Birth Matters Podcast, Ep 56 - Fertility Doula & 2 IVF Birth Stories (Pt 2)

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Today we continue our fertility journey series and share the second part of fertility doula Alison Wehr’s 2 IVF and birth stories. Alison’s second path to conception was a smoother one; today she shares how quickly IVF worked this time around, how she wasn’t nearly as anxious this time, and will detail her second born’s birth story that started with her water breaking a few days before her estimated due date. After she shares her son’s birth story, she discusses how she got into fertility doula as well as birth and postpartum work. 

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Episode Topics:

  • Advised to stop breastfeeding at 4mths to start fertility treatments at 6 months to conceive 2nd (due to her age)

  • Autoimmune condition seemed to reverse itself

  • 1st IVF try worked!

  • Switched care providers to one that delivered at Mt. Sinai West and one that she felt would more readily honor her preferences

  • Not as anxious this pregnancy 

  • 38w5d - water broke - called childcare, head to birthing center in taxi

  • Birthing center is closed

  • Have to poop in a bucket due to continuous monitoring and concern over baby

  • Pushing happens very soon after and was quick

  • Baby is born and is significantly larger than her first

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Interview Transcript

Lisa: So then how long was it from that point to the next time you started to think about conceiving?

[00:00:07] Alison: Well, it was pretty quick. Our reproductive endocrinologist had told us that if we wanted to have a second child or another child, that we needed to get started pretty soon. She was concerned about my age, which is, you know, considered to be a big deal when you're seeing a reproductive endocrinologist. They like, they like to do it as young as possible. I was 39 -- it was a month before my 40th birthday when I had Zoe. We had one embryo frozen. We were pretty sure that we were going to have to do another IVF cycle, or maybe multiple, in order to get enough embryos to have a pregnancy.

[00:00:51] My reproductive endocrinologist advised us to stop breastfeeding Zoe at four months, so I could have a cycle and then start fertility treatments again when she was six months old. So that's what we did. I was struggling really hard with breastfeeding with Zoe.

[00:01:11] I wanted to do it so bad. It was another part of my having faith in my body. You know, I had this amazing experience with birth that I was like, "Oh my gosh, my body did what it was supposed to do. Awesome." You know? But...

[00:01:28] Zoe had an undiagnosed tongue tie, and lip tie. Yeah, we struggled a lot and you know, I was really sad to give up breastfeeding, but I was also like a little relieved to switch her to formula. She had had a lot of problems with reflux, too. And, you know, I was convinced it was because something was wrong with my breast milk. And I think that's the first instinct I had, "It's got to be something wrong with me. You know, we switched her to formula, which was scary for me at first. I just didn't know. I was so worried about it. But she had the same reflux problems with the formula as well. That was when she was four months. I had had a cycle about, like, six weeks later, and then we were able to start going through the process of fertility treatments again, right before she was six months old.

[00:02:20] So I went back to the reproductive immunologist. He did the blood work over again for my immunology panel. And a lot of the markers for autoimmune problems that he was giving me medication for during Zoe's pregnancy were gone, which he said is common. Once your body has a pregnancy, it sometimes resets those autoimmune triggers.

[00:02:44]I'm not sure how that works. There's a scientist out there going, "No, that's not how that works."

[00:02:50] So I didn't have to do as many of the medications that had to do with my pregnancy for Zoe, but I still had to do daily blood thinner injections throughout the pregnancy. I only had to do two infusions at the very beginning, but not the monthly infusion, which was great.

[00:03:04] So we decided to try to transfer that one frozen embryo first. And then we would go from there. And that transfer worked, so I was pregnant.

[00:03:16] Lisa: Wow. That's pretty impressive.

[00:03:20] Alison: We were shocked.

[00:03:23] Lisa: I bet.

