Star

You hear stories about people being treated like a number at an IVF clinic and that was very much my experience. I remember freaking out to my husband saying like, Oh my God, we just, they just charged the credit card but 1000s of dollars at this retrievals costing, and now I can get ahold of them on the day that I need to start medication.

Tanya Tringali

Hey, everyone, I'm your midwife, Tanya Tringali. Welcome to the mother wit podcast, a show about the issues we healthcare consumers and providers face every day as we interact with the medical system. We'll talk about its blind spots, shortcomings, and share strategies we can use to feel seen and heard no matter which side of the table we sit on.

Tanya Tringali

Are you pregnant or a new parent looking to ensure a better postpartum experience? Or are you a birth worker looking to improve your postpartum care skills? Check out thriving after birth, an online self paced course by me midwife and educator Tanya Tringali. It's 10 and a half hours of video content featuring experts in lactation mental health, pelvic floor health, pediatric sleep issues, you also get worksheets and a workbook as well as options to have a one on one session with me sign up and Mother wit maternity.com/thriving. And let's improve postpartum care together. My guest today is star Lee, she's joining me to share her fertility journey. When I asked Starr for a little info on what makes her story unique. She said, I don't know that my story is unique, but rather I think IVF and fertility aren't discussed openly enough. But I do also have thoughts on the care of patients going through IVF. Meanwhile, as I read through what she shared with me, I heard lots of things that make her story unique, or at least super interesting and relevant to the things we talked about on the show. First, she had an easy time getting pregnant at age 40. And then after her first birth and 20 months of breastfeeding, when she didn't hit the first ovulation jackpot a second time, she intuitively knew that time was of the essence, if she and her partner were serious about having a second child, I'll let her share her own story. But this is definitely a story of being proactive by someone with a strong sense of self and a natural ability to advocate for herself. And even still, it was a difficult experience that she's still sitting with and working through despite beautiful babies and joyful births. Okay, enough for me, star. Welcome. And thank you so much for joining us today.

Star

Thank you. I'm glad we were able to make this work out.

Tanya Tringali

Me too. All right. Before we dive in, tell us all a little bit about yourself. I know you'll tell us much more as the story unfolds.

Star

Well, I am a now a mom of two. As you mentioned, I had my first baby at 40. And now my second when I was 44, when I had him. So I had a very long career in fashion design in Los Angeles. And I was kind of ready to leave, leave that area of my life and leave that career and move on when I met my now husband, and we decided to have our first son. So like timing wise, it just felt like a good time. I I think I mentioned to you that we decided to have our first son about two weeks into dating. So we decided very quickly that we were going to have him but being 40 and you know, kind of being a realistic about how this was going to happen. I met with my OBGYN and had the day three hormone tests and just just so it wasn't giving my partner like an unrealistic hope that we were going to have kids you know, I kind of you know, I'd never I didn't I had no idea where I was fertility wise. And in the prior to that I had always been trying to not get pregnant. So this is a big twist and the way that I was going about things and but I got the bloodwork back. It was wonderful. It was excellent. But my OB she she did say she's like well, you know, this is the bloodwork, nothing to do but try now because that's what's really going to tell you. We waited a few months into dating until we tried and we got pregnant. Five months into dating, as you said.

Tanya Tringali

For our listeners, we have a baby that's nursing and napping, so you might hear some baby noises and I'm getting the pleasure of staring at this beautiful little baby. But that's what you might be hearing if you hear interruptions or funny little noises.

Star

Sorry about that. No, no.

Tanya Tringali

I kind of want to touch on the fact that you, who did not even think you wanted children for a long time, like that was part of your sense of self, and this am I right that this happened for you this change was fairly sudden, when you met your husband? I mean, clearly you were talking about getting married and having kids very quickly. But tell me a little bit about that evolution, because I think you also said something that is interesting and a little bit counter to that statement. You said something like, there was this voice talking to me about motherhood, and I didn't know what to do with it. There was something like that.

Star

Yeah, yeah. Okay. Well, um, yeah. So I, as I said, I had a long career in fashion, it was really kind of my focus in life, towards my relationships, even my, like, more serious, long term relationships in my life, children was not in the discussion. And so I was living a very happy life. But I in let's see, in 2015, I started to do some shamanic work. And I started practicing with plant medicines. And during one of my journeys, it was the whole thing was basically this is what it is to be a mother. And I came out of it not really knowing what to do with that information. Because I wasn't planning on having children. And I was, you know, I was like, Well, I'm not planning on having kids. I don't think this isn't about me and my mom, because I get along with my mom. Okay. Like, it was very good. So I was like, Maybe it's like a creative project I need to birth or something. I don't know what to do with it. And just through different, like meditation practices and different things. I, you know, I've done like breath work journeys, and just a lot of different spiritual based practices that this kept coming up. And I would do this thing in like, the early morning hours between waking and between sleep and wake, where I would say like, Okay, if this is really supposed to happen, like make it so obvious, like, I can't, I can't make this kind of decision on my own. Not even knowing. I don't know how, like, I need a partner, like, the father of these children, you know. And so when it was very interesting how when I met my husband, he was very quickly, like, you know, I think you're supposed to be the mother of my children. And it was very clear, and you know, so we just, we just kind of dove in. for it.

Tanya Tringali

Interesting. I love it. Okay, so, back on track of your story, I just thought that was an interesting aside, and I I'm actually really grateful that I asked you to elaborate on that because I'm a pretty literal person. And so I was like, what does it mean to have this like voice talking to you about motherhood while you were so clear about not now I get it. Okay. So okay, first pregnancy spontaneous pretty quick. You're super stoked, like, everything's going smoothly there.

