Ep 80: Navigating Genetic Testing and Pregnancy Loss During a Pandemic with Cortnie

This week we have a tough episode about pregnancy loss. But we’re joined by a really lovely guest who’s sharing her story in the hope that it will help other parents in a similar situation.

Cortnie is an educator, wife and mom to a two-year-old. She recently got pregnant for the second time, but genetic testing during her pregnancy sadly revealed that her baby had trisomy 13, a rare genetic condition caused by an extra copy of chromosome 13 in the baby's cells. This diagnosis usually means a baby will have severe physical and intellectual disabilities and a very low chance of surviving the first year of life. This was, of course, an incredibly hard thing for Cortnie and her family to hear, and navigating what to do next was a huge challenge. 

Cortnie joins us to talk about how she and her husband processed this diagnosis, the kind of care she did and didn't receive and how the pandemic affected it, and how she and her husband came to their decision about the pregnancy. This is such an important story to share about Cortnie's experience and the changes our healthcare system needs to make if it is going to support parents when they really need it. 

In this Episode, You’ll Learn About:

  • How Cortnie's first pregnancy went and what the process of getting pregnant again was like
  • What the genetic testing process was like to confirm that her baby had trisomy 13
  • How Cortnie and her husband processed the diagnosis they received and grieved for their baby
  • The challenges she faced to get care and the procedure she needed 
  • Why Cortnie should have received a lot more resources, information and support once she received her baby's diagnosis
  • Why she wanted to share her story to help other parents in a similar situation



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Transcript

Nicole: Warning. This is a story that involves pregnancy loss.

Nicole: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified OB GYN who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, 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 www.ncrcoaching.com/disclaimer. Now let's get to it.

Nicole: Hello and welcome to another episode of the podcast. This is episode number 80. Thank you for being here with me today. On today's episode of the podcast, I have Cortnie. Cortnie reached out to me on Instagram when she was pregnant with her second baby telling me how excited she was that she found me. However, unfortunately, not too long after she reached out to me, Cortnie received the news that her baby had trisomy 13. Trisomy 13 is a condition where a baby has an extra chromosome, 13. It causes severe intellectual and physical disabilities. Most babies with trisomy 13 do not survive beyond the first week of life. And if they do live beyond the first week of life, 90% of them will die within the first year of life. It is a rare condition. It affects about one in 10,000 pregnancies. Now Cortnie wanted to come on and share her story of how she managed this devastating diagnosis.

Nicole: She is hoping that by sharing her story, she can help other women who may face a similar circumstance because as you will hear, it was quite a traumatic experience for her and she wants to do what she can to help it not be so traumatic for another woman who may be facing a similar situation. Now, as I said, and as you'll hear, this was an incredibly difficult and at times painful process for Cortnie and it is a true testament to her bravery and her strength that she could come on and share her story, especially so soon after it happened. It hasn't been that long since all of this transpired. So let's go ahead and get into Cortnie's story.

Nicole: Nicole: Thank you so much Cortnie, for agreeing to come on the podcast. I know this is an incredibly difficult thing to talk about and I appreciate your strength and your bravery coming on to talk about it.

Cortnie: Cortnie: Well, thank you. And thank you for the platform. I know myself and many other women, you know, are looking for advice, especially from a specialist, in terms of like this process. So it's been refreshing to have your podcast.

Nicole: Nicole: Oh, well, thank you. I appreciate that. So why don't we start off by having you tell us a little bit about yourself and your family.

Cortnie: Cortnie: Yeah. So I'm been married, my husband and I got married when we were around 33. So very late in terms of the whole pregnancy thing, I guess women don't really think about that. So we met, we both were in education, met there, had a beautiful wedding and jumped right into our first pregnancy. So we have an almost three year old around the house. So it's been fun just going on this journey and just really looking to our, expand our family quickly before we hit this 40 milestone.

Nicole: Nicole: I know exactly what you mean. My husband and I, I'm three years older than my husband, but I was 31 when we got married. So definitely know about that later start.

