Speaker 1: You're listening to Amma Mia podcast.
Speaker 2: Mamma Mia acknowledges the traditional owners of land and waters
Speaker 2: that this podcast is recorded on. We pay our respects
Speaker 2: to elders, past, present and emerging, and feel privileged to
Speaker 2: continue the sharing of birth stories and knowledge that has
Speaker 2: been a fundamental part of Indigenous culture.
Speaker 1: Hi.
Speaker 2: I am Cassania Lukic and this is diary of a birth.
Speaker 2: Part of the reason I love doing this podcast is
Speaker 2: creating awareness for some of the lesser known complications of
Speaker 2: pregnancy and birth, not to scare our listeners, but to
Speaker 2: help inform and educate. After finding out she had a
Speaker 2: low egg count, Today's mum went down the IVF route,
Speaker 2: but it wasn't until after her baby was born that
Speaker 2: things really became more complicated.
Speaker 1: I ended up losing quite a lot of blood. My
Speaker 1: placenta had come out, but she said, I think there's
Speaker 1: some placenta still inside you, so I have to actually
Speaker 1: manually go in and scoop it out.
Speaker 2: After getting home and struggling to breastfeed, our mum knew
Speaker 2: something was up and she fought to get answers. So
Speaker 2: let's meet today's mum.
Speaker 1: Hi, I'm Anna Bamford. And this is the diary of
Speaker 1: my birth with Camilla.
Speaker 2: So Anna, We've kind of known each other for a
Speaker 2: few years. We used to work together back of the day,
Speaker 2: kind of cross paths multiple times, and I was so
Speaker 2: happy when you reached out to tell your story, because
Speaker 2: while it is a really difficult story, I think it's
Speaker 2: a really important one fast to share. So what I
Speaker 2: wanted to start with is kind of the challenges around
Speaker 2: falling pregnant for you for the first time.
Speaker 1: Yeah, I first fell pregnant at the end of twenty
Speaker 1: twenty two and it was a surprise and I couldn't
Speaker 1: get in to see a doctor until I was nine
Speaker 1: weeks pregnant, and that pregnancy ended up in a missed miscarriage.
Speaker 1: So I ended up having a DNC.
Speaker 2: So being based in the US in terms of finding
Speaker 2: fertility support and an IBF specialist, how does it work there?
Speaker 1: LA is really one of the most you know, people
Speaker 1: come to LA to do IVF. There are a lot
Speaker 1: of clinics here. I was lucky in that I was
Speaker 1: I'm very close friends with a girl who really struggled
Speaker 1: to get pregnant and she had a few different clinics
Speaker 1: that she had sort of interviewed or spoken with. So
Speaker 1: she shared those names with me and I, yeah, just
Speaker 1: started calling and asking what the process was. In that time,
Speaker 1: I also had another miscarriage, so that's sort of further
Speaker 1: you know, cemented for Tyson, my husband and I that
Speaker 1: we we really needed to do this.
Speaker 2: Yeah. So two chemical pregnancies within the space of what
Speaker 2: six months?
Speaker 1: Yeah, so two.
Speaker 2: Chemical pregnancies in the space of six months. Low amh.
Speaker 2: High stress job. That's a lot of pressure on you
Speaker 2: and Tyson. So you find your doctor, you start going
Speaker 2: through the IVF process. How did you go with your
Speaker 2: sort of first round of retrievals.
Speaker 1: Yeah, so that surprisingly went really well, and you know
Speaker 1: the egg process of you have so many eggs and
Speaker 1: then you have so many embryos and it gets smaller
Speaker 1: and smaller, and we chose to also do the genetic
Speaker 1: testing with that, so we ended up, you know, with
Speaker 1: a certain number of embryos and decided to transfer pretty
Speaker 1: well straight away and were very lucky in that it
Speaker 1: was successful.
Speaker 2: How did you feel throughout your pregnancy overall?
