Ep 243: Denise’s Birth Story – Three abdominal surgeries within 2 years and a surprise pregnancy

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Fibroids, two C-sections, and one myomectomy. Denise showed incredible strength and bravery along her difficult path to motherhood. In addition to carrying her baby, she had fibroids that grew to enormous size - one was the size of a grapefruit! She had a myomectomy (fibroid removal) and two months afterward she discovered that she was pregnant again. She was told specifically not to get pregnant for at least 24 months to let her uterus heal but, as Denise says, “things happen”!

Since pregnancy number two was especially high-risk, she was referred to a maternal fetal medicine specialist. Even though she felt afraid, her peace was her priority throughout her unique and stressful birth experiences. She had a planned c-section and in the end she had a beautiful birth and a healthy baby.

In this Episode, You’ll Learn About:

  • How Denise got through two high-risk pregnancies
  • Why her first birth ended in an emergency c-section
  • When she was diagnosed with fibroids
  • What symptoms Denise was experiencing before the fibroids were discovered
  • How she felt after her myomectomy
  • How many fibroids were removed and how large they were
  • Why she wanted to have the same doctor for her pregnancy and the delivery
  • How pregnancy felt with and without fibroids

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Transcript

Dr. Nicole (00:00): Do fibroids mean that you have to have a cesarean birth? What happens when you unexpectedly get pregnant right after a major abdominal surgery where it was recommended that you not get pregnant for 18 months? When might a cesarean birth be the right option? Let's talk about it in this first story episode with Denise.

(00:31): Welcome to the All about pregnancy and birth podcast. If you're having a baby in the hospital, you are giving birth in a system that too often takes away power from women over what happens in their own bodies. I'm Dr. Nicole Calloway Rankins, a practicing board certified OBGYN, who's had the privilege of helping well over a thousand babies into this world. I've been a doctor for over 20 years, and I'm here to help you take back your power, advocate for yourself, and have the beautiful pregnancy and birth that you deserve. This podcast is for educational purposes only, and it's not a substitute for medical advice. Check out the full disclaimer at drnicolerankins.com/disclaimer. Now, let's get to it.

(01:13): Hello there. Welcome to another episode of the podcast. This is episode number 243. Whether this is your first time listening or you have tuned in before, I'm so grateful you're spending some time with me today. Denise is a passionate, personal and group fitness trainer serving specialty population since 2016. She works exclusively with individuals with developmental and physical disabilities. She was born and raised in the Tacoma Park, Maryland area, and is still in the Washington DC metro area. She and her husband got married in the thick of the pandemic in August, 2020 and found out they were pregnant three weeks later. Well, that started them on quite the journey together. Within two years or under two years, I should say. She had three abdominal surgeries, two C-sections, and one myomectomy, which is removing uterine fibroids. Both of her pregnancies were high risk, and the second one was especially high risk, but she still gave birth to two healthy babies.

(02:25): Both of her birth stories are unique, stressful, and she says ultimately beautiful. She believes that by sharing her story, it will help ease the anxiety that any high risk pregnancy patients out there may be feeling about birth. And I agree. Denise is so open and honest about her feelings and experience. She describes herself as getting hysterical at times. She had a lot of anguish with her second pregnancy, but she also shares how she was able to help keep herself calm and help keep herself at peace during these stressful times. And I know that you're really going to find this information useful. Now, before we get into the episode, a couple of quick notes. One, have you checked out my free birth plan class? This is a great class to help you make a birth plan in a way that's actually going to work to help you have the birth that you want.

(03:23): Making a birth plan is about so much more than just a piece of paper. Handing that piece of paper to someone when you get at the hospital does absolutely nothing to know whether or not they support what's in that paper. And if you wait until you get to the hospital, that's too late. Making a birth plan should be a conversation so that you understand that you're a doctor and the hospital where you give birth. Those are the two most influential factors in your birth. By the way, you need to understand whether or not they are supporting you in the things that you want from your birth. So check out that free birth plan class is dr nicole rankins.com/birth plan. Once you register, it just takes you straight to a video. It's an on-demand video class. You'll have access to it forever. So go ahead and hop on that birth plan class.

