#97 | Amanda Pahl's Birth Stories: Four Births and a Miscarriage

May 5, 2021

Amanda Pahls is a mother of four daughters, a blogger, and a home school educator with a passion for honoring  women's birth experiences. She joins us on the show today to walk us thorough her first hospital birth followed by three home-births and the dramatic difference in care she received between the two.  Her fifth pregnancy and most recent birth was a miscarriage, at home, which brought her a depth of grief, sadness, and even guilt that she never expected. She opens up about the hard questions we have to face after a miscarriage, like "what do I do with the remains of my baby?" and explains the importance of bringing more awareness, compassion, and empathy to mothers who've miscarried.  

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View Episode Transcript

I've never had the fear of miscarriage in any of my births. I think I'm a little naive. I've had lots of friends lose babies, but just really had no frame of reference for what that what that was like at all.

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

I am Amanda Paul's mother to four little ladies and I just love talking about birth, I get so excited and super grateful to have the opportunity to do so when I think back to our first birth or our first pregnancy, we're so excited. And I've always had an inclination. There we go inclination to have a natural birth, didn't know anyone who is really into it. I didn't have any friends at the time who'd had a home birth. And that seemed really scary. So which Bradley method classes and I watched every documentary I could and I just read every book I could find about natural birth. And it turns out our hospital birth experience was a lot more typical than a new. So in my mind, I was going to the hospital and I was going to give them my birth plan and I was going to have this beautiful natural birth. It it didn't go like that at all. I was actually kind of mocked and teased at the thought of wanting to feel my birth. my water broke at home. So we waited we waited a few hours, I shaved my legs to go out already I had the whole thing planned out, you know. And we we got to the hospital and got checked in and the first thing I remembers the IV hurts so bad like the IV was it still was the most painful part of the whole experience. I'd ask him if they'd move it and they say no, we have to keep it here. And I remember starting off just like really emotional because it's just that hurt. labor was going great. It was going awesome. And I felt like I needed to stand up. I said, I feel like I need to stand and walk around. And the nurses and the doctor really didn't want me to they had a cordless monitor but I was broken. And so they wanted me to be monitored in the bed. And there were no issues. We had no issues that our pregnancy at all. And so I was like would it just be okay if I, if I do it every now and then. So I'd get up unmonitored, start walking around by labor would pick up, my contractions would get heavy and it will come we want to monitor. As soon as I'd sit in the bed, my labor would stop, like, completely stop. And so we did this for 30 hours.

And I'm just feeling so emotional from the ups and downs I was allergic to the gel they were using for the monitor. So I had this nasty rash on my stomach and the IV was really painful. And after about 30 hours, well I guess it was about 28 hours, a anesthesiologist came in and said you have the option to get an epidural or the option for a C section. And that felt really unexpected because there weren't any issues. I was handling the pain. Well, my husband I were really clear we didn't want any medical intervention unless it was necessary. So we were really confused, like why do we need an epidural? And they said well, we want we want to slow your contractions down because you're going to be too tired to push and so we were very confused by it I cried and cried and after a lot of debate it was it was get an epidural or we're gonna see section new so with not much choice, I got an epidural. I ended up falling asleep and waking up and pushing for six minutes. The epidural and the IV were were so painful, it only numbed one side of my body. And it was just that part was really much more traumatic for me than I even realized till after I'd had time to process that birth that I hit a nerve in my back so I had to shooting back pain for a solid year. Anyways, had her it was awesome. I remember holding her the most. And I said I cannot do this again, not birth. I love birth. I love this baby, but I can't do it in the setting and he was very much so onboard. Six months later, we found out we were pregnant with baby number two, huge surprise but I was in that time I'd already started reading and just preparing myself a new natural home birth or something I wanted to I wanted to know more about so we found out we were pregnant and I said please, please can we find a midwife? Can we find a home birth midwife and do this and my husband was really reluctant he the thought of home birth was terrifying to him he The first question that he says and the first question that everyone I know says is what if some nothing goes wrong. And what we were so fortunate to learn is, well, they'll do, they'll do what they need to do. And they're trained to do so. And so I was really, really fortunate to find a midwife who became like part of our family. She just loved me and supported me. And our visits were so different. They, she wanted to know how my week was, she wanted to know how my daughter was, she wanted to know my husband, wasn't she really, it was so different, just the care and the responsibility of how am I eating, you know, taking better supplements, like there was just so much really positive responsibility placed on my husband and I, it was just very empowering for us, as people, and especially as parents, but when that birth came closer, I remember being so excited. And it was it was magical. It was a it was a to push to push waterbirth Nope, no complications, no pain. I remember. My first words were what that was so easy I was waiting for. I was waiting for so much more to go wrong. I was waiting for all the things that so many people in our lives were so afraid of. And I remember just like sobbing and my midwife holding me and telling me how proud she was of me. And just like speaking this new life into me was really magical. So after that we were sold, my husband was like, he just became this huge natural birth and home birth advocate when it was appropriate for people and just was like, it was a coolest experience. I remember him crying a little bit. Not a lot. Can't say that too. But he was like, thank you so much like thank you for convincing me to do that because it was just awesome. Our third birth was same in my midwife. That birth was so funny. I was actually dilated at 10 for two days. And my midwife was just teasing me she she got me coffee and I was playing tag with our daughters around the house dilated to attend and we were just I mean, in hysterics you were at 10 centimeters for two for two days and two days in it. Were you feeling like the urge to push over, hadn't crossed.