Speaker 1: I felt amazing and so lucky, you know. I think
Speaker 1: we had had a year of really high stress, and
Speaker 1: I think also just being surrounded by a lot of
Speaker 1: friends that were, you know, doing the same thing or
Speaker 1: getting pregnant and sharing such amazing news. That was really tough.
Speaker 1: And there's some self preservation that comes along with that
Speaker 1: because you want to obviously be happy for them, but
Speaker 1: it's really tough. But the pregnancy itself, I was sick.
Speaker 1: I had pretty bad morning sickness for like the first
Speaker 1: fourteen fifteen weeks and it wasn't really until maybe about
Speaker 1: twenty twenty three weeks where I thought, Okay, I can
Speaker 1: relax here and really enjoy it. But yeah, the pregnancy
Speaker 1: itself was pretty straightforward.
Speaker 2: So at thirty eight weeks, you get induced because your
Speaker 2: body sort of started to be getting ready. Is that correct.
Speaker 1: I decided to get induced purely because she said she's
Speaker 1: measuring big, and this is what I think is the
Speaker 1: best course for you. And so I was induced at
Speaker 1: thirty nine and one. But the week before, at thirty
Speaker 1: eight weeks, we were about to go out for dinner
Speaker 1: and I went to the bathroom and I started bleeding,
Speaker 1: and so we went to the hospital and they did
Speaker 1: an ultrasound and they said, oh, you're a centimeter and
Speaker 1: a half dilated. You know, the baby could come tonight
Speaker 1: or into three weeks, So go home or go out
Speaker 1: to dinner, keep doing what you're doing, and call us
Speaker 1: if there's any change. And then I think a few
Speaker 1: days later, my mucus plug fell out and I thought, okay,
Speaker 1: my body is like getting ready, and I spoke to
Speaker 1: the doctor and she yeah. It wasn't until then that
Speaker 1: we decided, Okay, we're going to induce in like three
Speaker 1: days from now. So it was a real last minute call.
Speaker 1: But she had said, your body's already getting ready, so
Speaker 1: you won't need the gel, which is the first step
Speaker 1: of induction here, so we just went straight to the
Speaker 1: Foley balloon.
Speaker 2: So they put the Foley balloon in, which it basically
Speaker 2: is to help open the cervix exactly.
Speaker 1: Yeah, and that was pretty manageable. It wasn't until they
Speaker 1: went to pull it out that the pain really really started.
Speaker 1: But I sort of wanted to feel that pain a
Speaker 1: little bit, so we went in at two am for
Speaker 1: my induction and I ended up getting an epi at
Speaker 1: about six centimeters dilated.
Speaker 2: Okay, so they gave you the balloon, you're doing your
Speaker 2: contractions and you're just in the hospital contracting.
Speaker 1: Yeah, naturally, Well, they gave me the balloon and potosin
Speaker 1: Okay to bring on the contractions, and they would come
Speaker 1: in every hour and turn up the potosin and she go,
Speaker 1: how are you going now? And I'm okay, I'm all right.
Speaker 1: She go, okay, all right, all right, And then I
Speaker 1: think it was about two pm when I got the epidural,
Speaker 1: but I remember her saying, do you still want to
Speaker 1: go to the bathroom? And I said, well, yeah, if
Speaker 1: I could. She said, all right, We're going to give
Speaker 1: you a walking EPI. It's sort of like a certain
Speaker 1: dosage so you can still be able to go to
Speaker 1: the bathroom. So I did that, and I remember when
Speaker 1: the anithetist came in and he was about to put
Speaker 1: the needle in my back and he said, oh, I
Speaker 1: don't know about this dosage. I don't know about the
Speaker 1: walking EPI. And the nurse was like, yeah, yeah, you know,
Speaker 1: it's like and they sort of went off to the
Speaker 1: corner and talked. And I have trust in medical professionals
Speaker 1: until they showed me otherwise. And that was a moment
Speaker 1: where I was like, oh my gosh, what is going on?
