and all that stuff. I'm already having to go to Chicago from Alabama. And so they look at it again and they approve it. And so I scheduled to have the surgery in February of 2018.

Kalishia: And so I'm looking in the groups, I'm kind of seeing what's happening. Um, the assistant is emailing me because they have a routine where you come in a day ahead of time, just in case you come to the hospital, University of Chicago to have the surgery done. And then they also like you to stay one night at the hospital and then another night at a nearby hotel where he'll either come and visit you or check on you to make sure you're good. And so I remember reading through the groups of how much pain people were going in and they're trying to decide, should you fly? Should you drive? And I'm like, Oh God, am I really gonna do this? This is painful. I've never been cut. I hate pain. And I had to start reading it cause I'm like, I'm doing this. I want my one more chance.

Kalishia: I gotta see, you know? Um, and so I decided to stop reading it, except for like the useful stuff, like bring your gas-X and your pillow to put on your belly. And so we scheduled for February 5th of 2018, I think, to get the surgery done. And so we go to New Orleans and fly out of there because it's cheaper and it's Southwest and it's, um, two hours from here. And so go, we fly to Chicago, it's freezing. Of course. Um, it's been a couple of days just kind of hanging out. And then on February the fifth, I go in and I meet Dr. Hayden for the first time in person. Um, and he tells me and my husband had the surgery is gonna go and what it's gonna look like. And, um, I go in, I have the surgery and so come out, he comes back and he tells me that he put four bands on there.

Kalishia: They're tight. Very good. And basically this now gives you the elasticity of holding up to a hundred pounds, which your baby will not be, but just given that service, the strength that it takes, because that's kind of what's been happening. Right. And so surgery goes great. Only issues I had was from the pain medicine. I don't do well with that. Um, but watching me overnight and had the best nurses, they called the Uber and set up Uber for, I mean, to get us back to the hotel, got back to the hotel. Um, I think I may have shut out the next morning and then had to get on an airplane and fly back home with a pillow over my belly, walking through the airport. Um, just a crazy experience just to come back. And, um, that time I wasn't ready to get pregnant. So definitely did not.

Kalishia: I think I got back on the Nuvaring and just didn't know when I wanted it to happen, but definitely, um, was, had to have happy to have had the surgery came back and, you know, talk to my doctor about it. She knew, um, Dr. Haney sent her a whole, like four page list of now how to handle this because for the follow-up appointment, I did go to her. So she needed to make sure that the cup was feeling right. It wasn't swollen. Um, I was cleaning it well and whatever he used, I guess it just evaporated because she didn't have to take any stitches or anything out.

Nicole: Okay. So then ultimately, what was the timeframe between when you had the surgery and then when you got pregnant?

Kalishia: It was like a year I found out close to a year later. Wow. So, yeah. So then, um, holiday time, November, December, we started talking about trying again. And so I got off the Nuvaring in by February of 2019 around that same timeframe I found out I was pregnant. Okay. And I think I was yeah, about maybe around six, eight weeks. So whatever I missed my cycle and took a test at home. Gotcha. That's how I was. No, I take the test at home and call them and say, Hey, I have a positive test. And so I come in and I tell the doctor, and I'm also excited about this time, because with that transvaginal cerclage, as I said before, you can go on to where they're like, sit down, don't do this. The other thing that really appealed to me about the TAC is that you could take baths.

Kalishia: You didn't have to stop having sex. Like you could have a normal pregnancy, like these women that are lifting weights and doing stuff that you're like really, you know, you're like you're doing that and praying that I could barely move two feet before my doctors fussing at me. And so it's supposed to give you more options. You can swim and you can, you know, walk in the park if you want. It's it gives you more options, um, along with being able to carry the baby successfully. Um, so that was something else that appealed to me about it. And so, um, went to see her and they still set me up for those like weekly checks, which I like. That's kind of how she is. And this time she kind of did it all house. I don't, I may have gone to high risk a couple of times, but we felt comfortable with the TAC.