My Water hadn't broken. I felt amazing. Um, there was definitely a heaviness and towards the end she was like just check. You can you can you can feel a bag of waters. And were you were you in labor having contractions or you were just so I was having some contractions, but they weren't normal. And so my her first fear was like I had an incompetent cervix and then showed Nope, that's not it at all. So she ended up giving me a tincture. And I can't remember if it was it was a root. But that really got my contractions going. And then we were like, we're gonna try and break my water because after two days, it was like, Oh, we gotta try something. She tried to break my water. When I say it broke. I mean, it splashed everyone around us. It was so funny. And with within, within minutes she was here. I said, I have to get in the pool now. It was awesome. Actually. The thing about this birth that really, really showed me just the importance of care of what's going on in birth is when I went to push, I couldn't. I mean, she was right there I was I'd been in the tent I was there was nothing blocking her. And I said I can't, I can't push like I I physically cannot push her out. And my midwife that I have, I have an idea. And so she went up and she checked and it turned out that she did she had a new nuchal hand her her hand is tucked behind her head. And so her elbow was stuck. And so she very gently moved her arm and she came right out no damage to my lady parts, which was like amazing, because I know friends who have been born with a baby with that, and it's, it's done a lot of damage. And after that, she told me she said, you know, most the time that's not something that gets checked. And it does it can it can cause fourth degree tearing. I had no chairing whatsoever in any of my home birth. But because they cared for me so much like my midwife, she soaks cloth in oils and in a crock pot and it sounds so silly but like legit cares for for my body in such a tremendous way where I haven't had physical trauma in any of my home births. But yeah, that was so cool that she would take the time not telling me push, push, push, she would take the time and say I think I think I can help you I think I know what's going on. And just what a difference I probably made in my other labor's and my pelvic floor and my recovery. Yeah, I mean, let's let's just take a minute here and appreciate that this is what it means to be a skilled provider. Because she yes unique that many obstetricians would never even learn in obstetric school. If they ever did, then they no longer are, but a skilled provider to say oh, you have a breech baby. Alright, now we're not doing a C section yet. We're gonna flip you over on your hand on your knees and four Or, oh, there's a hand presentation. Wait, I know an adjustment technique now just relax and let me reach in there and help the baby to move the hand. This is all the value in the world, isn't it? It's exactly what you're describing.

It's Yeah, I have friends that have so many pelvic floor issues. And I go I'm so grateful that I was treated in such a way where it wasn't a rush. It wasn't get the baby out. It was how do I how do I help you in this moment?

