Today’s conversation is a heavier one, and I want to say that up front: if you’re not in a place to take it in, it’s okay to skip this one and come back when you’re ready. I’m joined by Kayleigh Summers, a licensed clinical social worker, perinatal trauma specialist, amniotic fluid embolism (AFE) survivor, and the voice behind The Birth Trauma Mama. She shares how her own experience shaped the work she does now, and we talk about what it looks like to prepare for birth with hope at the center while still making room for the “what ifs.” We get into what Kayleigh calls catastrophic birth planning: not as a way to plan for the worst, but as a way to have a say in situations where you might not be able to speak for yourself. We also talk about why that preparation matters for partners, who may end up making the big decisions, and we cover the gift of putting your wishes in a notes app and sharing it with someone you trust.

Join YBYB: www.thelabormama.com/birth & use the code PODCAST to save 20%

I also wanted this to be real and practical. AFE is incredibly rare, about 1 in 40,000 births, and Kayleigh and I both agree that “it won’t happen to you” isn’t a helpful thing to hear.

We talk about:

• How to ask your provider what protocols and training they have in place
• How to respond when a question gets brushed off
• Why you don’t have to deliver at any particular type of hospital to be doing this “right”
• Keeping your awareness on the shelf instead of letting it take over your feed
• The reminder that surviving something hard doesn’t mean you owe the world anything

If you’re a provider, Kayleigh shares a free course through the AFE Foundation, and I’ll link it, along with her website, podcast, and social handles, in the show notes. Wherever you are in your own prep, I hope you walk away feeling a little more informed, a little less alone, and still free to get excited about the parts of your birth you’re hoping for.

Mentioned in this episode:

Course Name: AFE: A Practical Approach Course

The AFE Foundation Contact hotline is 1-307-363-2337 (or 1-307-END-AFES)

More from Kaleigh Summers, LCSW, PMH-C:

Visit thebirthtraumamama.com

Follow her on Instagram & TikTok: @thebirthtrauma_mama

Listen to her podcast: The Birth Trauma Mama Podcast

Helpful Timestamps:

• 00:00 Meet Kayleigh Summers
• 05:15 AFE and Emergency C-Section
• 11:41 Why She Started Sharing
• 16:45 Privilege and Access to Care
• 19:08 Catastrophic Birth Planning
• 29:14 Partner Decision Burden
• 33:20 Questions for Your OB
• 39:14 Preparedness Without Doomscrolling
• 41:10 Provider Resources and Hotline

About your host:

Lo Mansfield, MSN, RNC-OB, CLC is a registered nurse, mama of 4, and a birth, baby, and motherhood enthusiast. She is both the host of the Lo & Behold podcast and the founder of The Labor Mama.

For more education, support and “me too” from Lo, please visit her website and check out her online courses and digital guides for birth, breastfeeding, and postpartum/newborns. You can also follow @thelabormama and @loandbehold_thepodcast on Instagram and join her email list here.

For more pregnancy, birth, postpartum and motherhood conversation each week, be sure to subscribe to The Lo & Behold podcast on Apple Podcasts, Spotify, or wherever you prefer to listen!

A request: If this episode meant something to you, would you consider a 5 star rating and leaving us a review? Yes, we read them, and yes, they help keep L & B going! ♥️

Connect with Lo more on: INSTAGRAM | TIK TOK | PINTEREST | FACEBOOK

Disclaimer

Opinions shared by guests of this show are their own, and do not always reflect those of The Labor Mama platform. Additionally, the information you hear on this podcast or that you receive via any linked resources should not be considered medical advice. Please see our full disclaimer here.

Additionally, we may make a small commission from some of the links shared with you. Please know, this comes at no additional cost to you, supports our small biz, and is a way for us to share brands and products with you that we genuinely love.

Produced and Edited by Vaden Podcast Services

Mentioned in this episode:

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Today's guest is one that genuinely has been years in the making, I feel.

Kayleigh Summers is a licensed therapist, writer, and content expert in perinatal trauma.

Drawing from her clinical expertise as a therapist and then her lived experience as an amniotic fluid embolism survivor, Kayleigh is dedicated to supporting families navigating perinatal trauma and collaborating with healthcare institutions to implement trauma-informed care tailored to pregnant and postpartum populations.

As The Birth Trauma Mama, Kayleigh has cultivated vibrant support communities through Instagram, TikTok, and her own podcast, where she offers connection, storytelling, and valuable resources for individuals impacted by perinatal traumas.

Her work bridges clinical knowledge and personal insight.

It fosters hope and healing for more than 650,000 followers across social media platforms.

As I'm sure you've gathered from that intro, today's episode is a heavier one.

We are going to talk about amniotic fluid embolism.

She is going to share her story, and we are going to discuss prepping for, moving through or living through, and then recovering and healing from perinatal traumas like AFE or other ones that fall under that umbrella as well.

So if this episode, if that feels too heavy for you, or if you are not in a place to take that in, please skip this episode, come back later if or when you feel ready

Kayleigh, thank you so much for being here.

This has been a long time coming.

Really, I would say years just of me- Absolutely … if anything, following your story, following your growth professionally as well after the story as well.

So why don't you go ahead and introduce yourself?

I'm excited to have this conversation, which kind of feels a little geeky, but I really am.

I'm the same way.

So introduce yourself, and then let's, yeah, let's dive into it.

Yeah.

Well, though, thank you so much for having me.

This has been a long time coming.

I feel the same about you.

I feel like I've gotten to watch you kind of grow, both, like, family-wise- Mm-hmm … and career-wise.

Mm-hmm.

And it's just been really cool to get to connect in this space, and so thank you so much for, for having me today.

I'm really excited to be here.

Yeah.

So my name is Kayleigh Summers.

