Monday, September 17, 2012

Thinking About Having A Baby...Again

So I've been thinking a little a lot lately about doing the whole labor and delivery thing again. Just like before, it's something that I have a little bit of anxiety about...I feel like there's just so many scary things that can happen and so much that can go wrong (seriously, we watched What to Expect When You're Expecting the other night, and one of the delivery scenes had me up almost all night freaking out and worrying). It's a situation where I really have very little control, and I like to be in control.

Anyway, I've been reflecting on what labor and delivery were like for me with Lizzy...I wrote about it shortly after she was born, but in having a couple years to think about it and read about a gazillion other birth stories, I think I have a slightly different take on things now than I did then...and some of it I just want to get out of my brain and down on paper.

First, here's a summary of how things went with Lizzy:
My water broke about 4am on a Sunday morning. I got in the shower almost right away, and noticed that my contractions were coming really fast and furious. I'd have contractions that were about 3 minutes long, then a thirty seconds in between, and then another 3 minute contraction...so we headed to the hospital basically right away.

We got to the hospital at about 5am. I was dilated to 4cm, and was super discouraged, because I'd been dilated to a 3 for a few weeks (I think!). I felt like I hadn't been able to catch my breath since we had left home, and the contractions just kept coming and coming with no break, and I was getting hysterical. I was lucky to get 15-20 seconds in between each 2 or 3 minute contraction. In retrospect, if you look up the textbook definitions of transitional labor, that was exactly how I felt from the time my water broke up until this point...which is weird, because if I were only dilated to a 4, I wouldn't be in transition yet. Anyway, I asked for an epidural.

The anesthesiologist came around 6:30am. After he gave me the epidural, I mostly felt better, but almost as soon as he administered it, I couldn't stop shaking uncontrollably. Justin kept giving me blankets, and I kept telling him that I was NOT cold, I just couldn't stop shaking. Sometime shortly after that, shift change happened, and I had a new nurse, who Justin really liked and I really did not. I kept telling her that I was feeling a lot of pressure and thought I needed to be checked. She kept telling me, "Oh honey, it's your first baby, you're going to be here for a very long time." She also kept telling me to eat something, and that Justin needed to take a nap...neither of which I thought were good ideas, and totally ignored her when she brought me some food.

Sometime between 8am and 9am, I finally convinced the nurse to check me...and I was dilated to a 10. I remember commenting that I was starting to feel a lot of pain again, and her responding something about how my IV had gotten bumped and I'd been given way too much fluid. Something like 5 bags since I'd been there.

I sort of remember a doctor  (not mine) coming in, and I remember being given the okay to push. Justin and my mom kept asking if I was okay because I was basically silent the whole time (in my own world, I guess). I remember not being sure if I was pushing the right way, and also Justin telling me that I actually needed to inhale in between pushes. I remember being in quite a bit of pain, and being surprised about it--doctors have always told me that I have a very high pain tolerance, and everyone had told me that with an epidural, I should expect pressure, but not pain. But I felt PAIN, and remember wondering if there was a problem with the epidural, but being told that if there was, it was too late to do anything about.

And then, at 10:25am, she was born. 6 hours and 25 minutes after my water broke. I needed a few stitches, and I totally and VIVIDLY remember feeling those. I remember wincing and saying "Ow! Ow! I can feel that!", and the doctor saying that I shouldn't be able to feel that, and that he'd hurry up.

I think I was up and walking around by noon or shortly thereafter. I'd heard horror stories from people about how long it took them to feel their legs again after an epidural, and I was surprised that I could totally feel mine pretty quickly afterwards. That said, recovery was awful. I was in a lot of pain for weeks. I was SO SO SO swollen, everywhere (apparently due to the incident with being given too much fluid). I remember feeling like everything hurt all the time, and wondering why no one had told me how awful the recovery was. Looking back, I really don't remember much of the first week, other than it was terrible and I was miserable.