Star

Yes. I mean, I wouldn't say it was totally spontaneous. I was doing ovulation tracking. And I knew how did you timing and all that?

Tanya Tringali

Sure. But when I say spontaneous, just for clarity of our listeners, there were no, no assistive medications, hormones technology involved, right? You had a spontaneous pregnancy, you were just being scientific about the process, because you understood your chances were a little bit lower, simply based on age. Yeah, right. Cool. Okay. So any, if there's details about your first experience that you think are really relevant to getting into the second part, second pregnancy, please stop me and and add those details? Because I know that there are there is room first drawing some comparisons to the experience.

Star

Yeah, I mean, just the fact that like what you mentioned, it was just super easy. You know, it was so easy that when we got pregnant, it wasn't until you know, a couple of years later that we realized how fortunate we were and how, how easy we did have it got it, it was so easy that we didn't know how easy it was.

Tanya Tringali

Well, and on that note, you also comment on the fact that you were completely unaware of the concept of egg freezing and all of these things. And that, as I understand, that's something that you kind of wish were better incorporated into the care of younger people, perhaps people in your situation who are thinking, maybe I don't want kids or especially the people who say I do but I don't know if or when right.

Star

Yes, yes. And, you know, that's one of those things where I have never in my life, you know, I've seen, you know, a number of obese throughout my life from Planned Parenthood to private doctors. Like I've seen so many different doctors. Nobody ever brings this up at all with anybody it's it's only what type of hormonal birth control do you want? That's, that's really the basic question that you get asked and which was always interesting for me because I I actually don't like hormonal birth control for myself. And I used tracking methods for myself. And, you know, it just seems that doctors were very focused on hormonal birth control for young women. And that was really the only discussion that was ever had. Yeah. So I think that that, you know, this could definitely be something that doctors bring up to young women, especially young women, like you said, who really know that they definitely, definitely want to have a family, maybe just not right now. I think it's very important for those those people to be having these discussions.

Tanya Tringali

Yeah. And this is something that we call in medicine and in midwifery, we call preconception care. And it's something that has been done very poorly throughout the United States, quite possibly throughout the world. And preconception care should look like a lot of different things. Basically, if somebody tells you that they're trying to avoid pregnancy, well, then you take them down that path. But if they tell you that they are considering pregnancy, anytime in the near future, you take them down that path, but that is ignoring a middle pathway that you fell into and that many people fall into, which is okay, currently, I'm avoiding pregnancy, but I have a future that might involve children. And if we don't talk about that, I'm limiting my options. Right, right, for sure. And so we talked about this on the show, actually, a good while ago now in an episode that's called supporting single parents by choice with a midwife named Betsy freemen. So for our listeners who want to dive a bit deeper into what this experience looks like for somebody else in a different set of life experiences. That's a great episode. But this is only the second time we're kind of diving into this topic on the show. And so that's kind of why I'm really grateful to have your experience. Okay, so now, let's go a little bit deeper as you talk about wanting of baby number two.

Star

Yes, well, we always knew that we wanted more than one. So, as you mentioned, I breastfed for 20 months with my first son, my cycle started back at 14 months. We try to, you know, we're doing the same things that I was doing before with the ovulation tracking. For like, six months, and then at the six month point, we kind of thought like, you know, it wouldn't hurt to do a consultation and talk to an IVF clinic. So I did that. And Wendy, when I spoke with the doctor, she brought up a really good point, too, that I, you know, IVF, and the whole idea of it being totally new to me I hadn't thought about was that she said, you know, do you think he would want even more than one child? And I was like, Well, yeah, I can see us wanting three if we could have that. And so she really suggested going right into IVF, as opposed to doing an IUI. Because she just thought that getting the eggs out and preserving them as soon as possible would be the best option. So that was something you know, once again, I'd never even thought of or talked about or anything like that. So we decided to go that route of not doing the like less invasive procedures and just kind of going for it.

Tanya Tringali

And so who was this at the time? Was this your regular OBGYN You were having this conversation with?

Star

Well, no, this was at the clinic when I had the time, my consultation,

Tanya Tringali

okay, the reason I was asking was because another thing I think you brought up and I don't want to get ahead of you, because I know you'll get to it. But just so for my clarity, I got the impression that you had a first experience at one clinic. That was not great. And then you had a really great experience at another clinic. So I was just trying to figure out where this falls into the mix. Because so far, it sounds like you're getting some interesting advice that you seem happy with.

Star

Yes. Oh, that that is that is that I was but this turned out to be the clinic that was not such a great

Tanya Tringali

Ah ha. So the initial advice was fine and dandy, but it's what happens after Okay,