[00:03:24] Alison: I thought for sure we'd have another year's worth of IVF treatments. Maybe two years. But that frozen embryo -- frozen before Zoe was even made into an embryo -- really amazing that, that that worked. We felt really lucky. I was still anxious with that second pregnancy, but not nearly as anxious as I was the first time, because I knew I had done it.

[00:03:49] I knew I had made it to the end. And I was busy. I had a six month old baby. So I didn't have as much time kind of, you know, think about it as much. So we were pregnant with the second baby. We knew we wanted to make a change from our birth experience the first time.

[00:04:10] I had a lot more knowledge. And we knew we wanted a different provider, maybe a provider that would be supportive of our choices, which would be really cool.

[00:04:20]My husband was still pretty much wanting to make sure it was an OB, you know, we know so much more now about midwifery versus obstetricians. But at the time we didn't know as much. And a friend of mine recommended an OB practice that also delivered at the birthing center at Mount Sinai West. So that to me was the best of all worlds. I've got an OB and I can then have a baby in the birthing center, which is not home, but close. Right?

[00:04:51] Lisa: Yeah. That was how I felt when I chose that place in my first pregnancy.

[00:04:56] Alison: With the tour, I was completely sold. I was so happy and looking so forward to being there. The OB practice that I went to, it was, you know -- I went to my regular appointments and they were very quick and fast. Just kind of like my other OB, but I felt comfortable that I would be able to birth in the birthing center.

[00:05:18]I wish that experience with the OB practice had been a little more, like, loving. I wanted a midwife -- lo and behold, come to find out, I wanted a midwife.

[00:05:28] So the pregnancy with Kenny was good. I felt like he got really big really fast. His feet were always up in my ribs. That was so uncomfortable. Oh my gosh. I'm only five feet tall, so there's not a lot of space for a baby in there. I started doing the same things that I did with Zoe once I got to be around 35 weeks. You know, all of the pineapple core and whatever else I found on the internet that could get a baby to come faster.

[00:06:03] Once I hit 38 weeks, 38 plus two, which is when I had Zoe, I was like, "He's never coming. He's never going to come. It's going to be like 42 weeks. It's going to be like so, so long." I went into labor three days later, 38 plus five I went into labor with Kenny, but that three days was the longest three days of my life.

[00:06:27] Lisa: Expectations, right ? Wow, they're powerful.

[00:06:31] Alison: We kind of set ourselves up for disappointment. Like, we know we're doing it. But we still do it.

[00:06:38] So, 38 plus five Ken and I put Zoe down to sleep for the evening and came back out and were like cleaning up the kitchen, getting things ready, and my water broke. No contractions, no nothing. Just all of a sudden water broke. And when you have a child at home and you're expecting another one, things look a little bit different for how you're planning on getting to the hospital -- if you're going to the hospital, how it looks. You know, you've got the friend that's on call to come over to the house and you gotta wait for them to get there before you can go. And you don't want to call them too early. It was a lot more, logistically. So I called my friend and kind of just gave her a heads up that my water had broken.

[00:07:25] She only lived a couple of blocks away, but it was already 10 o'clock at night. So, I knew I needed to let her know before she went to sleep. My contractions had pretty much started by the time she got there at 11. And we decided to just go ahead and go to the birthing center. I didn't say this with Zoe's birth story, but I got to the hospital at six and she was born at noon.

[00:07:49] So my labor had moved pretty quickly during the time that we had gotten to the hospital, and I expected it to move maybe even a little faster the second time. Plus I knew that we had this lovely bedroom to go labor in. I felt like, laboring at home, I was worried I was going to wake my daughter up, and I just kind of wanted to be someplace by myself.

[00:08:13] So we went ahead and went to the hospital before I was in active labor. And, you know, we took a taxi again. I was completely fine this taxi ride. I remember getting into triage and there was like a little waiting room there. And we walked in and somebody's partner was in the waiting room and he was pacing back and forth, obviously very nervous. And, you know, Ken and I, we rolled in there like old pros. "We've done this one time already. Don't worry, buddy."