(04:07): You will not regret it. It's dr nicole rankins.com/birth plan. And that class is a great introduction into my teaching style and the way that I approach things. It's kind of a sneak peek or a great way to look at how I approach my online childbirth education class. The birth preparation course. The birth preparation course is my comprehensive childbirth education program that will help you get ready for that hospital birth, get you calm, confident, and empowered to have a birth in the hospital. Getting your support lined up is some of the things we start off with in the beginning, getting your mindset right. You'll learn all the details of labor and birth, the things that are happening in your body, some possible curve balls that could be thrown your way, how to get off to a great start in the postpartum period. You will love it. So you can check out the birth preparation course at drnicolerankins.com/enroll. All right, let's get into the conversation with Denise. Okay. So much, Denise for agreeing to come onto the podcast. I'm excited to have you share your birth stories because they are definitely unique.

Denise (05:12): Oh, thank you so much Dr. Rankins for inviting me. I'm really excited to be here.

Dr. Nicole (05:16): Yeah. So why don't you start off a bit by telling us a bit about yourself and your family.

Denise (05:20): Alright, so my name is Denise. I'm a certified personal trainer from the Washington DC Metropolitan area. I started training in 2016, and I work exclusively with individuals with developmental and physical disabilities, adults and children. I've been with my husband for six years. We've been married for three. We got married in August of 2020 when the world was very much still shut down. Shut

Dr. Nicole (05:47): Down, okay.

Denise (05:47): Very much. And just three short weeks after our wedding, we found out that we were expecting.

Dr. Nicole (05:56): Wow. Yeah.

Denise (05:57): And that was the first of two high-risk pregnancies. And so we have two kids. We have a beautiful, amazing, energetic, two-year-old boy and a beautiful, peaceful, calm one-year-old baby girl.

Dr. Nicole (06:12): Alrighty. So you have a full household and those babies are back to back. I see.

Denise (06:17): Pretty much. Yeah. I was pregnant from 20 20, 20 21 and 2022. Okay.

Dr. Nicole (06:24): Okay. Alright, crazy. Well, we're going to hear all about it. So we're going to talk a bit more about your second birth, which was actually a planned repeat cesarean, and we'll get into why that was the case. But I do want to talk about a little bit so people can understand your first birth was also a cesarean. So what happened with that?

Denise (06:43): Absolutely. So I was diagnosed with fibroids at the very beginning of that pregnancy. It was my first appointment, first ultrasound, and my physician told me how the fibroids could potentially impact the pregnancy as well as the labor and delivery. But if all went well, we were going to move forward and plan for vaginal delivery. And miraculously everything went well and we were set for a vaginal delivery. I was 39 weeks, went to the hospital, got checked in. Everything was fine, I was progressing. And then when I hit five centimeters, I stopped progressing. I got stuck, and I was at five centimeters for hours and hours and hours. And the evening physician came in and told my husband and I that our baby was experiencing irregular heart tones and recommended that we do an emergency c-section. And I was terrified and hysterical of course, because that wasn't a part of the plan, and I didn't know what was going on with my son and I didn't want to do it.

(07:51): It was all over the place. And we called, my mother, spoke to her, we called my mother-in-law, got their feedback, and I'm still pretty much on edge about it, but the doctor said, we have to make a decision quickly. And so it was just me and my husband, shout out to my husband, my rock, my everything. He kept me cool. He was cool. He was calm and collected. He talked about it. He said, there's no reason for us not to trust the doctor and what he's saying to us. It's important. The health of our child is the most important thing. We're in good hands, let's move forward. And that's how we did the emergency C-section. Okay.

Dr. Nicole (08:30): Okay. All right. And then how many fibroids did you have?

Denise (08:34): So I had seven, but I had two massive ones. So I had a donated one that was about the size of a grapefruit. And then I had another one that was the size of an onion. And then the remainder of the fibroids, they didn't grow, but it was these two. I mean, I looked much bigger than I actually was in the pregnancy. So when I was 20 weeks, I looked like 25 weeks because they were humongous.

Dr. Nicole (09:06): So before you were pregnant, did you have symptoms like pressure or just all bleeding issues or anything that's like, oh, that's what was going on when you realized that you have fibroids?

