Dr. Rebecca Dekker – 00:00:00:
Hi, everyone. On today’s podcast, we’re going to talk with EBB childbirth class graduate Jolene Brink about surviving HELLP syndrome and then pursuing a VBAC with her next pregnancy. Welcome to the Evidence Based Birth® Podcast. My name is Rebecca Dekker, and I’m a nurse with my PhD and the Founder of Evidence Based Birth®. Join me each week as we work together to get evidence-based information into the hands of families and professionals around the world. As a reminder, this information is not medical advice. See ebbirth.com/disclaimer for more details.Â
Hi everyone, and welcome to the Evidence Based Birth® podcast. I am so excited to talk with you today about a really important topic of HELLP syndrome. Before we get started, I have two announcements. First, starting tomorrow there is going to be a 20% off shop-wide sale at EBB. So if you’re interested in EBB t-shirts or educating yourself with our digital pocket guides or using our tear-away pads with your clients, if you’re a birth worker, go to ebbirth.com/shop starting tomorrow and you will see all the fun birth tools that we have on sale for labor day weekend. My other announcement has to do with today’s episode. In this episode we will be hearing a story about life-threatening HELLP syndrome and a traumatic emergency cesarean. Although listener discretion is advised, I also think this is a really important topic and we’re going to be doing some education about awareness of how to recognize the symptoms of HELLP syndrome.Â
And now I’m so excited to welcome to the podcast Jolene Brink. After experiencing a traumatic emergency C-section due to severe HELLP syndrome in her first pregnancy, which resulted in her son Leo spending six weeks in the NICU, Jolene embarked on a journey to reclaim her birthing experience. Determined to have a VBAC, or vaginal birth after cesarean, for her second baby, Jolene assembled a supportive medical team and found a hospital that honored her desire for an unmedicated birth. Through monitoring, advocacy, and the knowledge gained from the EBB childbirth class with instructors Dana Morrison and Cooper Orrell, Jolene achieved her goal welcoming her son, Guthrie, into the world without complications in 2022. Jolene is a freelance writer and senior communications manager living in Duluth, Minnesota, with her husband, John, their two children, and their pet cat. Jolene, welcome to the Evidence Based Birth® Podcast.
Jolene Brink – 00:02:06:
Hi, thank you for having me.
Dr. Rebecca Dekker – 00:02:08:
Jolene, I’m so thankful that you wrote in being willing to share your story because I think it’s important to both bring awareness to HELLP syndrome and also hear your second birth story where you were able to overcome that birth trauma. So I was wondering if you could take us to your first pregnancy. And tell our listeners about what happened to you when you were towards the end of your pregnancy with your first baby.
Jolene Brink – 00:02:34:
Sure, absolutely. I got pregnant with my first son in the fall of 2019. It was a fairly straightforward pregnancy. Little nausea, a little tired in the first trimester. Second trimester, no major symptoms. Everything was cruising along felt really great. And then around 30 weeks, I started to feel some symptoms, which also coincided with the beginning of March of 2020. So there was a lot happening in the world. And what I started to experience in my mind, felt like, possibly natural third trimester symptoms. I’d had such an easy pregnancy that I thought, okay, well, this is where I start to feel uncomfortable. So what I started to feel was pain in the back of my neck that over the course of a couple of days traveled down to the right side of my back. And it just kind of hung out there. It was really uncomfortable. And then I started throwing up. I’d had this nausea that came back, this kind of really severe constipation. But I just kept brushing it off as, well, this is just the third trimester. I’m almost there. I’m at 30 weeks. And with the beginning of COVID-19, it was really, really scary to think about leaving the house at that point in my pregnancy. And so I didn’t maybe reach out to my midwife at the time or go see them like I might have in a different circumstance.
Dr. Rebecca Dekker – 00:04:08:
Yeah. So what happened next? You were having these like really uncomfortable, painful symptoms. When did you finally seek care?