Star

Right, right. So we, we decided to proceed with them. This was my first egg retrieval. They went pretty quickly into it that I think that my consultation was in July of 2020. And my first egg retrieval was, I think the second week of August in 2020. They really went fast. We that kind of the problems that I was talking about with you. So the first day that I was to start my medication with them. You have to go in and get bloodwork and ultrasounds very frequently while you're doing an egg retrieval every couple of days. So I was doing my first blood tests and ultrasound to start my medication. And I could not get in touch with them to find out what my medication was and And, you know, being, I was like, of course freaking out. I was like, very upset. And, you know, you hear stories about people being treated like a number at an IVF clinic. And that was very much my experience, I remember freaking out to my husband saying, like, oh my god, we just, they just charged the credit card, but 1000s of dollars that this retrievals costing, and now I can't get ahold of them on the day that I need to start medication. And you know, I hadn't, I hadn't even been on medication. So it's not like I could continue what I was doing or anything, I had no idea what to do. And I finally got a hold of them at like nine o'clock that night. To get information on that, then we can. So I had the retrieval fast forward to after the, after the retrieval, I had, I think two eggs that were matured and going to be sent out to PGT testing, which is pre Implantation Genetic testing, which they generally advise people over 40, to do. And in for IVF, that actually really increases the likelihood of success. Just right off the bat, if you know that you have something that you know, is has been genetically tested. So they had to the two embryos that were sent off. And they when they came back, they did not pass and I got a call from the doctor. It was it felt like like a 92nd call, it was a very fast call of her saying, hey, you know, I just wanted to know, that didn't work out. Let me know if you want to go next month, and we'll do another cycle. There was no other no other discussion. It was very, very cold. And, and also just not very informative. Like, you know, what are we going to do? Like, we're just going to do it again. And at that point I had, I was living in Orlando at the time, and I had been planning to move to South Florida. So I had been posting online asking moms about clinics in Miami. And I find Facebook groups mom groups to be so super helpful because I had so many responses. Like I probably had like 60 responses or something like that. And I would say 85 to 90% of my responses were for one clinic, one practice, in particular, different doctors within the practice, but one practice so that I just I felt like I got a really clear answer for like where I wanted to go to next. And I was able to get a consultation with a doctor there. And I got a different feeling just in general from like him talking about his plan for me. He was somewhat surprised about the medications that I was on in the dosages. And simultaneously while while this other consultation was happening, I did a consultation with a nurse from the first clinic to see what our plan was. And they basically said, we'll just do what we did it last time, we're not going to do anything else. And we can do it next month and just kind of like go to it. All you have to do is you know, pay for it once more, and then we'll go do it. So I decided to, you know, switch clinics, and we were moving. We're moving down to Boca anyways. And you know, so that's only like 45 minutes away from the clinic in Miami. Very different experience at this clinic. This doctor, he first referred me to their nutritionists. She's like their lifestyle, nutrition. And just kind of like you're their wellness person. And it was unlike any type of like nutritionists that I'd ever met before. A lot of times I myself like I used to hear the word nutritionist and things like okay, like this is somebody's theory on what nutrition is, you know, like ever. I think a lot of people can call themselves a nutritionist, but she was she was a nutrition scientist, and she did everything based off of my bloodwork to customize everything. And I worked with her for a couple of months before we would proceed with an egg retrieval because my doctor he waits for her and all of the bloodwork to look optimal, before he will do anything. So like that, right? There was like a big difference. In you know, we did all updated bloodwork for every, every single aspect just to make sure that we were where we wanted to be. And for me personally, I tend to be a very naturally lean person that is not they wanted me to have a little bit more body fat to be a little bit more conducive to pregnancy and to be a little bit more favorable to that. So are you worked with this nutritionist and you know, she cut my workouts down to three days a week. And, you know, I was I was still working out because even she said, you know, at one point I was still so lean at one point and she's like, Okay, well, let's see what we can do to like get your body fat up with food. because she's like, I'm not taking away those three days, because I know that's your mental stress relief, you know, so she, she really just kind of like worked with tailoring things to me and like, what I needed medically, for doing my IVF retrieval, and also what I needed mentally, just for stress relief and going through the process. So yeah, let's see. So, just for like time reference for people, I had my consultation with my doctor in September of 2020. And I got the okay in January of 2021, to move forward with my nutritionist. And we did my first egg retrieval with my new clinic in February of 2021. So, you know, and it's, it's tough because I know whenever you want to have a baby, and you want, you're doing things like you want to be doing it right now. You don't want to wait. IVF is a lot of waiting, a lot of waiting for cycles, waiting for a break between cycles waiting for bloodwork waiting for embryo tests, there's, there's so much waiting. But what I found with like, with my clinic that I was working with it, it's sometimes felt like things took a long time, but I know that they were doing everything they could to make things optimal, and to give us the best likelihood of success.

Tanya Tringali

Hey, everyone, it's me, Tanya, your host here at the mothership podcast. You know, I sometimes invite my clients on the show to talk about their birth stories and postpartum experiences. But I want to tell you a little bit more about what those clients and I actually do together, I started mother wit to help people in the perinatal period achieve their health and wellness goals. That means whether you're hoping to conceive and struggling with high blood pressure, or high blood sugar, or you're having trouble managing anxiety, or depression and the postpartum period, or maybe you just need support and advocacy between prenatal or postpartum visits, I can help get a discount on your first consultation with me at Mother weight maternity.com using the code first console 10% off. That's one 0% symbol, all one word. I'm looking forward to working with you, and maybe having you on the show too. I love so much of what you're saying about your second experience. And I think so much of this should be routine and standard. I get exactly what you mean, when you say that first experience was very cold. I think that was the word you used was cold. Yeah. And, you know, how, how rude to charge someone an insane amount of money and then not be equally available. I mean, maybe it's because I'm a lowly little midwife here. But like, I have a very affordable service. And the second someone pays me I feel indebted to them. And I have like immediately available to them. I can't even understand a world in which somebody's paying enormous sums of money, and then they can't get a hold of their provider. I mean, that like gets under my skin at a level crazy. I can't even imagine like, I would have been so furious. Well that I would probably burst into tears, because that's what happens when I get that level of furious.