Kalishia: She had dealt with a few patients, not a lot that had had it and kind of knew what to do. And definitely doctors Haney's office was a great support if needed. And so went on through the pregnancy and had a great pregnancy. I was still able to travel for work. Um, I wasn't flying, so just car travel, but, um, yeah, it went smoothly. I remember doing the gender reveal with just some friends. It was more low key this time, but just, um, the, in sharing that with my family, it was the first time I was able to have a baby shower, which was really special first time that I started, um, even having the nursery or getting ideas in my Pinterest board about what I would want that to look like, because I'm getting bigger. And every time I would always show larger, so people would know, but this time, you know, I'm just still in the back of my mind though, you got the TAC, you got all this, the last two I'm waking up and I'm like, is the belly still here?

Kalishia: Is it, you know, it's this, um, I'm still doing those checks. I think all the way up to about 37 weeks. I didn't tell anyone then putting it on social media until about 37 weeks after I had done some maternity photos. I did a post with, um, the website I have that kind of supports women and kind of share my story and some of the info and have had people reach out even one girl that I didn't even know that a, um, former high school classmate knew. Um, one of her sorority sisters reached out and has now gone and had the surgery herself with Dr. Haney.

Nicole: Wow. Wow. So this pregnancy went totally normal. You went all the way to full term and had a seat with the transabdominal cerclage you do have to have a C-section. So at what point were you 39 weeks when you had the C-section?

Kalishia: I scheduled it for 38 because my doctor was just like, you know, I want to do that, sorry, 38. I don't want you to get bigger and bigger. And I was like, well, I think it needs to be 39 and I'm doing my research and she's like, no studies show or the, her research shows 38. I'm like, well, mine is saying 39 so we're going back and forth on that. I'm not the doctor, but of course she knows me and I'm just like, well, whatever's best. And so I'm still going weekly. And I think around, um, I had a high blood pressure scare, no, it was a headache scare. I had this headache that wouldn't go away overnight. And so they brought me in and they checked my pressure and it was high when I came in because of the, um, the headache, but then it went away. And so that worried her like, but she's definitely just on top of all this stuff. And she's like, um, let's see, when I did the glucose test or the sugar test, um, I think I failed. And so I ended up having the gestational diabetes during this one, cause now I'm 35 and pregnant. So I'm what they call, what, what do y'all call us?

Nicole: Ha advanced maternal advanced maternal age.

Kalishia: I'm like, here we go again. So I have all these other things to worry about. Not only do I have in gum and now I'm 35 and I'm breaking it. Right. Um, and so just all of that, just care and making sure that I'm good. And just following up by the end, I was coming to the doctor twice a week. Got it. Which I love, I mean, it got on my nerves, but I'm definitely loved that they took really good care of her. So we were scheduled for 38 and at 37, I came in at one of those appointments. And when they would put the thing on the belly to hear maybe something, then she didn't like how it sounded or maybe something happened or I was getting closer because she ended up calling high risk and they were like, you need to go ahead and just schedule her. So I think I ended up being scheduled earlier. And so she came at 37 weeks, my baby, her name's Kelly, she was six pounds, four ounces, no NICU time. Um, and

Nicole: Surgery went well and the recovery went well?

Kalishia: Went well. Recovering went well. I opted to get my tubes tied because I knew I didn't want to do this. I just cannot do this anymore. Um, the surgery in this part, it was like my one last hurrah. It was, if this didn't work, I was going to have to try something else because the other part is that each time you're getting pregnant, you're gaining this way. You're trying to, I mean, your body goes through a lot to not even have the aftermath of the baby. And so just trying to get my body back myself, back to a sane mind, you know, um, I just could not do it again, even though Dr. Hanan is like, you know, what's going to happen. You're going to hold that baby. And you know what you're going to say. I say, I'm going to say, I'm so thankful that this has finally happened. It's like, no, you're going to be like, I want another one, which has yet to happen for me. I'm good because I have her, my earth baby and my two angel babies. Yes. Perfect pregnancy no issues. Six pounds, four ounces, um, left the hospital in four days. I'm a breastfeeding momma. So we latched on and worked with the lactation specialist. We're trying to wean now, but, um, breastfed baby 13 months, it's been well, yes.