[00:08:47] Her water had broken on him on her partner. So, Ken had an extra towel and a bag. He like gave him this towel. We were just like, "We know what we're doing. Here you go, newbie, good luck." They pulled us back for triage. And, you know, I said, "We're here for the birthing center." The nurse said, "Birthing center's closed." So. We had done a birthing center class at the hospital that they make you do to make sure that you know all the things that you need to know to give birth in the birthing center. And somebody had asked a question -- you know, I imagine it was somebody with a doula -- asked the question in the birthing center class, "How often is the birthing center closed?"

[00:09:45] Lisa: It's gotta be somebody with a doula. You're right.

[00:09:47] Alison: It had to be somebody with a doula I now know. And the person teaching the class was like, "Very rarely!"

[00:09:57] Lisa: For listeners who might not have heard this on past episodes, the birthing center that we're referring to at Mount Sinai West closed in recent years. So unfortunately it's no longer an option. Sad.

[00:10:10] Alison: Very sad.

[00:10:11] Lisa: Although, if it was hardly ever open -- you know, there's that.

[00:10:14] Alison: Yeah they told me it was closed. They had hooked me up to the heart rate monitor in triage, just to check the baby. I said to the nurse, it's the same staff upstairs as downstairs -- meaning the birthing center and the labor and delivery floor -- can't you just send somebody down there?" I was doing my best to self-advocate without knowing exactly what to say. And she said, "Yeah, let me go ask. I'll be right back." And when she came back, she said that the heart rate variability strip that they were taking on Kenny was too flat. There was not enough variability in his heart rate.

[00:10:57] So then she risked me out for that reason. Like, "Birthing center's closed." "Okay. Can you go check heart rate variability?" You know...

[00:11:08] Lisa: Maybe he was just sleeping.

[00:11:11] Alison: So, now I know. But it was very scary for me at the time, because I didn't know what that meant.

[00:11:18] Lisa: Yeah, it sounds scary.

[00:11:21] Alison: It does sound scary. They like to see the heart rate up a little bit, heart rate down a little bit heart rate in the middle, up, down, middle -- which is very common for a baby that is awake.

[00:11:31] Lisa: Yeah. And they're not awake a lot.

[00:11:34] Alison: Right. If the baby is not awake or is very chill, then, you know, a lot of times the heart rate just stays kind of the same, which does not necessarily mean a bad thing, but it's just something that makes them want to keep taking a second look. Or keep looking. So anyway, then we were officially risked out of the birthing center, and we were going to be moved into a room in labor and delivery. And my first thought was, you know, was the big regret of coming to the hospital too soon. Like we, did this, we could have stayed at home and labored.

[00:12:14] You know, I came early because I was thinking of the Laura Ashley suite that I wanted to be in.

[00:12:20] Lisa: With more space.

[00:12:23]Yes, but I was not in active labor. And I knew that I was going to need to get there fast, or it was gonna be interventions that I was hoping not to have. We walked and walked and walked and walked the halls. I mean, there's only so much walking you can do. The halls are not big. We were dizzy from going back and forth.

[00:12:46] It was after midnight by this point. Luckily contractions started coming pretty fast soon after. I was in the room. I wanted to do the same thing, lean over the bed and rock back and forth. My poor legs. Both births, my legs were shaking because I was just standing and I would go up on my tippy toes for the contraction and then I would come back down. I mean, it was like squats, lots of squats. It was a much different experience with the nursing staff this time. I had nurses coming and going the whole time. At least two. I saw the doctors in my doctor's practice. They kept coming in, checking the heart rate monitor, readjusting, they wanted me to use an oxygen mask. I wish I knew more, you know, then. I'm curious -- were there decels? I don't know, we didn't really talk about, you know, what was going on. Or was it the same with the variability thing?