Speaker 1: And then the head an ethetist came in and she said, here,
Speaker 1: let me do it. And she talked to me and
Speaker 1: she was really calm. She was like, oh, you're having
Speaker 1: a baby, girl, that's so exciting. All right, the Eppie's
Speaker 1: done and walked out, and then I fell asleep and
Speaker 1: I went and I had a really nice nap for
Speaker 1: a couple of hours. And I woke up and you know,
Speaker 1: my husband's there in the room. I think we had
Speaker 1: watched like two movies or he had watched two movies,
Speaker 1: and I was sort of dozing on and off, and
Speaker 1: the midwife came in to check and she it was
Speaker 1: ten forty five and she checked. She went, well, you're
Speaker 1: nine centimeters dilated. You ready to push? And I was like, yeah,
Speaker 1: let's do this. So that is kind of how it went.
Speaker 2: And she came out perfect, perfect. You pushed fifty five
Speaker 2: minutes of pushing. Is he what I've got?
Speaker 1: Yeah? It was fifty five minutes of pushing. And the
Speaker 1: midwife called my obgyn and said she's ready to go,
Speaker 1: and my OBI said, well, why didn't you call me earlier?
Speaker 1: And she said, well, she just woke up and she's
Speaker 1: going to start pushing. And so my ob was at home,
Speaker 1: you know, and she had to drive in. Luckily it
Speaker 1: was like eleven at night. She got in for the
Speaker 1: last kind of half an hour of pushing, and yeah,
Speaker 1: she came out and was perfect. You imagine what it's
Speaker 1: going to be like. And for me, her coming out
Speaker 1: and being on my chest was really like as I'd
Speaker 1: imagined it.
Speaker 2: It like makes me tear up every time I talk
Speaker 2: about that moment with mums because for me, it's like
Speaker 2: such a visceral feeling that first time that they put
Speaker 2: on your chest. But the complications that you encountered were
Speaker 2: after Camilla came out. Can you tell us a little
Speaker 2: bit about what happened after Camilla was born?
Speaker 1: So she came out, was on my chest, and she
Speaker 1: she's always been a really strong baby. She lifted her
Speaker 1: neck or up and kind of we looked at each
Speaker 1: other and it was just like this amazing moment. My
Speaker 1: husband was there by my side, and we were just
Speaker 1: there in the moment. You know, it really feels like
Speaker 1: everything around you is muted out, you know, and you
Speaker 1: just kind of they're just that. It was like the
Speaker 1: three of us. And then I looked at my Obi
Speaker 1: and she had a look of concern on her face,
Speaker 1: and I said what's going on, Like, what's happening? And
Speaker 1: I had noticed at that point there was maybe six
Speaker 1: more people in the room than there was before she
Speaker 1: came out, and she said, oh, you're losing a lot
Speaker 1: of blood. I'm just trying to fix that right now.
Speaker 1: And I was like okay, okay, you know, and still
Speaker 1: sort of trying to just be in the moment, not
Speaker 1: really realizing what actually was happening. And I sort of
Speaker 1: looked at Tyson and he kind of kept looking down
Speaker 1: at her, and I saw his face starting to get
Speaker 1: more and more concerned as well. And then the nurse
Speaker 1: came up and said, oh, we're going to take your
Speaker 1: daughter and she's going to have skin on skin with
Speaker 1: your husband just over here, like I could see them.
Speaker 1: But we need to give you an injection to stop
Speaker 1: the bleeding, and some pills as well. And it all
Speaker 1: seems like such a blur, and I remember I took
Speaker 1: the the pills, but then I vomited them up straight
Speaker 1: away and it was all, yeah, it just felt like
Speaker 1: the room was spinning, and I ended up losing quite
Speaker 1: a lot of blood and she managed to stop the bleeding.
Speaker 1: My placenta had come out, but she said, I think
Speaker 1: there's some placenta still inside you, so I have to
Speaker 1: actually manually go in and scoop it out.