Star

Oh, yeah. So that that day, I was absolutely. beside myself. I did not like I didn't know what else to do. You know, I was reaching out.

Tanya Tringali

Yeah, totally. And then the flip side being this really lovely respect for your natural state and what you as a human can bring to this and the ways in which we can I'm not sure this is the best word choice but manipulate our own biochemistry to be as advantageous to the situation as possible. So I want to take take you back, not for your sake. But for our listeners, when you talked about body fat, I want our listeners to be really clear that estrogen lives in our fat cells like that's why they said what they said to her, I just figured that was gonna go over some people's heads. And I wanted to be really clear. So it is true that in the case of somebody who's extremely lean, if we need to get their estrogen levels up along with some other hormonal changes that can happen with that, we need them to put on some body fat. So if we understand energy expenditure at its most simplistic level, we have to either reduce energy output or take in more calories or both. And that's what they were playing with. And I love that because you don't see enough of that in Fertility Centers. I don't know if they had this or if you engaged in it, but I used to work with a person who who's an acupuncturist and she worked in our midwife Center. This is yours ago, and then she eventually ended up working with a reproductive endocrinologist and her acupuncture. You know, clinic for lack of a better word was in partnership with a fertility clinic because there's really good data that acupuncture can assist in fertility increasing fertility rates. So they worked together for a long time. And I believe she's now struck out on her own and kind of has her own thing dealing with fertility, pregnancy postpartum in the acupuncture world. But did they offer other services there, and in addition to the nutritionist

Star

At the clinic, no, but they do work with acupuncturist and I did, I was I got lucky, I was getting acupuncture, all the way through, and I actually did, you know, touch back on that I did acupuncture as soon as my husband and I started to try for our first son. So I was actually getting acupuncture before I got pregnant the first time I got acupuncture done postpartum, to help me recover with just hormonal recovery after I had my first son. So I was I was doing acupuncture in Orlando, through that whole period of time when I was trying to get pregnant. It's definitely been a constant kind of thread. For sure, yeah.

Tanya Tringali

Acupuncture is a funny thing, right? Because it can be sort of hard to study and hard to understand in a western medicine sense. But we do have a couple of areas where the data in the western medicine literature is really solid. Pain Management is probably the top number one place where we can say for sure, we've seen really good stuff. And then fertility is really high on that list also. So where are we have that data? That's clear, I'm thrilled to hear that places are really taking advantage of that. So can you talk just a little bit more? I don't know if if there are specific instances, but I would love it. If you could say for our clinicians listening, what were some of the things in your first experience, that if you could get the ear of a clinician and say, Hey, maybe don't do this? Or don't say this to people? Do you have any examples of things that you would love a clinician who's just listening in their own private world to hear you point out that were hurtful or harmful or just didn't help the situation at all?

Star

Well, I think the first thing that you really stressed to is the fact that they weren't available to me, first of all, I mean, that's the really big one. Secondly, when when you have to deliver bad news, I think that you know, your your demeanor, and your bedside manner as a really big factor in that. Because like I said that that call that I got was so cold, and just like crushing, really, it was really crushing, you know, because the other thing is, like I didn't being new in IVF. At that point, I didn't realize how many procedures people really do go through. So I was just like, I don't even know what to think about this. And, you know, they just, they just left me with this cold call and no information to it was just if you want to go again, just call us and let us know, you know.

Tanya Tringali

And then that sends you spiraling or maybe not you but every a lot of people spiraling about what does all this mean? Right? Like, if these embryos were not good? What does it mean for me in the future? Does that mean they're all not good? Right? Like you start to spiral into these places? Because you don't have enough information?

Star

You don't know anything? Yeah. I mean, as I mentioned, I've done to you, I don't think I've mentioned it, since we've been talking here today. But I did a total of four egg retrievals. And one of those retrievals, I, even at my clinic that was wonderful, I did not have a good retrieval, I had four eggs that came back that did not pass. And instead of me getting, because just explain a little bit, whenever I would do these, like they would send me each day. Like, if if something had grown enough to be frozen, they I would get an email telling me that, you know, just kind of like this form email, like when embryo was matured and frozen, and the biopsy was taken and it was sent out. So my doctor did not want me to get an email, saying like four eggs did not care to you, but they can't even be actually this, this for four embryos couldn't even be biopsied. And he called me and he just he was just very caring and the way that he handled it, and he he was like, you know, I wanted to call you personally and let you know that the four embryos that we have, we could not even biopsy them. They were not healthy enough to even biopsy and they didn't grow that well. You know, well enough to even get to that point. And you know, he just expressed how Uh, sorry, he was and not even that, but like, I just I remember the tone of his voice, he was very genuine, he was just, he's a very genuine caring doctor. And that really came through to me. So it's not that everything just worked out perfectly at my new clinic. And I never, you know, I got some bad phone calls. I definitely did. And, but it was how they handled it. And that was really, really a different, just a whole different tone and set up a different relationship to have with the clinic itself.

Tanya Tringali

Yeah, and I think what you're touching on is, you know, more important or whatever, just on a different level of importance to the idea of bedside manner, which is problematic throughout medicine in general. But it's this idea that people who go into the medical field regardless of what you are, at the end of the day, whether you're a doctor, a midwife, a nurse practitioner, etc, etc. I want to believe that people get into this work, because we crave and are potentially very good at human relationships and interactions. And yet, I, it's hard when we're talking about things like this, because I see things in medical school and residency programs that I think beat that out of people. And the system further, creates this barrier where we don't have time to be a certain way, because we've got to move on and see the next patient and all these things we've talked about ad nauseam on this show. But at the same time, there are people like myself, and many, many other wonderful practitioners, who, who just refuse to let go of this piece, and who find a way to connect with people, even when time is limited, and all of these things, and then there are people who just don't. And that is such a problem. But that's what makes me say things like we should have to have a bedside manner test before you're admitted into medical school, more midwifery school or any other school for that matter. But it's so it's so interesting to hear you share your perspective on this journey that we know is so emotionally fraught, which I want to talk a little bit more about also as the emotional piece.

