Amanda Percival Bio
Amanda is 37 years old and is a nurse who lives in Portland, OR with her husband Ben and their three children Oliver, who will be 5 in October, Declan, who is 2.5, and MacKenna who is 7 months old. Connect with her on Instagram @mandanp1212 or via Facebook: Amanda Percival.
Resources
Nurture by Naps
This episode is sponsored by NAPS, which stands for Newborn and Parenting Support. Founded by two labor and delivery nurses, NAPS offers evidence based support from actual nurses. It’s like having an expert best friend who’s seen it all and has the answers to all your questions (yes, even the 3 a.m. ones). NAPS’ lactation consultants are experienced nurses ready to help you figure out feeding, whether you’re breastfeeding, pumping, combo feeding, or just needing some general guidance. From pregnancy prep to navigating life with a newborn and even through the toddler years, NAPS offers personalized support, workshops, and community to help you handle every “wait, is this normal?” moment with confidence. Head to nurturebynaps.com to learn more and start getting the guidance you deserve, exactly when you need it.
Listen to the episode (episode 946) for all of Amanda’s stories and Amanda shares more details about her pregnancies, births, and postpartum experiences below.
1st Pregnancy
They got pregnant for the first time in November of 2018. They found out about 5.5 weeks and were very excited but unfortunately she had her first miscarriage about 2 weeks later. They were pretty devastated. They were told that they could start trying again as soon as they felt ready and so they did and ended up getting pregnant with Oliver the very next cycle. She had a ton of anxiety all throughout her pregnancy and was just so worried that she was going to lose him. It did get better once she hit the 2nd trimester but never really went away. Had a lot of nausea up until about 22 weeks and then had a few really good weeks in there. Then at 25 weeks she was diagnosed with GD. Was able to manage with diet alone. Was militant about it because she was going for a natural unmedicated birth so she didn’t want to potentially create and further complications. Had first cervical check at around 36 weeks and she was closed, high and posterior. That’s when her doctor broached the subject of induction. Even with controlled GD you can have accelerated placental degeneration after 40 weeks and an increased risk of preE. Didn’t want to the induced. Doctor was super supportive so they worked together to make the best plan for her and the baby to be safe while also taking into account how she wanted her labor and birth to go. They decided to wait to induce until 40 +6. Started trying to do everything she could to encourage labor. Walked a ton. Did curb walking. Spicy foods. Miles circuit. Bouncing on a birth ball you know all the stuff. Had her next cervical check at 39ish weeks she was 1cm dilated and 80% effaced. Baby was super low. She said she could feel his head when she checked her. Continued to try to walk that baby out of her. At her 40week appointment she was 2 cm and 80% effaced and baby was a station 0. She had her doctor do a sweep and stretch and she was able to get her to a loose 2 almost 2.5 cm. Lost her entire mucus plug that day. Had random contractions so a few days later she messaged and asked for another sweep. So she had another sweep at 40+3 and her doctor said she was almost 3cm dilated. By this point she was really ready and really getting very nervous because she only had three days left before her scheduled induction. The next morning she had a big gush of fluid that she thought was her water breaking so she went to the hospital and they checked and said NOPE! You probably just peed yourself and then sent her on her merry little way. Came to terms that evening with the fact that she was likely going to need to be induced. Tried to take it easy. Day before her induction her husband and she went out and had a nice dinner and then went home and watched all the episodes of shows where people have a babies like FRIENDS and The Office. it was really nice and then they went to bed early.
