What does a Natural, Early Induction look like? Jelena's story, Part I

In today's episode I speak with a woman who enjoyed a completely healthy pregnancy...until she didn't-- when cholestasis shows up.

 Cholestasis of pregnancy, I learned this week, is an issue with the liver that sometimes arrives in the second or third trimester.

We hear about how it's managed outside the hospital, and some of the surprises that awaited her in the postpartum. 

What follows is the first part of our conversation.

Transcript

Paulette  0:00  
You welcome to what you didn't expect in fertility, pregnancy and birth, how we think and feel about this enormous transition often lives in the gap between what we expected and what we actually experienced. This gap exists in part because of how we tend to talk about and portray these events on all kinds of media in a one dimensional way, everything was amazing, but it's more often the case that there are beautiful things that happen and at the same time really challenging things that happen. This show shares true experiences, both the easy parts and the difficult parts, and how we manage what we didn't expect, the intense things that can happen in the course of this transition can impact how you see yourself, that you see your partner, and how you parent. The better we understand us, the better we can manage all the things that follow. I'm your host, Paulette kamenecka. I'm a writer and an economist and a mother of two girls, and I met many, many challenges in this process, none of which I expected. In today's episode, I speak with a woman who enjoyed a completely healthy pregnancy until she didn't when cholestasis shows up. Cholestasis, I learned this week, is an issue with the liver that sometimes shows up in pregnancy. We hear about how it's managed outside the hospital and some of the surprises that awaited her with postpartum including postpartum depression for her partner. What follows is the first part of our conversation. Hi, thanks so much for coming on the show. Can you introduce yourself and

Jelena  1:27  
tell us where you're from? Yes, I can happy to be here. Okay. My name is Yelena, and I am actually a parenting coach. So I do five moms who have younger children, and I am in Geneva, Switzerland, that's where I live. But I'm originally from service, and my name is Levit, more exotic, if

Paulette  1:47  
I can say awesome. How's it going in Switzerland?

Jelena  1:50  
Oh, it's nice. It's nice. You know, a lot of people have actually this amazing view of Switzerland and the mountains and the chocolate and all that great stuff. And, yeah, well, most people think, you know, beautiful mountains and the Chocolate fans, and then this is what actual people who live here is, and it's like, just, you know, poor people, terrible. It's difficult. And I think it's somewhere in the middle.

Paulette  2:15  
That's a very funny. Are you telling me that you're not all eating chocolate all the time? Because that can be true.

Jelena  2:19  
 No, that is true.

Paulette  2:23  
Excellent. You write about something. So we're here to talk about pregnancy and the family that you created. But oftentimes the family create is in some ways, a reflection of a family you came from. Either you want to play towards something or away from something. So is that the case in your life? What kind of family did you come from? Do you have siblings?

Jelena  2:46  
Yeah, and this is so true. What you're saying, Oh my gosh. It is so true. Even though we're trying to run away from it, sometimes we want to do things so much different than what our parents did. We're just kind of stuck in a loop, it seems like. So I don't have any siblings, so I'm the only child. And I grew up. I grew up here in Switzerland with a sort of background of, you know, back in the time it was Yugoslavia, so Serbia, Croatia and Bosnia together, and it was a very, very different kind of upbringing, if I can say, than Swiss people, until I kind of, like, really got into the more educated kind of Swiss schools and etc. And it was, it was kind of classic. My parents were very much into doing things in a normal way, trying to kind of steer away from our rooms and doing things. My mom did start some, you know, reading new books about parenting and things like that. But it was very, you know, they try not to spank me too much, and they try how they could, like all parents, do, you know, they try the best and and, which was already a good start, I think, you know, sometimes we can come back, come from very traumatizing families, and we had even more work to do than when we bring up our own family into this world. And so I'm happy that I had actually a childhood that was, I could say, happy, even though I had my own lot of tea traumas, big traumas, like we all do. But that was already a start with my own inner journey that my mom had already started.

Paulette  4:24  
So did you know that you wanted a family of your own?

Jelena  4:27  
I did. I did. I actually. So I had my son when I was 26 which here in Europe is we could say it's early. I'd say in Europe, maybe women have kids, maybe more, in their 30s. But very early on, I felt this biological need of, oh my gosh, I flew on and have children and, and there was this deep desire and this understanding that there was for sure that I that was going to have kids and, and I did. I did in a most unexpected way I could say, but it wasn't planned. But it was like, oh, one of those moments of, oh, oh, my gosh, I'm pregnant. Wow, we're so not ready. Let's do this.

Paulette  5:13  
So it sounds like it was easy to get pregnant, is what I'm I'm hearing from this. It was,

Jelena  5:19  
well, I was very intentional about when, you know, we our own little, you know, intimacy time. So I was, I was with my ex husband for about five years, yeah, before we actually had a child. So it's not like we never tried. We never tried before. So it happened, you know, it was an accident, but yeah, it wasn't really an accident, because we were together and we wanted to be together. Yeah, we were not trying. That's fine.

