Autoimmunity and Pregnancy: Stella
Stella is my second (possibly third) pregnancy with Hashimotos Thyroiditis. I was diagnosed in my immediate postpartum after Jack was born (read more about it here) but I had long suspected something was going on prior to getting pregnant with him, I guess we’ll never really know. The predictable thing about pregnancy with autoimmunity, and more-so autoimmunity in general, is its general unpredictability. Its been about two years since illness ravaged my life and left me with little energy to be out of bed, but since then I’ve established with a functional medicine doctor and experienced great healing, I was on the straight and narrow for several months and I was feeling pretty good overall.
I’d done a lot to heal my hormones (supplements, supporting detox pathways, food and lifestyle) after seeing the results of my DUTCH test, but I still felt that there was some sort of hormone interference, the only thing left to consider was my Mirena IUD, over the last 7 years I’d had one, but had a strong sense that this might be the missing link to finding my way back to me. Before I could even get a call in to the GYN (it was a Saturday) to get an appointment for removal my body expelled it. Guess you could say that it took the hint! I never did follow up with the doctor and within a few days I was feeling like a totally different person. My mood and emotions were rapidly improving, sex drive was back and I just felt totally different.
Side note: doctors will tell you that side effects are rare, or that you are imagining them; if your body is telling you something is awry, its best to listen. Also should mention, its NOT uncommon to have a strong prolonged withdrawal reaction to Mirena removal or stopping hormonal birth control of any kind, they cause a lot of imbalance in our bodies, not just to our hormones, but vitamins and minerals too. Beyond the Pill by Dr Jolene Brighten is an amazing resource for those looking to avoid or recover from Post Birth Control Syndrome (PBCS) or those who are just interested in learning about womens health and hormones.
We started using Daysy as our primary method of birth control (Temp tracking, Fertility Awareness Method aka femtech). We honestly didn’t think I could get pregnant because of all of my health challenges, so it was more of just a back up. After about six months we knew we were during our “fertile window” and decided to see what would happen… confirmed positive pregnancy test 11 days later. I had truly healed my hormones, escaped PBCS and gotten pregnant intentionally within 6 months of IUD removal. Birth control changes your biology, it can even impact your partner choice. For me, if you would have asked about having more kids (age 35 with 3 boys already) I MIGHT HAVE CUT YOU!
The nausea, vomiting and healthy food aversions came on hard and strong not long after we found out I was pregnant. I was waking up around 2am nightly with vomiting, we tried everything,- crackers, ginger everything, acupressure, acupuncture, Chinese herbs. I had a stack of carbs on my nightstand and would make a hydroflask of hot tea with collagen and honey before I went to bed, nothing had much of an impact on it. Instead of losing weight though, I actually gained weight, pretty significantly in the beginning. I didn’t want veggies or anything remotely healthy, I was tolerating gluten and starchy carby bready things were the only thing that didn’t make me vomit. My sensitivity to gluten seemed to have let up (pregnancy down-regulates the TH1 branch of the immune system so your body doesn’t perceive the baby as an invader, it's not uncommon to have some symptom relief if you have a TH1 dominant AI condition) I rolled with it despite knowing it wasn’t the healthiest choice, it was either that or spend the day hugging the toilet. I knew that the nausea and vomiting wouldn’t last forever and stressing over my food choices would ultimately be more harmful to my health.
We were super excited but due to my indoctrinated fears of “advanced maternal age” and my own health history we were cautiously optimistic to put it lightly. In all reality we were on eggshells until about 8 weeks or so when we kind of felt like we were at least out of the deep neck of the woods. At 13 weeks, the end of the first trimester we let the world in on our little secret, then in the next breath it was panic. Literally less than 8 hours after sharing our news I ended up having a massive bleeding spell, TMI I know, but if you’re still here you’re probably used to it by now. We promptly called the midwife, actually Mike called because I was not composed enough to make a phone call and was still in absolute shock. She suspected a subchorionic hemorrhage and advised us to come in the morning for an ultrasound, or go to the ER if it got worse. It was confirmed the next morning and despite how scary it felt at the time, we were reassured that while they are somewhat rare they typically spontaneously resolve and you go on to have a normal pregnancy. Three weeks of taking it easy and pelvic rest felt like an eternity BTW.