I am a licensed clinical social worker who specializes in perinatal trauma, and so I own a practice in Downingtown, like, right outside Philadelphia area, where we work with families and, pregnant patients, postpartum patients who have experienced a traumatic pregnancy, birth, or postpartum journey.

And, I got here, as many of us do, because I had my own experience, with my son Callahan.

I was a therapist prior to his birth, but then I ended up kind of switching my concentration, and became trained in perinatal trauma And so that's kind of- I was- Yeah, go ahead.

I, well, I was gonna ask you that 'cause I was just sitting here and I'm thinking, "Did she do perinatal before her birth?"

No.

'Cause I, I don't… I've just never heard that.

And we didn't mention this, you guys, but we actually, Kaylee and I got to meet at AWAN finally this year.

Yes.

So we actually have met in person.

And then I watched the video that you, or the film that you were a part of and all of that.

Yeah.

And so as I was listening just now, I was thinking, "I don't know when she started this work," but obviously you have a story to tell of- Mm

of how you really got into this niche.

So I would- Absolutely … love to, love to hear that and love everyone to get that kind of… I told her before we started, the CliffsNotes version- Oh, yeah … and I'm not trying to diminish-

No

… Lo: the story that you have to tell.

No one needs to be here for an hour.

But I know that it's a messy story.

But please, yeah, share that story- Yeah … of what got you into this.

Absolutely.

And so I will share, for those who are listening, it is a traumatic birth story, and so just proceed gently and kindly to yourself.

Or maybe come back at another time when you feel more ready.

Yeah.

You can, you can skip this little part of the episode and get to the rest.

But yeah, so back in 2019, I was pregnant with my son, Callahan, and I had a really typical, normal pregnancy.

It was great.

At 40 weeks and two days, I went in for a typical prenatal appointment, and I had high blood pressure readings at both the beginning and the end of that appointment, earning me a trip to triage because I was already post dates, and, I mean, no one's messing around with high blood pressure at that point.

And so after a long conversation with the OB on call, I made the informed decision with them to move forward with an induction of labor, both due to the gestational hypertension, which was, like, their concern, and my concern was actually that I was growing a very, very large baby.

And I kind

of- A valid concern.

It's a real thing right there.

It… And I got a, you know, I got a little bit of push, like a little, like, "It's fine, you're gr-" like all throughout my… "You're, you're right on track," and I trusted them, believed them, but I also felt like I was growing a really big baby.

And so went through the induction.

Will not bore the audience with the long, slow induction process for a first-time mom.

We did, you know, the Cervidil- Overnight we did the, Foley bulb balloon, we did the Pitocin, quickly followed by an epidural, blah, blah, blah, blah, blah.

And then I was finally 10 centimeters.

My OB came in and checked me and let me know I was 10.

I was finally gonna meet my baby, and, she left the room to go get gowned up, and it was my husband and my nurse on either side of my bed.

And I turned to my nurse and I said, "I'm not feeling well." And she said, "Okay, that's pretty typical for transition.

Let me get you a bag to be sick in." And I said, "Nope, something is very wrong." And as she went to go turn and look at my vitals, I started screaming that something was wrong with my heart.

And seconds later, I went into cardiopulmonary arrest, so my heart stopped and I stopped breathing.

And my nurse, called a code blue, and lots of people came rushing in They made the decision to start CPR and take me right across the hall to the OR.

And there they performed a perimortem C-section where they were able to deliver my son within six minutes of that code call, which is remarkable.

for anyone who's listening who works in healthcare, from the time that button was pushed, six minutes was all that elapsed before my son was on the outside of my body.

And so, he was born unresponsive and also needed to be resuscitated as CPR was continuing on me.

Thankfully, he was resuscitated quite quickly and taken off to the NICU.

At this point, my OB was very suspicious that I was having an amniotic fluid embolism, and so because she was so wonderfully on it, she started to consider the fact that AFE has typically two phases, so that cardiopulmonary collapse, as well as something called DIC, which is essentially where your body throws a ton of microclots, consumes all of your clotting factors, and you bleed out rapidly.

It is a very dangerous condition.

And so my OB, even though I was not bleeding yet, made the decision to prophylactically place a Bakri balloon into my uterus and call for an MCP.

And they were able to resuscitate me from that initial cardiac arrest, about nine to ten minutes after the arrest.

And, I started to bleed very rapidly, after that because I was in DIC, and I had a profound case of DIC, so I would require, a hundred and forty-three units of blood product by the end of this ordeal, which is more than ten times, the human blood volume.

And so at this point, they were putting blood in as fast as it was coming out, and they were doing everything they could to keep me alive, but I went into cardiac arrest again, and so CPR had to be reinitiated.

And the vibe in the OR at this point was very much that I was not going to survive a second cardiac arrest in the shape that I was in.

And so my OB actually left the OR at that point to go speak to my, family and let them know that they were doing everything that they could to stop the bleeding but that she needed them to pray.

And then she went back into the OR, and thankfully they had resuscitated me again.

But they made, the decision that they were gonna have to kinda do something drastic if I was going to survive this.

So they called over to Lincoln Medical Center, I was at Paoli Hospital at the time, and, requested for ECMO, and an ECMO team to be transferred in because I wouldn't survive a transfer out.

And so, ECMO is the highest form of life support, and for me, I was on VA ECMO for both heart and lung support.

And, They were able to cannulate me about an hour after that call, and, that definitely played a huge role in saving my life.

I would then go on to continue to bleed.

Lots of interventions were done to try to stem that bleeding, but unfortunately, eventually I would require a hysterectomy and the removal of my right ovary.

And so when they performed that, they found another five to six liters of blood in my abdomen alone.

And that put them in a position to be forced to do that hysterectomy.

They ended up leaving my abdomen open and packed, with a Luna vac in place for transfer.