Paulette  5:47  
Yeah, 100% so good. I'm glad that your entrance into pregnancy was relatively easy, because you did not get it directly. And what was the pregnancy like,

Jelena  5:59  
yeah, so this is what kind of like things, you know, I don't know if I can say shit,

Paulette  6:07  
knock yourself out. Yes.

Jelena  6:10  
Hit the fan. So my whole pregnancy was a normal pregnancy. I had nausea at the beginning, but I was able to kind of do all those naturals very much into natural health, natural really

Paulette  6:20  
pause here for a second. Let's agree that 26 is a young person. How much do you know about pregnancy before you become pregnant, even though you've already stated at a stable relationship, we knew we were going to have kids, were you well educated on what would happen once you got pregnant? Was

Jelena  6:36  
your Bible educated? This is a really good question. So I wasn't ready educated a bit because I was so much, I'd say my, you know, early journey of natural health. And so listening to a lot of interviews women men who were doctors and doing things differently, like Functional Medicine and naturopaths and and so they did talk a lot about pregnancy and how to do it, and all that stuff about vitamins and what kind of diets and etc, although there's a big range of opinions on that. So I would say I had a little bit of information and one of my best friends back then in the States, because I actually I gave birth in the States. I lived in the States with my ex husband, and back then, my best friend, already had a child, and with her, I had already helped some babies. I was very much I loved children, and with her, it's like I was already introduced in a certain way of giving birth and and parenting.

Paulette  7:40  
So let me guess, are you in Oregon or Maine, or where are you in the US? Okay, good, because your context matters, right? And so yes, those are places where a more natural approach is probably more common. So I'm glad that you landed in a place that kind of felt comfortable. I

Jelena  8:00  
would not have been able to land anywhere else. Okay, good, yeah, yeah, my ex husband was like, you know, Vermont is really the place where you would actually like to be. And he was true, okay, so, yes, very granola people, very international, like farmers markets, all that stuff, yeah, yeah, yeah. And so, yeah, it was really nice to have this introduction. It's not like just all of a sudden out of the globe. Let's learn about pregnancy and what can happen, although you are never prepared. If you've never gone through totally never prepared, you've never been a mom, you've never prepared for what that means.

Paulette  8:39  
But yeah, experiential, for sure. It's experience, right? Yes, yeah, totally. And then again, I

Jelena  8:44  
only have second child. Is completely different also, yeah.

Paulette  8:47  
So, so we're in Vermont. We're super excited. We're taking our vitamins, we're listening to functional medicine doctors. We're pregnant. What happens next?

Jelena  8:58  
Yes, oh my gosh. So I didn't know the right things, you know, they tell you, I wasn't even drinking. I don't drink. I don't like alcohol. I was in smoke. So, you know, my liver seemed to be on the state I was, you know, pretty good. I did have this slight nausea. I used those amazing acupressure bracelets, which helped me, and I didn't have any issues until later, when all of a sudden, you know, later,

Paulette  9:25  
like later, like, second trimester, trimester.

Jelena  9:29  
It wasn't a third trimester. Yeah, it was a third trimester. And I just started itching like crazy,

Paulette  9:35  
and itching like your arms, itching like

Jelena  9:39  
what you started with my arms, and then it was the whole body. And I remember, was at night, then I tried to, do, you know, those natural stuff, like oatmeal bath or putting some essential oils over, allowed to with a big dilution to, kind of nothing was helping. And so are

Paulette  9:56  
we imagining that, like, like, Oh, oops, I rolled in poison ivy. Or do we know what's going on here? I

Jelena  10:02  
had no idea what's going on. I knew it wasn't boys mad because I hadn't, you know we were living close to the forest, but it wasn't definitely know that it was just allergies, like, did

Paulette  10:12  
you think that kind of thing? Or were you thinking this is pregnancy

Jelena  10:16  
related? I had no idea. I had no idea because it seems so strange to the itching skill, so much.

Paulette  10:24  
And I have to say, for for young Elena, I'm already feeling sorry for you, because Itching is such a frustrating thing to deal with, right? Even if you itch it, it doesn't go away.

Jelena  10:36  
No, it doesn't. That's the worst part. Can just continue. It's kind of like that thing you have in your ears, you know, and you can't get to it, yep. So I was planning a home birth. I had my midwife, which was amazing, because then I could just directly ask the question she was there. I was paying her also for that service. She told me, Oh, okay, right away, go to the hospital, do some testing, and this is where we saw that I had what they call cholestasis, which is a problem with the liver, but the bile actually can be processed properly and then goes into the blood. And then the main symptom is itiness.