Not Yeah, not to mention the patient's that your midwife had to have? You be at 10 centimeters for two days? It would have been Yeah, you would have had a C section but you would have been covering section by them.

Yeah. Yeah. back on your feet.

Stayed. Yeah. And she stayed with me. We ordered pizza. We had a sleep over. Wow. It was I I know. She said I'm not gonna leave you. You know, there's no reason to be afraid. But she has a loving children. And she said that a few of her she had dilated to 10 for a few days, too. So she it was special. She was like, I remember this.

And I just want to make a comment about the crock pot thing you said earlier. I don't know exactly what she did. But there is something to be said. It was like when Trisha made my postpartum soup pads. When I was in labor, there's something to be said for that touch of nurturing maternal care. It's just it's so precious. And we forget, yes, instinctually what we want, we want that woman's arm around us that nurturing care. And you know, it's represented by these gestures. And by these activities.

Yeah. And I, I we, Kris and I would laugh, but he was like, it sounds so wild to say she cared about my vagina so much. But But How awesome is it that she took that care because I'm, I'm experiencing so many benefits of that now even later, where I don't have you know, I don't I don't have this damage set. I could have had that care not been taken. So that was, yeah, that was a fun birth. That was a really fun birth. So our our fourth daughter, Francis, she, we were so excited, because at this point, we kind of felt like, Oh, homebirth is our jam. We know our thing. Our midwife is literally like a second mom to me. And I remember calling her and I said, I think I'm dilated to like an eight or nine. And she she teased me and she said, Do you think and she I wasn't doing like another two weeks? And she said, Do you really think that I got there? And she said, Yeah, I can stretch you to a nine i think i think you're gonna have a baby, baby today or tomorrow. And how did you know that? How did you know that? I felt it. Okay, so this is wild. And this will tie into my next birth. I've always felt my cervix dilate. And with ADA, I felt the same thing. I told her I went to her checkup I wasn't due for another week, I went to her checkup and I said, Would you check me? I feel like I'm really dilated. And this one, I left this out. But she started laughing and she grabbed her assistant and she said get the bags packed. She could stretch me to attend. And so that's we that's the one that I was dilated at attend for two days. But she Anyway, she followed me to my house because we were like we're having a baby. This isn't just the checkout unit. How did you know? How can you tell? There is this like, it is the most bizarre thing. It is like this stinging internal feeling that I feel like I just know, it was so weird. I could. I knew as soon as my dial or my cervix was dilating, even with no show or anything, I could just feel this feeling. And it always know Oh, it's like time it's getting close. And it's such a specific and bizarre feeling. And I'm going to touch more on this because it really helped me in my very last birth. So frankies was our my my easiest birth no one even knew I was delivering her. I got in a tub. It was peaceful. I feel like I wasn't even a part of it. I was just listening to the music. I was breathing. And I had one big contraction. And I thought yeah, I'm gonna push by didn't say anything to anyone because it was just this really peaceful moment. My best friend was there. And I reached down and I said, Oh, her head is born. And we filmed it underwater at the GoPro in 4k. And it was so cool watching her little eyes open and look around the pool. It was wild. And my midwife just started laughing and she said what what is going on? And I said, Yeah, one more just very gentle push and she was born. But this was the only birth where I had something that when when people say What if something goes wrong, so delivered her was beautiful. And the water started to turn real dark real fast. And that was different. I'd never had that happen and my midwife kind of got this look in her eyes, but she doesn't normally do. And she said do you feel alright and I feel great. And she said I think you I think you might be hemorrhaging a little and so she very quickly without I mean skipping a beat massaged my uterus. I mean, she kind of punched me really did a deep deep massage of my uterus and said, You know, I'm not gonna freak you out. I just want you to get out of the tub. There was no chaos. I don't even think anyone else knew what was going on. It was so peaceful. She gently got me out of the tub. We handed Frances to my dad or to her dad. My husband got on the couch, she said, I'm gonna give you a quick exam. And she said, I'm getting a massage her uterus a little more, you're not gonna like it, but did so and completely stopped it with just that massage. And I remember laying on the couch and I was like, was that bad? And she was like, Well, yeah, that can be really dangerous physically at times, though, you'll just get a shot of pitocin.