[00:13:44] I just, I don't know. But I had all the things again, I had the pulse oximeter. I had the oxygen mask this time. I had the bands around my belly. I had the blood pressure cuff. I had struggled with constipation my whole pregnancy. And I had had pelvic floor injury that I believe was due to the directed pushing with Zoe's birth. I had been doing a lot of work with the pelvic floor therapist.

[00:14:14] It's great that you knew about that back then.

[00:14:17] Alison: Yes. And they told me to get my placenta encapsulated. She told me this while I was pregnant. She was like, here's a card. You'll know if you need it.

[00:14:27] Lisa: That's great.

[00:14:28] Alison: I needed it. Anyway, you know a hard part of a pelvic floor injury, too, having the constipation with it, I was having a hard time. But I had to go, I had to poop when I was in labor. And unlike my nurse the first time that said, "Then go to the bathroom," this nurse said, "You can't go to the bathroom. You have to go here." You know, the rooms in this hospital were teeny and the bathroom is like right there. It's like right there. You know, it was not a long walk. And she was like, "No, you can't go. You need to stay right here. We want you on the monitor."

[00:15:09] So I ended up having to poop in a bucket next to the bed. You know, it was, it was like a dehumanizing experience. But my husband, when we were talking about this the other night, he was talking about how amazed he was that I could poop next to the bed.

[00:15:32] He was very impressed. As soon as I pooped in a bucket next to the bed, we'll say it for what it actually was. I didn't get to go to the bathroom -- my cervix just dilated.

[00:15:43] And then it was time to push. And you know, I had been really unhappy with my pushing experience for my birth with Zoe, and I was really wanting to be in charge of my pushing experience. And luckily an amazing provider was on duty from this practice when it was my turn to push. And I was, I was so thankful for her. I'd only -- she wasn't my main provider, but she was just, you meet them a couple of times when you're just in the last phase of pregnancy, when you go in just to meet everybody. But she came in, she did not turn on any lights. She did not break down the bed. I had a really strong urge to push. We worked together, me and the doctor worked together and she just kind of coaxed the baby out. There was no counting. She was like, "Just push when you're ready. Don't push too hard. He's coming. He's going to be here soon. Don't feel like you have to rush. No hazmat team came in. It was just me and the doctor and Ken.

[00:16:52] I still pushed on my back, which felt like the most natural position for me to be in then, even though I never thought I would do that again.

[00:17:01] Lisa: As long as you were allowed to do what felt instinctive? That's what's important. Right?

[00:17:05] Alison: That's what I felt like I wanted to do. Anyway, he just kind of came out.

[00:17:10] It was not a big production. I pushed him out and she was just there. It was amazing. So Kenny was born. We got to the hospital at midnight, and Kenny was born at 7:30 in the morning. So not too long, even though we came without contractions. I think we got lucky.

[00:17:33] Lisa: Yeah.

[00:17:35] Alison: Kenny was seven pounds, two ounces. That was a great experience. So he came and we were able to leave after just one night again, which we were able to do the first time too. I was so anxious to get home. The hospital is not my happy place, so I was just like, "I'm ready. Let's go." So we were able to go home.

[00:17:54] Ken went home just a few hours after Kenny. My husband's name is Ken and my son's name is Kenny. Ken went home just a few hours after Kenny was born. Because I wanted him to go home and be with Zoe because she was just with some of our friends. So I spent that night in the hospital by myself, just me and Kenny.

[00:18:13] And it was so nice. We had a nice little bonding time and I got to go home that next morning.

[00:18:18] Lisa: No separation this time. Yay. With the concerns about the fetal heart rate, was there ever talk about internal monitoring, which I would think you were like, "No way, I don't want to do that."

[00:18:30] Alison: Well, yes. And that's what I would have said. I don't remember if they even brought it up.