Jolene Brink – 00:04:15:
So I had an appointment that was scheduled at 32 weeks and six days. And so, I experienced these symptoms over the course of about two weeks. There was some vision blurring. There was looking back now, all of these pretty, pretty serious things. But I decided to wait until this 30 regular kind of 32-week appointment. And I went in, everyone was masked for the first time. It was really, really scary. I was working with the birth center in Missoula, Montana, with this incredible midwife named Jeanne Hebl, who I just absolutely adored. She’d been a really great, exceptional care. And she took my blood pressure and then she took my blood pressure again. And then she took it one more time. She’s like, hmm, seems like things are a little elevated, but didn’t tell me what my blood pressure was. And honestly, at the time, I wouldn’t have known what high blood pressure was versus not. And then they measured me and they noticed that my baby hadn’t grown in two weeks. And at that point, Jeannie said, you know, I think what we’re going to do is we’re going to send you to the hospital nearby. And they’re just going to. You know, we’re probably just going to do some observations for a couple of days. They’ll probably give you a steroid shot to help baby. We’re going to try to get this blood pressure under control. I found out later that my BP was 160 over 125, which is… I mean, you could probably speak to what I
Dr. Rebecca Dekker – 00:05:43:
Abnormal. Yeah.
Jolene Brink – 00:05:44:
It was really abnormal.
Dr. Rebecca Dekker – 00:05:46:
And especially the bottom number there is pretty bad.
Jolene Brink – 00:05:49:
Yeah. And so I went to the hospital thinking it would be a couple of days. I’d go back home. What ended up happening instead is I went into the kind of labor and delivery area. I did a urine sample. It was, it was red, which was not good either. At first they thought that they were treating regular preeclampsia. So elevated blood pressure. You know, some swelling. And then they did blood work and they came back, the nurses and the doctors, and it went from concern to emergency pretty quickly. And they said, you have HELLP syndrome. This is life-threatening for you and your baby, and you are going to deliver your baby today. Immediately went into the steps for emergency C-section. I went under general anesthetic because with HELP syndrome, you have such a low platelet count that they worry about clotting, I think is one of the big concerns.
Dr. Rebecca Dekker – 00:06:54:
You can’t have an epidural.
Jolene Brink – 00:06:56:
Yeah. Yep. And so I went to sleep and then I woke up, I had a little boy.
Dr. Rebecca Dekker – 00:07:02:
Did you see your baby right away or what happened after you woke up from surgery?
Jolene Brink – 00:07:06:
The surgery was on a Thursday morning. I woke up a couple hours later, my son went straight to the NICU. And I don’t think I saw him the first day, but I know for sure that I was able to see him and hold him the following day. So Friday afternoon, about 24 hours, which they needed to monitor me to kind of bring my body back into stasis and to get my blood pressure back to where it needed to be.
Dr. Rebecca Dekker – 00:07:38:
And were you in intensive care then after your surgery or in a regular labor and delivery unit?
Jolene Brink – 00:07:43:
I was in a regular labor and delivery unit. So once I had the C-section and once Leo was safely in the NICU, pretty quickly they were able to bring things back under control. It took five days for my blood pressure to really kind of even out, but luckily I wasn’t in the ICU.
Dr. Rebecca Dekker – 00:08:02:
So for our listeners who are not familiar with HELLP syndrome, it is considered a variant of preeclampsia, which is important to raise awareness about. You can visit preeclampsia.org for lots of info. But can you tell us more specifically what HELLP syndrome is? Like, what does it stand for? What does it mean that you had this going on in your body?
Jolene Brink – 00:08:23:
Yeah, well, I can tell you that the way I’ve described it to my friends is that preeclampsia is a highway, and most people are familiar enough with knowing that it’s potential risk with the childbirth. HELLP syndrome is like an off ramp where my body just, in a just completely scarier direction. It stands for Hemolysis, Elevated Liver Enzymes and Low Platelet levels. So it’s, and it’s, I read somewhere that it impacts fewer than 1% of all pregnant women. I don’t know if you’ve seen that statistic before, but it’s considered very rare. But what’s interesting is after having experienced it, I’ve met a lot of people who know someone who have experienced it. So it felt really rare at the time. And as I’ve gone through that experience and then on to having my second son, it’s out there and it’s something that I really want people to know about and just be aware of.