Cortnie: Cortnie: Yes. Yes.

Nicole: Nicole: We're going to hear about what happened with your second pregnancy. So how did that pregnancy start out for you? Was it planned? Were you excited? I'm guessing. Yes, but just tell us a bit about that.

Cortnie: Cortnie: Yeah. So, we wanted to wait at least two years before embarking on this second pregnancy, just to give our two year old, a chance to, you know, have that lovely only child syndrome. So we started trying, around, I want to say September, but it wasn't happening. And it was just like very frustrating because with the first child literally, we were like, alright, let's do it, you know, pregnant. So with the second pregnancy, it did take longer. In fact, I got to the point where I stopped taking pregnancy tests at home and just because it just became like, so definite like, no, you're not pregnant. I just allowed the, you know, cycle to either come and or not. But we finally got our first positive in January and we were very excited. I mean, I honestly couldn't believe it. I'm like, Oh my God, we've been trying, I was calling a doctor, like, what's wrong with me? And she's like, nothing, you know, it just may take longer. There's a 20% chance, blah, blah, blah. Of course you don't want to hear that. So we were, we were excited to be pregnant with our second child.

Nicole: Nicole: Got ya, so very much so, excited and planned and ready for this pregnancy.

Cortnie: Cortnie: Yes. Ready.

Nicole: Nicole: You were seeing a physician for your prenatal care?

Cortnie: Cortnie: Correct. And she's the same physician who delivered my first child, really great OB and I really, really, really love working with her. And yeah, she was just as excited as well, especially since I was, you know, calling the office, like let's go and trying to be seen. And so she was, she was excited too.

Nicole: Nicole: Gotcha. So it took you about four, four or five months, is that?

Cortnie: Cortnie: Hmm. About.

Nicole: Nicole: Okay. Which, you know, it feels like forever in pregnancy terms. It's actually not what we consider long, but I know what it feels like as well. Like it took six months for our second one and it was, I mean, for our first, for our first one and it was like, it feels like it's forever, like, but in the grand scheme of things in medically wise, it's not dangerous, but I certainly can relate to like, when is this going to happen? When is this going to happen?

Cortnie: Cortnie: Right. Clearly, you know, we just can't control it all. I was just thinking like, we'll have a baby with this Zodiac sign and I was like well, I guess not.

Nicole: Nicole: Then you get to the point in your prenatal care where you were offered genetic testing. So what was that kind of discussion like? Was it just sort of here it is, this is something we recommend or offer, how did that go?

Cortnie: Cortnie: Yeah, so I got the same genetic tests done with my first child, even though I was younger in terms of, you know, this geriatric age, which I'm coined as. So yeah, it was just, you know, a no brainer in terms of getting it, however we were right in the beginning of COVID. So because of that, my testing was actually done a little later than what it should have been. So definitely got it, but because of COVID, I didn't get my results, you know, it takes two weeks and I don't know if that's, I guess that's normal. So by the time the results came back, it was just like, oh my gosh. You know? And I knew it was something because, my doctor shot me a text message like, Hey, can you talk?

Cortnie: Cortnie: And like I said, I've been going to her for a while. So something about the tone of the text message was like, Oh my God, something is wrong. I just immediately knew and you know, my husband and I were working from home. So I, you know, yell for him to come upstairs, not knowing, you know, the news that she was gonna give us, but, you know, we were both here to talk to her. And she told us, you know, she was very sorry. Well with that, you know, she just told us our options. You know, I think she gave us like three. One, you know, you can just continue on and, you know, we'll continue to monitor you. Or the second option was to actually go get the second level of testing and the CVS, to get that done to either confirm it or, and then a third, if we did find out that we had it, you know, she just said that some women, you know, decided to just continue on with the pregnancy, even after the final confirmation, but, you know, she did go into what that look like and in terms of the success rate for the baby, and also the stress that it would wear on my body.