So this all happened over the course of about nine hours, and then I was transferred to Lincoln Medical Center, where the ECMO unit had come from so that they could maintain my ECMO circuit.

And, at this point, I was like hemodynamically stabilized, but my heart was not recovering from the cardiogenic shock, and that was the biggest issue.

So they had tried every kind of medication, the dobutamines, the milerons.

Nothing was working.

It was only making me tachycardic, but it wasn't changing my, like, pulsatility.

And so, the interventional cardiologist told my family, "We have one last thing we can try.

It's called an Impella.

It's the world's smallest heart pump.

It goes into that left ventricle.

It's like a little windmill.

And it clears out that blood to give the heart the chance it needs to rest and hopefully recover.

And if that doesn't work, she's not going to survive 'cause she's not a heart transplant candidate." I was in multi-system organ failure at this point.

And so they did place that Impella.

And two and a half days later, I was taken completely off of ECMO and Impella support.

I was just on a ventilator.

The day after that, I was extubated, and the day after that, like fifth day, I think, postpartum, I met my son, Callahan, for the first time.

And so I had a very, very unexpected rapid recovery, once they were able to place that Impella.

And also, in my opinion, a big, a big thing that played a part in that was also that they had started skin-to-skin in the cardiothoracic ICU.

So they would bring my son in every day and place him on my chest, to be able to do that skin-to-skin while I was still on ECMO

Thank you for sharing all of that.

I know you have many times, but I swear every time I hear it, which has only been a few times, I'm still… This is so cheesy.

I'm like, "You're such a miracle, Kayley."

Ah.

You're

supposed to be.

Being a provider and hearing some of that stuff, you know, the DICs, the units of blood.

Like, I've seen cases not that bad- Yep … to use very basic vocabulary, but, like, half as b- I hate for everyone to say that, like, if you think about numbers, and it's- Yeah … yeah.

I mean, it's a wild thing to experience and walk through as a provider, so it's hard- Yes

to picture, what was going on in the OR, what was going on with that care team.

I know you've spoken about your provider and how grateful you are for her-

Yeah

… Lo: um, forethought, and I do.

I just listen to that, and I think, "Thank goodness that she thought, 'I'm gonna get in front of anything that this might be.'"

It's incredible.

I mean, it really is so, so cool to hear that part of the story and the role that she played, 'cause from the, my limited knowledge about some of this, like, her role was- insanely important.

So very- It

was, yes

… Lo: cool to hear from that pers- to think about from that perspective too.

Yeah.

And I will say, I was correct.

Sh- my OB will tell you that he was the heaviest baby she has ever delivered.

Because he was 10 pounds, 14 ounces.

That's a really big

baby.

But he was also, like, obviously had no muscle tone, so, like, felt even heavier- Right … when she delivered him.

Right.

But yeah, I was correct.

No one believed me.

10 pounds, 14 ounces.

I mean,

10, 14 is a large baby.

That's a large baby.

I mean, you don't have to explain anything after that, so.

Yeah,

it's a really- And you're not a huge person.

No, no.

I met you, like I said.

Just

like a very average.

Just a regular person.

Okay.

So before we started, I, you know, I was saying I love learning from you.

Sometimes I'm learning as a provider of- Mm-hmm … you know, the, uh, the education you share about the way providers can prep, think, talk about this, whether it's, like, within an actual experience or after, if they're speaking to a patient who's maybe walking in with this history, this fear.

And then also you obviously speak to parents who both are maybe preparing for birth and/or have walked through traumas as well.

And so- Yeah … I love… I realize that that education doesn't always apply to all of us, right?

Maybe only one of those- Sure … things does, but I've always loved that you have perspectives on all of it, right?

Because this experience is not one that most people will go through, certainly not in all of those different- Yeah

spots either.

So when it comes to work and shifting, I mean, at a basic level, we can all say, "Oh, I see why you wanted to do this," but were there specific parts about your healing, your recovery, I know you talk about your husband's recovery and processing.

Was there kind of a specific moment or certain part of the experience that made you say, "I have to focus in on this population because I needed this," or, "I didn't get this," or he, speaking to your husband- Yeah

he needed this.

What… Can you pinpoint that?

Yeah.

I mean, I would say that, during the first six months, so I had Cal in July of 2019, and then, I started the Instagram page in January of 2020.

And for me w- A coup- it was a couple of things.

I felt very much like I like came out of this fog, and I started looking around, and no one was talking about this.

And I always give the caveat that I, that I am sure there are people out there who were.

I didn't see them or find them, so like props to those people who were talking about it back then.

But it wasn't a popular thing to talk about.

There was lots of- Can I- Yeah

… Lo: ask you, when you say no one was talking about this- Mm-hmm

are you speaking about birth trauma- Birth trauma … in general, or AFE- Yep … birth tra- Okay.

Just clarifying.

So no one was talking about when the supposed best day of your life becomes the worst.

Exactly.

Okay.

No one was talking about when everything goes wrong.

No one was talking about what it means to experience such a, a devastating day when, again, you expected it to be one of the best of your life, and like the, the rippling impacts of that.

And so the other piece for me was that when, I will say just from like my little community of AFE, amniotic fluid embolism, when you go through an AFE and you survive, you're like, okay, there's a lot of survivor's guilt.

And you're like, "Okay- What am I gonna do with like, how am… and no one has to do anything, but there is this feeling of like how am I gonna help?

What am I gonna do 'cause I was lucky enough to survive.

And for me, I felt like I was lucky enough to survive cognitively intact, like the same human that I was prior, which is insane given the downtime and ECMO and all of the things.

And so I remember saying, "Okay.

Well, I'm not a doctor.

I'm not a researcher.

I'm not gonna figure out why AFE happens and how we can prevent it.

I would love to.

It's not gonna be me." Me either.