Star

Yeah, we'll also just one other thing that I wanted to say is like it the first clinic that I was at, they didn't seem willings the right word, they didn't even bring up doing other tests. And like, what else could we do to maybe understand a little bit better how to customize this, whereas my, my clinic that I ended up working with, you know, for the longer term of it, we, we just we covered every single base that we possibly could, and even even things that other clinics might think weren't necessary or might not be helpful at that point. We just We did everything. You know, and I think that, you know, for something like this, this is a matter of growing your family or not growing your family, you're creating a life, you know, it's it's a big deal. And if you need to turn every stone over, do it, you know,

Tanya Tringali

well, the opposite of individualized medicine, which is what you got from the second place is unfortunately, cookie cutter medicine, which is like robotic, we follow this procedure. That's what we have. That's what we do. And unfortunately, that trickles down from the person with the like, highest level of education or degree, who's kind of ideally running the show and creating the idea behind the practice down to the people who answered the telephone. Because if everything is robotic at the top, it just it gets more robotic as you work your way down through the staff levels, because their tool bag can only be as big as the person at the top. That's how I see it anyway.

Star

Yes, I agree. Because at my second clinic even like, like you said, everyone from the hallway, the hallway down like it the second clinic by the time, you know, I'd had so many procedures by the end of this that like the the women at the front desk knew me. The nurses were like, telling me they're white. Okay, I had to like I had to know if the pregnancy test was positive or not like they were they were like rooting for me and they knew me, you know, all the way like the entire staff like all the way through Oh, for sure.

Tanya Tringali

Yeah. So the second pregnancy that was IVF was it a successful easy pregnancy? Were there any issues with the pregnancy or the birth?

Star

Um, overall, it was very easy that I'd say the one difference was in the first trimester with my first son that I conceive naturally, I worked out and lifted weights um, Probably five days or five days a week, the whole entire time with the IVF pregnancy. I did not I was very inactive the first trimester I had. I did have a sub chorionic hematoma, which is like a little bit of bleeding that happens.

Tanya Tringali

Very common, usually not a problem.

Star

It's very, very scary when it happens

Tanya Tringali

Sounds so scary. That word is one of the scariest things you can say. I mean, subchorionic hematoma, just hear that word again. I mean, it sounds awful. And yet, it's something that we find incidentally on tons and tons and tons of people. And I although I don't mean to say to people who haven't gone through IVF, that their pregnancies are less special or less important. But I hope that people can understand that when somebody has invested financially, been through the hormonal craziness that you go through all the different levels of things you've gone through that there's this sense of and even you can say this from your first experience, your second you did not work out the first time you acted like you were a normal, healthy person you were but the second time you were more protective over this space, because this might be my only shot, there's that round like that this might be my only shot.

Star

Well, and he was my only healthy embryo. So he was my only shot with this. Yeah, so I mean, it was that was different in the first trimester. And I was extremely nauseous. I had complete food aversion, I actually lost love I lost weight. And that was like, you know, it that's like one of those things. I mean, it can it can happen. I know that can happen during pregnancy in the first trimester, it's not favorable. So we were trying to like, minimize that as well, as much as possible. I was on the the anti nausea medication, which helped somewhat, it helped me not feel completely nauseous. It didn't exactly help with the appetite so much. But, but it was, you know, typical, like, rough first trimester, I guess. And what was really interesting is I moved right around my 12 week of pregnancy. And since I was moving cities, I set up an appointment with an OB, so I would have somebody to work with, you know, just in case I need somebody to call. So I made sure I was meeting somebody right away that week. And I met with her and, you know, she she did an ultrasound, and she was looking, she's like, okay, you can go back to working out. And she's like, You don't have to tell you this just railroad pregnancy. Now you're good, you know, which was amazing to hear. And also kind of touching on what you were just saying, when I met with this OB, she had such a relaxed, gentle rapport with me that I knew right away that she was the person for me. And, you know, I don't know, I think that like when you meet a doctor or, or a provider, like, you know, like, what, how do I feel around this person? You know, and listen to that.

Tanya Tringali

Absolutely. I love that. That's the advice for the clients that health care consumers listening is like, it's okay to listen to your gut. The other thing is, on that note, I hear a lot of people sticking with someone, despite the messages that are counter to that,

Star

I've heard that so many times.

Tanya Tringali

And I'm always a little dumbfounded at the level with which people are scared to change providers. And I don't want to minimize the feelings that people are having when I said that kind of offhanded and flippantly. But what I am trying to do is say, feel empowered to leave your provider if that's what you need to do to feel seen and heard and validated. I mean, that's what we have to do in order to better the whole system. It's got there have to be factors for all involved. It can't only be one sided, where it's like, okay, let's work on getting the providers to be different in all these ways. Healthcare, consumers need to interact with the system differently, and put their foot down and say, I won't stand for this.