The nausea and vomiting stopped pretty abruptly around 15 weeks, but I was afraid to acknowledge it and jinx it. Over time it became just a passing memory, but looking back on it now, I don’t know how I could manage her now and deal with nausea like that, kudos to all you Irish twin mamas. I was finally able to stomach plants and they were tasting good again. Summer is usually my favorite because I love nothing more than a big-ass salad with allll the toppings. I got back to my usual way of eating, mostly plants and protein with healthy fats, I even got to indulge in my old love SPICE without the gut ache or resulting acne. I ate what my body craved, but for the most part was still pretty inclined to eat nutrient dense. My biggest cravings didnt kick in until the end, but were queso dip from Cafe Rio and Buttermilk pancakes with blueberries from the local breakfast spot which was there the whole time.
I was conscious, but not overly concerned because the bulk of my eating was good nutritious food. I had my glucose tolerance test on time and opted to bring my own, I got the fresh test, it was actually pretty tasty (Ive never had that feeling about a glucola aka the orange drink) though way too sweet for my palate I managed to get it down. I came in a few points below what would have classified as GDM, the midwife explained that she would see that more frequently when women who ate a more paleo template would do the glucose challenge, our bodies are just not that conditioned to eating copious amounts of sugar in one sitting like that, therefore produce less insulin.
I don’t know that I’ve ever felt so lucky to be pregnant over the summer, but I definitely feel like the availability of all the good produce helped me crave and eat better things than I might have otherwise if I’d gone through it in winter when we all just want to eat carbs and hibernate on the couch until May.
I also lucked out that the second trimester covered most of summer since I was able to get most of my exercise swimming in the pool and walking the dog around the neighborhood. It wasn’t strenuous exercise by any stretch of the imagination, but I know how my body tolerates that kind of exercise—it doesn’t, so I didn’t push it, the last thing I wanted to do trigger the flare I had been lucky enough to avoid. While I would walk and swim I tried to focus on my breathing, all the way down to tongue position, abdominal and pelvic floor muscles and shoulder position. I’m not going to lie, I think between the neural connections I made through those exercises and my strong abdominals from luge, she carried pretty close to my body despite my somewhat short torso. I think it helped me a lot in labor and recovery as well.
Two days before she was born, looking way less pregnant than with any of the boys
Walking any distance, or even up the stairs, became quite difficult in the last 6-8 weeks of pregnancy. I had pretty bad SPD but continued doing movements to strengthen my pelvis and honored my bodies requests for frequent breaks. Pregnancy is NOT the time to try to tough your way through things. By the end of summer the only recreational walking I was doing was to the massage therapist and back, and even then towards the end she would demand to drive me home though it was only a third of a mile away.
As we approached her due date I got a little bit nervous, after all, I had never had a birth that had not been meddled around with. Every birth I had ever had was loaded with many hospital interventions ranging from IV pain meds, membrane stripping and breaking of water, to pitocin and an emergency Caesarean, to high doses of magnesium and a failed epidural during a VBAC that the hospital did not want to let me have. I kept reminding myself that I had read all the books ( I can’t even begin to tell you all of the pregnancy books I read while I was pregnant, I was always reading something and reaffirming that I was making the right choice to be out of a doctors care and out of the hospital) As I would read and educate myself about physiological birth not only did I know I was making the right choice for our family but I could see how each of my previous births played out because of the interventions that I had because I was hospitalized.
We had initially planned to have a birth center birth, but after deciding we were moving out of state and unable to find a birth center that could take us on we were forced to decide between a home birth and a hospital birth, at a hospital that was not keen on VBAC, even after a successful VBAC. My intuition told me that a hospital birth would not be good for us and we settled in to the idea of birthing at home. Given that I have had migraines as long as I can remember and having bad luck with epidurals not providing much in the way of pain relief I was confident that I could handle it, and knew that Mike would be by my side and that would be all the comfort I would need to get through.
Up until this point we had only had the one ultrasound to confirm the SCH and I had wanted to avoid them as much as possible because after learning more about the technology I felt like they should really be kept to a minimum. If you’re pregnant or considering pregnancy, I urge you to do the research yourself and come to an informed decision. Despite my “advanced maternal age” we decided to also forego the non-invasive prenatal testing (blood test to check for genetic diseases) This was our miracle baby and theres not really anything that a test could tell me to change the way we felt about her. We were at peace with whatever outcome. We weren’t even concerned with knowing the gender of our baby, but ended up finding out anyway. We had skipped the 20 week anatomy scan but ended up getting one at 23 weeks when we had to decide between hospital and home, we wanted to make the best choice because home was going to mean at least a 30 minute drive to the nearest town and closer to an hour to the nearest regional hospital.