So. That's that. Now, given some time...here's what I've been wondering: 
I remember that in the week before my water broke, we had almost gone to the hospital 3 or 4 times. I'd been having steady contractions, but they just never got any closer together. Looking back, I wonder if I'd been in early labor for a day (or two even) before my water broke, and just didn't fully realize it. I've been a little stressed about the fact that they say labor is shorter with each subsequent baby...and if labor is much shorter than it was with Lizzy, I'm worried about getting to the hospital in time! So, thinking that I'd been in early labor makes me feel a little better, for some reason.

I also wonder whether or not the epidural actually worked for me...or how long it worked for? I think it worked initially, and may have allowed me to relax and fully dilate. But then after that point, I'm not sure that it worked for much longer, and I have no idea whether that was due to the amount of fluids I'd been given, or something else. But I really don't KNOW for sure whether it was working or not...I have nothing to compare it to. I've wondered since shortly after Lizzy was born whether not getting an epidural would have made a difference in how I felt postpartum...if I'd have had an easier recovery if I hadn't gotten one. I don't know. Sometimes I wonder if knowing then that I'd only have another couple hours in labor, if I couldn't have gone without it. I think I freaked out initially hearing I was only dilated to a 4, and thinking that I'd have another 20+ hours in labor and that I couldn't handle contractions like that for another 20+ hours. But 2 or 3 hours? I wonder if knowing that it was only like 2-3 more hours would have felt more do-able. Then, on the other hand, I sometimes feel like the reason I dilated to a 10 so quickly was because the epidural allowed me to finally relax. Or maybe that first time I was checked, I was measured incorrectly, and I really was starting to approach transition, like I felt. I just don't know...

I find myself going back and forth between thinking that I should really try to go without an epidural this time...but then again, who knows whether labor this time will be anything like it was with Lizzy? It COULD be 20 hours for all I know. I could not get the epidural only to be miserable and have problems progressing because I can't relax. Or, I could not get the epidural, and find that it really makes all the difference in terms of recovery. Or, I could get an epidural, and find that it's a completely different experience than last time, for better or for worse. I have no idea.

Feel free to chime in y'all...because I'm really feeling torn. Did anybody have an epidural with one kiddo and not with another? What was that difference like for you?

24 comments:

  1. With my experience my epidural seemed to wear off while pushing. When I started to push I had to hold my stomach to feel the contractions but after an hour of pushing I started to feel a lot more.

    I also began shaking with the epidural and went really quickly to 10 from 4. Like super speed! I'm not sure if it was the epidural or not. I had a leep done so they thought that might happen to me.

    As for recovery mine was very easy. I only used ibprophen for a couple days. So I'm not sure if the epidural makes a difference. It might just be how your body recovered. It's so hard with birth since it's so rare and different for everyone and every time.

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  2. Well, i had two completely different experiences. One csection and then a vbac. I had issues with the epi with Brady but this time my only issue was that it wore off right when I started pushing and felt everything (those stitches, ouch!!!)

    With Brady, after being in labor for a long time, then trying pitocin and even with everything else we had tried, i never dilated past 1. Looking back, I think I might not have not needed a c-section if my water hadn't broken early and started to spike a fever because i think my early labor is just super long as it was the 2nd time.

    With Bennett, the epi was magic, lol. I got the epi at 6 am and I was only 1cm, by 10:00 (maybe earlier but that was when I was checked!) I was a 10 and ready to push. It was crazy. Anyway, I hear a lot of ppl say their labors were exactly the same or completely different but that recovery is much easier the 2nd go around :)

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  3. I didn't want to get an epidural, but I did end up getting one, even though I wasn't in much pain. I feel like I was scared into getting one by the nurse. And like you, I don't think it actually worked. I think it made things worse. I think I wasn't in too much pain before it because I could move around and things, and then after, I just felt heavy and "weird". I felt tingly and light headed and just all around funny. I ended up with a c-section because I never progressed from a 6 for like 12 hours. After my water broke I went from a 2-6 in less than an hour and so they started prepping our room, brought in the warming lights, blankets, etc. and nothing ever changed. :( Next time around I'm not going to get an epidural unless I'm like blacking out from the pain and it looks like it will be a LONG time. But, who knows what will change once we're actually in the "thick" of it... You know? I'll pray for peace for you guys! :)

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  4. I didn't have an epidural. If you're thinking about going that direction, I recommend reading Dr. Bradley's book, or even better, taking a class. Unmedicated birth is hard, hard, hard, but it was a fantastic experience for us. No tearing and I got to get up and take a shower after she was born. Felt so good!