She's like, but there's, you know, there's no reason to be concerned if we were able to get that uterus to contract and stop it. And she's like, that's what, that's what that massage did. I remember laying there on the couch and thinking like, oh, that could have been like a scary thing. But it wasn't at all it was. It sounds so weird to say out loud. But even in after birth, hemorrhage, it was so peaceful, I really had no idea at all. And then she checked my iron levels, my blood levels, and we were good. But even in that scary moment, having someone who just cared about my well being She didn't even I mean, she was just so smooth. Even even in my labor, she'd hug me and hold me and say, What are you thinking of? What do you do you have any fears, let's talk about him. She was able to help me process previous trauma and even things before I was a mom. I just don't feel like I would have ever had without her. But yes, I'm gonna I'm gonna move into this last, this last my last birth because this this one is really rocked my world changed a lot of my perspective. So we found out we were pregnant. this past November was a huge surprise. But we were very excited and very surprised to find out he was a boy, our first son and so it was like, one crazy that we're pregnant again, but to I can't believe we're having a son. And so I remember texting my midwife right then and said, Hey, you know, are you accepting clients and, and she laughed, and she said, I'm just like, so excited. And we told all of our family and friends and Christmas is a big week, we waited to surprise our daughters. And it was like wild it was it was the most fun morning of my life. It was it was magical. And I've never had the fear of miscarriage in any of my births. I think I'm a little naive. I've had lots of friends lose babies, but just really had no frame of reference for what that what that was like at all.

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So it was December 28. We went to make dinner and I said I started having that feeling like my cervix is dilating. And I told my husband I said something is something's not right. I have that that feeling and there's I'm just gonna lay down and I said surely maybe it's like, maybe it's some kind of something but I knew instantly like no, the only time I ever had this feeling is well my cervix is dilating. And it was very hot. And it was very fast. This feeling it's bizarre to describe but I I stood up and I knew I like knew I was going to go into birth I started having intense contractions I ran up to the bathroom and I went into labor. I but I mean there was an enormous amount of blood. My husband was by me he said what do we do? I said, I think we just have our baby. And I did it was a normal birth. It was the most painful birth Actually, I most of might have been very pain free. This was not the case. The contractions were so painful. Pushing was hard. And I did I gave birth to our son in the toilet and I I picked him up and I set them on the counter and I said we need to make sure we can account for as much as we can. I went very I went into shock I delivered the placenta I pulled the placenta from the toilet. And I we laid it on the counter and we just stared and I called up my sister in law who was an ultrasound tech and works with a lot of women who've had miscarriages and she said you know don't go to the hospital. You're gonna bleed a lot. You need to you need to find a spot where you can rest and be comfortable but this is going to sell She's like, it's just gonna suck and I had no idea the amount of blood loss I would experience and and how scary it would be to we adjust, like hours before pick out his middle name. And so it was such a bizarre thing to go from planning about this baby and dreaming of this baby to birthing this. This It sounds so graphic but to birthing this dead child, I had no idea that's what miscarriages were I always thought you started your period. Or it was like, Oh, I don't know why I had never really thought about what it was how far along were you? I was 11 weeks. So I feel like there's so many people go, Oh, you were just 11 weeks. And that's like, painful to hear. But I feel like I was fortunate and that I didn't have to have further procedures. I was grateful that I got to deliver him. I was grateful that you know, we got to have our home birth, but it was very painful. Emotionally, I was trained as a therapist, and I know trauma and grief really well. And I thought I'm gonna be fine. This is normal. This isn't an Oh, that wasn't the case at all. It messed me up. I have never, I have never grieved the loss of any, any sorry anybody like this. And then just the to not to not have known what to do in that situation. I had never heard anyone, anybody I was trying to make anybody tell me what the actual miscarriages was or postpartum that I was going to go through all the postpartum stuff that I did with the girls down to even just smelling like postpartum which is so bizarre. But I decided after that, that I was just going to talk about it all that my miscarriage was birth, it should be acknowledged is that especially for women who are birthing babies farther along when they're they're able to hold, you know, hold their children. And I think miscarriage needs de stigmatize. I have told women, you know, if your doctor tells you, your baby doesn't have a heartbeat, go by a strainer, put that in your toilet to catch everything. Because you're not going to go home and start your period you're going to you're going to go home and have a baby, I've now received 1000s of messages and hundreds of them have been we went to the doctor, we didn't have a heartbeat. We were told I'd go home, I could go to work tomorrow, it'd be fine to come home and have these traumatic births. And so I there's just got to be more information put out there about miscarriage and what it really entails.