Star

Yeah, yeah. I agree. That yeah, I mean, after that, it was pretty pretty. I mean, it was a pretty basic pregnancy, because I, you know, I was 44. I did do a lot of ultrasounds and monitoring with, like a fetal maternal specialty clinic. And I think it was even like, I think it was weekly after 32 weeks, so I, they knew me, everybody there knew me also. And that was another interesting kind of thing for me, because I tend to be someone who prefers thus, medication intervention, or anything done if it's not necessary. As you said, I was very protective of this pregnancy because I really kind of wanted to do a birth center birth and bring my other son with us and you know, kind of have it be a family thing. But I also had this thing of what if something happens and I just for me personally, I knew that I was going to go into it a little bit more relaxed in for so I just I made the decision for my own like mental state, I guess. But, but my, my, my doctor at the fetal maternal specialty plays like each week she'd be like, so did you set an induction date? And every week, I was like, No, remember, we're just gonna wait and see when he wants to come. And at first, it really bothered me and like kind of unnerved me because like, how somebody's gonna make me induce my baby, I don't you know, and I, if I didn't have to induce I didn't want to. And so of course, I went back to my OB and would talk to her. And she's like, it's okay. I'm your doctor. And, you know, if you want, if you don't want to induce we're not good. Nobody's making you and do you now. But she was just, she's very encouraging. And even my therapist was like, you know, your fetal maternal specialist doctor, she sees the worst of the worst, probably, and that's where she's coming from. She's not being mean to you by saying these things. But you know, it was just something I just kind of had to get used to. I was like, No, yeah, I'm not, I'm not planning an induction and, you know, but towards my family, by the end of it, she kind of like, got to know me. And she's like, Okay, I know, you're waiting to see when he wants to come.

Tanya Tringali

And I think that's, that is such an important piece of the puzzle. We may, on the medical side of the equation, come up with this plan that we try to implement for most people based on various characteristics. What is it about this pregnancy that makes it quote, air quotes, high risk, all of that stuff. But it cannot be a cookie cutter, one size fits all approach. So you graciously said, Put me through the weekly testing. I'm good with that. But you know what, when it comes to induction, I want to do a little more of a wait and see approach. And I'm as I'm gonna go out on a limb and make an assumption that, of course, you would have changed your mind if something showed up on the testing. But your approach was, if my weekly testing is fine, I would like to wait for spontaneous labor. And from what I recall from what you've already shared with me, you're very clear.

Star

Yes, yes.

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Star

I had a very spontaneous labor. As I said, you know, in hindsight, maybe it's because I had already gone through childbirth prior to that, where I had had a birth doula set lined up. And you know, so I had been in touch with her throughout the pregnancy, and especially as I was getting closer in touch with her more, and, you know, she would check in and I was like, a little bit of cramping. And, you know, I was like, I think I really downplayed that, you know, but I think it's because I had been through it before maybe. But, I mean, with this one, it just, it went from like zero to 60. So fast. So, so fast. I mean, it was it went from, I remember looking at the texts, like afterwards, in the time that you know, the time stamps with my doula. It was like 230, I think, or 240. And I was like, oh, you know, I'm kind of having a hard time staying in bed. Now it's getting a little bit more intense. I think I'm going to have my husband Rob bath, and I'll just like labor in the bathtub until I think you need you to come over to the house. And it was but it was still pretty calm. So we do the bath and I had like one contraction and I thought, Oh, this is why people have late water births. Like this is really relaxing in here. And I had, so I had two contractions and I was like, Okay, that's a lot more manageable. But my third contraction, my body started pushing the baby. And I looked at my husband and I was like, we have to go right now. Like right right now. And of course, it's the middle of the night we had to find a friend to come over to be with my son and you know, rushed to the hospital and my husband and the person to Security Hospital. They ran me in a wheelchair up to l&d and he was born four minutes later. So yeah, so he was very spontaneous.

Tanya Tringali

For the record, almost every baby I've ever caught in a parking lot, or on the front steps of the hospital is a second baby. It's always the second babies that come like that. And it's partly because the body really does know what to do. It is true that it's done it before all of that is true. But I also think there's a psychological component where people try to do math, that doesn't make any sense. There's no place for everybody bizarre math, about their first birth and what it means for their second birth. And I'm always like, I yay, this steps I know.

Star

Even even after we got to the hospital, my husband has said he was like, Okay, well, just for a little bit of like information. My first son, I was in, like, I was having continual continual contractions for over 30 hours with him. So it was more much more drawn out. But, you know, afterwards, he was like, my husband said, I thought we were going to be at the hospital for you know, get settled into the delivery room for what, 45 minutes, an hour, maybe two hours, and then we'd have the baby. Now we were there for minutes. So it was like, yeah, definitely a shock to both of us.

Tanya Tringali

Okay, so as fun as that was, I love that part of the conversation that was like my midwife heart right there. I do want you to talk a little bit about the mental health challenges that came with a second pregnancy. And I think, as I understand it persisted into postpartum.