Denise (09:20): Absolutely. I had the heavy flow. I had the debilitating stomach and back pain so much. So sometimes I couldn't go to class, I couldn't go into work. I would get physically ill, sometimes I would throw up, I would've headaches. The low energy, I had it all. And my system started when I was a teenager, and I just kind of thought just some women have bad periods and some don't. It was never of any kind of discussion that I could possibly have fibroids. No one ever told me that. And at that time, it wasn't social media, there wasn't a lot of stuff.

Dr. Nicole (10:04): So you were just going along, this just must be how my life is. Yep.

Denise (10:10): For years.

Dr. Nicole (10:11): For years. I mean, when you went to the gynecologist, was there any suspicion or discussion or it was just

Denise (10:19): No, I would say that I have bad periods. It's like the first and second day I'd get really heavy flow. And then the response was go on birth control, but no discussion about fibroids or anything else. It was going on birth control.

Dr. Nicole (10:40): And then as women do, you just kept it moving, doing what you had to Yeah. You kept it moving, kept moving. Yes, yes, yes. Okay. So then you had the C-section and the C-section went well, I presume, and recovery went. Okay. And then a few months after that, how soon after that did you have the myomectomy?

Denise (11:04): It was seven months after the emergency C-section. So five months postpartum. My menstrual cycle returned and so did all those fibroid symptoms. So the back pain, the stomach pain, the pelvic pain, the headaches, and I'm postpartum. So it was just a really, really challenging time. Get adjusting to an infant, just a really tough time. My doctor said, you should really get your fibroids removed. And I was very hesitant, but as I told you earlier, they were massive and I could see 'em and they were still visible. I could feel

Dr. Nicole (11:42): Them. Yeah, because tiny, so you could probably see that. So yes, you could probably see those big fibroids.

Denise (11:52): And she said it could impact fertility later on. And I mean, I didn't plan on having more kids, so I was like, whatever.

Dr. Nicole (12:05): But I would

Denise (12:05): Like the symptoms to be called

Dr. Nicole (12:07): Down.

Denise (12:08): And she said, if you do get 'em removed, they'll most likely, your symptoms will most likely be eliminated or greatly minimized. But I was still very, very apprehensive because the recovery of the C-section, it was really, really tough. It was really painful. So I was very, very scared. But my doctor's in a practice with a fibroid expert, and she's sure that I was in the best hands, and I very much value and respect her position and her advice. So I moved forward and got the procedure. Okay.

Dr. Nicole (12:45): Okay. So then how did the myomectomy go?

Denise (12:47): The myomectomy recovery was fine, and I think because I had already recovered, had an experience with the C-section recovery, that my body was adjusted, I guess to an extent it had adjusted to it, so it wasn't that bad at all. I remember going in and they're telling me and prepping me, and they told me to count down the 99, I mean from 99 to one. And next thing I remember, I woke up and they said the procedure was done. I was like, what?

Dr. Nicole (13:24): Isn't that a weird feeling when you have surgery? And I had surgery to have my tubes removed, and it's the weirdest thing. All they say is like, okay, we'll see you later. All of a, it's like, wait, what happened? And you have no recollection of anything that happened to you. It's like a really weird feeling. So then how many fibroids did they remove?

Denise (13:46): So they removed five, they removed the two big ones, and then there were three smaller ones, and then the two that were leftover were too small, and my doctor was concerned about scarring on the uterus. Got it. She left those there.

Dr. Nicole (14:02): Okay. And did you feel better afterwards?

Denise (14:07): Okay. Absolutely felt better. But Dr. S, I only had one period post that surgery because I got pregnant two months after the myomectomy, and I was told not to get pregnant for at least 24 months to allow my body to heal. I had every intention to listen to that doctor because I wasn't going to have any more kids. Right

Dr. Nicole (14:32): Then things happened. Things happened. Okay. So I mean, how was your mind mean? What were you thinking? How were you feeling?

Denise (14:46): I had a lot of emotions going on. I was afraid. I think that was the biggest emotion because I knew, they told me specifically, don't get pregnant because it could be a very complicated pregnancy with lots of issues and a huge risk for both you and baby. And again, I wasn't planning to have any more kids, so I never even thought that far along. And I was like, what am I going to do? How am I going to, I just recovered from this myomectomy. I have a seven, well, nine month year old at nine, nine month year old child. How am I going to do this? I have a business. How am I going to still be pregnant and still take care of this baby? And I was like, I can't do this. I cannot do it. I cannot go through another pregnancy. I can't do it. And I cried because it was really tough s from the first pregnancy, and that was my only experience. So I was terrified, absolutely terrified.