1st Labor & Birth
At about 2am on the day of her scheduled induction she woke up with contractions. Every 7-8 minutes. Continued to get more intense as she laid there. Tried to sleep in between but couldn’t. Had a really big contraction at about 430 and she felt another gush of fluid. Checked and it was bloody show. Woke up husband. Contractions were lasting about 45secs-1minute. Told to call hospital at 6 because they were due to be there at 8 to be sure there were no delays in induction. They called and thought that they would probably just cancel because she was in labor. Told her to come in anyway because she was probably just in early labor and it could still be days. So they went in thinking they’d check and say she was in labor and they didn’t need to do anything but when they got there they checked her and told her that only 1.5 cm dilated. During that time her contractions had also slowed down and by the time got to the hospital they had almost entirely stopped. She was having 1 every 20 minutes or so. Decided to proceed with induction beginning with a cooks balloon that could stay in for up to12 hours and help her dilate to a 5. They put it in at 9:30 and she Labored all day contractions picked back up once the balloon was in. Checked her again 12 hours later and the balloon had come dislodged from her cervix but hadn’t fallen out. It was just kind a stuck in her vagina but it had dilated her to 5.5cm at 9:30 pm. Got into tub at about 11. Contractions were regular and she was coping well. she was in the tub for about an hour, when she started to get too hot. Got up to cool off and when she stood up her water broke at 1:10am. Tried to stay in tub a little longer but she was hot and uncomfortable and felt like she need to move around so she got out. Contractions escalated exponentially after her water broke and she was really really hurting. Checked her when they got back to room to test and see if her water was actually broken and checked her cervix at the same time. Tested and it was my water and she was 6cm dilated. Then she labored a while longer and was really having trouble coping with the contractions at about 3 am she started asking for an epidural. Tried nitrous and fentanyl first. Neither worked and she asked to be checked again to decide if she wanted the epidural or not and they did and she was 6.5 cm. Got epidural at 4:30 and had immediate relief. Tried to sleep but couldn’t. Checked her at 7am at shift change and she was still at 6.5 cm. They started Pitocin. Then at about 10am she felt a lot of pressure. They came in and checked her and she was fully dilated. She started pushing at 10:30 and pushed for an hour and a half and Oliver was born at 12:16 and he was 7lbs 9oz and she remember the midwife said Amanda reached down and grab your baby and she did and brought him up to her chest and he did the breast crawl and he was absolutely amazing and had the longest eyelashes ever.
2nd pregnancy
They decided to start trying for their second baby when Oliver was a year old. Got pregnant on the very first try. Shortly after she found out she was pregnant she had her second miscarriage. Technically a chemical pregnancy. Started trying again the next cycle and again got pregnant a couple of cycles later. Had their first US at 7.5 weeks and the baby had a heartbeat but it was really low and she was measuring small so they weren’t super hopeful. Then two weeks later they had another US and their sweet baby no longer had a heartbeat. So at 9.5 weeks she was diagnosed with a missed miscarriage. She had a D&C the next day, on December 23rd. Devastating. After that it took them a really long time to get pregnant again. It was about 7 months before they finally got pregnant with Declan. Had a small subchorionic hemorrhage again and was put on pelvic rest until it resolved at 14 weeks. Had nausea but not as bad this time. At 30 week ultrasound she was diagnosed with a complete posterior placenta previa. Did not have GD. They told her that most previas move out of the way on their own and only rarely do they cause issues. They said that she would mot likely be able to have the natural vaginal birth that she was eager to try again for. Stopped working at 28 weeks because she felt off. Headed to OB appt at 30+5 and felt a big gush and she checked and sure enough she was bleeding pretty heavily. she had been warned that placenta previas can bleed as they move and the uterus grows and typically resolves on its own with any issues but that she should be seen monitored in L&d if and when it happens. she was shocked seeing that amount of blood. she panicked and couldn’t think so she parked at her OB office and called her mom. she could feel that she was still bleeding very heavily and she told her to call her OB and turn around and go to the hospital. So she did. Then on her way she called her husband and told him to meet her at the hospital. Parked in main garage and walk to er. Lots of blood. Angel nurse helped her and got her up to l&d . Husband got to hospital while she was getting checked in. Got her to triage. They pulled off her pants and they saw how much blood and the room filled up with people and things were very serious and scary. Two nurses immediately began putting IVS in her arms and other were fetching a Doppler and saying she was hemorrhaging. They started prepping her for an emergency C-section. They were getting the NICU team ready. They gave her steroids to help mature Declan’s lungs. It was chaotic and terrifying. This whole time they were trying to find Declan’s heartbeat with the Doppler and they can’t find it. They went to grab an ultrasound and in those moments even though she could swear she felt him moving she thought she’d lost her baby and she was so panicked. Finally they find his heartbeat with the US and the whole room breathed a collective sigh of relief. Everything settled down a little bit after that. They admitted her and told her that she would have to be bleed free for 48 hours before she could go home. This was right before Christmas. she spent 10 days on and off in the hospital after that initial bleed. They released her on Christmas Eve and she was readmitted on December 26th when she started bleeding again. she was released on December 27th because the bleed was much smaller than the first. she was then readmitted that same evening when she passed two golf ball sized clots and had another very large bleed. This time she was told she’d have to remain in the hospital until the baby was born which didn’t end up being that long because the day after she was admitted Declan’s heart rate started to trend upward and he seemed to be in distress and she her labs were also beginning to look a less stable and she began going into preterm labor.