[00:18:35] If they had, it would have been, you know, a quick shut down, you know, Ken and I were talking about this the other night. He was remarking on how different he felt during the labor experience the second time where he felt the first time, you know, I told you we were pretty much just left alone to do our own thing. And he felt like he was there in case I needed something, but that was his like sole job was just caring for me. Whereas during Kenny's birth, he felt like he was protecting me from the medical providers, almost, in a way. There were a lot of people in there -- "Do this, do that. Don't do this, don't do that." There were a lot of people in there giving direction. And he felt like he spent the whole time just like, "Whoa, whoa, let's talk about this." And that was not a position that he had to be in the first time. An advocate position or, you know, the person that asked the questions or the, you know, the person who's trying to find information and put things together. He didn't have to do that so much the first time. Second time he did. And he had to do it a lot because I wasn't there in my mind to be able to help.

[00:19:55] Lisa: I would think having just gone through the whole process before, even if he didn't have to advocate as much the first time around, just the confidence that you both brought to the second birth helped him better advocate.

[00:20:09] Alison: I think it did. But, you know, after the birth, he was exhausted.

[00:20:17] Lisa: He shouldn't have had to do so much advocacy.

[00:20:21] Alison: He had to work so hard to make sure that I was able to do the things that I wanted to do. He was so tired. He was so tired, and we were there like a much shorter time. The labor was shorter.

[00:20:34] Lisa: Yeah. But that emotional energy.

[00:20:36] Alison: Yeah. We were talking through our birth stories talking about like what would we have wanted a doula to do in these situations. In hindsight, we both wished we had hired a doula for the first one. And we didn't hire a doula for the second one because I felt like I was going to be in the birthing center and "Aren't all nurses in the birthing centers basically doulas?" That was my mindset going in. Never did I think about, well, you don't always get in the birth center, or even when you're in the birthing center, you might not have a nurse that's right there with you advocating for you the whole time. You know, they work for the hospital and they have other patients. But, boy, if I have a third...

[00:21:23] Lisa: Getting a doula. Now you are a doula. But even doulas need doulas. Right?

[00:21:30] Alison: Yes!

[00:21:31] Lisa: That seems like a good segue into: what made you feel inclined or called to birth work and fertility work and postpartum doula work?

[00:21:43] Alison: So, you know, after Kenny was born, we were pretty sure that our family was going to be complete at that point because, you know, we had had so many struggles building the family that we had, and we had this perfect little family and two awesome kids. It felt complete to us. And because of what I had gone through during my births, and learning to advocate for myself and just learning how I wanted it to birth, I became a birth nerd. This is what happens.

[00:22:15] I couldn't stop learning, just going from my own experiences and researching, like, why did this happen? What was this about? You know, and just learning and learning and learning. And it just, it turned into a hobby. And then my hobby turned into a job. We had planned for me to stay home with the children for at least the first couple of years. So I wasn't working. Any time that I had, I was learning birthy things. Taking care of babies and learning birthy things.

[00:22:49] And because I had that space for that two years, I really had a lot of time to think about like, what do I want to do? My career before had been in restaurant management. It's a lot of fun, but the pay sucks and the hours...

[00:23:11] Lisa: The hours are crazy.

[00:23:13] Alison: Long. And it's nights and weekends. It was a lot and it was not something that I wanted to do with young children.

[00:23:22] It's not something my husband would want me to do with young children. I had done that for so many years and I wanted to do something else, you know, and I had enough space in my brain at this moment to decide what I really wanted to do. And it was to go into birth work.

[00:23:38] The fertility doula work kind of started at the same time. And it was mostly because of friends and friends of friends finding out their friends were going through fertility treatments and they were like, "Call Allison. She can help you. She'll at least tell you where to go."

[00:23:53] At first it started off where I was helping a lot of people with their insurance coverage, because that is tricky. Sometimes things aren't covered, but there's sometimes ways that you can put it back through, or maybe something should be covered. Anyway, it started off with a lot of helping people with that. Or started with talking to people that were going through fertility treatments or going in for their first appointment -- what to expect.

[00:24:14] When I went to my doula training, which was in 2016 in Brooklyn, we had to bring something in that symbolized why we wanted to become a doula. It could be anything.