"It's not gonna be me."

Me

either.

So it was like, what is my skill set?

Like, what can I do?

And that's when I, I was like, "Well, I'm a therapist, so I can do feelings. That's literally what I do."

And how can I talk about it in a way that it's accessible both from my personal experience and also my professional education?

And that's kind of where I was like, this is where I can make an impact.

A- again, I'm not gonna unfortunately figure out AFE, but I can… There is this population that has no support, that isn't even finding people to be able to talk to about what happened.

And so that's really, those were the moments that really brought me here.

Right.

I like hearing you say, one, that you don't have to do- No … anything.

Just survive.

And I think I just wanna reiterate that to everyone listening, that when you do go through a hard thing, and I'm like diminishing big hard things to just hard things

Yeah

that our responsibility isn't then to go change the world because- Nope … we went through something.

I think that's so important to hear because it's a beautiful thing to want to and to go do it and, but it doesn't make you a, quote-unquote, like a better survivor or- No … oh, you handled postpartum so beautifully, so now you're gonna help everyone else, and that makes you, you know, a better mom.

You know, like each- Yeah … of us is allowed to kind of move forward after a hard thing in our own specific personal way, and I just think that's so important- Yes … to hear 'cause you do have sometimes a guilt, I'm sure, after- What you're talking about, surviving that versus even, you know, if we talk, quote-unquote, "smaller things," just like, "Oh, I handled that really well.

Maybe I need to help other people.

I feel bad that it wasn't hard for me." And, and just that that's not always our obligation and our calling, and that's okay.

Yeah.

That we can just be grateful for our life, we can be grateful for our good experience, we can be grateful for our health, and not have to have this burden attached to it.

I, I mean, I'm grateful that you felt called to do more.

It's obviously incredible that you did, but that we don't have to.

I just want you guys to hear that

100%.

And I will talk at length about the privileges that I had in order to be sitting where I am sitting today- both in terms of the hospital care I received and the knowledge and support that I had after.

I use therapy as a great example.

I had… The Postpartum Stress Center is in my area, which is one of the, like, renowned clinics, especially back then before we- a lot more people, thankfully, are specialized in perinatal mental health.

Karen Kleiman Center was 45 minutes from me, so I was able to have people watch my baby while I drove, because there was no virtual back before COVID, while I drove 45 minutes each way to be able to go to therapy with someone who was specialized in this.

Right.

That is a massive amount of privilege.

I was able to get short-term disability from my job to be able to take more time off.

Did I absolutely deserve to take more?

Yes.

Like, I I will shout that from the rooftops, but- But that

doesn't mean everybody gets to,

right?

Exactly.

So Exactly.

Yeah.

And so again, there were just a lot of things that make, a lot of privileges that make it a lot easier to be sitting here.

Yeah, that's an important thing to call out as well.

I, absolutely.

Even if we wanna help, sometimes it's not always available to us, and so that's all right to sit in that space and live in that space, too.

Definitely.

Yeah.

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Okay, let's get you back to the episode

All right.

So when it comes to the birth you planned for versus not getting the birth you planned for, we can dumb that all the way down to just this conversation of birth plans, right?

Mm-hmm.

And the way we prep for birth, and the way we move towards our births.

Obviously, I think we talked about this when I was on your podcast.

We talk about centering hope.

You brought that up.

Mm-hmm.

And, you know, I'm a big birth plan- Yes, I think you should do a birth plan.

I think it should be a tool you use for your education.

Like, I don't think you should walk in there and think, "I'm not gonna do this," 'cause then it just means everything's gonna go off the rails.

That's not the perspective I teach or educate from.

But I do love, or I have loved hearing you talk about, I'm gonna throw out a kinda scary word if you've ever heard it, like catastrophic birth plans, or just getting families to engage with the idea of these really comprehensive conversations, I think, and plans for births that goes the way we want, certainly, or births that maybe go ways we aren't expecting.

So can you just talk to me, talk to us about what that might look like, practically speaking?

What does that birth plan look like when we're considering this- the possibilities and also centering hope, right?

And still saying, "This is what I'm looking for, and this is what I'm hopeful for, and these are the ways I hope I get to push," and still acknowledging those very real preferences and hopes and ideas we have for our birth.

Yeah.

So I'm gonna cover the things that I think people don't think about.

Yeah, please.

Because I think that there's so much education out there on typical kind of like- Right … decision making, which is valid.

Like, oh, what if I don't want an induction?

I have to have… Like, all of that stuff.

Like, how do we make a C-section more friendly for the patient, right?

Like clear drapes, and what can, what can we offer?

Can we not be strapped down?

Which is one I want to actually talk about, because just really quickly, you don't have to be strapped down during your C-section, and there are still hospitals that do that, and it's wild, and I think it creates a situation where someone is much more likely to be traumatized.

I still don't understand how hospitals are still doing that.

Mm-hmm, mm-hmm.

Mine was not doing it, and this is 10, 11 years ago when I started my career.

Mm-hmm.

At the same time, we were, we've never… they don't have to do

that.

And so I, I get- They don't … brushed off a lot as like, "Oh, people don't do that anymore."

I still hear clients come into my office who- It feels

wild to me too

… Kaleigh: yes, have, who are then strapped down.

So I will mention that one.

But when we're thinking about, which I do call it catastrophic birth planning, and I think it can be this piece where you really are like, okay, me, and if you have a partner, are gonna sit down today, and we're gonna talk about some of the scarier things.

This is our space to do that, not because we think it's gonna happen, not because we're, you know, planning out all of our worst case scenarios.

But what people don't realize is that it gives you autonomy in situations where you will not have any.

And what I mean by that is when you are making choices beforehand about things that are things you wouldn't normally maybe wanna think about, but when you make these choices beforehand, you are setting yourself up to have autonomy in situations where you normally would not.