Dr. Rebecca Dekker – 00:09:22:
Yeah, I was reading about the prevalence of it on preeclampsia.org and they said, anywhere from 5% to 8% of pregnant people in the US develop preeclampsia and then 15% of those develop HELLP syndrome, which they calculated is about 45,000 women a year in the US alone. So you mentioned hemolysis, which means the breakdown of red blood cells and then the elevated liver enzymes, meaning your liver is being adversely affected. And then another dangerous part of it is the low platelet count. So you could experience bleeding. And so looking at the warning signs that you had. It looks like the most frequent symptom is upper abdominal pain and then severe fatigue, high blood pressure, protein in your urine, nausea, vomiting, headache, visual changes, and jaundice is pretty rare, but it can happen. So those are the most frequently reported signs and symptoms. And so which ones of those did you experience again?
Jolene Brink – 00:10:33:
I had blurry vision. Pain in my upper right back. I felt sick. I had nausea. I had some swelling and then I had the high blood pressure. So I had a lot of the indicators.
Dr. Rebecca Dekker – 00:10:50:
And the blurred vision. Yeah, exactly. And that sometimes people mistake it for like just having a virus, you know, if you’re feeling tired and achy and nauseous. I was also reading the latest statistics that 85% will have high blood pressure and protein in the urine, but sometimes that is not present. And then bleeding is actually an unusual way of knowing that you have HELLP syndrome, but it is a severe thing that can happen as HELLP syndrome progresses. And then also we have preeclampsia stands for eclampsia, which is like life-threatening seizures. So some people with HELLP syndrome may also develop seizures. And I think it’s interesting you said you were around 30 weeks when your symptoms started because typically symptoms develop between 28 and 37 weeks, but it can occasionally happen in the late second trimester or at term. But most cases occurred before 37 weeks. And it looks like the lab results are needed to usually to diagnose it, to look at your blood counts and to look at your liver enzymes and what’s going on with your kidneys and your platelets. So you met all the criteria for it. And the treatment is delivery, which is what you experience. So moving on, how did you process everything that happened to you from, you know, having an uneventful pregnancy to having this emergency cesarean under general anesthesia at 32 weeks? Which I’m assuming your husband was not able to be there with you. And then your, your son was in the NICU for six weeks. So how did you like, like cope and then process later with what happened?
Jolene Brink – 00:12:35:
Yeah, my husband was able to be with me when we went into the hospital. It was March 26th. Our son was born that day, and then Montana went into lockdown the following day. And so for the two weeks that followed, we were able to be in the hospital together. And then there was a point when the administration made a decision that only one family could be in the NICU at a time. So the second half of our NICU stay, we had a video stream set up between home and the NICU. And we would just switch off and on. My son was stable pretty quickly. And he was, so he was three pounds, three ounces, and he just needed time to grow. And so for us, the blessing of it all was just that we had a lot of time and a lot of space. And it was very, very quiet. And so in the beginning, what we were processing was just gratitude that we’d passed my body and my blood pressure came back to normal fairly quickly, even though I was told that in some women, it can take months or years to stabilize your blood pressure. I was able to be off of blood pressure medication after five or six weeks. And so I was healing, my son was healing. And I think what helped us as well was just this really small moment that stands out to me. It might’ve been two or three days after Leo was born. We were at the community medical center in Missoula, Montana, and there’s a the man, Dr. Fawcett, and he specializes in these kind of rare and complex women’s health issues with OB/GYN things. And I remember him coming into my room and sitting down and having a conversation with me where he said, just because this happened to you doesn’t mean that you can’t have more kids, which I think to have that conversation just a couple of days afterwards and to have someone kind of look me in the eyes and say, like, this isn’t the end of having kids. You know, this was really, really scary, but there are things that we can do to test and prevent and to watch for this in the future. And that was really reassuring because I always knew that I wanted two kids if I could. And so in the back of my mind. I just, there was just some comfort in that.