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  5. Here's my theory. You got your first epi too early. Just like I did with my first baby. And then? It wore off by the time it came to push. This time my doc told me that I felt so much LAST time (like, SEVERE, RING OF FIRE, COULD FEEL HER STITCHING ME UP! OUCH!) b/c epidurals are like rolling down a mountain, they start off with the highest "numbness" and then it rolls down and gets less and lessa s time goes on, and so this time, since I did So MUCH labor at home? I got there JUST IN TIME for an epidural and since it was fresh, it was AMAZING and I was so coherent, could push correctly, but felt no pain once it kicked in. It wore off within a few hours and then I was up in the bathroom, walking around, no problem.

    So basically, I have no advice--except, know your body. Feel it out. If you live close to the hospital wait for as long as you can, and when you get there, get checked, GET IT. I don't think any of your after recovery had anything to do w/ the epidural. I was feeling awesome this time around after a few days/week. Where as last time I felt a little worse and tore worse.

    Go with the flow and don't overthink it, thats my two cents ;P

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  6. I totally get the struggle, Meredith. I said this on my blog, but I think second time moms are at a disadvantage because they know what's coming. And even worse if their first time around was not good. :-/

    I didn't have an epidural, I had three third degree tears, and my recovery was a total breeze. I was never even in pain once the stitches were done. I was sore a bit when I'd overdone it on a few days, but it was never painful. Whether that has to do with the epi or not, I have no idea. But I know it is possible to have a smooth recovery, even with serious tearing.

    Every labor is different and you can never know for sure what your experience will be, but more than likely, you aren't going to have a 20 hour labor! My advice - don't go into it with your mind set of either epi or no epi. Just go with the flow. I don't normally say that (generally, I say if you don't go into it determined not to get the epi, you'll end up with one.) but because you have experience and because you know it went quickly for you before, I think that will make flexibility work for you. If you get to the hospital with crazy contractions and are only a 4 again, you know this time that doesn't necessarily mean hours and hours more of labor. But if that happens, and 3 hours later you are still a 4, get the darn epi!

    Praying for peace for you, girl.

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  7. I had an epidural with Ryann, mostly because I feared how long I would be in labor, and since I was on pitocin with high blood pressure and constantly being monitored, the fact that I wasn't allowed out of the bed was incredibly defeating.

    But? My epidural was a freaking dream. I didn't feel a thing, seriously the entire time. I honestly didn't feel her come out, the only reason I knew I had successfully pushed her out was because she ended up on my chest. But part of that was just because she was incredibly small (9th %tile head). And also I think because my epidural was so incredibly awesome I labored down a bit. I pushed for 18 minutes.

    I will say my recovery was just fine, and I know I was up and walking within an hour of delivery. I was stiff and sore, but I felt pretty much back to normal by the end of the week. I had zero problems with the epidural other than it cause my BP to plummit when they first put it in. Otherwise that thing was amazing.

    I tend to think it is luck of the draw with the epidurals, some bodies handle it better, some doctor's place it better, etc. I'm not sure what I'll do this time around, even though I loved mine, I wonder what will happen if I go into labor on my own, you know? Maybe if I don't have to be constantly monitored and hooked up to a million things I'd get by without one. Because in all seriousness the stupid blood pressure cuff squeezing my arm every 5 minutes was more painful and annoying than anything else about my delivery.