Speaker 2: So generally, I think what happens. That's why they check
Speaker 2: the placenta when you delivered the placenta. They need to
Speaker 2: make sure that they've got all of it out. But
Speaker 2: obviously yours had detached.
Speaker 1: Yeah, exactly, And so she said, I've got to go in,
Speaker 1: and obviously I had the EPI, so I couldn't really
Speaker 1: feel it, and she, yeah, put her hand in and
Speaker 1: scooped it out, I guess, And I remembered that her face.
Speaker 1: I could. I was just looking at her face and
Speaker 1: thinking something is not right. But I think in that
Speaker 1: whole time I was in shock. I remember feeling like
Speaker 1: nurses coming up to me and talking to me and
Speaker 1: literally seeing their mouths moving, but then hearing what they
Speaker 1: were saying like a couple of seconds later. Like it
Speaker 1: was a really surreal, scary feeling, but also wanting to
Speaker 1: just be with Cammi and my husband, and so then
Speaker 1: I stabilized and they moved me into postpartum at about
Speaker 1: three thirty am, and that was counted as night one,
Speaker 1: and we were in there for two nights. And I
Speaker 1: remember the next morning my obg Ayn came back, who
Speaker 1: delivered Camilla, and I said, I'm really scared. You didn't
Speaker 1: get all the placenta, and she said, I did. I did.
Speaker 1: I went in and I scooped it out and I
Speaker 1: got it and it's all good. But I could feel
Speaker 1: again and that something wasn't right. Camilla latched straight away,
Speaker 1: and I think this is where I get emotional, because
Speaker 1: I felt like I let her down, you know, in
Speaker 1: some way, like she was really like, they're on the boob,
Speaker 1: good to go, and I just could feel that I
Speaker 1: wasn't producing milk, and it was obviously very early, but
Speaker 1: I also wasn't even producing colostrum. You know. She was crying,
Speaker 1: crying and crying, and I was like, she's just hungry,
Speaker 1: Like she's really really hungry. I need a lactation specialist
Speaker 1: to come in here and help me. And the lactation
Speaker 1: specialists and the nurse are kind of coming up and
Speaker 1: like literally grabbing your boob and trying to get stuff out,
Speaker 1: and nothing was really coming out for me, and I
Speaker 1: just felt helpless because I knew I had lost a
Speaker 1: lot of blood, so I was really trying to hydrate
Speaker 1: and do all the things to get it going, but
Speaker 1: nothing was working. I mean I was getting the tiniest
Speaker 1: amount coming up. A week later, I went to the
Speaker 1: bathroom and this thing fell out of me and I
Speaker 1: was like, oh my gosh, this is some of my placenta.
Speaker 2: Did you get an iron infusion or a transfusion at all?
Speaker 1: No? I didn't.
Speaker 2: Do you know how much blood you lost?
Speaker 1: Yeah? I lost almost a later and a half.
Speaker 2: And they didn't give you an infusion or transfusion.
Speaker 1: Yeah, I know. And I remember them really clearly saying,
Speaker 1: we might move you to another room to give you
Speaker 1: a transfusion, but we're monitoring the situation. I remember going okay, okay,
Speaker 1: and yeah, they never did because from what I remember
Speaker 1: and what Tyson remembers is I stabilized and they moved
Speaker 1: me into the postpartum ward. A later and a half
Speaker 1: is quite I know, a lot significant. Yeah, And I
Speaker 1: remember when we came home. Through my health insurance, I
Speaker 1: had I think it was twelve visits with a lactation
Speaker 1: specialist and she came over and I told her what
Speaker 1: was happening. She said, you know, you could have almost died.
Speaker 1: Like that was really scary, and I think it was
Speaker 1: only then that I realized the seriousness of the situation.