Dr. Rebecca Dekker – 00:14:50:
That’s so important to point out because so many people who have traumatic first births go on to not have another one because they’re so, they’re so afraid of having another traumatic experience. It’s really comforting that, that he came and talked with you about it.
Jolene Brink – 00:15:05:
Yeah. And I think what it did was it planted a seed that what we need to do was take some time and to heal. But that we could make decisions later on about having more kids without it being really like embedded with this early fear. We were in Montana at the time. One way that we processed our grief at the beginning of the pandemic was I looked at John and we looked at this little tiny baby and we said, well, I think what we need is our family. So we moved back to Minnesota. We loved Montana, but it was good to be home. And we kind of settled in, found a house in a little town that we love. And I started trying to get pregnant when Leo was around 16, 17 months old. And it happened pretty quickly. And right away, I made an appointment with my primary care doctor and I said, I went through this traumatic experience. I need to have a team that understands that what I’m going into is really, really scary. And I’m going to want extra support. And so that was a big reason why I actually sought out the EBB Program that was available in Duluth, because I knew that I wanted to be in a hospital with this pregnancy. I wanted to be near things where I would feel safe. I also wanted kind of the care and the advocacy that would come from working with people that work with your program.
Dr. Rebecca Dekker – 00:16:31:
Okay, so you were interested in kind of surrounding yourself with support, that wraparound support so that you would feel… even if something happened, you would have a team in place who could immediately go into action and care for you. And tell us more about like the EBB childbirth class in particular, you said you were drawn to it because of like the wealth of information, but how did you find out about Evidence Based Birth® to start? Like, did you already know about it in your first pregnancy or did you learn about it afterwards?
Jolene Brink – 00:17:03:
My first pregnancy, the plan was to give birth at a birth center. So I was already kind of in the mindset of that was the birth I wanted. What happened was very different. Going into the second pregnancy, knowing that I wanted to have a hospital birth at a hospital that was attached to a NICU in case there was an emergency, but trying as much as possible to bring in elements of what would be if I could be at a birth center. And there’s a program, the Doulas of Duluth, that work with EBB. And I just knew immediately that I wanted a doula to be part of my care team. And they also offer your classes. And so it kind of all came with the package. And so I went into the EBB program as someone who had a child already, but had never given birth, right? Like hadn’t felt like I had gone through that experience.
Dr. Rebecca Dekker – 00:17:57:
You were asleep when you gave birth last time.
Jolene Brink – 00:18:00:
Yeah. And I wanted to make sure that I knew how to advocate for myself so that in the hospital setting, I could as much as possible kind of bring those two pieces together, which is also why it was really important to me as much as possible to have a VBAC. Because again, I was kind of like closing the loop on, like I had this pregnancy up until the point where I went to sleep and there’s this blank space. And I knew with the second pregnancy that I wanted to try to set myself up to be able to experience what I had missed with my first.
Dr. Rebecca Dekker – 00:18:32:
Wow, that’s really impactful. What was your experience when you and John took the class? I’m assuming you take it with other parents. So your situation was a little bit unique in that you’d had this different first experience. And what kinds of things did you learn that helped you feel more prepared?
Jolene Brink – 00:18:49:
Yeah. Well, the experience of taking it with a bunch of first-time parents, it’s different, right? Because they’re all wondering what’s it going to be like to have a baby and to go through this process. We already had an 18-month-old running around. But because I knew I wanted the VBAC, I knew to go in and to listen and ask questions about what comfort measures I could ask for, how to kind of navigate moments where I might be encouraged to take things that I didn’t want. And it just kind of gave me some tools to be able to, in my appointments leading up to the birth and then the birth itself, I just felt like I had the tools to have better conversations with my OB and to really set a birth plan.
Dr. Rebecca Dekker – 00:19:34:
Did you feel like your OB was truly supportive of you having a VBAC? How did you figure out like which care provider to go to for that?