Dr. Nicole (15:55): Oh my gosh, that's a tough situation to be in. Did your doctor even mention, do you want to continue with the pregnancy? Was there any discussion about that at all?

Denise (16:09): She did ask me if I wanted to continue with the pregnancy, and then we talked about the risk associated with everything that had happened from the emergency c-section to the myomectomy. And she said, I have seen women carry and everything go fine, and I will assure you, we will give you top tier care. She gave me a personal cell phone number, she called me, text me, we will make sure that we do everything we can to have a successful pregnancy. And I was like, I can't do it. I don't think I can do it, but I can't terminate either. I can't do it. Right. Had to come to grips that I was actually pregnant. I think I definitely went through a season of disbelief, and then once it sunk in and I accepted it, I was like, okay, what's the game plan coach? What are we going to do?

Dr. Nicole (17:13): Okay. And how was your husband feeling through all of this?

Denise (17:18): Shout out to my husband, shout out to my husband because he was and is my rock through the whole thing. He never got emotional. He was always very sound and very calm and very rational through the process and said, this isn't what we planned, but it is what it is. Baby is loved. I love you. Let's go get it.

Dr. Nicole (17:44): Let's do it. Okay. Okay. Well, there we go. There we go. All right. So what was your pregnancy and your prenatal care?

Denise (17:53): Yeah, so I was referred to a maternal fetal medicine specialist. So as I was with my first pregnancy, I was high risk for many reasons, not just the myectomy, the fibroids or advanced maternal age. I was also diagnosed with gestational diabetes during that pregnancy, the second

Dr. Nicole (18:13): One.

Denise (18:14): So I had a lot going on. I

Dr. Nicole (18:16): Mean, you had to feel like because you do fitness, so why is this? Why,

Denise (18:21): Why, yeah. And throughout my whole life, everyone told me you're fit. Pregnancy is going to be easy for you. It's going to be a raise. And so that was hard too. All of these things that was happening. I was also anemic, so I had a lot going on, but the pregnancy was a lot more comfortable. And the previous pregnancy, and I think it's because the fibroids were gone, those big massive fibroids were gone. So I cured smaller. I was just much more comfortable. I wasn't as in much pain. I had a lot of pain during the first pregnancy, but the second pregnancy, not so much. And I was really intentional about trying to enjoy it and not stress and be angst because I was under a lot of stress at that time. But the maternal fetal medicine specialist, my physician, they were just so gentle and nurturing and compassionate with me. Everyone from the medical assistant to the reception and the administrative coordinators, everyone all hands on deck, and I'm just so, so grateful for the care that I received, because I know I wouldn't have gotten to the finish line without them. I'm grateful. Beyond grateful.

Dr. Nicole (19:42): Yeah. Yeah. Wow. Did your fibroids, did the ones that were left, did they grow or anything during pregnancy or did they just kind No, they

Denise (19:52): Were complete non-factor, which was amazing to me because I had such massive ones in that first one. So I was really concerned what's going to happen, but no complete non-factor.

Dr. Nicole (20:06): Okay. Okay. All right. So then you knew from the beginning that you were going to have to have a planned C-section? For sure.

Denise (20:14): Yeah. Everyone, my physician told me that would be the safest and best route for me and baby, especially because we had that myomectomy all these procedures under a year.

Dr. Nicole (20:25): Gotcha.

Denise (20:26): So they said at 37 weeks

Dr. Nicole (20:29): We

Denise (20:30): Would plan for C-section.

Dr. Nicole (20:31): Okay. And that's what I was going to ask. If they said if it was going to be 37 weeks, we're not even going to wait for one contraction to happen. We're going to go ahead and plan the C-section as under controlled circumstances as possible. Yeah. Yeah. Okay. So that's good. Then you had some time to, you knew what to plan for. You knew your due date might've been one thing, but that baby was coming three weeks before that.

Denise (20:58): Yes, and the baby was born on my birthday.

Dr. Nicole (21:03): Aw. So you all share a birthday. Yes. We share a birthday, and we will get to what happened with the C-section in just a minute, but is there anything that you did in particular to plan for the C-section?