Cortnie: Nicole: Gotcha. Gotcha. So she calls you and tells you that the baby has trisomy 13, correct?

Cortnie: Cortnie: Yes. Yes. That was detected in the blood test.

: Nicole: Okay. And then she goes through all the options of ending the pregnancy versus continuing the pregnancy and versus doing another test to confirm it, even though the first test is pretty, pretty accurate. And what, at that point, did you decide to get a confirmatory test?

Cortnie: Cortnie: Absolutely. Yeah, I did, just because I don't know, and she said that sometimes, like there's a small percentage that the CVS may come back negative. So, you know, my husband and I, we felt that there was a little hope so right away, as soon as I hung up with her, you know, I was on another line making an appointment with the high risk doctor to get in as soon as possible to have this test, because that test the results took an additional two weeks to come back in, to you know, give us a little more into the actual genetics of the baby. So yeah, we were lucky to get in the next day. My husband wasn't allowed to go in, so like that was tough, you know, going through the consultation in terms of like what they're going to be looking for, how they're going to administer the test and the process of actually growing the specimen to then determine the DNA from that.

Nicole: Nicole: Gotcha. So you decide, because this is a really, I'm guessing this desired pregnancy, something that you really wanted, you want to be 100% certain that something is wrong. And gosh, just to kind of back up a little bit of CVS is chorionic villus sampling and it's a procedure where a little piece of the placenta is actually taken in order to look at DNA. And it's the gold standard in terms of diagnosis early in pregnancy for any chromosome problems. And as far as trisomy 13, I'll just briefly say that it is a devastating condition for babies, and I'll link to some information in the show notes, but most don't survive or if they do, they have significant longterm problems and difficulties. So, when you heard that information and you had that time between you getting the results, you quickly make this decision, you're going to get the CVS. And, but then you have to even wait, even though it was just a day, there's still this time that you're waiting, what was going through your mind and what were you and your husband kind of talking about at the time?

Cortnie: Cortnie: Yeah, so we are huge believers in spiritual. So we were really just, you know, we were trusting in God that, you know, like there's this thing that, you know, you can pray for what you want, or, you know, you can just ask God to just do what is best. At that point with that, we were really just hopeful that the results were gonna come back in our favor and that we will be able to deliver another healthy baby. And even during the sampling, he wasn't allowed to come with me, but what happened is they also do an ultrasound, a pretty intensive ultrasound. Normally the one that you don't get into until a little further, and I cannot remember the name of ultrasound. So the, as the doctor, you know, was looking and looking for some of the features that she said are, normally they stick out what trisomy 13.

Cortnie: Cortnie: She said that the baby actually looked normal. You know, they look for like fluid behind the neck, the limbs and, you know, you know, she was actually hopeful in terms of the scan that things were going to come back in our favor. So we, you know, we held onto that faith and, you know, my mom did her research. It was just like, yeah, you're going to be fine. Like this, you know, just the fact that it doesn't happen a lot. I think it's very rare. So we were just hoping that things were going to come back in our favor.

Nicole: Nicole: Gotcha. Gotcha. And your husband could not be with you during that appointment. Was he on video at all or on the phone or?

Cortnie: Cortnie: Yeah, so I did FaceTime him in during the consultation when she went into the genetics and the chromosomes and the pairing and, you know, what happens if there's an extra chromosome. And so he was able to sit in on that. And then I also tell you the risks associated with, you know, sampling from your placenta, which she said that she'd never had any cases but they always have to give you that disclaimer, but during the actual procedure, no, I didn't videotape. I mean that, Oh gosh, that was very, that was an invasive because they, you know, the needle that goes into you to actually pull out the sampling, it was, it was pretty traumatic, but yeah. Yeah. Oh my gosh. So many other women, you know, that are giving birth during this time, you know, COVID has really kind of shifted a lot of things.

Nicole: Nicole: So that was just incredibly difficult. I just can't even imagine. So then you get through that and then you have to wait another two weeks. Okay. And so at that point, you're probably what, 11, 12 weeks along somewhere in there?