Jolene Brink – 00:19:41:
Yeah, I saw a couple different care providers before I found someone that I felt understood what I was looking for. And I was working with, her name was Claire Maloff at St. Luke’s. And she was fabulous. A lot of times I would come to her with something I had learned in the EBB class. Like I want this or I don’t want this. And she’d be like, yeah, let’s do it. Like, that sounds great. And it was always her and I having a conversation of, okay, we want to have this feedback. We want this to work. And we’re going to go in with the mindset that if something goes wrong, to also be okay with the fact that the most important thing was that I was safe and my baby was safe. And so she would say, like, yes, we can not do that. But these are the things that you need to do. So I really didn’t want an IV. I didn’t want to go in. And she said, like, that’s something that you have to do. Because we need to be able to help you out if something went wrong. But she was really supportive about making it, making it happen. So I was really, I was really grateful for that.
Dr. Rebecca Dekker – 00:20:43:
Okay. And what were some of the key differences then in your prenatal and monitoring care this second time around?
Jolene Brink – 00:20:50:
So the second time around, I started a baby aspirin at around 13 weeks, which is one of the things that was recommended by, I actually saw a specialist the spring before I got pregnant who sat down and looked at my kind of health record from when I had HELLP. That aspirin I took up until the middle of my third trimester. I had more blood work done and I had more ultrasounds done, which I was completely fine with because what I talked with my provider about was the fact that, if I was going to start to show symptoms of preeclampsia or HELLP syndrome again by having blood work, I think it was every other week. And then every week at the end of my second trimester that we would be able to catch it sooner and they would be able to treat it so that even if it started to come on, it would be hopefully less severe and less of an emergency.
Dr. Rebecca Dekker – 00:21:46:
Was there any discussion about nutrition or anything else related to just like your overall health?
Jolene Brink – 00:21:53:
I wish there would have been. That was definitely missing in the hospital setting. And that is definitely something that I felt like I got a lot out of the birth center experience. But with my second pregnancy, I felt like I kind of had some tools already. I do, though, wish that there would have been. So, in the hospital setting, we did talk about the practicalities and the blood work. But I do think that there is another area of Preeclampsia education where maybe nutrition and other pieces can come into play. But that wasn’t part of my experience.
Dr. Rebecca Dekker – 00:22:32:
I did want to point out when you’re talking about recurrence, I just pulled up the most recent statistics and I found that the risk of recurrent HELPP is about 4% if you had normal blood pressures before help syndrome started. But that’s only from a study of about 139 patients. In another study where they were combining multiple studies, they had a total of 512 patients who became pregnant again who had previously had HELLP. And they found a rate of 7% developed HELLP, 18% developed preeclampsia, and 18% developed gestational hypertension. So there is a higher risk than the general population, but most people won’t get HELLP syndrome again, but a percentage will. And then you mentioned the baby aspirin, and I think that’s important for people to know that low-dose aspirin is evidence-based to lower the chances of having preeclampsia when you are at moderate to high risk of having preeclampsia. So that was definitely an evidence-based treatment you got. So moving on to your second birth story, tell us how it began. Take us to the beginning of your birth story.
Jolene Brink – 00:23:45:
Yeah. We, it was just really kind of beautiful. So, I mentioned that I was getting blood work. And my blood work kept coming back with no issues. And so week after week, we would pass these milestones of getting to that 32-week mark, which was a really big deal for me to at least know I could get that far. And then every week after that was just this moment of realizing that we could do what we what I could do what else we could do. So the pregnancy went really really smoothly. And the week before little Guthrie was born, I did what I called my self-induction week. So we were at that kind of sweet spot where my OB wasn’t worried about me going over at this point, I wasn’t getting any pressure for induction, but I also was at a point where it was okay for Gus to come. And so one day I had a manicure. One day I got a massage. I ate a lot of dates. And I had acupuncture on a different day. So each day I treated myself to something. Because it was, it was a journey to get there. And that Friday, I woke up and my water broke. And so I started the process, the birth process with my water breaking. It was this beautiful July morning in Northern Minnesota. Everything was kind of blooming. So I opened up all the windows and I made some muffins. And then my son woke up and my husband woke up and I mentioned that my water broke. And we sent my little son off to preschool and played a board game and just took things really slow because I knew the minute that I went into the hospital, that was going to be, we were going to be there. John immediately got on the phone and, you know, the hospital, they wanted me to come in because with water breaking, they felt like that clock had kind of started ticking in terms of risk of infection. But I just wanted the opportunity to lay back home for a little bit. So we played a board game, did some things, ate some lunch, and then we drove to the hospital. It’s about a 30-minute drive. And I just remember there was this like really tall grass and it was like waving and there was like this bluebird sky. It was just like the perfect day. And I felt so happy, which was such a reverse, right? From the emergency of the first baby in the middle of a pandemic. And so we got to the hospital and I had light contractions that whole afternoon and throughout the night. And I was progressing pretty slow. And so by the next morning, I was tired, but just wanted to, I wanted a natural birth. I didn’t want anything except the nitrous oxide, right? The laughing gas. I didn’t want an epidural. I just wanted comfort measures. I just wanted to see if I could do it. And by noon that day, I was feeling tired and the doctors are starting to feel anxious about the fact that my water had been broken for over a day. And so I was starting to get some pressure to move it forward with some more measures.