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  8. Also, I wanted to add that my epi never really wore off. I had mine in for at least 6 hours and never felt a thing. Occasionally I started to feel more pressure, and my nurse pushed a lovely little button and it went back to normal (or complete numbness). The only time the button didn't do anything for my pressure (wasn't ever really pain) was when it was time to push. I think a lot of docs and nurses turn the epidural 'down' or 'off' or something when it is time to push, just so you can feel enough to get the job done, and maybe mine did, but she was out before I felt anything. I've got no idea though, just some thoughts.

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  9. Interesting post!

    My advice: if you are on the fence at ALL about getting an epidural, it seems like 99% of the time women will get the epidural unless they are 100% against it. Does that make sense? Unless you are like: 'There is no way in heck I'm getting one' then you probably will end up begging for one. And honestly? That's okay! Like the others said, just go with the flow and don't put pressure on yourself to avoid one or ask for one. Every labor is SO different, even for the same mom.

    Also, I have heard of a lot of people relaxing enough with an epi to allow further dilation. So it definitely might have made your labor go faster but I guess you'll never know for sure.

    I had an epidural both times. The first time my recovery was a LOT harder than this time around. I think a lot of second-time moms find that is the case, regardless of an epi or not. Especially since my epidural with Cecelia was not the best and I felt every.freaking.ounce.of.pain by the time I was a 10. And the first time (harder recovery?)--the epidural was freaking amazing. How is that to confuse you even more?

    Just take it a step at a time and don't worry too much about epi versus none. Easy for me to say, I know!

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  10. I had no epidural because there was no time. My recovery was pretty easy after getting out of the hospital. I did tear. I wouldn't stress too much about whether to get the epidural or not. Here's my advice, prepare to not have it (learn breathing and have that plan) you can always choose to have it but if you are armed with techniques, it will make it much easier. My nurses were amazing! I hope you get better nurses.

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  11. I swear...I think all epidurals are different. I have friends who delivered at the same hospital as me and they even had different experiences. With both of my kids, I got the epi but felt major pain when I pushed. I felt EVERYTHING. I was also able to lift my legs all by myself and stand up afterwards.

    I think I can safely say this second baby of yours will come faster. However, since you've been there before I think you'll have a better grasp of where you are in the whole process. With Eli, my sister-in-law told me I was headed to the hospital that evening and I told her no way...it'd be another day or so. She was right. And then with Gabby, I just knew. I knew when I definitely wasn't in labor and when I was.

    And gah...all those fluids?! No wonder you were shaking! I can honestly say I had amazing recoveries but I could have done without all the swelling from the IV.

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  12. I've only had one baby, but I did not have an epidural, and I was honestly shocked by how easy my recovery was. I basically felt completely normal almost immediately. And I had a 2nd degree tear. But I was not swollen at all (no IV), and I was surprise that I didn't bleed all that much after, or have pain either. I think I took one dose of ibuprofen in the hospital. That was it.

    I did ask for an epi, during transition. Because I had an INTENSE labor that was only 5 hours long. On hour 4, I got into the tub at 4cm. 45min later I didn't think I had 6cm of intense back labor left in me. That's because I was at 8cm and in full-on transition. Not 5min after I was checked at 8cm, I was 10cm and my body was pushing on it's own. She was out just a few minutes after.

    It was intense, and it was painful, but I would not have done it any other way. That said, if you're thinking about going without, definitely study up on ways to relieve pain without meds, and try to get a nurse that is natural birth friendly. My main labor nurse really wasn't, and caused me a lot of stress in my early labor. She went on break for an hour, and I got the most amazing nurse ever - and that was the hour I went from 4cm to holding a baby!

    Good luck, and remember, you CAN do it no matter which way. Lizzy is proof of that!

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  13. I had a c-section after being in labor for 36 hours, so I'm not much help, but yes I did have an epi. For me, it helped calm me down.