Cortnie: Cortnie: I think 13. 13. Okay. Okay. Yeah. So we were in our second trimester at that point. Yeah.

Nicole: Nicole: Okay. And then you have to wait two weeks and then during that time, I can only imagine what's going through your mind. And were you ever thinking, like, what did I do wrong? How did this happen? Or were you not, not at that point yet?

Cortnie: Cortnie: So I tried to stay away from that part at that time, because, you know, I'm still, you know, praying every night, God just allow this baby to be healthy. And, you know, I really just try not to let my mind go there. Even staying away from the blogs and, you know, the apps with the women who may talk about certain deformities, genetic issues that their children have. So I really just tried to stay away from it and just keep myself busy.

: Nicole: Yeah. That, that makes sense. You get the final results back that unfortunately it confirmed that the baby did have trisomy 13. And then how did you come to the decision to decide to end the pregnancy?

Cortnie: Cortnie: Yeah. So at that point, the quality of life, when I was an undergrad, I work with youth with special needs. So I know that world very well. And honestly, this is something that even the children that I worked with didn't have, you know, children had cerebral palsy, but it was really just the quality of life. You know, I would never, it was hard. I mean, of course, to be completely honest, it was, I can say it was one of the hardest decisions that I've ever had to make in terms of resolving a pregnancy because, you know, I've been that person that throughout life, was very careful about the choices that I made. I've never had to go into planned Parenthood, which is totally okay, you know, if that's your best decision, but I try not to have to make that decision and, you know, try to be very responsible in terms of making sure that the decisions that I made were at a point in my life.

Cortnie: Cortnie: So it was tough having to make that decision and even tougher because my husband was in denial and he felt that the test was wrong. And I just like baby, like this is science, you know? And the thing we really had to talk in terms of like, just the fact that, you know, the fact that we were able to get this cycle that we're testing and that these are the cards that we've been dealt. So either we continue or we end. And I knew that I did not want to put my body through the stress and emotional stress of having to actually deliver and watching, you know, my baby suffer. So, you know, we decideed, but there was this second layer that came along with that decision because I belong to a faith baseed hospital.

Cortnie: Cortnie: So with faith-based hospitals, they don't do procedures, they do not do DNCs unless the baby resolved itself on its own. Right now, I had to, on top of all the other stressors, find a reputable hospital that would take me. And I felt like if we had to do it, I at least wanted to do it with dignity for the sake of the baby, but it was tough. There are only two institutions that do it here in Michigan, and I called them. And because of COVID, they were not seeing patients unless mom had a health problem and couldn't go elsewhere. So I didn't qualify to go there. And they just kept pointing me in a direction of a family center and I just could not see my, it just wasn't for me. And you know, I just couldn't do it. And there was another hospital in Detroit with one doctor who did the procedure. So I was able to get in to see him and, you know, it's just crazy. Cause I'm like, at this point I wanted to just get it over with so that the baby, you know, wasn't getting bigger and I was starting to feel kicking. And, but I did find a doctor, but it was tough even finding a doctor that would take me and do this procedure.

Nicole: Nicole: So you had to navigate this on your own?

Cortnie: Cortnie: Yes. Yeah. And my doctor pointed me in the direction, but again, you know, because of the hospital that she works at, she couldn't help with that second level.

Nicole: Nicole: Right. Oh my God. So on top of the stress of you've come to this incredibly difficult and hard decision, and then you have to add this extra layer of taking it upon yourself to get the care that you need.

Cortnie: Cortnie: Yeah, absolutely.

Nicole: Nicole: Oh my gosh. That, and in the middle of a pandemic.

Cortnie: Cortnie: And in the middle of a pandemic and only two places in Michigan perform this procedure on top of that. Well, that's what I was told unless...