We decided since we were having the ultrasound already, we may as well find out the gender—its a girl, I knew before the tech asked me, I knew before the pregnancy test was dry actually. I knew her name was Stella, interestingly enough she was due during a full moon. Despite being tired I had a hard time sleeping all through pregnancy, and I developed a real awareness of the moon; I could look at the moon in the sky and know what time it was when I would get up to use the bathroom, I even began to count time in full moons. Stella wouldn’t come with the full moon, but a couple days later.
She was due on a monday, 11/11 to be exact. The moon was to be 99% full. We had guessed that labor would start Sunday night and she would join us Monday morning early. We were sort of correct. We went to dinner, our last date before baby, the closest thing we got to a babymoon was Mike watching me devour a rare 16 oz T-bone. We thought the walking downtown might help get contractions started, which it did. I didn’t want to sound all the alarms, or exhaust myself, so I went to bed knowing the contractions or water breaking would wake me up when it was really time, everything that I had read to prepare said “sleep if you can, you will need the energy later.” We woke up at the usual time Monday morning. No baby, no contractions. This theme would repeat for two more nights. Regular contractions before bed, but no baby yet. Wednesday night would set out to be much different. I noticed that the contractions were stronger than previous and were getting closer and closer together.
Wednesday night. The full moon had come and gone. My friend from an old nursing job was staying over to help with the boys should labor start. The boys were all tucked in and we headed off for bed contractions and all. About midnight I awoke to contractions just three minutes apart and lasting over a minute. Oh shit! We were supposed to call the midwife when they were five minutes apart! They came right over anticipating that it would be a quick delivery, but little miss Stella proved us all wrong. I think it was around 4 am that they decided to do a cervical check (they don’t routinely do these) and I hadn’t progressed much past a 6 so they decided to go to the birth center to sleep for a bit. I was still having regular and painful contractions but was able to go back to sleep. It wasnt until about 11 am that we called them back because I’d started bleeding and we were a little concerned (remember, this was in fact my first rodeo) We danced, swayed, rocked on the ball and took hot showers all day. I was still dilating but we were all surprised at how long it was taking despite all my best efforts to change positions and get her to budge.
Her heart tones were reassuring so we decided to continue waiting for her to make her move. Showers have always been my go-to form of pain relief, so when the contractions got really intense I begged to go take a shower, one of the midwives joked that I could as long as I was OK with having her in there with me to catch the baby. I didn’t really have any strong must push moments, just little grunts. Swaying in the shower felt good and was a welcome distraction to the contractions that felt like they were on top of each other. Then it hit me. This baby was coming NOW. I shut off the water, flung back the curtain and told the midwife I knew it was time because I felt like I had to poop! I had no time to get to the bed, I didn’t even have time to get out of the bathroom. My water finally broke. Stella was born in the bathroom while I was standing, leaned over the counter with two pushes and a yell in to the sink! She was finally here, 301 pm, right before her brothers got home from school.
I sat on the toilet with her on my lap, she was observed closely by the midwives but was otherwise allowed to cough and sneeze all the fluids up on her own. She was pissed about the sunlight on that unseasonably warm November day. It finally became obvious why it had taken so long…her cord was short, which can slow their decent. Once the cord stopped pulsing it was banded off and Mike cut her free and took her to the bed for skin on skin time. Within a few minutes the placenta was passed and I went to bed to join them. It wasn’t by any means easy, but it was over. My body had done the thing that it was born to do, and was able to do so because I got out of its way.
She was quick to smile and loves her people. She holds our hands and dislikes being alone. She nurses well and has slept most of the night since she was born. I didn’t have a ton of pain following birth, no tearing that required stitches. I was up and about probably sooner than I should have been, but I felt really good and bleeding was very minimal. I still do feel really good. Its been almost 12 weeks since she joined us and I can honestly say I often feel a bit guilty for feeling so good. My antibodies are still low and I feel like she healed me on so many levels. I was able to redeem and let go of my previous traumatic birth experiences, I was forced to let go of any semblance of diet perfectionism, I was able to exercise and take care of my body and feel like I was doing enough-- because I was.
Kind of a boring story about autoimmunity, and I know its an experience I will forever be grateful for, there are definitely times boring is good- pregnancy is one of them.
I’ve had a couple food reactions starting when she was about eight weeks old, so I know my immune system is starting to rev back up again, but I am hopeful that I can continue down this road of mindfulness and self love that I can stave off the dreaded antibodies as long as possible. I know not all of us can be so lucky and I have thought about it every day.
Just two days before she was born, I felt AMAZING
Hard to believe there's over 7 years between them, hard to ignore the difference in mom and baby in Hospital vs Homebirth