Can you speak to the decision? Well, in your case, there was no decision but for women who are in the position of having to make the decision to go home and spontaneously miscarry versus having a procedure like a dn C, based on the interactions I've had with women they have, most women have said they wish they would have had the option to go home that the hospital was was cold and scary. And then they never got to see the baby the remains were just taken. And that that was really traumatizing. I, it's a bizarre topic to talk about. But I had probably, I had pages of messages of what did you do with his body? My husband? And I really couldn't remember Did we? Did we fold Fold him up in toilet paper? And do we flush them? Or do we put them in the trash? And it appears that there's a lot of women with a lot of trauma have they didn't dispose of their baby's body the way they wish they would have? And I'd never I'd never even heard of that. What do you do with your baby's body when it dies? Way too soon. And so that's something that one girl messaged me and said, I've been in therapy for three years. I just cannot I can't get over the fact that I would have flushed my baby. And I think it's a very instinctual thing to do. I don't think there's anything wrong with it. I don't think there's a right or a wrong way. Women who have said, you know, my baby's still in the freezer, I don't know what to do. There's just a lot of trauma that comes with that actual, what do I do with the body? But yeah, as far as DNC I think if it's necessary, you don't really have a choice. But that's a traumatizing experience in itself. And I think a lot of women don't feel like they have a choice. And they might not and there's just a lot of people need to be able to share their stories to work through that. Amanda, we just did a post product. We just did a miscarriage roundtable a couple of months ago. And we had three women who all shared their stories about miscarriage. We do roundtable episodes sometimes where three women come together and talk about a shared experience and a couple of them had a DNC one did it at home naturally, you know, they all had very unique stories. The one who had her miscarriage at home, was planning a home birth. And the other two women were it was just so illuminating for them to see that there was another way to do it. And in her case, yes home birth midwife led her through a memorial service and had her two boys have evolved and her husband like her husband really didn't fully grieve until this process but they wrote letters But I think what you just said is exactly it. It's just knowing that you have a choice. It's not that that's preferable to just doing that, like having your miscarriage in the toilet and flushing it or having a procedure. What we want to do is just whatever is going to bring that mom and that couple of the most peace because as you know what's like a primary emotion around miscarriage, it's guilt. And we just we have shame and shame, like what did I do? Did I do anything to cause this? Oh my gosh, I didn't give that baby's body enough respect and love and I, it's so painful to think about the women who wrote to you and they feel regret about however they handled it. I just feel so much for those women because it's the body after the spirit is gone, the soul is gone. The energy is not and here's this woman whose feelings of guilt after her own trauma of losing that baby it's like it just makes experience so much more painful.