For example, if… I will use the breastfeeding example ' cause I think it's one of the best examples.

I wanted to breastfeed.

That was like a part of my plan.

That's what y- they, like, make you write it down, I think, at some point.

I, I don't… It's all blurry, but I think when I came in, I had to write that my plan was to breastfeed, and I very much wanted to do that.

I will say I was the type of person going in who was like,

" Lo: Eh,

we'll give it the old college try.", I did the, the breastfeeding classes.

Like, I did feel passionately about it, but not, like… Anyway, so wrote down breastfeeding.

When I was intubated and on ECMO The team came to my family and said, " Kayley said she wanted to breastfeed.

In order to protect her supply, we would like to pump her, but we need your permission to do that." And my family, knowing that, again, I wanted to breastfeed, made the decision for them to pump me.

I do not think that was a wrong decision.

I do not think that there is honestly a right or a wrong decision here.

I think we make the decisions with the best, intentions and with the information that we have at the time, and the information that was that I wanted to breastfeed.

And the issue in my case, so I was pumped while I was unconscious.

The issue, and if there's any lactation consultants listening to this, please remember this.

The issue was that when I woke up, quote unquote, when I was out of the medically induced coma, no one checked back in with me.

The vibe was very much like, "We did this wonderful, great thing for you so that you can still breastfeed Meanwhile, just to be clear, I'd had six abdominal surgeries or five abdominal surgeries.

I had chest tubes in still.

Like, I was in severe pain.

I had a fractured rib from CPR.

Like, I was in shambles, and they would come in and they would pump me every four hours, and I would just cry.

And they weren't getting any milk, to be clear.

I had a lot of blood loss, so there was, like, no milk being had, and it wasn't being given to my son because of the medications that I was on.

So, like, small amount of colostrum.

And so all of this to say that, two things.

If I would have said, "Hey, if something catastrophic happens where I'm intubated and unconscious, I will choose for myself to be pumped." I would ch- and I think that's what I would've chosen, but it would've made me feel 1,000 times better about it when it happened because I had made that choice.

Right.

So even though, right, I still wouldn't have felt great to be pumped while unconscious, no one, like, loves that, it would have felt like, "Oh, I told them this." Like, I had a say in this.

There were so many things that had to be done to save my life, including a hysterectomy, that I did not get a say in.

Would I have chosen it a million times over to be here?

Of course, but that's not the point.

We don't… There were so many things we didn't get a choice in.

And so someone definitely should have come to my bedside and said, "Listen, we did this just to give you the option to either breastfeed or not.

Whatever you do with your baby will, your baby will be okay, whatever you wanna do either way." And that conversation was not had until my family pulled the lactation consultant aside and said, "You will have this conversation with her because she's not listening to us, and she thinks she's being a bad mom by, quote-unquote, 'giving up.'"

Right.

And so again, kind of making those… So that's a decision I would make.

I would also make the decision about, what do you wanna do in terms of people meeting your baby?

And this is one that, like, sometimes we can't imagine.

But if you are going to be, like, down and out for several days, like it is very hard for me that probably like at least 50 people met my baby before me, which says a lot about how supportive my family and friends are.

That's how many people came, right?

And that feels sad and hard, but also it feels like my baby was loved on when I couldn't love on him, and I would prefer that.

And so I would have chosen that, again, if I had talked about it, if I had thought about it.

So thinking about what you want when you are intubated, what are your preferences?

Do you want to be pumped, right?

Do you want other people to see the baby and love on your baby?

Is there a certain time limit like, oh, after… If I'm still, you know, intubated after two days, yeah, people can start to see the baby besides my partner or besides my mom.

Some other things to consider are also, like, medical things.

I was talking to a friend who's a doula.

We actually did a, a podcast on catastrophic birth planning and, like she had very specific parameters for how long she would want to be on life support, and when she would no longer want to be on life support.

And so those are very, like, hard kind of morbid conversations to have.

And they're also really important

Yeah.

I would say as, from working at the bedside as well, when you do come in and we admit you, Mm-hmm … for, you know, quote, unquote, "normal labor or triage," wherever you are, we do ask the things like, "Who's your power of attorney?

Do you have a living will?" Like, we do ask, and I would say the vast majority of patients don't have those things, right?

I had none of it.

Because they're 27 and they haven't- Yes … thought of it, and, and I get that, right?

I don't remember at what point Cal and I figured out some of that stuff, so I'm not- Right … speaking like, "Oh, I had this all figured out." No.

Absolutely not.

No.

But, but it is interesting to just think, like, in theory, in the process, we are saying, "Hey, like, these things, we might need to know these things."

It's not like we're having some big discussion.

If something goes wrong, I, you really should have this, and please get it.

But we do check in, and I just think it's interesting that so few of us do it, or think about it, I'm sure, because why would we?

Right.

But then sitting here listening to you, I find it also interesting to say you probably would've chosen so many of the things they did choose for you.

It was just that almost privilege of saying, "That is what I chose before we ever did this." And I just think that's such an interesting nuance.

Like, it's not that you would've done different things.

It's that you were just absent in the decision, and that really applies to all of birth planning, right?

Yes.

Like, so much of these things are not about what actually happened.

It's just that we weren't present for it, whether that be a trauma or a decision where you just felt like you were, you know, steamrolled and you didn't even get to speak up, right?

And, and that's this, like-

Exactly

… Lo: I wanna say mini trauma or some- You know, but it's still, you walk away and you go, "That didn't feel good.

And even though I'm, wanted what we did, I didn't get to decide it, and that didn't feel good." So I just think that's a really interesting nuance of what you just shared, is that it's not that you would do everything different.

It's simply that you were a part of it, and that's so important to us as we process any part of our birth, good, bad, and all the messy middles.