Paulette  11:16  
As jalina says, cholestasis is a liver problem. It slows or stops the normal flow of bile from the gallbladder. This causes itching and yellowing of your skin, eyes and mucous membrane, something like jaundice. Cholestasis sometimes starts in early pregnancy, but it's more common in the second and third trimesters. It looks like it can have a number of serious issues for the fetus, so early delivery is sometimes considered and coldest days is generally resolved after delivering for them. And was that was that tricky to uncover? Or no, they knew exactly what to do.

Jelena  11:51  
Yeah, they knew what to do. I guess it probably has to do with certain editing enzymes. I can't exactly remember what it was, but probably some elevated enzyme when it comes to his liver, and especially as she knew was pregnant. She was a midwife, so she knew what to kind of go test for. Okay, good. So it came back very quickly, and we tried all the natural staff for it, some liver cleanses and things like that, and nothing actually worked in homeopathy or anything like that, and I had to take some medication for about two weeks. The problem with that, one of the reason why it's important to catch is that the placenta actually ages faster, and as it ages faster, it's kind of like, you know, a woman who's smoking and the baby doesn't at the end, doesn't get enough nutrients, and it can be dangerous. And so whenever you diagnose with that, they want you to actually give birth earlier.

Paulette  12:43  
As mentioned, holistic This is a liver problem, and it's a particular issue in pregnancy, because not only is your body relying on your liver to clean your own blood, but the fetus is also relying on mom's liver to release its blood. How is it managed? Doctors can give medications that can improve liver function and lower bile levels. If that doesn't work, it can pick an earlier delivery date

Unknown Speaker  13:07  
than the due date.

Paulette  13:08  
So where are we in your pregnancy? Now? Are we 37 weeks?

Jelena  13:13  
Yes, oh my gosh, it's such a good question. So it was, it was close to the due date, but I remember that when that happened, it was probably right around the time when I was able to actually give birth at home. So it could have been around 3536 weeks, I think so.

Paulette  13:32  
And what do you say? Give birth at home? Aren't they gonna have to induce?

Jelena  13:39  
So that was their whole thing, yeah, yeah. So the whole thing was that okay, I had this home birth planned, and was I going to be able to have a home birth? Because I was supposed to have this, you know, early birth, earlier and so they kept on checking, you know, every weeks I had those testers to see that the baby was okay, the footprint was okay, which for me, was just something I really didn't want to do. But oh well. You know, sometimes life throws you something and you just have to go with it.

Paulette  14:07  
Other than feeling like we've a little bit gone off beast here in your plan, because now you have to involve doctors in a way that you weren't thinking about it. Are you calm? Are you nervous? How do you feel about

Jelena  14:18  
it? So, you know, I was actually pretty trusting, which was pretty amazing. That's awesome first time, because I had my home birth plan and I had my midwife, and I trusted her so much. And that relationship, for me, something that is the most amazing relationship and support that we can get as a mom, is having someone who you trust, knows all that stuff can give you, also advice who can give you. For me was also natural remedies, things like that, to help you. That was the best gift that I actually offered myself and my son as well.

Paulette  14:54  
One thing I like about the work is that I think we all because medical care in general, you are totally entrusting yourself to someone else's care, although birth is this very weird space where you're not sick, you may or may not need medical intervention, but so we're all imagining that we're going to get the kind of care you describe, where you can fully just rely on your care provider. And so it's so nice that that worked out in your case, that's

Jelena  15:21  
comfort, yes, yes. And I knew myself. I knew that if I was going to have a birth hospital, and that I was that was the plan, it was going to be difficult for me because of my own way of, you know, saying hospitals, and hearing stories, also, of my own friends who went through hospitals, but so the fact that she was there and that I knew that we were going to try things, and we did try things that actually worked. I was actually able to have my birth at home one week before due date.

Paulette  15:50  
Well, so how does that work? Yeah, yeah.

Jelena  15:54  
So what we did, and we may not, you know, believe that some may for me, just totally worked. So for me, it's just like 100% working it. So we did some homeopathy. We also did some acro acupuncture that really helped to kind of get my cervix ready mentally, also kind of working, not only on the liver, but also myself as, like, really relaxing. And she did this kind of painful thing my midwife, of at some point when we're closer to the supposed due date of inducing, she, how do you say she, you know, like when they put the finger around to, kind of like, it's not, you know, kind of like, take,

Paulette  16:40  
like, a membrane sweep. Yes,

Jelena  16:43  
exactly. She did that, which can be something that can, you know, start to activate some contractions, little by little or not at all. For me, everything actually worked. And I got to the point where I was ready to drink that magical potion that midwives know about,