Nicole: Lovely. That is lovely. And you still have this cerclage, correct?

Kalishia: I still have it. So in case I changed my mind. I mean, I didn't give her cause it would be too much to try to get rid of it. And so, yeah. Cause you don't get rid of it. They go ahead and have three, four, you know, five. I'm just my heart. I, I'm not even as optimistic as I am. It's just, I don't want to just put my body and now I'm 35. Can you imagine Jesus? No, this is well.

Nicole: Gotcha. Gotcha. Gotcha. So gosh, what an experience and just, I mean, that's just a lot. Did you at any point get like professional counseling?

Kalishia: Yeah. So after the first loss, I think I started seeing my counselor and then in between, he's actually a guy, but he works for me. Um, and I'm gonna cry. He's a Christian counselor. In-between I think after the second one, my husband and I did together. Um, and then with the last one, I may have seen them as needed, but not as often as I did those first times. Yeah. Definitely needed that. I mean the prayer and all of that is great, but I definitely advocate to have someone to talk to the kind of help you through your thoughts because everybody's not understanding kind of what you're going through. And like I said, people say things that, you know, they don't mean this could be people that love you or even just with the spouse, you know, me and him, women handle these things totally different depending on their personalities, their, um, previous experience, like I said, my hus, he already had two sons. And so I'm like, you know, you already know this feeling. I don't, yes. I do care for them in a way, but you know, it's just different and so definitely needed to have that.

Nicole: Gotcha. Gotcha. Well that's really, and that can sometimes be hard, especially I think for, uh, you know, I don't, well, one thing, like, I don't think we, as the medical community recommend that enough and then sometimes people can, I don't know it, depending on black communities, thoughts about counseling and the church sometimes can give you a difficult time about counseling, but it sounds like you found, um, something that was really supportive.

Kalishia: Yeah. Yeah. And, and that's how the group also, um, when I started it's called Womb and it's just a support group. We don't meet as often now through just COVID and other stuff. Um, but, um, we were meeting like, I think weekly or every other week, and that was a good help for me because even before I got pregnant with Kelly, as I would, I found a book, it was called grieving the child. I never knew. And so it was a lady that wrote kind of her experiences. And as I would like read through the book and kind of pick out the stuff that we were going to talk about at the meeting that was kind of healing as well, because I had to deal with my own emotions as I'm coming now and dealing with emotions with other women. Um, so that was healing for me as well.

Nicole: Gotcha. Gotcha. Gotcha. Well, just to wrap up, what would you say is your favorite piece of advice to give to a pregnant person or someone even thinking about pregnancy? What's your favorite piece of advice?

Kalishia: I think one is to really know your body, like know your body and to really have the difficult and hard conversations with like your medical team. Um, one of the things that's disheartening to me is when I talk to women and they tell me their experiences that they've had through pregnancy, especially those in the black community. Um, it's very disheartening of how the doctors treat them of how, you know, um, they're with a certain practice. But then when they go to deliver the baby is someone that they don't even know someone that's not even in. I mean that doesn't even understand the issues that they've been dealing with. Um, how people will not even listen to them when they're saying, this is how I'm feeling, this is what's going on. I didn't experience that because my doctor, she just was so good and she's an awesome doctor, but even the relationship that we've had over the years.

Kalishia: And I know it can be hard if you're moving in different things, but even when I, um, got the pediatrician for my daughter before she was born, I went in and had meetings with different ones, ask questions because that's important to me. I like to ask questions. I like to know, even when you tell me something, I want to do my own research. You know, I want to have the option to choose for myself unless it's a life or death experience. And so I think just really educating yourself, not being afraid to listen to your gut and then working in, in line with them, like as a partner. So if you have time to think about a procedure, think through some things that are not life or death, um, definitely do that and make sure you interview the right doctors. It's okay for people that I don't think we think that, you know, you can, you can not choose this person and, and, and go to multiple doctors and ask questions and say, this is kinda what I've done before they have appointments just for consultations, um, to get the right fit. I think that's the most important,

Nicole: Love it. Love it. Love it. That is it is. That is excellent. Excellent advice. So where can women connect with you if they're interested in connecting with you?