Denise (21:21): Yeah, I was really intentional about my mental and emotional health, making sure that I was calm, because again, I had so much stacked up against me with going into this pregnancy, and I wanted to enjoy it, and I knew if I was not together, if my mental health and my stress and my emotions were not managed, this was going to be a much more difficult process. So I made sure that I was calm and I was very mindful about the stuff that I was consuming in terms of the things that I was watching or the things that I was listening to. At this particular time. There was a Kevin Hart movie that came out on Netflix, and it was about him being a father because he lost his wife during childbirth.

Dr. Nicole (22:17): No,

Denise (22:18): No. I refused to watch that. I really wanted to watch aftershock, the documentary. I refused to watch that or read anything about very sad and tragic maternal health outcomes for other people. I avoided all of that kind of content. I just needed to be as calm and peaceful and optimistic as possible. Sure,

Dr. Nicole (22:41): Sure, sure. And it doesn't sound like you, you knew the possibility of things that could happen, but you just were intentional that constantly hearing about it isn't going to

Denise (22:55): Help you serve me. Yeah. It was just going to make me, because I'm one of those people, I can go from zero to a hundred instantly, and I can fixate on all the negative possibilities. So I had to do something to combat that aspect of my personality.

Dr. Nicole (23:12): That makes sense. That makes sense. So was there anything that you wanted in particular for your cesarean?

Denise (23:19): Yes, absolutely. I wanted to be with a doctor, professionals that I had some kind of history with the emergency C-section. I didn't know anybody, any of, none of the nurses. I didn't know any about it. So I really wanted to be with someone that I had a history with, I had a relationship with, and that is how end up having the baby on my birthday, my maternal fetal specialist, she said, I'm available on these days and these days, I was like, well, can we do it the day before my birthday or the day after? She was like, I'm not available on those days. This is the day. I was like, here we go. That's going to be the day. Okay.

Dr. Nicole (24:02): Oh, the maternal fetal medicine specialist actually did your C-section. Okay. That's not that common because a lot of MFM doctors, yeah, a lot of them don't even go, they don't operate anymore. They just do ultrasound or just stay in the office. Oh, wow.

Denise (24:17): I didn't know that. Yeah, she was my, yes, she was there with me from beginning to end, and that was the main thing. And then making sure my husband was with me the first pregnancy, we were still under covid protocols, so I wanted him to be close and connected with me as much as possible. I made that very clear and it was honored. Okay.

Dr. Nicole (24:46): Good. Good, good, good. So then, was there anything that you were scared about or worried about that could happen with your C-section?

Denise (24:54): Everything. All of the risks that my maternal fetal medicine specialist and physician told me, which I appreciated, those were at the forefront of my head when we were going in. Anything can happen. So yeah, I was afraid of everything. Okay.

Dr. Nicole (25:17): Okay. So I'm sure they mentioned the risk of bleeding, hysterectomy, all of the things.

Denise (25:23): Yes, all of those things. And I even got really hysterical when we were talking about those things. In the beginning, I had to go through a lot of paperwork and we talked about you lose a lot of blood if you need to remove your uterus. These are the possibilities. And I lost it.

Dr. Nicole (25:42): I lost it. Okay. Okay. Do you feel like you came to terms with it on the day of the C-section or what helped you to go into the moment? Or was it just kind of like, we're just going to go with it? What helped you feel like?

Denise (26:01): I think what helped is that my maternal fetal medicine professional was there with my doctor, excuse me, was there with me. And so she came when I was having a meltdown with my nurses who were amazing. I had just met that morning and we were very kind and nurturing, but when she came, we started talking and I was like, this is somebody familiar to me that's going to be there with me. And she was just so, it's going to be okay. I'm right here with you. I'm going to make sure you're okay. We're going to be fine. And my husband listened to her, babe, we're going to be fine. My mother was also there and she said, we're going to be fine. Everyone is here for you and with you. We're going to be fine. And that's what calmed me down. And then she actually walked with me to the operation room, my maternal fetal medicine doctor.

Dr. Nicole (26:57): Okay. So then how did the cesarean go?

Denise (27:01): It went really well, like I said, because it wasn't an emergency and it was so quick. Everything was really controlled and orderly. And the anesthesiologist was awesome. The surgeon was awesome. There were some interns in there, medical students, excuse me. They were there, Dr. I had my makeup done. Okay.