Absolutely.

and we don't always get to be a part of it, and there's, like, grief in that.

Like, we can't… I, I do want to remind people that, like, we can't foresee every possible thing that could possibly happen, nor do I want you to sit there and go through every single possible bad outcome scenario where you would need to choose something.

Like, these are more general conversations, and, like, you get to grieve those things that you didn't get to choose.

And none of us would choose a complicated, scary birth experience.

But I think, I think talking about it with your partner, if you have one specifically, is really, really important because they are going to be the one making all of the decisions.

Like, I wish that I would have talked to my husband prior about life-threatening bleeding and, like, if that happened, you know, try-- obviously, I would like to keep my uterus, but if it is life-threatening, please just do the hysterectomy because while they were gonna do it anyway 'cause I, I would have died without it, like, he did have to sign off on that, and he did have to feel like he was making that decision without any input from me

Right.

Right Which is a lot No, it makes, it makes perfect sense.

Then that leaves them with their traumas and their burdens of what they had to decide, and, and did they do it right- Yeah … and are you angry at them?

Absolutely.

You know, like this whole related, I would… Not, like, parallel traumas, right?

Yes.

Like, two things going on at the same time.

Which- Exactly … I mean, we haven't really spoken to that, and that's, you know, multiple podcast epica- Mm … episodes I'm sure you have about partners and supporting them- Yeah … both before and after as well.

But very- Mm-hmm … much a specific part of this story that also needs to be acknowledged, needs a space to talk about things.

Probably less spaces now, since we're often talking about men who don't share as much.

But certainly, a massive part of the combo.

And like you said, in the prep, in the planning, and then in the after and the follow-up for, for however it goes.

Yeah.

And have them write it in their notes app on their phone.

Right.

That's what Cal's always done.

Yeah.

We talk about stuff, and then he makes- … a notes app.

, We shared it with, one of my nurses that I worked with.

Like, she was gonna watch our kids with our first one, so I'm like, "I just want you to have this, too, so Calvin knows he can call you and just flesh it out.

You know, if I can't make a decision with him, he could talk to you, and you know my heart." And so I also really like that as a sa- and then giving him someone to go to.

And we don't all have that, a friend or a parent or a sister.

You know- Sure … we might not have that.

But I loved being able to say to him, like, she has this, too.

She knows some of my preferences and hopes, and, you know, you can call her if, if you ever, if you ever needed to." Again, we… That was like fourth kid where I finally thought- … oh, here's some ways to do this stuff.

Okay.

Guys, this was not my first baby.

No.

Or my second.

No.

Maybe my third.

We were- I don't even remember

I don't know.

I was winging it, clearly.

100%.

Figured it out about 10 years later,

so it's fine.

Yeah.

But if you're here with your first, look, you can do better than I did.

Yes.

Take from us.

One thing I wanted to throw on, just as we were talking about kind of catastrophic or maybe unexpected things, one thing that's good or could be good for you guys to talk about is just donor milk.

Like, would you want- Mm-hmm … that being given to baby?

Is that available?

It's not a hu- you don't have to have some big massive convo about it, but that's definitely something to think about.

Yep.

Obviously, formulas are available, too, but I think definitely talk through those things, prior if there were a reason you weren't breastfeeding.

Like, what do you want?

What's available to you guys?

Yeah.

Okay.

So if you are on social media like so many of us are, particularly when you're pregnant, when we have cases of an AFE, they usually end up in the public eye.

Like we just had that very famous nurse, I think it's been about two years now from when we are recording.

About a

year and a half, nurse-

A year and a half

A year and a half.

Yeah.

Mm-hmm.

I'm sure you know who I'm talking about, obviously.

And so I think when we have those things pop up into the public eye, it creates a lot of fear naturally about AFE and perhaps this is a conversation that most people kind of, they might know it's a thing, but we still, you know, we all still choose to get pregnant and have these babies knowing- Totally

that it's a possibility.

But then this makes it feel very possible, right?

Or I know, you know, air quoting, "I know someone this happened to. This is real." So what do you say to clients maybe who are in front of you prepping?

Even, you know, I get all kinds of comments, I'm sure you do just on social medias about, " What can I do to prepare for this or prevent this?"

Or how do you address that?

I mean, 'cause I know there's not a ton aside from what we're talking about is prepping, you know, in your pa- in your partnership and so what do you, how do you walk or talk people through that?

Or maybe there are a few things that you do tell them when

it comes to prepping.

Yeah.

So in terms of, like, they're nervous, they heard about an amniotic fluid embolism, they heard about even just, like, a postpartum hemorrhage, a cr- like, any of the things, I always tell them to speak to their OB about, "Hey-" This came up.

I'm thinking about it.

Can you tell me, like, do you guys have protocols in place?

Do you guys run drills, sims?

Like, what does that look like if someone were to have an AFE on your unit?

Now, here is likely what the response will be.

Maybe not always, but we get a lot, and so I like to prepare people for this.

You'll get a, "Oh, don't even say that. Don't even say AFE in my presence," which is such an unprofessional response, from a provider.

I will say they are human, and AFEs are traumatic and terrifying for providers as well.

But what I suggest you say is, "I totally understand you're trying to reassure me." Like, maybe they'll say, "Oh, that'll never happen to you." " Listen, I understand you're trying to reassure me.

I love that.

It's actually not reassuring for you to tell me it's not gonna happen.

It would be more reassuring if you could just explain to me, like, what are the protocols, the standards that you guys have in place to deal with something like an AFE?" Love it.

And then they should tell you that they do maternal code sims, that they do… They have a hemorrhage cart, that they, you know.

There are lots of things, that people can have in place to be able to take care of patients who have severe maternal events, and, you have a right to know what those protocols are.