Speaker 1: And when we got home, you know, we were totally
Speaker 1: in love with Camilla and new parents and it was
Speaker 1: all really exciting, but the feeding thing was really I
Speaker 1: knew something was up. So I called the lactation specialist
Speaker 1: and she came over and she's talked to me about
Speaker 1: triple feeding. So triple feeding is when they tell you
Speaker 1: to first pump for thirty minutes, then put the baby
Speaker 1: on your boob for thirty minutes, and then the third
Speaker 1: one is top up with.
Speaker 2: Formula, basically trying to get your supply going.
Speaker 1: Yeah, so I was I was doing all of that
Speaker 1: around the clock, like all the time, and my supply
Speaker 1: just was not increasing at all. And I said to
Speaker 1: my husband, like, I think this is something to do
Speaker 1: with my placenta. Like when the placenta comes out, that
Speaker 1: is what signals to the brain that it's time to
Speaker 1: start the milk. And he said, you know, I mean
Speaker 1: we both know now, but like he was like it's
Speaker 1: all right, Like the doctor checked, and the doctor did
Speaker 1: check anyway, So yeah, it was a whole really really
Speaker 1: hard situation to try and work out. And I think
Speaker 1: you know, before even having a baby, like, I hadn't
Speaker 1: thought about, oh what if my milk doesn't come in.
Speaker 1: I guess I was naive and I thought, Oh, it's
Speaker 1: just going to happen for me, you know. And so
Speaker 1: then a week later I went to the bathroom and
Speaker 1: this thing fell out of me and I was like, oh,
Speaker 1: my gosh, this is some of my placenta. And that
Speaker 1: was about ten thirty at night, and I was worried.
Speaker 1: I was like, am I going to start bleeding?
Speaker 2: How old was cammy at this time?
Speaker 1: One week? Exactly? A week?
Speaker 2: Okay, So a week after a piece of tissue falls out, Yeah,
Speaker 2: and you're like, this is my placenta. Your intuition is
Speaker 2: telling you, as it had since the hospital, that there
Speaker 2: was still placenta there.
Speaker 1: Yeah, And I kid you not. The next day my
Speaker 1: supply slightly increased, and I was like, oh my goodness,
Speaker 1: this is placenta. So I went back to the hospital
Speaker 1: the next day. My mom was here by that time,
Speaker 1: and I said, can you please do another ultrasound? Like
Speaker 1: I literally brought the piece of the thing that had
Speaker 1: fallen out of me in a glass jar to the
Speaker 1: hospital and I said, please, can you check this and
Speaker 1: they came back and they told me that it was
Speaker 1: a blood clot and it was no placental tissue whatsoever.
Speaker 1: And I was sort of none the wiser, you know.
Speaker 1: I thought, Okay, it's a blood clot. There you go.
Speaker 1: So then I went back home still continued the whole
Speaker 1: triple feeding thing. People listening are probably like, oh my gosh, girl,
Speaker 1: why didn't you just put the baby on formula? And
Speaker 1: in hindsight, I should have done it earlier, but I
Speaker 1: felt this annoying responsibility that I should try my hardest
Speaker 1: to breastfeed her. So I did that, and I think
Speaker 1: I would pump for like an hour and get like
Speaker 1: thirty mils of milk. It was really awful.
Speaker 2: I know exactly what you're talking about, that pressure that
Speaker 2: we put in ourselves to like, no, I need to breastfeed,
Speaker 2: and you kind of get like a bit obsessed. Again.
Speaker 2: I had a similar experience, and at one point I
Speaker 2: was like, for my mental health, I just need to stop,
Speaker 2: Like I can't do this anymore. Yeah, but I really
Speaker 2: want to get to your six week appointment. You went
Speaker 2: to the doctor and you insisted on them checking you
Speaker 2: again because something was still not right.