2nd Birth
So at 32+1 her team of doctors recommended an emergency C-section before it got worse. So she was prepped and her husband was in the room with her and Declan came into the world at 2:22 pm and he was 4lbs 5.7oz. they were able to do 60 seconds of delayed cord clamping. Baby in a bag. Saw him through the clear partition. Then he was taken o the NICU and her husband went with him. she was left to be closed up on her own. Which she knew had to happen but it was all incredibly traumatic. They spent 5 weeks in he NICU after that.
3rd Pregnancy
We started trying for MacKenna when Declan was 14 months old. they got pregnant again on the very first cycle but just a week later she had her 4th miscarriage. Tried again and got pregnant with MacKenna the very next cycle. she had a small subchorionic hemorrhage again but it resolved itself super quick this time. It was gone by the very next ultrasound which was jut a couple of weeks later. she had so many ultrasounds and was being monitored very closely because of her history and her age. she saw a perinatologist. she didn’t have GD or placenta previa but she didn’t get off Scott free because this time she developed HG. Sick until 26 weeks. Had a few good weeks and nausea came back. Started talking about induction at her last perinatologist appointment. Due to the increased risk of stillbirth associated with advanced maternal age and going post dates. she posed the question to the group, did her own research and listened to the advice of the doctor and her perinatologist, and in the end decided to induce at 40+1. 38 weeks was first cervical check. she was Closed high and posterior and firm but she was 25% effaced. Continued to do all the labor things. Started EPO. 39 week appointment 1cm dilated 60% effaced. they did a cervical sweep at that appointment. she had been having prodromal labor every single night since 37 weeks and she was just absolutely done. 40 week appointment still 1cm and 70% effaced and they did another sweep and she was more midline and her doctor said she was able to get her to 1.5cm. her induction was scheduled to the evening the next day.
Labor & Birth
So they went in the next evening at 8pm to be induced. Got checked in and checked her and she was 1-2cm dilated. Inserted a cooks balloon at about 10:30pm. This time thy told her it could be in for 24 hours and this time they only inflated the uterine balloon. It was very painful this time. Immediately started having very painful contractions every 5-6 minutes. Constant cramping all night long. Midwife checked at 7:30 and said that the balloon had dislodged and was stuck in her vagina again. She yanked that thing out of her like she was playing tug of war and it came out with this sickening pop and a stream of blood and it hurt like nothing I’ve ever experienced before. She didn’t check her after she removed it but she said that because it came out it meant that she was 4-5cm dilated. Contractions slowed down and an hour later they started Pitocin. she had contractions on and off all day and they were upping the Pitocin every 30 minutes. Throughout the day MacKenna start3d having variable decels and they told her that it was likely that her cord was getting compressed somewhere. It improved with position changes. She had one really big scary decel where like 20 people ran into the room but she popped back up and everything was fine. Very scary. Around 5 pm contractions started to come very regularly 2-3 minutes apart and the were painful but manageable and she felt like she was hitting a stride after about 20 hours. So at about 6 pm the midwife came in to check her and after she did she told her that she was confused and asked if she could repeat the check. she said yes and she checked her again and said that she was still only 1-2 cm dilated. She said that she thought the previous midwife hadn’t placed the balloon correctly so it hadn’t dilated her at all. she was crushed and she started bawling because she was exhausted and in pain and thought that she had been making progress. she lost it for a few minutes. They gave her the option to replace the balloon continue with pitocin or to do both. she had to take a minute to collect myself and figure out what the next step should be. she called her sister who is an l&d nurse and talked it out with her. she had a nice cry all this time she’s still having contractions every few minutes. she was so upset because she really wanted that epidural free birth and she was seeing all these interventions just piling up on her and the she knew that at this point she needed that epidural because there was no way she could handle having that balloon placed again without it. In the end she opted to replace the balloon and run Pitocin concurrently but that she would first get an epidural. So she got an epidural about an hour and a half later and the midwife came in to replace the balloon. When she did she checked her and she was 3.5cm dilated and super soft. At about 10:20 she felt a lot of pressure and thought that maybe the balloon had dislodged so they called the nurse and sure enough it had and it just slid right out. She checked her and she was nearly 6cm dilated at this point. The next step was to break her water, which she did. MacKenna continued to have variable decelerations so they asked if they could place an internal monitor next to her head inside the amnion to measure the true strength of her contractions and maximize the use of Pitocin. So they did that and then she started to have minimal variability in her heart rate. They said that this was likely due to cord compression so they decided Tom do an amino infusion or administer fluids via the internal monitor which was like a catheter to give her cord a little more room to breathe. Heart rate got better. After the amino infusion she started to have this very big sense of anxiety and foreboding and an intense sense of urgency. It caused her to have a panic attack. she just felt like she needed to get her out soon. At about 3am she felt a ton of pressure and she told her husband. she said she’s complete it’s time to push go get the nurse. So the midwife came in and checked her and sure enough she was complete and ready to push. she started pushing at 3:05am and she was so motivated to get her out that she only had to push 6 times. 3 contractions later at 3:18am she was born. She had a nuchal cord, that was wrapped around her neck and torso twice and she also had a true knot in her cord. Both of these were the culprits of her decels and minimal variability. When she saw that she was like “I knew it.” She was 6lbs 12oz of pure perfection.