    I would recommend trying to not over-think it. Go into the moment and if you want one, get it. If you don't, don't. Honestly, I think "planning" for an epi or to not have one is a little bit of a joke, because you just never know what's going to happen. You may get to the hospital and already be at a 9 and decide you can do it without. Or you may get to the hospital, at a 3, and decide to go for it. Either way, you made the right decision, you know what I mean? You're the only one who can decide which is the right decision for yourself and your sweet babe.

    Love ya friend!!

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  14. I agree with Kristal. Go with the flow. I know that's easier said than done. But I went in there with just a few things in mind and the rest, like the epi, I just played it minute to minute. It's both a blessing and a curse that we don't know what labor will be like. But the not knowing can also be kind of fun if you think about it. The anticipation can either drive you crazy or excite you in a good way. Try to focus on AFTER birth. That's the part that rocks ;)

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  15. I agree with Andrea, most of my friends insist that they feel everything when it comes time to push and that the epi only helped them when they were progressing [or stalled them, one or the other].

    There are a lot of questions without concrete answers in looking back and trying to plan. I'm sure you could be just fine without an epi. I'm certainly no super woman. My recovery was fantastic and without an epi, they make certain to numb you up before the stitches. ;)

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  16. I had an epi with Jack all natural waterbirth in a birth center with Luke.

    First time around - I really didnt educate myself before going into it, and I had the typical snowball of 'complications' in the hospital. Now, I think modern medicine is AWESOME, but in my case, things were pushed on me - and I was terrified. I felt like I didnt have an advocate, I had never even met my doctor - all he talked about was baseball - I was clearly just another hour on the clock for him. My water broke at home, so I went to the hospital. From the minute they hooked me up to the monitor - the nurse started talking about a c-section. I wasnt even having contractions yet and she was terrifying me! My blood pressure ended up skyrocketing and it was kind of a mess. (my birth stories are on my blog if you want real details). I am really grateful that I was at the hospital, but there are things that should have been done differently, things I should have insisted on, and things that should never have been pushed on me.

    Second time around, I went with a midwife the entire pregnancy. She actually cared about me, remembered my name, remembered Jacks name, I was a person! She monitored me closely for any signs of Pre-e, and she was licensed to deliver in the hospital should I need to be there. Turned out, I didnt need to be there. I had a beautiful water birth in a free standing birth center. My husband was the first person to hold our son, ad after that he never left my side. All his checks were done with me right there, some of them I was even holding him. Was natural labor hard? Heck yes. I will never regret it though, and as long as I (and any future babies) are healthy, I will never have another medicated hospital birth.

    I know it isnt for everyone, I really do, and I would never force it on anyone. But for me, for us, it was a world of difference, and it was wonderful.

    *Oh, and because there has been some discussion of whether or not the epi numbed pushing, for me - it did. They have me a bolus in my epi BEFORE they checked me, and I was at 10. I couldnt feel a thing when I was pushing with Jack.

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  17. Had epidurals with both my boys (and will with this next one) and it was a totally different experience, first time kinda just took the edge off and def felt everything, second time I didn't feel a dang thing! But in saying that first go I had horrible back labor and second time I walked into triage at a 7 without feeling contractions. I think it depends on your labor and possibly anesthesiologist, but I felt like every little bit helps and was at a 10 within minutes of both of my epis. My labors were 5 and 3 hours and my OB said it's pretty accurate that your labors get shorter with each.:)

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  18. I didn't have epidurals with either, but I did have IV pain meds with Ansley. I felt much better post birth with Braeden going unmedicated! If you want some help getting rid of your fears, Ina Maya Guide to childbirth is a great book!! It was really helped me learn more about birth and had tons of great birth stories as encouragement! I can't recommend it enough!

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  19. I think it's fine to just do what feels right to you in the moment. If you can't decide one way or another beforehand, try not to stress yourself out about it too much. Just let it happen!

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  20. I'm just a person who randomly happened onto your blog via YHL, and this is one of my favorite topics (birth, that is).