Star

Um, yeah, yeah, somewhat. Yeah, I definitely. I hit a point, you know, mid, sometime in the middle of IVF, kind of once you realize, like, whoa, I'm like, really deep in this, where I remember I was actually at, I was on a, like, a wonderful, like, beach vacation with my son and my husband for my birthday. And I remember, I just, like, I just kept crying, like, just spontaneously crying, and it really hit me of like, how depressed I was, and that I definitely needed to get professional help, you know, and I needed that support that sort of just unbiased support. So, you know, pretty quickly after that, I found somebody. And what I've since found, because I, you know, that was in one city, I now live in another city, I have been able to find people who specialize in, in fertility therapy, you know, you can really, if you look, you can find people who have experience in this, and oftentimes, they have their own personal experience. And that's kind of like what's drawn them into the field. So they have a lot of empathy and compassion. So I, you know, I started seeing therapists, at that point, and continued through the pregnancy, when I moved during my pregnancy, I just I knew that it was something that I needed to continue because I think that there's, there's so many different levels of what what's affecting a person going through this, you know, I mean, obviously, the stress the stress of it, the high stakes of bringing a life into the world, but then also the fact that you are consuming just an insane amount of hormones, it just completely unnatural amounts of hormones are being injected in. You know, I think that all of that, like, piled on top of each other, it's just really heavy. And it doesn't just magically go away and disappear once you get that positive pregnancy test. Because even throughout the pregnancy, you have just like a, like a paranoia after having gone through so much to get pregnant. That I remember the alternative pregnancy I remember telling somebody like I don't think I'll be able to like just relax and breathe until I'm holding him, you know, then I'll be like, okay, he's actually hear, you know, because, you know, when you go through years of trying to get there, it's it's hard to even believe that it's gonna like and with you having the baby that you know, because an IVF there's so many steps where it can go wrong, where if you don't make you know, when you hit one point, like if you if you don't get past that point, then you won't go to the next one. You know, it's like there's so many barriers and so many like blocks that you have to like work through that I think by the time that you are pregnant with your baby, it's it's just, I don't know, you're just very jaded and kind of like in just a little bit of like disbelief of like, this is actually going to happen Is this really, really gonna happen? So, you know, so I continued, you know, to get therapy after I was pregnant. And I still do just because I don't know, I say therapy is like one of those things that it can always help. And as you know, you know, now as a mom of two, it's like, it's, it's, it's all different phases in different stages. But to get that like, like I said, unbiased support, you know, because you have your brands, you can always have a family and your partner but like to have somebody who is unrelated to all of that is really, really helpful, I think,

Tanya Tringali

yeah, I completely agree. And I think this is a place where people who have experienced IVF, and people who have experienced the loss have a lot in common, because somebody may have had, you know, two spontaneous pregnancies, but if they experienced a loss, regardless of how early it was, that next pregnancy is so deeply affected by the experience of the first. And it reminds me a lot of the struggles that I see people working through during pregnancy when they've when it's an IVF. Pregnancy. And that's again, part of where I was coming from when I drew comparisons to the way people experience and feel spontaneous pregnancies versus IVF pregnancies, by no means is that to minimize the spontaneous pregnancy group, it's to elevate the sort of emotionally heightened state of the others. So that's all that's all really important. And I think that's definitely something providers need to be more attuned to, because we know how common for example, miscarriages, and we can get a little numb to talking about miscarriage. But there's nothing numbing about it when you're in a one on one situation with somebody and it's their experience. And I think it's exactly the same when we're dealing with people who have IVF. On a final note, there's one other thing that you touched on that I think would be great to talk about, that we've really not talked about at all on the show, maybe it's come up like a little bit here and there. But you I think, had some thoughts on what it means to be a mother that is older when you become a mother. And this is a topic I'm particularly fascinated with. Because as I think our listeners know, I was a very young mother, I was pregnant at 19 years old gave birth at 20, I only ever had the one child that I have who's now 22. And with that said, I managed to surround myself, my community was older mothers, most of my friends in the years my kid was young and growing up were easy, 15 years older than me, like they probably became mothers in their mid to late 30s, some of them possibly even older. And I was so acutely aware of the way we were different as parents, and I'm watched those people even now the ones I'm still friends with, with our grown up children, we're really different parents. And I think that there is such interesting insights that the different age groups of parents can give to each other. So I'm really curious to hear your thoughts on this.

Star

Well, I for me, personally, I think that having having had the opportunity have my long career is a huge, huge factor, because as I mentioned to you, I was really kind of ready to move on from that I had worked in fashion, really for like, about 18 and a half years, you know, so I felt like I'd kind of proved to myself what I needed to prove to myself, but that, you know, I had that, like, sort of lofty creative career that people don't think is going to be success, like, who goes into fashion design, really, you know, but I did it for many years. And I supported myself in a very expensive city. And, you know, I can feel like I had my accomplishments there. So it was able to walk away from that. And, you know, now I'm like, a stay at home full time mom, and I don't have any regrets about my career. So that I really, really appreciate. And then one thing that I was actually talking to one of my friends before who one of my friends had her kids in her late 30s. And she was saying that she felt like as an older mom, you might have a different sense of time in time, then maybe if you were younger, where I think that we feel very acutely aware of the fact that how of how fleeting these moments are. Where I think maybe if I was younger, I might not have that same perspective. You know, like, I mean, obviously I haven't kissing babies sleeping on me here, I'm like a very responsive parent, co sleeping nursing, you know, it's a lot for mom. But at the same time, I know that this is a season. It's this is such a short period of their lives. And, you know, I mean, no one ever said having kids was easy. So I think that I had a really realistic point of view, going into motherhood, that it didn't think that it was just going to be an easy walk in the park. Because it's not there, you know, these are you got some, like, big little personalities that you deal with and in these kids. So, you know, those two things. And then also, as I kind of, like, touched on before, I, as an adult, I really kind of developed my own spiritual practices with meditation. And I think that that has helped me parent differently, I guess, in some ways, in my meditation has changed over the years, I used to be somebody who would meditate for you know, sit on a pillow at my alter, you know, for maybe an hour a day or something like that. And meditation, it's not like that anymore. You know, some of my meditations might be 10 minutes now. But what I always tell myself is, instead of like, sort of beating myself up for my meditations, and my practice changing, you know, as I become a mother, and I don't have the same time, I remind myself that like, all those years of meditation, it's like trading me for being present right now with my kids. And, you know, I think that, you know, having that those years of experience with that has shaped who I am, as a mom, for sure.