Dr. Rebecca Dekker – 00:26:54:
Were you having contractions or no contractions?
Jolene Brink – 00:26:57:
I’m having contractions, I think I was dilated to like a two or a three. So enough, but not enough to feel like it was going to happen immediately. And so my doula was there. So her name is Katie Green. And there was a whole point where there were like all these doctors staring at me. And I was feeling this pressure to like, we need to do this. We need to do this. And we know you want a VBAC, but you need to do this to ensure the VBAC. And I was just feeling like there are way too many people in this room. We need to slow things down. And so Katie kind of like shooed everybody out. We took a minute. I cried because I was worried that we had gotten to this point and there was going to be an emergency again. And we decided to let them do the Foley balloon, I believe is what it’s called, and do a small drip of Pitocin at the lowest, lowest level just to kind of move things forward. And so we did that. I took a nap. And when I woke up, my contractions had, I had, I was dilated to a six or seven. Things were really moving. I was able to get into the tub. And they were watching. I had..
Dr. Rebecca Dekker – 00:28:03:
Did they turn the Pitocin off at that point, then, so you could get into the tub or did you get in with the Pitocin running?
Jolene Brink – 00:28:10:
I think I was in with the Pitocin running. I think it stayed with me. But with all the monitoring, baby’s heartbeat was fine. My heartbeat was fine. My blood pressure never spiked. Everything was like vitals were good. And so I labored in the tub for a little while. And then around 10 o’clock that night, I was ready to start pushing. And Guthrie was born at 1 o’clock on Sunday morning.
Dr. Rebecca Dekker – 00:28:36:
And how was the pushing process? Did you get out of the tub and push in the bed or what were you doing?
Jolene Brink – 00:28:42:
Yeah, I ended up getting out of the tub. I was on the bed. I was pushing kind of like on my hands and knees. And then eventually I was on my side with like one leg up and an arm over here. All over the place. And there was a nurse that was in my ear and she had given birth without medication to three or four kids. And so she had been there. And so she understood what I was trying to do. And the whole nursing staff knew my backstory with Leo and knew that I wanted a VBAC and that felt supportive. But this in particular nurse, she was helping me breathe and she was helping me do like the guttural sounds. And that really, really helped to have someone be in my ear to kind of keep me in that mindset. And I just remember she, I remember her in my ear. And then there was… And then he, and then he was, I mean, the pushing took forever. And he also, maybe, you know what this is called. We found out later that his hand was up by his cheek. And so I was pushing out both a head and a hand. And so I had some pretty serious back pain for most of labor. But then he was here and I had my, I, it was, I had my VBAC and when he was in my arms, I couldn’t believe that we had done it, that it had happened. And it was, I was just, I was just so grateful.
Dr. Rebecca Dekker – 00:30:07:
Were you like crying, laughing, smiling? What was your reaction when your baby was on your chest and you had physically experienced this, like every sensation and you were fully awake?