Dr. Nicole (27:23): You were all right.

Denise (27:24): They were like, yes, you look great. We're going to make sure your makeup is still fine. The students. So they kept me relaxed. They were asking me about reality tv and How do you feel? Are you okay? Shortly after I got the epidural, my husband then came in. That calmed everything. It was really cold. I remember it being very, very cold. I didn't remember that from the previous pregnancy, but I was very cold epidural. It didn't initially work. I had still had a lot of feeling. So that was a little scary to me because I could still feel stuff. And they had me on the table, and then they tilted you

Dr. Nicole (28:15): The table

Denise (28:16): From how it was explained to me. The medicine would travel faster. So we had to do these tests like these, okay, can you feel this? And then they would go further down, can you feel this? And I kept feeling it, and I could kind of hear them talking and she keeps feeling it. But then eventually I was numb, kind of hyperventilating through that,

Dr. Nicole (28:35): Of course.

Denise (28:37): But I was numb. And then we moved forward. They kept me occupied. They were talking to me. They kept me calm, and I could kind of feel pressure. My doctor was talking to me, I could hear her voice. She was saying to me, are you okay? Everything's fine here. My husband was talking to me. I had a lavender stick. One of the medical students was put it right by my nose so I could smell it to keep me calm. And then a little bit of pressure, they told me, you're going to feel pressure. And then I heard my daughter cry. Waterworks came, they allowed us to have our phone, so they took pictures. They allowed us to take pictures of her. So it was a very, very beautiful process. Nice. And they brought her over to me. She said they put her on my chest still.

Dr. Nicole (29:27): While you were in the or?

Denise (29:28): Yes, still while I was in the or. And it was a nice calm, not a traumatic experience.

Dr. Nicole (29:34): That's beautiful. That's beautiful. So it sounds like it was as good as it could have been.

Denise (29:39): Yeah. I think all things considered it was as good as it could be. Okay.

Dr. Nicole (29:44): Okay. And did you have any issues with bleeding or was it a complicated surgery or anything like that?

Denise (29:50): No complications with the surgery. I know I could hear, I remember hearing the surgeon and my physician, maternal fetal medicine physician, talking about how they had to move quickly. I could hear that, but no word of intense bleeding. Okay.

Dr. Nicole (30:10): Okay. Okay. And then how was your recovery for the second?

Denise (30:18): I thought it was similar to my recovery from the myomectomy, and I think just my body had adjusted to it, or I guess those nerves had already been cut from the first C-section. So it wasn't like that first recovery. It was actually okay. Definitely took my time. Everyone told me, don't try to jump the gun and do too much. I was very compliant, very, very compliant with all of the instructions that they gave me. And I think I healed pretty well. Okay,

Dr. Nicole (30:52): Good. And then, did your daughter have any issues? Because sometimes babies born at 37 weeks have a little bit of trouble transitioning or feeding. Did she have any concerns or

Denise (31:03): No, she had no issues. Latching and eating. She could hear. She could see. She passed the jaundice test, the hearing test. So they kept us for three days. And after she had all her tests and they assessed her, they did an ultrasound on her brain, everything was fine.

Dr. Nicole (31:23): Oh, they do that.

Denise (31:25): They did an ultrasound on her brain because during the pregnancy, there was, and from what I understand how it was explained to me, it looked like one side of her brain was a little larger than the other. But the maternal fetal medicine, my physician said that it's sometimes difficult to tell the bigger that you get with the ultrasound. So they said we would wait until she's born and then do the ultrasound on her brain to just double check and make sure everything's okay.

Dr. Nicole (31:55): Okay. Okay. Alright. When you look back on, and I guess I should ask, what about postpartum, like breastfeeding? Did you breastfeed? Did you have any issues postpartum?

Denise (32:06): Oh, it was, breastfeeding was a way better experience The second time around. The first time, the first time I almost quit because it was so painful. It was so painful. I had the milk, but it was just an intense pain. And I was like, I don't know if I can do this. But I stuck it out. So I was really scared the second time around, but we had no issues. We had no issues.

Dr. Nicole (32:35): Okay. All right. Good. Good, good, good, good. And have you had any more, how are your fibroids? Are they just status quo? How are things with your fibroids?