Speaker 1: Well, I actually went to the doctor at two weeks
Speaker 1: postpartum and I said, something's not right. My milk supply
Speaker 1: is not in and she prescribed me a pill to
Speaker 1: take to increase my supply. I went home. I was
Speaker 1: chatting with my mom and we looked up the side
Speaker 1: effects and they were like full on side effects. And
Speaker 1: that's when Mum said to me, Anna, you were fully
Speaker 1: formula fed. Your sister was fully formula fed. It is okay,
Speaker 1: and I think you have to come to terms with
Speaker 1: it in your own way. I think you can have
Speaker 1: so many people tell you like it's okay, but you
Speaker 1: really just need to get there yourself. You need to
Speaker 1: give yourself permission. So many people can tell you just
Speaker 1: put them on formula it's all good, but it takes time,
Speaker 1: and every woman is going to kind of make that
Speaker 1: decision in their own way and their own time.
Speaker 2: I agree with you one hundred percent. It really does
Speaker 2: need to be an individual decision. Because of the noise.
Speaker 1: And so many people were telling me, but it wasn't
Speaker 1: until like I had decided I am going to stop.
Speaker 2: Apart from the fact that your milk hadn't come in,
Speaker 2: was there something else telling you that there was still
Speaker 2: placenter in there.
Speaker 1: I was still bleeding at six weeks at my you know,
Speaker 1: six week appointment, and I had heard that the Lokier
Speaker 1: or Lockier changes in color and amount, and that stayed
Speaker 1: pretty constant for me. I also had this kind of
Speaker 1: it was like a pain in my stomach and I
Speaker 1: just had this like feeling as well, there's something still there.
Speaker 1: And even though you know, my husband, my mom, the
Speaker 1: doctor was like, nope, it's gone. I felt crazy. But
Speaker 1: I also was like, I have to just follow my
Speaker 1: instinct with this. And that brought me to my six
Speaker 1: week appointment, which I went in and she basically said,
Speaker 1: all right, so do you want to go back on
Speaker 1: the contraceptive pill, and you know, and we spoke a
Speaker 1: little bit about everything in the feeding situation and I
Speaker 1: was still trying, but really much more on formula at
Speaker 1: this point. And I think Cammie was getting like one
Speaker 1: bottle every three days of breast milk, if that gives
Speaker 1: you an understanding, and I'm you know, feeding around the clock. Anyway.
Speaker 1: I finally said at the six week appointment, I'd really
Speaker 1: like you to do an ultrasound and I just want
Speaker 1: to check. And she did an ultrasound, and she came
Speaker 1: back in and she said, yeah, there's something there, and
Speaker 1: I was like, oh, my goodness.
Speaker 2: Did you feel so vindicated?
Speaker 1: Then? Yeah, I felt totally gas lit. I know everyone
Speaker 1: throws that word around, but I felt really scared because
Speaker 1: I had read, obviously, because I was convinced. So I
Speaker 1: had read that, you know, people can get really sick
Speaker 1: when they have retained placenta in there that hasn't been
Speaker 1: taken out. And yeah, so I was really worried. And
Speaker 1: then she said, oh, we need to do a saline sono,
Speaker 1: which is when they put salt water up there and
Speaker 1: do an ultrasound with salt water in your uterine cavity
Speaker 1: to really look at what this is and where it is.
Speaker 1: So we did that and then she confirmed it again
Speaker 1: and she said, we're going to have to do a
Speaker 1: DNC to get this taken out. And I was like,
Speaker 1: I hate to say I told you so, you know,
Speaker 1: like it was just this awful feeling. And I also
Speaker 1: don't I really don't want to make this about the doctor.
Speaker 1: She was doing what she could the best she could
Speaker 1: with the information she had. You know, she's very experienced.
Speaker 1: I've sought her out so I don't want this to
Speaker 1: be like a thing about the doctor, because I saw
Speaker 1: a few different doctors.
Speaker 2: I think it's just more about advocating for yourself. And
Speaker 2: we are hearing a lot about this, like if you
Speaker 2: really feel something, really pushing for it no matter what
Speaker 2: anyone says, because what's the harm?