Nicole: Nicole: Yeah. Once you get to be a certain point in pregnancy, it really should be somebody who's skilled and trained in doing so. So that, that doesn't surprise me. So then were you able to get with that doctor like get in fairly quickly and then how did that whole process go for you and how far away, how far away was it from where you live?

Cortnie: Cortnie: Well, I'm not far from Detroit. So about 20 minutes out, I was able to get in with him only because I had to pull strings, because my mother and my stepmother, were both like, you know, on top of all the emotions I'm dealing with, like they were trying to help me as much as they could in terms of like this next step. And I just didn't have the mental capacity. And so they were calling around and my stepmother's long time doctor friend happened to know this doctor and name dropped. And because of the name drop, I was able to get an appointment with him because I'm not even, you know, with the hospital to even get in there. So I was able to get in there only because I dropped so and so sent me and I got in to see him.

Nicole: Nicole: And then how, how was he in terms of helping you through this and the compassion level and the staff and all of those things? How was it once you got to that point in the process?

: Cortnie: Well he, I want to say he was very, very nice, just an older doctor. And you could tell that he's been doing this for a while and just very straightforward, you know, so different from my OB, but you know, he did provide the information that I needed. However, you know, it's just a little different when you select your doctor or interview. So, but just very straightforward, you know, it's just like, well, this is how it goes. This is how it works. And basically you can come in either Friday or you can wait till Monday, so you can tell that this is just something that he does. And he does often, but I did feel very comforted knowing that he was skilled in this area, that he performed this procedure for many women. And I was grateful that, you know, he was going to help me. Despite insurance not kicking in at all and me, you know, having to dish out the money to even pay for it. But he was, he was very kind.

Nicole: Nicole: And why didn't your insurance cover it?

Cortnie: Cortnie: No, they did not cover it because it was second trimester and it wasn't considered, I guess they didn't consider it a procedure that needed to happen despite the fact that the second layer of testing and what we know about babies that are born with it, it was not covered.

Nicole: Nicole: So you had this devastating diagnosis, you have to find someone yourself to help with the procedure and then insurance doesn't pay for it.

: Cortnie: Not at all.

: Nicole: Oh my God.

Cortnie: Cortnie: Yeah. And then they said, well, if you come in, we'll need a thousand dollars today. The rest of the money will be due on Friday when you come in. So they were very, you know, straightforward. Like if you don't have it, we won't do it. And I was just like, okay. And they knew the reason behind it. Of course they knew, of course they did.

Nicole: Nicole: Oh my God. Okay. And that, did they offer you any type of emotional support during did any like a counselor or...

Cortnie: Cortnie: No. And I actually, because I didn't know how I was going to feel after, especially my husband couldn't come into any of these appointments with me, but no, they didn't. And I actually asked like, well, is there something if I'm need, um, you know, what can I, he was just like, Whoa, I don't want to offer you any, you know, opiates. And I wasn't really seeking for something to be addicted to, but more so help me cope with the pain, I guess, because I felt it, you know, like this process was just not easy. And then I didn't have a lot of time to even really process it because, you know, at this point we're going on 16 weeks, but no counseling,

Nicole: Nicole: Did you see a genetic counselor at all during any of this?

Cortnie: Cortnie: So I was offered the help through my sister who works in one of their medical facilities. She does genetics with animals. So she, I know it was weird. So she connected me with someone who was in one of her master level classes who offered to get me an appointment. And this was before I scheduled the appointment with the doctor and honestly, I thought about it, but I also felt like time was not on my side at this point. And you know, I felt like anything that I did was going to delay it and I didn't want to continue to delay, especially since it was so hard to get appointments.

Nicole: Nicole: Sure. But even, I guess in the very beginning, when there was a suspicion, did your regular OB at that time offer to send you to talk to a genetic counselor about it?

Cortnie: Cortnie: No, she didn't.