[00:24:31] Lisa: Interesting.

[00:24:32] Alison: I brought in a picture of myself pregnant at 24 weeks when I hit viability week with Zoe, and that was my thing. This is why I wanted to become a doula because I remember being 24 weeks pregnant with this girl that I had tried so hard to get pregnant with, and being terrified to give birth, because I had no idea what I was doing. This is, this is the whole reason, you know. So. Sorry, I'm getting all....

[00:25:02] Lisa: That's beautiful.

[00:25:05] Alison: Anyway. That was the reason. It was really important to me to kind of incorporate that all together. Because that was the hard part for me. That was the threshold that I needed somebody to hold my hand and walk me over, you know. That's when I needed help and there might've been somebody out there that could have helped me then. I just didn't know. I didn't know where to look and I didn't know what to look for. From the beginning of my doula journey, it's been with a heavy focus on working with people that have gone through infertility. I did work with clients that did not use fertility treatments. But I would say the majority had some kind of infertility history.

[00:25:46]It's so important to help people move through that phase because you think when you're going through fertility treatments that "Oh, if I could just get pregnant, if I could just get pregnant..." And then when you get pregnant, there's so much more. Like, "Is this going to work? I'm scared. Is my body going to work? What do I need now?" It's like, there's still stuff there. You know, it's not...that's not the end. It's almost like the beginning in some ways, you know, more things to work through.

[00:26:15] And, just being somebody to talk to that's been through it sometimes is all people need, is just to say, "Okay, you get it. I want to complain about something." So that's kind of how it all started, in a big pile.

[00:26:34] Lisa: And so did you seek your various certifications all at once? Or you started with a birth doula certification? Is there a fertility doula certification or is that more of an unofficial thing at this point in time?

[00:26:45] Alison: Once I completed my birth doula training and I was in my certification period, I decided to take a lactation counselor training just to add in another piece. I was trying to do a lot more postpartum work just because it worked better with little kids at the time, you know? Because it was hard for me to be on call for too many births a month. Where I could do postpartum, while they probably were at school. And I felt like lactation was a really important part of that. So I took a lactation counselor training during my certification period for doula work, but I really searched high and low to find a fertility doula training.

[00:27:25] I couldn't find what I wanted exactly. Because I'm a birth nerd, I enjoy taking certifications and classes and I just like to collect, you know, certifications. I had been on the lookout for some kind of fertility doula certification for a while. I really wanted it to focus on working with people going through fertility treatments.

[00:27:52] I was finding a lot of things on, like, charting or fertility awareness method trainings, but I wasn't finding a lot on how to help people go through fertility treatments. Sometime in, like, beginning of 2018, I found that Bebo Mia was doing a fertility specialist certification and its focus was on artificial reproductive technology.

[00:28:22]That was it. I'm like, "Oh my God, somebody is doing this. " The founder of Bebo Mia has her own infertility story. They're a group of doulas that are in Canada and she created a support group that she was running as part of her doula practice for people going through fertility treatments.

[00:28:39] And it spun off into her creating this fertility specialist certification so other people could run these same kind of support groups. The inaugural group, I think, was summer of 2018. And I purchased it in 2017 and had to wait for summer of 2018. I was in the first class.

[00:29:00] I signed up and I blew through that certification as fast as I could. Luckily it's kind of like a doula certification where you have to have clients, as part of being certified, you have to share case studies and I had some clients that I was seeing already then. So I was able to kind of incorporate that into my certification and I flew through it and, you know, got the certification. Do you need it? Absolutely not. Doulaing is all from our heart. I felt like I needed some more tools to use to help people through this. And I think it was really, really helpful for that.

[00:29:45] Lisa: You've mentioned a couple of ways that a fertility doula can support someone on that journey, such as helping navigate insurance, which is huge, and emotional support. What are some other things that can be helpful to people on that journey?