Jolene Brink – 00:30:20:
Extreme relief, extreme awe, just this incredible sense of being on the other side of so many things. And also you asked how I process, you know, the birth of my first son with this birth of a second son, I was so focused on this healthy pregnancy and this feedback that once he was in my arms, I kind of didn’t know what to do, right? And then he was healthy and he was with me. He wasn’t taken to the NICU. There was no, and so it took more of an adjustment than I thought there would need to be to realize like, oh, you don’t need to like test his oxygen level all the time. Oh, you don’t need to like poke him and prod him. It was really strange and felt, yeah, it just felt a little.
Dr. Rebecca Dekker – 00:31:09:
Like the normal almost felt off or weird because you never had that.
Jolene Brink – 00:31:14:
Yeah. Yeah, it’s what I wanted. But then once I had it, it… Yeah, it just felt very, very quiet, but also like, I was… He was just there. We were able to be together.
Dr. Rebecca Dekker – 00:31:31:
One question a lot of people have when they’re planning a VBAC has to do with monitoring, with the fetal monitoring. So what did you plan? How did you work with that during your birth?
Jolene Brink – 00:31:42:
I asked multiple times to not have fetal monitoring. And I think I remember from your class, there was a conversation that we had about occasional monitoring or every hour or trying to limit it. The hospital that I was at, because of my VBAC, they made me have the fetal monitors on me at all times. And I was told that it would be against me with a wrap and that it would be fine. Well, they were like all over the place. Someone needs to invent a better system because it was really uncomfortable to be laboring and then to constantly have a nurse coming and checking and moving those.
Dr. Rebecca Dekker – 00:32:24:
Okay, so you kind of had the belts with the discs on you. Yes. What about when you got in the tub?
Jolene Brink – 00:32:31:
They took them. No, I think I was able to be in the tub with those on.
Dr. Rebecca Dekker – 00:32:39:
Okay, so they were waterproof.
Jolene Brink – 00:32:40:
Yep. But there was one point where I was clearly laboring and clearly having contractions, but one of the monitors slipped a little bit in my belt. And a nurse that was on shift came in and she’s like, oh, we didn’t catch those contractions, so they don’t count. Which I don’t recommend telling a pregnant lady who’s getting ready to deliver that those. I was like, no those count, those count.
Dr. Rebecca Dekker – 00:33:01:
They were doing something.
Jolene Brink – 00:33:04:
Yeah. So it just felt like it caused a lot of extra negotiation with the nursing staff when I really just wanted my space. But that was kind of my compromise of I’m having this VBAC. Clearly, there’s a, there’s a higher risk of it not being successful. And so I kind of was picking and choosing the things that I was willing to go with.
Dr. Rebecca Dekker – 00:33:29:
And if our listeners want to learn more, you can go to EBB 113, the evidence on VBAC. And we talk about, you know, the main risk that care providers are worried about is the risk of uterine rupture. And we talk about the prevalence of that and the risk factors for that. And then I guess one of the signs can be changes in the fetal heart tone. So that’s one reason there is this emphasis on fetal monitoring with VBAC, which can be difficult if you’re planning an unmedicated birth because you feel a little bit limited in movement and that additional sensation of having the monitors strapped to you can be uncomfortable. But it’s like you said, it’s a compromise you make if you’re having a hospital birth with a VBAC sometimes. And some hospitals offer smaller, we have wireless monitors now, ones that stick to you. And they, you know, might not be more accurate, but you might have a little bit more mobility. Although sometimes when you move around, then it messes with the monitoring strip and the nurses might be like, we need you to stop moving, which is hard to do if you’re having an unmedicated birth. So it’s it can be tricky to navigate that whole conversation, especially knowing that you have the right to informed consent and refusal. But we also have care providers who get really anxious about risks. So it’s like managing all of those feelings in the room can be tricky.
Jolene Brink – 00:34:52:
Yeah.
Dr. Rebecca Dekker – 00:34:53:
So what was your postpartum experience like with this birth compared to the other one?