Tanya Tringali

Every single thing you said really resonated with me in terms of what I've seen, from my dear friends that were older when they became parents, and also spoke to the contrast of my own experience. I wholeheartedly agree with all of that. And I, at the same time, I'm perhaps jaded enough to think that even if there are young people listening to the show, which I've looked at my statistics, and young people actually don't listen to my show. So there's nobody probably in the camp of the early 20s, having babies who listen to my show, it's actually pretty interesting. The age groups that I'm getting, but anyway, if young people find the show one day, I don't actually think that the words that you just spoke are going to change them or their experience, because it is that thing about time, right? Like when a kid's in the backseat, saying, Are we there yet? It's because an hour of their life is proportionally so much greater than an hour of a 20 year olds life, the hour of a 40 year olds life. And I totally feel that now. But I and I look back and I recognize that although I wasn't a toddler saying, Are we there yet? At 20? I was the 20 year old mom version of aren't we there yet? Like every day was longer and harder for me than it was for 40 year old at that time.

Star

Yeah. One other thing about that, too, is, I feel that. You know, like I've always said, I never thought I was going to become a mom at 40 and 44. But I have lived a very physically active life and been really into weightlifting and fitness for many, many years. And I can honestly say that, you know, keeping up with a four year old at 44 is no issue whatsoever, you know, at all for me, and I am really thankful for my fitness life. Because I don't you know, I don't feel like an older mom in that, in that sense, like physically. So I mean that, you know, it's definitely possible to keep up with the kids, for sure.

Tanya Tringali

Absolutely. And that's why it's always preferable that people have a good relationship with movement in some capacity prior to pregnancy. People who do have an easier time staying active during pregnancy, continued returning to activity postpartum. But because that's become less common the way our modern lifestyle is, I get people coming to me for fitness support, who are postpartum and saying, Okay, I need help because this kid's getting heavy. This kids moving fast, and I need to keep up. And I mean, one of the things I love I've said this before is that I'm thrilled I'm over the moon that people don't come to me ever and say, like, help me, I want to I want to be skinny. They say I want to be strong. I want to be I want to have endurance. And people are really starting to understand the difference between, like doing it for some aesthetic, bullshit reason and doing it for functional reasons. That that really better our lives. And so that's been just That's a change that's happening in my professional life that I'm just over the moon watching.

Star

Yeah, sure. When it was also said, you know, I was really grateful that I had a habit of working out setup for so many, you know, like over a decade, you know of like lifting before I had kids because it was so natural for me to stick with it, as you said during pregnancy and afterwards because afterwards I've said, like, if you didn't have that habit beforehand, it's hard. Like when you have a new baby, and you're busy with a new kid, it's I get it like, it's not, it's not an easy thing to add in. But I think that having that how that really does help.

Tanya Tringali

Right, because if it's a habit, you crave it, and you're trying to fit it in, as opposed to I don't have this habit, and now it's even harder to fit in. So I'm trying to make it fit. Absolutely Absolutely.

Star

Yeah, I actually just kind of an interesting thing is, I used to always get DEXA scans, you know, for my body fat and my muscle mass and everything. And so I had it done before I had any kids. And then I had one done at five weeks postpartum with my first son. And as I said, I worked out the entire time, I lifted weights the whole time, throughout the pregnancy, I eat really healthy, I lost like 18 pounds of muscle, and I doubled my body fat.

Tanya Tringali

And some of that is not because of what you did, it is what the body needs to do to support a healthy pregnancy.

Star

And then that's why it really had a lot of compassion for you know, women in postpartum because, you know, you hear so many people, like they have a hard time losing the weight, they just, you know, all these struggles that women have. And when I saw those numbers, knowing what I did, even health wise, you know, for, you know, my fitness and nutrition were still on point, and I still had those numbers changes. I was like, wow, this is why it's so hard for women postpartum. You know, it was just really eye opening to see the actual numbers.

Tanya Tringali

And I'm not gonna go down this rabbit hole, but I'm gonna say anyway, aging is another piece of the puzzle where we could repeat parts of this conversation, because of the way our body composition changes as we age. So, you know, I think of postpartum as this, like, little window into what the lived experience will be for most of us as we go further, deeper into aging. And how we respond to this moment, can give us some insight into how we might want to respond to aging over time. Anyway, rabbit hole we shouldn't go down. Absolutely. Starr, thank you so much for taking the time to share your story, and share your insights and perspectives. I think I loved those parts just as much.

Star

Thank you for having me.

Tanya Tringali

Thanks. Thank you for listening to the mother wit podcast. If any of the issues we discussed today resonate with you or your experience, I'd love to hear from you. Leave me a voicemail at 917-310-0573. Or better yet, email me a voice memo at Tanya at MotherWitMaternity.com. I really want to hear what worked for you what didn't work, what support you'd wished you had, how you got through the tough times how you advocated for yourself, or especially any tips you want to share with our listeners. I want to hear all of it. And if you'd really like to work together, you can get a discount on your first consultation with me at motherwort maternity.com using the code firstconsult10%off. That's one 0% symbol, all one word. Okay. That's all. It's wonderful being in community with you all. Thanks again for listening and see you next time.

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