Postpartum 1
Immediate postpartum she had a second degree peri lac and a few minutes after Oliver was born she spiked 102 degree fever and ended up with an infection called chorioamnionitis. Gave her Tylenol and she threw it up and so they gave it to her rectally. Then she felt terrible and she was falling asleep as they were talking to her Oliver started nursing. They did slap a nipple shield on her before Oliver even tried to latch. The nurse took one look at her nipples and said “your gonna need a nipple shield”. In retrospect she should not have let them do that but she was so out of it with a high fever. Due to the infection she developed uterine atony and her uterus was having trouble contracting all the way so she continued to bleed heavily and ended up with a postpartum hemorrhage. she didn’t need a blood transfusion but she did have to have an iron infusion. Lots of stitches. Oliver had issues with low blood sugar. So they told her that she needed to supplement and told her that she needed to start pumping to get her milk to come in. So she started pumping and triple feeding. Discharged a couple of days later. they triple fed for 4 weeks because Oliver was “not gaining enough weight” . At 4.5 weeks PP she developed antibiotic resistant mastitis and was readmitted to the postpartum unit for 5 days. At this point she was suffering from pretty severe postpartum anxiety and depression. When she got out of the hospital, she chose to exclusively pump because of the state of her mental health and she went and saw her doctor and was put on medication to help with her anxiety and depression and a couple of weeks later she felt tremendously better. she EP’d for 12 months.
Postpartum 2
Immediate postpartum with Declan was much different. He was taken to the NICU and she was closed up and taken to recovery. she had her phone with her and she was checking in with her husband about how Declan was doing and he was sending her pictures and videos. The nurse in recovery offered her pain medication but her spinal block hadn’t worn off yet so she didn’t feel like she needed it so she refused like a big dummy. 15 minutes later she was writhing in pain and it took 4 different pain meds to get it under control and she was high as a kite. Everything after that point is very blurry and she don’t remember a lot of those first 12 hours. she do remember that she was absolutely adamant that she needed a pump and she repeatedly asked for it. Even after they brought it to her she was so out of it that she asked for it again but even in that state she knew she needed to pump and did so every 2 hours and it’s really the only thing she remember. she don’t even remember going to the NICU to see Declan for the first time, which is heartbreaking. she do remember getting up for the first time and it was excruciating. Everything hurt. There was just so much pain. Emotionally, and physically. she didn’t get the time to rest and recover either she was in the hospital and then she was discharged a few days later and she went straight to the NICU and she was there every day and she slept there every night and they did that for 5 weeks. Very intense recovery period much harder than with Oliver. Declan had an NG tube so she was initially exclusively pumping until he was able to latch which wasn’t until he was off of respiratory support which was about a week or so into his NICU stay. After that they latched to a dry breast so that she wouldn’t drown him in her milk. they continued doing that until he got a little bigger and better at latching and they latched him to a full breast and then started doing koala blocking where he wouldn’t get any tube feedings and only nurse on demand for 6 hours. Eventually with a lot of support they were able to transition to exclusive breastfeeding which they did for 19 months. she did experience delayed breakthrough depression and anxiety when they got home. When they were in the NICU she was hyper focused on getting her baby through the hardest time in his life so she neglected myself to do that and it all came crashing down on her when they got home. she ended up upping her dose of medication and that helped significantly.
Postpartum 3
Immediate postpartum with MacKenna she had a 1st degree peri lac and lower uterine atony which caused a very small hemorrhage, a small piece of retained placenta that had to be removed manually and terrible postpartum shakes but other r than that this was the easiest recovery of all. She latched and started nursing beautifully. her nipples were a little torn up at first but healed up about a week later. This was the first time she didn’t pump at all and not having to worry about that was amazing. they went home the very next day and it’s been great since then. We’re going on 8 months of exclusive breastfeeding and it’s going great. her mental health is so much better this time around. She’s growing fantastically and crawling all over the place now and started pulling up to stand a few days ago.