Speaker 1: And n octo sound exactly. And when I went in
Speaker 1: at two weeks and they gave me these pills, I
Speaker 1: asked for an ultrasound then and they said, no, just
Speaker 1: take these pills. We got all the tissue out, it's
Speaker 1: all good. And I really wish I pushed then, so
Speaker 1: went and had the DNC and then she said that
Speaker 1: there was a lot of bleeding in that DNC. So
Speaker 1: I wanted to go and get a second opinion. So
Speaker 1: I went to my maternal fetal specialist who I had
Speaker 1: seen throughout my pregnancy, and he did an ultrasound and
Speaker 1: the tissue is still in my uterus. So with placenta
Speaker 1: a creta, it's a very rare condition. It is becoming
Speaker 1: more known, but there are three sort of steps to it.
Speaker 1: There's a creta where the placenta attaches to the wall.
Speaker 1: There's in creta where the placenta actually grows into the
Speaker 1: wall of the uterus, and then there's per creta where
Speaker 1: the placenta grows through the uterus, and so he thinks
Speaker 1: that I have in creta where it's grown into my uterus,
Speaker 1: you know. So that was just another thing to face
Speaker 1: in the journey of it. But I think at the
Speaker 1: time he assured me that there was like no blood
Speaker 1: supply to that tissue anymore. So I was worried about,
Speaker 1: you know, with retain per Center, they talk about you
Speaker 1: hemorrhaging and stepsis, and he assured me that that would
Speaker 1: not happen. And what the future holds in terms of,
Speaker 1: you know, other pregnancies, we don't know. I don't know.
Speaker 1: I have a check up with him in a couple
Speaker 1: of months, and I think right now, just focusing like
Speaker 1: on the present and being with Cammy and Tyson is
Speaker 1: the most important thing and what we're trying to do.
Speaker 2: So what do you think you've kind of learned from
Speaker 2: this process?
Speaker 1: I mean so many things, but the main thing is
Speaker 1: to trust your gut, trust your instincts, and don't be
Speaker 1: afraid to advocate for yourself. If you really have a
Speaker 1: strong feeling, trust that and follow that and book the appointment.
Speaker 1: I mean we hear it with like endometriosis and women
Speaker 1: having to see so many different doctors until they get
Speaker 1: that diagnosis, and I think it's, Yeah, it's so important
Speaker 1: to trust your instincts and follow up on things. I
Speaker 1: have no idea the situation that I would be and
Speaker 1: had I not demanded that ultrasound, I don't even want
Speaker 1: to think about it. But I think we're faced with
Speaker 1: so many different decisions when we have a child, and
Speaker 1: for me, like feeding was the biggest one, but obviously
Speaker 1: you have to come to terms with your own answers
Speaker 1: and in your own time, but also just there are
Speaker 1: so many decisions. Make the decision because there's going to
Speaker 1: be another one.
Speaker 2: Yeah, thank you for sharing your story so soon after,
Speaker 2: Like there's no like tight ending to this. You know
Speaker 2: you're still going through it. So really appreciate you sharing
Speaker 2: your story while still sort of navigating it.
Speaker 1: Yeah. I think that's why I really wanted to, because
Speaker 1: it's something that I don't want to scare people, but
Speaker 1: I think people should know about it and be aware
Speaker 1: of it for.
Speaker 2: Sure, because placenta accreta is rare. I wanted to get
Speaker 2: some input from our obstrition and gynecologist doctor Bromin Devine
Speaker 2: on the condition.