[00:30:01] Alison: I think one of the biggest components that we try to incorporate is self-care. Like, finding the ways to add in self-care. Because if you're, you know, you've got your reproductive endocrinologist appointment and you've got acupuncture, you're doing yoga for fertility, and you're trying to do your job, your, your regular nine to five or whatever -- I mean, it's not self-care if you're like running into acupuncture, like sliding in the door, "Sorry I'm five minutes late! I've gotta get to yoga next!" You know, that's not, that's not caring for yourself. Right? But more like figuring out what you're getting the biggest bang for the buck, as far as self-care.

[00:30:42] And it might not be on all of those things. It might just be one thing. You know, maybe the bath once a week is giving you everything you need. But trying to find out where the holes are, what needs to be fixed and kind of, you know, helping people go through a plan to fix that.

[00:31:00] Lisa: One thing that I was hearing, I think in that was, it's so helpful to have someone who's a little more objective seeing the bigger picture and helping you be strategic with it. Because when you're in it, in the minutia of it, I can imagine that it could feel like it's just one foot in front of the other.

[00:31:17] Alison: Exactly. There came a point for me where I was like, "I'll do whatever. You tell me what to do and I'll do it. I just want to get pregnant and have a baby. You tell me exactly what to do. I'll be there, every day." But there are other things that you have to kind of incorporate for your quality of life. You know, are you spending time with your friends? Your family? Your partner? Where are things kind of lacking? But it's being objective. Having an objective listener too. So a lot of it is cultivating a self-care plan, and insurance coverage. I'm pretty familiar with United States insurance.

[00:32:03] Lisa: Much to your regret, probably.

[00:32:05] Alison: My first phone call to the insurance company I just cried the whole time. But now I'm just like, all right, here are the key words, find me what I need." It just helps somebody like skip that whole middle.

[00:32:17] Lisa: Yeah, that's huge.

[00:32:19] Alison: And also finding the right provider is something that I work with people on a lot, and then if clients are mid-cycle during the time that we're working together, we may do a weekly check-in where it can be whatever it needs to be.

[00:32:37]When I was in -person, in New York City, there were some other things that I added on, which were pick-ups, like where I pick people up after they have surgery and get them home. Once you have anesthesia, you have to have somebody to come get you.

[00:32:52] Lisa: Did you find there was a lot of emotional processing in those cab rides?

[00:32:56] Alison: Sometimes. I think everything with fertility treatment there's a lot of emotional processing. It's so important to have somebody to make sure that you get home, tuck you in and turn on the TV. Order Seamless Web or make you something to eat, you know.

[00:33:12] Lisa: That's huge.

[00:33:13] Alison: I also attended appointments to either take notes or help ask questions. Sometimes you walk into a doctor's appointment, you have like a whole idea of what you're going to say and you get in there and it all leaves your brain. We always make a list of questions before we go in, which is just the way every doctor's appointment should be. Especially for people like me that have anxiety problems with medical providers.

[00:33:34] I can also help create other questions that may come up along the way. And I also help people with injections. I can't do injections myself because I am not a nurse. I'm not trained to do that. But what I do is go to people's homes and we set out their injections for the night and we watch the videos of how to do it. And we talk about how to mix the medicines, which needles to use, and we put it all out, and I'm their biggest cheerleader. Sometimes it's just nice to have somebody there as a witness.

[00:34:14]When you're giving yourself an injection, it's not easy, not easy. And you know, fertility treatments -- for many people, that's the first time they'll ever give themselves an injection. Just some examples of things that I used to help with in person, and that was in person. Now I can do that in Costa Rica.

[00:34:32] Lisa: Plenty of that you can still do virtually, right?

[00:34:34] Alison: Yeah.

[00:34:35] Lisa: Well, thank you for sharing about that. Are there any other things that you haven't gotten to share? Any reflections on how your giving birth experiences -- and/ or the work that you now do? -- was it healing in any way toward some of the challenges of the conception journey?