Nicole: Nicole: I'm sorry. I'm just having a hard time, like wrapping my head around this because it, it just feels like you were just left to figure so much out on your own in a very, very hard situation. Oh my gosh. Okay. No, no one said like, I just, it should be routine that when you have a diagnosis like this, that you should get referred to a genetic counselor? So I'm, and I'm not saying, I don't want to, like, obviously you have a good relationship with your OB and I'm not trying to trash her. It's just that, and I don't know if it's the resources or what, but wow. Okay.

Cortnie: Cortnie: And even to that point, I felt that the high risk doctor, you know, should have gave me more insights, but it was really just a call with the diagnosis. And that was it. I didn't receive next steps. Like she just said, you know, I'm sorry. You know, you can try again after your first cycle comes back and I will see you early on, if you would like to do this screen earlier. And that was it. I didn't even get recommendations in terms of where to go from that call.

Nicole: Nicole: Okay. This, wow. I'm so sorry. You had to go through that. I mean, I feel like that's inexcusable, you know, that our system failed you in such a vulnerable and hard time.

Cortnie: Cortnie: Yeah. And I didn't know, you know, I've researched and again, which is why I wanted to share my story. So that women do understand, because this is new to me right now. So, you know, my prayer is that someone, this could be, you know, useful for them. But no, I was not offered a genetic doctor to even talk to me about what that meant. And, you know, if it was just a mutation that occurred and, you know, if it has something to do with my husband or I, like, we don't have any known, you know, genetic disorders in our family. So this was really just, we were surprised.

Nicole: Nicole: Sure. Of course, of course. So you're finally able to get the procedure scheduled and it sounds like gratefully, you have the means to pay for it, even if it may have been a stretch or maybe have family or for, you know, you were able to pay for it. I don't want you to relive any of the detail cause I know it's very difficult, but I guess just in general, how was the process of the procedure?

Cortnie: Cortnie: Yeah, so they put me completely under, well, I'm sorry, there was a two step. So I went in the day before the procedure where, and I'll let you I'll pause and let you explain because the terminology where he inserted something into my cervix to...

Nicole: Nicole: Maybe something called laminaria in order to help your cervix open up. So help your cervix dilate slowly over that day. So it wouldn't be as difficult to do the procedure.

Cortnie: Cortnie: Yes. So I went in the day before, and that was emotional because walking in, it was just like, you know, that finally we were doing it, you know, and then went in the next morning and yeah, they gave me the whole anesthetics to get knocked me out. And I woke up and, and it was, you know, it was over.

Nicole: Nicole: Okay. Okay. And then how did you recover from it? Did you get back to yourself fairly,

Cortnie: Cortnie: Physically, and the doctor explained that the hardest part was actually the night before, but after that the only pain I had was in my throat strangely and in my neck. So I don't know. I was just like, what were they doing?

Nicole: Nicole: Probably from the tube that was down your throat. Yeah.

Cortnie: Cortnie: Absolutely. But other than that, I did take two weeks off to mentally get myself back and found a project to do around the house to just keep me focused on something. So yeah, my recovery was very easy and simple. The physical recovery, the physical recovery.

: Nicole: Yeah. So how, how did you and your husband grieve the loss of your baby?

Cortnie: Cortnie: Yeah, we did just that, you know, we just let it out and we talked about it and, you know, we still pray, you know, we call her our little angel.

Nicole: Nicole: You don't have to share the name, but did you name her?

Cortnie: Cortnie: We did. We did. And, so we went through the process in terms of together. We talked about it together. The good thing that COVID did do was we weren't out. So you really have to go and tell everyone, hey, this, you know, we lost the baby. Because we really weren't in contact with so many people during that period of time. And, you know, again, we just, we felt that peace with our decision and, you know, we still, it's still a process. You know, we still have our moments that come and go, but you know, our two year old quickly brings us back to reality. Like, hey, I'm here. You know, there are still moments. His thing was, I wanna try right away and I'm like, well, hold on, I need a minute. So it's definitely, you know, there are those moments and that, and I'm sure everyone may go through that differently, but you know, my support system in terms of my mother, sister, they broke all the rules in terms of coming over during that time to hang out, and be with us as much as they could. And my grandma was sending care packets and food and just, you know, really trying to, you know, love us from a distance.