Speaker 3: Well, this is a condition known as placenta accreta spectrum
Speaker 3: or PAS, it's referred to, and it's a rare complication
Speaker 3: in pregnancy, but it is becoming more common. So what
Speaker 3: happens is when the placenta forms very early at the
Speaker 3: time of implantation, the trofectoom or very early placental tissue
Speaker 3: burrows into a specialized lining in the uterus known as
Speaker 3: the decidua. But if that happens in an abnormal way,
Speaker 3: it can borrow in deeper than the decidua into the
Speaker 3: muscle of the uterus and form a very abnormal attachment
Speaker 3: and sometimes that can burrow all the way through the
Speaker 3: muscle of the uterus or sometimes right through the uterus
Speaker 3: into some organs next to the utresus, like sometimes into
Speaker 3: the bladder and things like that. So it's a spectrum
Speaker 3: of abnormalities, very very serious and can be associated at
Speaker 3: the time of the baby's birth and catastrophic bleeding. So
Speaker 3: it's something that we do try and pick up while
Speaker 3: the person is pregnant, and the best way to pick
Speaker 3: it up is usually with a very good quality ultrasound,
Speaker 3: and then if we do detect it being present, we
Speaker 3: often make a plan for that person to have a
Speaker 3: caesarean birth with a hysterectomy at the time of the birth. Now,
Speaker 3: obviously that doesn't happen in every circumstance as it happened
Speaker 3: in this one, because it wasn't diagnosed till after the
Speaker 3: baby was born, and in fact after most of the
Speaker 3: placenta came away. So sometimes what can happen is an
Speaker 3: isolated part of the placenta can be stuck to the
Speaker 3: utress and not come away, as happened in this case.
Speaker 3: What that led to was an abnormal establishment of breastfeeding,
Speaker 3: because what causes milk production to start is the placenta
Speaker 3: coming away, so not being pregnant anymore, the placenta coming away,
Speaker 3: loss of all those placental hormones starts the big cascade
Speaker 3: that allows breastfeeding to establish. But if there is placenta
Speaker 3: left behind, then sometimes that can be interfered with. One
Speaker 3: of the reasons we're seeing placenta accrete a spectrum a
Speaker 3: little bit more commonly is that we're doing more caesarean sections,
Speaker 3: and caesarean sections lead to scarring in the uterus, and
Speaker 3: it's scarring in the uterus that can cause the placenta
Speaker 3: to sort of burrow through the scar in an abnormal way,
Speaker 3: but other things as well, Sometimes having had a curete
Speaker 3: in the past with a little bit of scarring associated
Speaker 3: with the curete, other types of utrine surgery can lead
Speaker 3: to this condition where the placenta doesn't implant properly, it
Speaker 3: implants too deeply and right through or through partially through
Speaker 3: the utube.
Speaker 2: And what about its effects on future fertility.
Speaker 3: If you've had an normally adherent placenta in the past,
Speaker 3: you are at risk for it happening again, And certainly
Speaker 3: if you've had uterine surgeries in the past, you're at
Speaker 3: risk of placenta a crete a spectrum occurring. So what
Speaker 3: would happen in a subsequent pregnancy is and it would
Speaker 3: be watched very closely and had some high quality ultrasounds
Speaker 3: to determine, because a really good quality ultrasound can see
Speaker 3: that interface between the placenta and the uterus and see
Speaker 3: if it's abnormally adherent, and then she'd be managed through
Speaker 3: the pregnancy according to the risk. So if it was
Speaker 3: deemed that it would be more appropriate for her to
Speaker 3: look at having a caesarean section berth and then have
Speaker 3: her uterus removed. That's a big ask though, because it
Speaker 3: means you have your uterus removed. Unless you look at surrogacy,
Speaker 3: you're not going to have any more children. So it's
Speaker 3: definitely something that is discussed in a very in depth
Speaker 3: way with the patient and the treatment team, and it's
Speaker 3: often a multidisciplinary team. We have the obstetricians but also
Speaker 3: specialist gynecologists who do very complicated surgery, so it's a
Speaker 3: very carefully managed pregnancy. The next time Round.
Speaker 2: Diary of a Birth was hosted by me Kasenye Lukich,
Speaker 2: with expert input from Dr Bronwin Devine. If you like
Speaker 2: our show, don't forget to subscribe and rate. It goes
Speaker 2: a long way to allowing us to continue sharing your stories.
Speaker 2: This episode was produced by Ella Maitland and myself Kasanye Lukitch,
Speaker 2: with audio production by Tina Mattalov,