Something you can also ask, and I mean, listen, we only have so many options for hospitals, and they're getting fewer and further between, so I do wanna…

We should've said this at the beginning, but I do wanna remind people, AFE is incredibly rare.

It's one in 40,000.

There are only about 100 a year that happen in the almost four million births in the US.

So I do wanna put that out there, but I'm also not someone who's gonna just be like, "It's rare. It won't happen to you."

I don't find that to be helpful for anxiety, and so I do want you to know it's rare, and I also want you to know that people have protocols in place.

But the thing that you can ask is if their L&D unit, if their nurses are ACLS certified, because a lot are not.

They aren't?

Which is a- I didn't know that.

Apparently, it's, like, not a thing that pe- I could be wrong, but I'm, I have heard that, like, people do not have to be ACLS

or something ACLS Yeah.

Yeah

Am I wrong

on that?

I don't know.

I mean, I don't know I don't know.

We'll look it up We definitely had to be, and then they- Yes … brought in, you know, the renewal program every year, and it was actually- Yes

you know, the hospital made sure that we were

ECMO capable.

And, maybe it's OB ACLS- Mm-hmm … could be that because- Mm-hmm … again, a maternal code is, is much different than a typical, like when we have two patients who are down instead of just one.

But you can ask questions.

I think that's just an example of, like, a question that you can ask that would be helpful.

And I also, you know, I get a lot like, "Should I only deliver at an ECMO capable facility?" And like, no, I don't think that, given the statistics.

If that makes you feel, like, that, if that option is available to you and that makes you feel the most comfortable and the safest for giving birth and that's it, go for it.

I'm all for it.

Do I recommend that everyone do that?

No.

Yeah.

I don't.

Yeah.

I don't think

that's- We have that conversation sometimes with the NICUs, right?

Mm-hmm.

'Cause there's different levels of NICUs, right?

Totally.

And so inside of my birth courses, I talk through this just, "Hey, some people choose their hospital based on the level of care the NICU offers because they wanna know they're where the best of the best is if something were to happen."

And it's like, you don't have to choose thing… I mean, there's these, there's different things we could all value for choosing a hospital.

So I think, and my brain just went there too, of no, there's plenty of, plenty of us delivering at hospitals with all kinds of capabilities, and that's-

Yes

… Lo: that's like a very normal, like, rote decision that you can make.

It doesn't make… Yeah, it's not predictive of anything going wrong, right?

Nope.

The whole probable, predictive, possible conversation, like it doesn't mean anything's gonna happen if you're not where you would need to be if something were, yeah.

Also, I

almost- And again-

… Kaleigh: like my hospital didn't have ECMO, and-

Exactly.

I'm like, it's not available to a lot of people.

Oh, yeah.

It's very

difficult

to- We have care deserts.

Yeah.

We have lots of places where people are driving hour, like, come on.

We don't all get to make that choice anyway.

Also, birth center births,

home births, all the things.

Yeah.

I believe in all of the birthing and all of the places, wherever you feel most comfortable.

Right.

Right.

The other thing that I was thinking about, I mean, I love that question where you said or not that question, that statement of like, "I get you're trying to reassure me, but I actually do wanna know what's in place." It makes me think of- you know, after we hear about this, you kind of see nurses sharing, I remember videos going around about, like, the phone number, first of all, that you can call, and they'll walk you through the AFV, you know, kind of steps and, and what to be doing and what to be thinking, which is incredible.

I never saw that in my hospital, so I'm, like, programming my phone, right?

Yeah.

And just how providers, I guess this is speaking more to providers, but how they too, there are some things you can do to be, to be more prepared, right?

And so as a, patient, you can be asking, "Hey, do you guys do this? Do you have that, that number available?"

I've heard people suggest that even as a patient you could plug that into your phone or ask a nurse about it so that that is a thing.

And I think sometimes, again, it makes us think, like, oh, this is going to happen to me, going back to kind of our earlier conversation of it doesn't mean these things are gonna happen, but it does mean you've, like, addressed their possibility, and so you are autonomous inside of them, you have the best resources inside of them, that you're doing the best you can with what's available to you.

I just think that's, like, the heart of this is, is learning about these things, planning for these things.

It doesn't mean they're gonna happen.

It just means that you are a, a part of them, and you walk away from them going, "I made decisions. I was there. I was in it," even when they aren't the things that you wanted to happen, that, that autonomy and that, I'm gonna say presence, even though I get sometimes we're intubated, we're not actually there.

Totally.

That autonomy and presence inside, I think, is still just so, so valuable, and we can give ourselves that by preparing in the ways that you've been talking about.

Yeah, and I think people would be surprised to hear me say this, but I feel very strongly about this.

If you are someone who's preparing in this way and you are aware that birth trauma can happen, you are aware of complications that can happen, you're having the conversations with your partner, you're kind of like, "Okay, I'm aware.

These are the choices that I would make," you don't need to flood yourself and your feed with all of the possible scary complications that could happen.

It is actually not helpful.

My sp- I will talk about awareness, and anyone who has had a birth trauma story, you shout it from the rooftops.

You do you.

I love that for you.

You get to do that.

People who are pregnant, and especially people in my community who have survived birth trauma and are going on in a subsequent pregnancy, you've already opened the… Like, you have seen all of the things just by having your own birth trauma.

It really pulls back that curtain, unfortunately.

You don't need to bathe in it when you are pregnant, especially as you were talking about, like, it's not gonna happen just because you talk about it, but, like, especially if you have, like, an OCD situation happening, it is so hard to be in these situations and not think that it's going to happen because you keep thinking about it or you keep seeing it everywhere because your algorithm realized that you watched it, and now all of a sudden it's full of complicated traumatic birth experiences.

It's a fine needle or a fine- Yep … line to walk, for sure- Yep … of saying awareness is important.

Yep.

And are there things I can do with that awareness?