Denise (32:46): Yeah, status. They're stable. They're stable. I've had no issues. My menstrual cycle has improved. Okay. Still minimal symptoms. The symptoms have dramatically doled down decline, so it's not as nearly as painful. The flow isn't nearly as heavy and I have more energy. Gotcha.

Dr. Nicole (33:11): When you look back, comparing what your periods were like then versus what they are now, how was that going through

Denise (33:20): That before? Yeah, absolutely. I can't believe I lived through that. I mean, it was like 20 years of that, of these insanely heavy flows. I didn't know until the social media world and following physicians such as yourself and people talking about fibroids, that those really intense, insane flows. That's not normal. I didn't know that back then. I'm just like, wow. I really wish I would've gotten, I clearly had them back then, and I wish I had addressed it earlier.

Dr. Nicole (33:58): Yeah, yeah. When people always have that experience and they're like, if I would've known or if somebody would've brought it to my attention that it was a possibility, how things could have been different. But I'm glad you got things under better control now. Yeah, absolutely. Thank you. Yeah. And then I guess my last question is, do you feel any sort of sadness or regret that you didn't have a vaginal birth or weren't able to or anything like that?

Denise (34:34): Yeah, if I'm being honest, sometimes I do. There have been conversations that I've had just with random people who one time this woman said, oh, you cheated, you

Dr. Nicole (34:48): Cheated. I knew you wouldn't be like, I knew you did. Not just,

Denise (34:51): Okay,

Dr. Nicole (34:53): I got cut open. I didn't cheat nothing.

Denise (34:55): Yes, she definitely told me I cheated and I didn't really have the baby. So that was really painful. That was definitely painful. See,

Dr. Nicole (35:06): So unnecessary and so natural. Why would somebody say that? Yeah.

Denise (35:11): Yeah. I was really shocked. My feelings were really hurt, and it did make me feel like, wow, I really wish she didn't say that, but it made me feel like, wow, I wish I would've had a vaginal pregnancy. It made me feel a little bit like it wasn't authentic and authentic, even though I know that it was.

Dr. Nicole (35:35): Yeah. Yeah. Same for me. I had two C-sections also, and I still feel the same sort of, so I can 1000% relate. All right. So as we wrap up, what is one piece of advice that you would give to someone who's having a baby?

Denise (35:51): I would say prioritize your mental, emotional, and physical health, because pregnancy is just so unpredictable. It's so unpredictable. Even the best planners, the most fit people in the world can have complications. And if you manage your health physically, mentally, emotionally, navigating those risks, those obstacles that you may face will just be much easier. It'll just be better. It'll be better for you. It'll be better for baby. It'll be better for your support system. Yeah. Yeah,

Dr. Nicole (36:32): Absolutely.

Denise (36:32): That's my advice.

Dr. Nicole (36:33): Yeah. I love it. I love it. So where can women connect with you? You can say nowhere or it's up to you.

Denise (36:41): I'm online at Cruise Control Fitness on Instagram and Facebook, and Cruise is spelled C-R-U-S-E. Okay. So like Tom Cruise without the I. I'm also cruise control fitness.com.

Dr. Nicole (36:56): Okay. All right. I think that's really admirable work that you do, by the way.

Denise (37:00): Thank you so very much. I really appreciate

Dr. Nicole (37:02): It. Yeah. Well, thank you so much for coming on. It was a delight talking to you.

Denise (37:06): Absolutely. Thank you for having me. It is been an awesome chat.

Dr. Nicole (37:16): Wasn't that a great story? I so appreciate Denise coming on and sharing her story and just really, really appreciate her honesty and just open conversation about both of her births. Now, after every episode when I have a guest on, I do something called Dr. Nicole's notes, which are my top takeaways from the conversation. And these are my Dr. Nicole's notes from my conversation with Denise. And I got a few. So first off, I'm going to be honest. As doctors, we too frequently cover up symptoms instead of trying to figure out what's causing the issue. Denise complained about heavy periods, but there wasn't an investigation into why she was having heavy periods. It was just suggested that she get on birth control pills, and that's not the way things should go. We should always look to see if there is an underlying reason for something, and then we fix the underlying condition and not just trying to mask things with medications.