Nicole: Nicole: And do you feel like you had any support at all from within your, like the healthcare system, your doctor's office or the, it sounds like, no. But was there any like followup or have you seen a counselor or anything like that?

Cortnie: Cortnie: I haven't seen a counselor. My doctor did call me the day of the procedure and after to just kind of check in and see how I was feeling. And I actually decided to do my followup with her over the other doctor, because I just couldn't imagine walking back into the office. Just the association with his office, just, you know, but I did post care with her. But no, I haven't, you know, talked to a counselor.

Nicole: Nicole: Okay. And this is fairly recent within the last couple of months that this happened.

Cortnie: Cortnie: Yeah. May 8th.

Nicole: Nicole: Okay. Okay. This is, I mean, looking back on everything, how do you feel about decision you made? How, how are you feeling right now?

Cortnie: Cortnie: Yeah, so, well, this is the first time that I've talked about it since the grieving process with, you know, my family, my mom, like I shared all of this with her. And she was calling, she really wanted to get inside to see how I was feeling and, you know, the moment that I said, you know, I feel like, you know, I'm killing my child. She immediately stopped and said, hey, you know, you can't look at it that way because the baby is not healthy. And, you know, and I think that helped in terms of me knowing that the decision was made to, you know, just not have to see our baby suffer. And that's really the thing that I hold on to in terms of the comfort is just knowing that our baby didn't have to suffer.

: Nicole: Right. Right. Right. So, you know, you really wrestled with that.

: Cortnie: Yeah. My God. Yeah. He's felt like you were killing your child. Oh yeah. Oh gosh. Yes, absolutely. And yes. And my husband's family who they're very Bible based and they had their thoughts, in terms of the decision and I just didn't have the capacity to deal with it. And I told him, you know, to just, I just didn't need to know what was being said again, like this was not something that I wanted to do, let alone hear anyone else's opinions towards the decision that we made. Sure, sure. So, yeah.

Nicole: Nicole: This is so incredibly hard and I am so grateful that you have shared your story because I know that it is going to help someone hearing it. I'm 100% confident of that and you are so strong. I cannot say that enough.

Cortnie: Cortnie: Thank you. Thank you. Thank you.

Nicole: Nicole: So if you wanted just to wrap up, what is one thing that you want every woman to know after you have gone through this experience?

Cortnie: Cortnie: Yeah, I guess it's really just to follow what your heart says. I do believe it's a decision and only a mother can make, rather to, you know, continue, and I get that some women may want that closure. So I, my advice or last piece is to just really, you know, do what you feel is best and be with that and, and be okay with that seriously. This was just the choice that we made and, and definitely the genetic testing is very important, especially the earlier you can get it, definitely do it that way. You know, you will know what's going on in terms of, you know, your baby.

Nicole: Nicole: Right, right, right. And then I guess one more question, do you think you will try and have another baby at some point?

Cortnie: Cortnie: Absolutely. Yes. We're not going to leave our little, little Ms. Logan to be a single child, only child. Right. I'm not going to stress or worry about it. You know, we're just gonna see what happens. And I do feel confident that we will be fine. And that was another piece of information that I did get that was reassuring in terms of, you know, a lot of women, you know, are able to get pregnant again, have completely healthy and normal pregnancies after dealing with a trisomy. Yeah.

Nicole: Nicole: Most of the time. Yeah, absolutely. Well, Cortnie, thank you so much for agreeing to come on and share your story as, like I said, you were so incredibly brave, so incredibly strong as so, so appreciated.

Cortnie: Cortnie: Well, thank you. And thank you for this platform. And I am confident that I will be back at some point and there will be a good story to follow up about an easy pregnancy and healthy. So I will make sure to keep in touch with you and continue to listen to this amazing platform that you've created for women.