[00:34:56] Alison: Yeah. My birthing experience felt very healing to me, because --as we talked about a few times -- about the trust I had in my body, whether or not I could trust my body to do the things that I felt like it was supposed to do. My birth experiences helped me process that. And that doesn't mean that I'm just forever healed of that feeling. Sometimes things still don't work in my body. Right.

[00:35:27] Lisa: Yeah. True.

[00:35:28] Alison: But I feel like I got a lot of important things out of my birth experiences. They weren't perfect. If I had a third, I have some changes that I would make. But I still feel glad to have had those experiences.

[00:35:49] Lisa: Are there any tips that you would have, or, additional insights that you haven't already gotten to share, that you think would be helpful for people who are on similar journeys, especially with struggles to conceive?

[00:36:02] Alison: Yeah. I think it can be very helpful when you're going through fertility issues to connect with others that are also going through those same experiences. People feel different ways about connecting and how to connect.

[00:36:19] And luckily -- the technology that we have these days -- there are lots of different ways to connect. There are Facebook groups you know, you can join a Facebook group and never post. Just read what other people have to say until you feel like it's your turn, you're ready, you know. But at least seeing other people's journeys and knowing that you're not alone, it's nice to see. A lot of people want to keep their fertility struggles private, and it's not necessarily because it's shameful. It's because it's, it's personal. And you don't want to talk about your personal things with everybody.

[00:37:10] Sometimes your closest friends or your family aren't the best people to support you going through something, especially if it's something that they don't understand. So finding the support from others. I mentioned Facebook groups and then Resolve.org, they have in-person groups and they're doing a lot of their groups on Zoom now, too. So that's another option, and they also have a provider directory on their website where you can find therapists, if you wanted to find somebody to talk to in person or to talk to somebody that has more experience in taking care of the mental health part of that, which, you know, it's, it's tough.

[00:37:54] So getting help, the help that you feel like you need, however you need it, is important. And you can go to Resolve and find therapists that are experienced in working with people going through fertility treatments, which I have found is important

[00:38:08] Lisa: Yeah. It's its own niche. Yeah.

[00:38:10] Alison: They also have a helpline that you can call, they don't answer the phone, but you leave a message and a volunteer gets back to you.

[00:38:19] Lisa: That's great.

[00:38:20] Alison: They're a wealth of information. And there's also companies like Fruitful Fertility that puts people together with a mentor.

[00:38:28] You volunteer as a mentor and you get hooked up with a mentee, and mentees get hooked up with mentors. It's all people that are going through fertility treatments or have been through fertility treatments. That's a really good source of more one-on-one kind of support. And you know, if you feel like you need more personal one-on-one support there are fertility doulas that do what I do. And there are others, you know, all over the country. So finding the connection, however you can find it. Oh, yeah, and podcasts.

[00:39:06] Lisa: Yeah. That's what I was just going to about to bring up.

[00:39:08] Alison: Oh my gosh, right? You can hear story after story after story and making that connection helps so much with the anxiety and the stress. Hmm. Oh, it helps so much. Yeah. That's my, that's my tip. And my trick is connect. Connect however you feel comfortable connecting.

[00:39:32] Lisa: So that it's less overwhelming and less isolating. Yeah. Well, thank you, Alison. This has been such a treasured time. I have loved hearing these details and everyone go over to Infertile AF podcast and look up Alison's story. And again, I'll link to it in the show notes, but it is so good. Thanks so much for taking the time.

[00:39:56] Alison: Thanks so much for having me, Lisa.

[00:39:58] Lisa: Absolutely. And, and everybody, look, I will also link to her website. If anyone is looking for a fertility doula, know that she does virtual work. If you happen to be in Costa Rica, she's there locally right now. So she's wonderful. And if you're looking for a birth doula, postpartum doula, all those things, lactation counselor, she does all those things. So thanks again.

[00:40:21] Alison: Thanks so much.

[00:40:22] Lisa: Take care. Bye.