Prenatal PPD & PPA During COVID-19, IUGR, ECV, Breech Cesarean Birth with Virtual Doula

by thebirthhour | Mar 3, 2021 | Birth Stories, Breech, Cesarean, Hospital, Loss, Postpartum Depression

Following an ectopic pregnancy that ruptured one of Shana’s fallopian tubes, she unexpectedly got pregnant almost immediately after her first loss. At the time, she was living in London, England and preparing for her husband, Doug, to move in early 2020. During the first half of Shana’s pregnancy she dealt with heavy bleeding from a subchorionic hematoma, untreated prenatal depression and anxiety, and was working towards submitting her PhD dissertation all whilst living on her own. As she and her husband were preparing for his transatlantic relocation, COVID-19 began shutting down borders, which prompted Shana to move back home to the DC area instead.

With the help of Shana’s long-time therapist in Maryland, she was introduced to both a psychiatrist specializing in perinatal mental health as well as Ursula, a doula and founder of Birth You Desire. With all three of their support and a special shout out to modern technology allowing for virtual services, Shana was able to do all she could to get her mind, body, and spirit prepared for the second half of pregnancy and everything ahead. At the start of her third trimester, Shana and Doug learned their baby was intrauterine growth restricted (IUGR) and was breech, which required weekly visits to the midwife and OB for fetal monitoring as well as countless hours spent practicing Spinning Babies exercises, yoga, and receiving repeated chiropractic care. Whilst the conversations around the necessity of an early emergency cesarean section intensified as the weeks went on, their daughter had a miraculous growth spurt at 36 weeks, allowing her to reach full term (but was still stubbornly breech). An external cephalic version (ECV) was scheduled at 39 weeks.

Leading up to the ECV, it was uncertain whether their doula would be able to be physically present during the birth because of quickly changing COVID-19 restrictions. In a rare situation, Ursula’s virtual presence was a blessing because after 3 attempts of trying to get the baby to turn, Shana was taken into the operating room to deliver their daughter, Poppy, by cesarean section, whilst Ursula was on the phone with headphones shared between Shana and Doug offering support and guidance the entire time (even without COVID-19, it was unlikely she could be present for the ECV and certainly not in the OR).

Aside from being more mucousy than what’s considered normal, Shana, Doug, and Poppy had a blissful first 24 hours together in the hospital. After that, however, an incredibly astute nurse noticed that Poppy would turn slightly blue when feeding and took her to the NICU for a quick peek. There everyone learned that Poppy was born with a fairly common congenital abnormality called tracheoesophageal fistula (TEF) and esophageal atresia (EA), an abnormal connection between the esophagus and trachea and between the esophagus and stomach. She was immediately transferred an hour away to the NICU at Johns Hopkins Hospital with Doug, whilst Shana waited to be discharged the following day. Poppy had a successful primary repair of her esophagus and trachea at 3 days old and then proceeded to be in the hospital for the better part of 4 months. Because of COVID-19 restrictions, only one parent could be present in the hospital with Poppy at a time, so with the support of their families, Shana and Doug relocated to Baltimore to live in a nearby hotel. They encountered various complications including a blood infection, repeated narrowing of her esophagus, trouble feeding, terrible reflux, and very poor weight gain, which all required prolonged hospitalizations and several procedures. After 4 months, it was discovered that Poppy had a hiatal hernia caused from her initial surgery. She received a final surgery to address the hernia and had a gastric-tube put directly into her belly to help with feeding, which, so far, has made a tremendous difference in everyone’s quality of life.

Poppy is now nearly 6 months old and her parents are very much enjoying settling into their home as a family of 3 at long last. Shana is currently working through the cumulative trauma and complicated emotions around Poppy’s journey. Despite the challenges, Poppy wakes up every morning with the biggest smile on her face and is a stunning example of resilience and strength.

Shana Silverstein Bio

Shana lives just outside Washington, DC with her husband, Doug, their six month old daughter, Poppy Chaya, and their first baby, Marcel the Poodle. She is on the precipice of receiving her doctorate in neuroscience from University College London and the National Institutes of Health. Her research focuses on social learning and memory around empathy related behaviors. Shana is also a certified yoga teacher. Connect with her by email at shana.silverstein@gmail.com.

Motif Medical

This episode was sponsored by Motif Medical. Motif designs insurance-eligible products for busy moms. With a focus on innovation and empowerment, Motif’s line of breast pumps and maternity compression garments are sophisticated, yet discreet, and made to support mothers as they navigate new motherhood. Discover why moms are reporting more milk in less time with the Luna breast pump, and see how you can get it covered through insurance at motifmedical.com/birthhour.