Jolene Brink – 00:34:59:
It was really strange to have a baby that I could bring out into the world right away. So this was 2022, COVID restrictions were at a very, very different place. And so, you know, my birth story with my first son is so intertwined with March of 2020 and all of the anxiety around that. And that we had him and then we were in the NICU and then we had isolation for a really, really long time. And so I’ve had babies in very, very different worlds and very different kind of life settings. And so similar to… I had my second baby. I had Guthrie. And I just got to hold him and feed him and do all the things that I had wanted to. And then. People could come visit us and we could come visit them. And I took him to the grocery store when he was, I don’t know, two or three months old. And it felt crazy. And so my postpartum experience with that was kind of just experiencing what is normal or what should have been. It wasn’t what I had with my first. And I just really savored it and embraced it and also learned what it was like to have two babies and to be chasing around a toddler with another little one. It’s full of joy and full of exhaustion, but it’s good. It’s just been a really beautiful journey.
Dr. Rebecca Dekker – 00:36:21:
Yeah. Well, thank you, Jolene, so much for coming on to, you know, share your story and help raise awareness for HELLP syndrome. I think one thing I forgot to point out earlier that I think is really important to know is like the importance of early identification. And that’s one reason I’m so thankful to you and the other survivors who share your stories with examples of what it feels like because the symptoms can be kind of vague and you might dismiss them. But early diagnosis is key because the fatality rate can be up to 25% and you’re way more likely to survive if you identify it early. So making sure that people are listening to you when you’re telling them. And so we’re thankful to your midwife in Montana for listening to you and taking it seriously and sending you to get help right away. So shout out to your midwife and to all the medical professionals who’ve helped you and your doulas and your childbirth educators. Do you have any final words of wisdom for our listeners, Jolene?
Jolene Brink – 00:37:22:
I would just follow up with what you just said, which is that I know that I dismissed my symptoms, because I assumed that that pain was part of the process. And I also… There’s a way in which I wanted to be a model patient. And in March of 2020, when things were crazy. I remember not wanting to bother my midwife. I remember thinking, wow, she’s probably really busy with people who are giving birth now and figuring out what to do. I’m just going to hold off until my regular appointment. Like, it’ll be fine. And then I think as women, we’re often taught to kind of dismiss our gut instinct in terms of our health, because I had just been taught, like, just tough it out. You’ll be okay. It’s probably not that bad. And it was a lesson that I really learned that the need to ask for help and the need to advocate for myself, which is again, why I felt like your classes were just so essential because I, even after going through that experience with my first son, when I started the process of birth with my pregnancy process with my second son, I caught myself in the hospital still wanting to be that model patient and still wanting to just make it easy for everybody. And it’s like, no, I need to kind of find my space. So if there’s anything I could leave for your listeners, it’s to not dismiss when you need to maybe ask a question. And then the last thing is that someone shared the mantra with me, don’t be scared to break yourself open. And that is one thing that I’ve just kind of carried with me. And I think it helped me in my pregnancy journey. So maybe it’ll help other people’s and theirs.
Dr. Rebecca Dekker – 00:39:11:
Thank you, Jolene, for that advice. So important to trust yourself when something doesn’t feel right, listen to your body and your intuition. So thank you again, Jolene, for sharing your story with us. We appreciate you.
Jolene Brink – 00:39:23:
Thank you so much.
Dr. Rebecca Dekker – 00:39:25:
This podcast episode was brought to you by the Evidence Based Birth® Childbirth Class. This is Rebecca speaking. When I walked into the hospital to have my first baby, I had no idea what I was getting myself into. Since then, I’ve met countless parents who felt that they too were unprepared for the birth process and navigating the healthcare system. The next time I had a baby, I learned that in order to have the most empowering birth possible, I needed to learn the evidence on childbirth practices. We are now offering the evidence based birth childbirth class totally online. In your class, you will work with an instructor who will skillfully mentor you and your partner in evidence-based care, comfort measures, and advocacy so that you can both embrace your birth and parenting experiences with courage and confidence. Get empowered with an interactive online childbirth class you and your partner will love. Visit evidencebasedbirth.com/childbirthclass to find your class now.