Nicole: Nicole: Well, they will 100%. You have an open door invitation.

Nicole: Wow. Okay. So what an incredible story, what an incredible testament to Cortnie's strength and bravery. I know that that was really difficult to hear and I'm sure it was infinitely more difficult for her to tell. So I really, really appreciate her taking the time to come on and share her story with us now, you know, after every episode where I have a guest on, I do something called Nicole's notes, where I talk about my takeaways from the episode, and here are my Nicole's notes from my conversation with Cortnie.

: So the first thing I want to say is that so much about Cortnie's experience was wrong. We, as a healthcare system really failed her during such a difficult time, a woman should not be left to navigate this type of situation on her own. And I'm really deeply sorry that she had to experience this. What should happen when you realize that there is a problem or an issue with the pregnancy like this, you should see a genetic counselor in order to get a full picture of what the condition entails.

Nicole: And then once you make a decision about what you want to do, and then the option should be reviewed. And that's whether you decide to continue the pregnancy or not, once a decision is made, we should provide you with resources and support to help you through it and not figure things out on your own that can include setting up appointments, recommending a counselor, to see connecting with specialists, maybe even connecting with other moms, who've been through a similar circumstance. And then of course, she should not have to pay for this out of pocket. No one should have to pay for any of these things out of pocket. That's just, you know, incredibly crazy to think that that's, that, you know, that that's what happened or that any woman have to experience that circumstance. It can be difficult to coordinate these types of things just because of the way our healthcare system is designed. It's rather fragmented actually, but it can be done and it's how it should be done. And just because it's difficult, that doesn't mean that it's something that we can't do.

: And then the second thing I want to say about this episode is that ending a pregnancy is a very incredibly difficult decision for women. And in some states there are laws where Cortnie would have had to have a forced waiting period before proceeding, or she would have been forced to see the baby on ultrasound or hear the heartbeat, which you can imagine could have been quite traumatic. And this story is an example or exemplifies why I believe politics has no place in this arena. Women are quite capable of making the decision for themselves about what happens in their own bodies and with their pregnancies. And the government does not need to interfere with that.

Nicole: And I also really dislike it that this is often framed as a pro-life pro-choice debate. I actually find it quite offensive that because I support a woman's choice to decide what happens in her body, that somehow I don't have a commitment to life as an obstetrician and particularly one who was a hospitalist, like 99% of what I do is deliver babies. That is my work to help bring babies into this world safely. Of course I am on the side of life. It's just that I know. And I have seen this happen time and time and time again, throughout my 15 years of practice, that this is a personal decision. Women have the strength women have the knowledge. Women had the ability to make these decisions for them selves. And it's not something that the government needs to be a part of at all. All right.

Nicole: So that is it for this episode of the podcast, be sure to subscribe to the podcast in Apple podcast or wherever you listen to podcasts, Spotify, Google play. And I would really appreciate it if you enjoy the podcast, leave me a review in Apple podcast in particular, it really helps to show to grow. It helps other women find the show. And of course, I love hearing your comments and I give shout outs from those reviews on future episodes. And I would really love to hear your thoughts on this episode. I know this is a difficult topic, so we'll talk more about it in my free Facebook group, All About Pregnancy and Birth. You can find that group just by searching for it on Facebook, or it'll be linked up in the show notes. It's a great group of supportive group, non judgmental zone that will of course continue around discussions of this difficult topics. So head on over and check out that group, be a part of it. If you're not already, it's All About Pregnancy and Birth on Facebook. Now next week on the podcast, I am talking about health coaching. I am actually a certified integrative health coach. So I'm going to talk a little bit about that on the next episode. So do come on back next week and until then, I wish you a beautiful pregnancy and birth.

Nicole: Thanks so much for listening to this episode of the All About Pregnancy & Birth podcast. Head to my website at www.ncrcoaching.com to get even more great info, 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, as well as everything you need to know about The Birth Preparation Course. Again, that's www.ncrcoaching.com and I will see you next week.

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