It's so painful and women who said you know what happened at my in laws house that happened at work. It happened at a friend's house, so I didn't even tell them because I was so embarrassed. How do I come out and tell them I just you know, it happened on Easter happened on Christmas. There's all these stories that and there's just layers and layers and layers? And I'm going How did I have no idea as a 35 year old mother of four what a miscarriage was? Where I just we're not prepared to to lose our babies. It's not I don't we weren't there. Yeah, our stories are so important. And D stigmatizing that guilt and shame that comes with it, that it's not, not anybody's fault. So what did it teach you? How did it change you? I feel like I have a lot of empathy and compassion, even which is how I share my other birth stories. I think I would share them whenever I could. With this just, I mean, they were amazing, but also just going I need to have a sensitivity about it. Because who knows, if the mother across the table has felt this loss, it's it's not a loss, it's gonna leave you it's, you know, that baby was so much a part of you physically, emotionally, everything in though they're gone, that there's they're still there. Just being aware of and then just going how incredible women are, you know, women who have shared they've lost five babies, or, you know, they've buried their their 37 week olds, just these incredible stories of growing women are incredible, like, we're amazing that we can experience such as such pain and keep and keep going. It's just really, and then just going I gave birth to my my daughter's in my dining room. How incredible is that? I got to do that, that they, they were healthy. And they made it full term and just kind of how incredible that really is. I have a lot more respect for birth, and just the development of a baby and even just to get pregnant. I'm just kind of it's made me step back and just have a reverence for all that I didn't have before. I think when you have people in the industry, like me and Trisha, who are so passionate about what we do you know you when you don't when you aren't close to it, you assume women like Trisha and me are in this because we're inspired by birth. And it's beautiful. And it's amazing. But I think what really can drive us is our longing to see change our longing to see conversations happen, our longing to see yes, men, this isn't just an inspirational side to this. There's so much work that has to be done. And I think that's what keeps you up to like, we need to keep talking. We need to keep sharing stories. And educating.

Yeah, that's Yeah, and I think our stories matter. I mean, I think they're the thing that really will, will change will change the whole industry, especially postnatal care. It's like, that was my, my most treasured moments was being cared for after I had a baby and just going women need this, they need this care.

Well, you know, I remember when I studied sociology and undergrad hearing that progress doesn't happen at a societal level without a small, seemingly radical group of people. I'll never forget that term, a small, seemingly radical group of people. It's how, you know, we have equal rights. It's how animals have right to tell the gay movement has right everyone seemed radical at first. Yeah. But I think what you're doing right now by talking about it, and I know you have quite a big following, that you're talking about this, this is what causes change. It's not waiting for the government to do something. It's not waiting for providers to do something. It's literally one woman at a time like all of us, just out there sharing with others and that that will lead to change. Exactly what you're doing is going to lead to improvement. I mean that that miscarriage that you went through, had is having a ripple effect that's helping so many other people now.

Does it feel that really appreciate you saying that? Yeah. I really appreciate you saying that. I one night I got really emotional and just reading message after message and I said, You know, I miss I miss my son I wanted I wanted him so badly. But how cool is it that I'm able to talk to so many women in there and there They feel safe enough to share their stories with me. Like, I feel like there's I earned that in some way. And it I don't want to say the words worth it. I mean loss I don't think ever feels worth it. But it does feel like a tremendous gift to get to be, I hope to be a part of Yeah, some changes that happened and that when my daughter's had daughters ago, we can talk about this a lot easier, the lot. The loss had meaning.

Yes. For all the challenges that we faced with social media in the modern day world, there are incredible benefits to having it and this is one of them, that we have the ability to communicate and share and connect with so many people who have a similar or shared experience or need to hear it. And while it takes an incredible amount of time that the maternity world is so slow, with progress and change. It's so slow this grassroots work is just like Cynthia said it's where it's coming from, you know, it's the driver.

Yeah, I feel really grateful to be a part of that and just like you said his loss has meaning I feel like yeah, his life and his loss has meaning and hopefully that continues to impact a lot of people and lead to real changes.

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I'm so grateful I think there's so much healing and sharing your stories that's that's what therapy is giving people space to share it so I really do. I'm being genuine when I say thank you guys for for allowing me another space to do so. Yeah, you guys are doing cool stuff.

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About Cynthia Overgard

Cynthia is a published writer, advocate, childbirth educator and postpartum support specialist in prenatal/postpartum healthcare and has served thousands of clients since 2007. 

About Trisha Ludwig

Trisha is a Yale-educated Certified Nurse Midwife and International Board Certified Lactation Counselor. She has worked in women's health for more than 15 years.

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