(38:20): Now, there's nothing wrong with medications of course, and actually birth control pills may help in heavy periods with fibroids, but you want to know what the underlying issue is and not just dump medications on top of symptoms. Now, this doesn't mean that we always find a reason for things, and sometimes it can take some time to uncover why things are happening. Pelvic pain is a big one that can be difficult to figure out what's going on. But the point I'm making is that we have to try. We can't just say, oh, take these pills, take that. We have to look at the underlying causes of things in a holistic way, by the way. So not just physical causes, mental health causes, what are you eating, your stress, all of those things. And then come up with a comprehensive plan from there. Alright. Number two is I love the way Denise mentioned the importance of mindfulness and overall health.

(39:18): It's so important to protect your peace. She mentioned that she couldn't look at a documentary that was about black maternal health and women dying during childbirth because it was going to be too much for her. She knew that it was going to get her anxious and not necessarily be helpful for her during her pregnancy. And to be clear, this doesn't mean that you ignore potential problems, but it can be really easy to get consumed and that doom and gloom cycle, that doom and gloom space of information, and you don't necessarily want to stay there. So I'm not saying that you ignore the possibility that problems can occur. I'm not saying that at all. As a matter of fact, you should be prepared for the possibility that problems can occur, but you don't want that to overshadow your joy. You don't want that to take an outsize role in what is happening and what is going on in your pregnancy.

(40:18): You don't want that to be the focus. So definitely protect your piece. This is one of the things in the birth preparation course that I talk about. The very first lesson in the course is actually on mindset. Because mindset and birth is just going to get you such a long way in terms of having the birth experience that you want, regardless of if things go exactly how you anticipated. Okay? Next thing I want to say is about cesarean birth. Cesarean birth can truly be beautiful. They don't have to be this painful, stressful thing. You can still do delayed core clamping at the time of a cesarean. You can still do skin to skin contact in the operating room. It may not be right away, but it can happen in the operating room. You can create a nice environment in the OR with music playing, things like that.

(41:06): It doesn't have to be doom and gloom. And I also want to thoroughly, thoroughly, thoroughly dispute the claim that someone told her fix their mouth to say this, a cesarean birth is cheating. That is so just completely disrespectful. Don't say that to anyone I know. None of y'all would ever say that to anyone. It is not cheating. It's a major abdominal surgery, and you still gave birth. You grew a whole human being inside your body, and there's nothing that's a failure about that. So it's not a failure. It's not like you did anything wrong, and it certainly ain't cheating. Okay? Remember that You still give birth. You grew a whole baby. Know that, believe that. And don't let anybody tell you anything different. Okay? And the last thing I'm going to tell you is if you want to learn more about fibroids in pregnancy, then check out episode 1 0 3 of the podcast.

(41:58): That's dr nicole rankins.com/episode 1 0 3, and you can learn when it's appropriate to have a C-section with fibroids. One of the big things that people that we don't do a good enough job of explaining is that if you had fibroids that were removed from the, what's called the contractile portion of the uterus, the part of the uterus that squeezes, then cesarean is the safer option. Because during labor, your uterus is squeezing over those scars. Yes, we put the uterus back together when we take out fibroids, but not as strong as it was without surgery. And if the uterus is squeezing, squeezing, squeezing against those scars where the fibroids were and they could potentially burst open, and that's catastrophic and awful and can be life-threatening potentially. So that's why you have to have a C-section depending on where your fibroids were removed from. But I go into all of the details about that, different types of fibroids, how it can impact your birth, how you can have a vaginal birth with fibroids, all of that in that particular episode, that's 103.

(42:58): Okay, so that is it for this episode. Make sure you subscribe to the podcast so that you never miss an episode. You can subscribe wherever you are listening to me right now. If you can leave me a note, an Apple podcast, that's great. A five star review would be lovely. If that's what you think, you can leave that note there for me. Let me know what you think about the show. Also, share this podcast with a friend. Sharing helps them, and it helps me to reach and serve as many pregnant people as I can. I'm on a mission to do so. Come check me out on Instagram. Also, I'm on Instagram at Dr. Nicole Rankins. I'm thinking about starting a answer. Ask me something and I'll answer in the podcast. I'm kind of working on that in my head, so stay tuned for that. But in the meantime, let me know what you think about the show. Anything you want me to talk about on Instagram. I'm on Instagram again at Dr. Nicole Rankins. So that's it for this episode. Do come on back next week and remember that you deserve a beautiful pregnancy and birth.