    Epidurals are funny. Everyone does experience them differently -- it works for some and not for others, just like any medication. Knowing of your experience before, you can prepare yourself for the epidural being the same, should you choose to get it. You might also talk to a doctor about what your reaction was, specifically, because then you'll likely know what the reaction really was, and whether or not it's safe/normal on-going for you. You could also contact the drug company that created and provided the particular epidural and speak with them about it.

    Aside from that, I've opted to not have other children myself. I have one boy. I had an unassisted homebirth (planned) that was painless. Intense, but pain-free (or rather, pleasurable). I would likely do this again, or homebirth with a midwife if I felt that would be better.

    I think that really helped me prepare for birth was learning to trust my body to do what it needed to do and try to let go of the need for control. I used mindfulness techniques to try to embrace whatever would happen in the process, so that I could be aware, make good decisions (like choosing to go to the hospital if I felt that I needed to), and so on.

    And you know, it seems to me from your description that you were very aware and did very well. I find the most frustrating aspect of your story is the fact that people ignored you. They essentially said "oh, whatever" to what you were saying/experiencing, as if you would have no idea what was happening to you. You are not a textbook, you are a birthing woman, and that is a unique experience!

    A friend of mine had an unassisted birth in the hospital because of that sort of stupidity. She checked in, they told her it was early, and they ordered the epidural. There was a back-log, and they said the wait would be two hours. They suggested that her husband go home and get some things to "keep her comfortable" and he expected to be back in about 45 minutes later.

    She was then left alone. She beeped the nurse, asking to be checked because she felt a lot of pressure. The nurse said "It's nothing, just your first birth. It's going to be a while." Didn't even come to see her, just answered over the intercom! My friend's labor was 4 hours from start to finish, 3 of which she did at home, the last one in the hospital. She was in the room, by herself, and the baby girl was born (healthy and fine).

    She waited for someone to check on her before beeping anyone to say "oh, and by the way, the baby is here." She just hung out with her baby. Her partner showed up about 30 minutes after that, and HE freaked out and ran and got the nurse.

    Sometimes, I think medical staff are a bit daft. As if she didn't know!

    Anyway, whatever you decide, just know that you will be ok. You have experience now, and the opportunity for a lot more knowledge too. And you can make good decisions for yourself and your family, so really . . . you have nothing to worry about. If it's what you want to do, you'll find the way. :)

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  21. My sister had an epidural with one (or two) and then went natural with one (or two, I can't remember.. she had three). She's only 4'11" and thin, so the epidural made her numb in the legs for almost 24 hours. She hated that feeling after she had the baby, so she opted to go natural the next time. She loved it. I also have a sister-in-law that I have a love/hate relationship with. She's honestly no one I could ever imagine doing in natural (I think she's a cry baby), but she did it as well.

    Good luck with your decision!

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  22. After 2 c-sections, I have no advice for you. BUT you know your body the best and if you feel like you aren't getting what you think you should be once you get to the hospital? Keep pushing and fighting for that until YOU are comfortable.

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  23. Also, that wasn't supposed to come out harsh. I was in a blur after Brayden was born and learned a LOT from that experience that helped me the second time. :)

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  24. I think all of the suggestions and support for going with the flow are great! As a doula, I believe in a woman's right to birth the way she wants, and what is best for her and her baby. Also, learning some coping techniques is never a bad idea. You never know if you will need them or not. To me, it sounds like you might have been in transition when you got to the hospital and that the epidural wore off when it was time to push.

    Because epidurals are so popular, and some providers can't imagine a woman birthing any other way, they often times forget women who don't have epidurals (or adequate epidurals) can feel them doing the stitches, and even massaging the uterus to encourage the placenta to detach and be birthed. If you opt for natural or your epidural fails, it is totally okay to remind the doctors of this and ask them to be more gentle. They can give you a local anesthetic while they do the stitches (if you even need them this time around).

    I've had my own crazy healthcare journey (non-pregnancy related), and have become a bit of a patient advocate, so if you or anyone would like to talk about ways to advocate for yourself in a healthcare setting, please feel free to contact me via my blog.

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