And then also, I always think about it like I've learned it, we've spoken, and then I'm f- it's sitting on the shelf.

In a box, yep.

And I'm done opening that box, and I think it's very important that we plan and prep in that way.

So-

Yes … we're willing to acknowledge- And you can do that-

Leave it alone

… Kaleigh: yep, with the catastrophic part of the birth plan.

Right.

Make a time for it.

Create some boundaries around it.

You're allowed to revisit it and go back to it.

But all in all, you're just kind of keeping it, like you said, on the shelf.

Right.

And before I forget, for any providers that are listening that are like, "Ooh, well, I do actually want some more information," I actually work for the AFE Foundation as well.

And so when you mentioned the, You know

the number by heart, Molly

… Kaleigh: hotline.

I

don't.

I don't even know.

Well, it's End AFE- Oh … so you'll put it in the show notes.

Right.

I will.

I will.

But we have a completely free course on the pathophysiology and treatment of amniotic fluid embolism, and you get two CEUs even though it's free, so you should definitely do that.

It's on our website, afesupport.org.

Yeah, it's really cool.

It is.

And I do love, again, going back to some of the stuff I've seen shared, where it's like Draw a purple tube of blood, draw a red tube of blood.

I haven't done the full course, so I don't know if it gets into those specifics.

But if you are a provider, just again, going back to your OB who was like, "We're gonna do this stuff right now 'cause I think that's where we're going." Like, what if you're that kind of nurse, and speaking to nurses specifically, who's like, "I'm gonna do this stuff right now," and someone's…

Ideally, this is gonna be exact-- Not ideally.

Prefer-rentially, you wouldn't want that needed later.

But if you do, like you've done the steps, and to just be able to say, "I already did it. I already got it. Like, we're on it." I think what a, what an incredible way to show up as a provider, just like your OB did.

Yeah.

Yeah.

Our nurses are our biggest champions.

They are the ones in the ORs saying, "Hey, should we put AFE on the differential? Hey, I have this hotline we can call." It's not necessarily the OBs.

It is the nurses, the L&D nurses in those ORs who are doing that.

And so, you can absolutely change the outcome by being aware.

Yeah.

I like that little plug for nurses.

Again, I love how you speak sometimes to the provider and then to, to the parents and to the families because- Yeah … this, yeah, this kind of traumas, they, they impact everybody, right?

And so we all walk away from them, and we carry something home.

And we're probably all, and this is me speaking as a nurse, going, "Could I have done something differently, too?"

And so I just think that's such an important part of your work, too, is saying there's multiple people involved in these different traumas, and so each of them need the support and this care as well when, when we walk, walk away after them.

Absolutely.

All right.

Well, thank you so much for sharing all this.

It's so, such a tender, tender space, and I do hope if you are listening and it's your first time, that you are able to do what we talked about.

You know, open these boxes, talk about them, tuck them away, still center hope, and still be very thoughtful about that position you wanna push in or having your water birth or getting that skin-to-skin.

You know, all of those things that feel, I don't know, just a little more approachable and more fun to think about, you should be.

Those things are really- Yeah … those are fun to think about, and they matter.

So I want that for all of you while you prep, is to be able to center those things, too, and just have some of these boxes on the side when you need them for sure.

Mm. So thank you for sharing all of that.

I know you've mentioned a couple times your socials, different places people can find you, but would you… We'll drop them in the show notes, but just mention those as well.

I don't know if you've actually shared-

Oh, yeah.

You

can- … your actual Instagram and

your handles Yeah

so go ahead and do that.

You can find me at thebirthtrauma_mama on Instagram, TikTok, maybe Facebook, too, I think.

And, thebirthtraumamama.com is my website, which has lots of great support resources.

And then you have your Birth Trauma podcast

as well.

Oh, I do have a podcast, yes.

My bad.

So

definitely more than-

The Birth Trauma Mama podcast.

I will shout it out for you.

Don't listen to her podcast- Thank you so much … only mine.

But she does have one.

Yes.

okay.

Last question I love to ask before you guys leave, what is something in your life that's bringing you a ton of joy right now?

Hmm.

The age of my child.

Like this age, he's seven, is the best.

And I often will say, like, n- the newborn stage is not for me.

Whether it was trauma related or not, I'll never know, but, this stage is so much fun.

Like, they're just like people, like real people, and but my son is still, like, cuddly and, like, loves to hang out with me, so I'm holding on to that.

Oh.

That is bringing me so much joy.

My seven-year-old just turned eight a couple days ago.

Oh.

So I have one right there with you, and it's fa- Someone had shared this thing, and I had shared it, around her birthday.

It basically was eight is still little, and it was like- Mm-hmm … they're growing, and they're precocious, and they're so funny, but they're also still little.

Like, let them be little.

Yes, let them be

little.

And I'm assuming you would agree, but it perfectly describes my girl because- She, you know, she's a second grader now, right?

That's a, that's a- Yep … big kid by a lot of- Big kid … parameters.

Ooh, she's still little, and she's still snugly, and sometimes- Yes … she still acts like she's four- Mm-hmm

which is both sweet and not great, you know.

Mm-hmm.

Yes.

It's a little bit all of it.

But I should send it to you.

It just was a sweet little reminder of like, yeah, she's still really a little girl even though she's a big girl to a lot of people, too.

So I know exactly- Right … what you're talking about right now.

Yes.

Yeah.

The sweet spot, for sure.

It is.

Well, thanks again for coming.

Y'all, like I said, I've been on her podcast.

If you wanna listen- Yes … to us twice, just- Yeah … go listen to that episode too.

Back-to-back baby.

I love your work.

I love what you're doing.

It matters, and I'm grateful as a provider and as a mama, too, so thank you.

Thank you so much, Lo, for having me.

It's been wonderful.