Paulette  17:06  
Jolina. Did not have a lot of details about the potion, but when I looked into it online, I found multiple references to a quote midwives brew, which is a concoction that can include a number of ingredients like castor oil, nut butter, lemon verbena and apricot juice. Usually, the castor oil is used to induce labor, as it can cause spasms in the large intestine, and the thinking is that maybe it can also initiate spasms in the universe that could start contract actions. There is no clinical evidence for castor oil and labor reduction, and it can induce modeling diarrhea and dehydration. So don't try this at home without medical approval, but I'm guessing that this is what Joanna drank,

Jelena  17:50  
and it's a mix. So we're not going to say it here, because I think it needs to be very you know, you need to be careful that you you should take early in pregnancy, because it's very potent, and it's just a mix of some things you can eat. So I drank it, and I drank half of it, half of that potion, you can say, a few days before, to see if my body was going to react. And it actually started reacting, started having some contractions. And as that worked, and my mom hadn't arrived yet. She said, okay, so stop there. Let's not do it, and let's do it when we planned on doing, you know, that early birth, and as I joined that ocean, actually, everything just started kind of like going and and it worked great. It was just incredible. My body was ready. I was actually also mentally ready. I know that my talking to your baby is important, being on this same brain wave, saying everything's going to be okay, and trusting is so important because that's when you can actually really relax and you can let the body do its thing. Because you just know, I mean, for so many years, we've done this as women. So the fact that my midwife was there, my friend was there, also I was at home. We had the band, all that we had the backup. Everything was the way I wanted it to be still with some music, lights, lights, you know.

Paulette  19:16  
So let me stop you there for eight one second, just to emphasize that cholestasis does not have any effect on the labor or delivery, right? So you're not doing anything dangerous here. You're trying to get the baby out early, as your doctors have recommended, and you're just going through a normal labor process at

Jelena  19:35  
home, exactly, exactly. So, because it's just about the placenta and the aging of the placenta. So it's really so those women, what they do is they would just go to the hospital to be induced, so it doesn't change anything. Yeah, that's that's important to besides, yeah,

Paulette  19:53  
okay, so your friends are there. We got candles lit. There's music arrived. I'm hoping Yes,

Jelena  19:58  
yes, there. My husband is there. We've got the rose petals in the middle of the like, you know, starting to get, you know, closer. And it's like, hey, the petals. And they're all laughing, saying, like, of course, Yelena is remembering this even during, you know, birth. And so it, it's just to show also that if you prepare your body and you trust your process, it was painful. It was very intense. But for me, it was short, even for a first birth. You know, when they say, you know, it takes longer, and it definitely can be normal. But for me, it was five and a half hours only. But it was very intense. Yeah, it was very intense and, and I love it when, you know, my midwife said, Oh, I saw in your eyes this moment of like, you want to give up because the pain is so intense, is the moment the baby's gonna come out. And I remember that feeling of like, oh my gosh, I can't do this. And then, you know, up in the head pops out, and, you know, everything, everything's fine. It wasn't. It was incredible. It was incredible. It was incredibly powerful to be able to have a natural birth while doing it earlier. Yeah, yeah. Agreed. That is unusual. That's amazing. Yeah, yeah.

Paulette  21:21  
So once you deliver the baby, the placenta is also delivered, and so the issues with cholestasis go away. Or, Yes, once the pregnancy is over, then you're going backwards to what it was, okay,

Jelena  21:34  
yes, yes. This is one of the thing that they don't know why it's happening, and that you may probably have the same for the next pregnancy. So I haven't had a second pregnancy. So I don't know that's kind of, you know what they say. But when I said, you know, shift in the fan, it was more also emotionally. So when it comes to, you know, physically, everything was fine. I was also trusting the process. I had my in life, parallel my husband, at that time, was also going through stuff that was just very crazy and emotionally

Paulette  22:08  
life stuff not to do with the pregnancy or Exactly,

Jelena  22:13  
okay, yeah. And I think that it actually also shook him, because he had a lot of trauma. And this is where, when you give birth, also, not only, you have some stuff that can give her surfaces, for surfacing and even through, through pregnancy, but after also for the partner, just he didn't have a dad. I mean, he did, but he wasn't present. He felt abundant, and then he actually killed himself when he was in his late, I think not latents. There's just so much trauma related to actually becoming a dad, yeah, and for me, there wasn't so much, you know, of that kind of trauma resurfacing when I was pregnant or after being postpartum, but within that relationship, that's when, wow, got very, very difficult. I'm

Paulette  23:03  
going to stop my conversation with jalana here for today. I appreciate her sharing how she managed a condition that seems to fall on her unexpectedly. Her trust for her care providers and the process are impressive in the face of that uncertainty in this particularly vulnerable period, and they served her really well. We'll hear more about how she manages the surprises. She confronts in the postpartum

Speaker 2  23:24  
period with her partner, next week. Thanks for listening. If you like this episode, please share it with friends. We'll be back next week with the rest of jolena's, inspiring story.

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