Kalishia: Um, I have a site I need to revamp it, but definitely check it. It has a spar for light prayer requests. It has some of my story with the TAC and my first experience of loss and it's called thewombgroup.com and it's T H E W O M B as in boy, G R O U P.com.

Nicole: I love it. Well, thank you so much. I'm of course we'll link that in the show notes. Well, thank you so much for coming on to the podcast. You, I just love your story. Like it's a story of strength of perseverance of kind of knowing yourself and what, you know, you could do. Everybody comes to different options and choices, and it felt like you were very comfortable and confident in yourself and deciding what was best for you in the moment along this journey. And that's just really wonderful.

Kalishia: Yeah. It took me some time to get there. Cause I didn't know at first, you know, but just what research and praying and just really looking at my body, what it can do. I knew I could get pregnant. I knew that wasn't the issue. I knew that once we kind of, you know, and so I had to kind of really come to grips with how I was going to work out these other pieces if I really wanted to have a baby. Yeah.

Nicole: Yeah. Yeah. Well, thank you so much Kalishia for coming on to the podcast again. I appreciate it. And you take care.

Kalishia: You're welcome. Thank you

Nicole: That a great episode. It's nice to see that Kalishia ultimately had a successful birth after having had two very difficult pregnancies. Now, you know, after every episode where I have a guest on, I do something called Nicole's Notes, which is where I give my top three or four takeaways from the episode. So here are my Nicole's Notes from my conversation with Kalishia, number one, I admire how she pushed until she got a resolution for what she needed in order to feel good about how things went with her second birth. And when she to get a NICU consult now, to be clear, I am not saying that you should push for everything to be done or anything like that. What I'm saying is that you need to always do whatever it is that is under your control in order to help you feel better about a situation during your pregnancy, during your birth, really, even during your life. We don't have control over everything, but we do have control over some things.

Nicole: So take control of the things that you can control. Number two, when someone has a pregnancy loss, don't say anything about what they could have done differently, unless they ask for your opinion. Please don't give any unsolicited advice. Most pregnant people I have found do not want unsolicited advice about the things that they could have done differently. I know it often comes from a place of wanting to be helpful, but it really isn't. So some things that you can say instead are, I'm sorry that happened to you or I don't know what to say. Just know that I'm thinking about you and wishing you well. But please don't give any unsolicited advice about what the person could have done differently. Number three, when you have multiple pregnancy losses, it can be really, really difficult to decide what to do. I want you to know that what ever decision you make is the right decision for you.

Nicole: Maybe you decide to have adoption. Maybe you decide to pursue having a surrogate. Maybe you decide that you're not going to have children. Just know that whatever choice you make, that is the right choice for you. And then the final thing I will say is that if you need to please get professional help in order to help you process pregnancy loss. We're getting better about talking about it and our society and making it not quite so taboo, but there's still room for improvement. So don't be afraid to seek out professional help with counseling, if need be, you know, a therapist in order to help you process your pregnancy loss. All right. So there you have it. Be sure to subscribe to the podcast and Apple Podcast or wherever you're listening to me right now. And I would love it. If you leave that honest review in Apple Podcast in particular, it helps other women to find the show and helps the show to grow.

Nicole: Also, if you're not following me on Instagram, please follow me there. I'm there @drnicolerankins and I post lots of great content in the feed and stories. I do live Q and A sessions a couple of times a month or so. So do come check me out over on Instagram. We can continue the conversation after the podcast there again, that's @drnicolerankins on Instagram. So that is it for this episode, do come on back next week. And until then, I wish you a beautiful pregnancy and birth. Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website, drnicolerankins.com to get even more great information, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class, on How To Make A Birth Plan That Works, as well as everything you need to know about my signature online childbirth education class, the Birth Preparation Course. Again, that's drnicolerankins.com and I will see you next week.