From Five Children Naturally to Janice’s Pregnancy at 46 With Donor Eggs

On episode 68, Janice is 46 from western North Carolina. She is a registered nurse and has been in psychiatric nursing the last eight years. She has just recently became international board-certified lactation consultant. She is looking to find a remote nursing position from home, so she can stay home with her new baby. She started having babies when she was just twenty. At the time, she didn’t know anything about home birth or natural birth. Janice had a friend that was also pregnant at the same time. She introduced her to Spiritual Midwifery, a book by Ina May Gaskin. It inspired her to take home birth midwifery childbirth classes. The couples met with the midwives to see if any of them were a good candidate for home birth, you got a home birth paid by insurance. She was a candidate for home birth, so she had a great and easy first home birth. In fact, all of her other kids from her former relationship between 20-29 were home births. She even had a set of twins born at home. Her pregnancies were super easy with no complications. She has five children from a previous relationship, and her partner also has five kids from a previous relationship. She met her now fiancé when she was 39. At 41, they had been together for seven years when she and her fiancé decided they wanted a baby together. Pregnancy was the furthest from her mind in her 30’s. In her 40’s, it was the only thing on her mind. She thought having another baby was going to be easy. They have 11 children together. She was three months postpartum during the recording of the show.

They called it unexplained advanced maternal age unexplained infertility.

Her fiancé had a vasectomy which they had reversed in 2019. She had it in her mind that the reversal wasn’t going to work. She was very skeptical because she wasn’t getting pregnant. After about six months of trying, she went to the fertility clinic. She didn’t like the first clinic she went to because they wanted to go straight to IVF. The clinic wouldn’t listen to what she had to say, there wasn’t a conversation. With the second clinic, for the next year and a half, she tried three IUI’s that weren’t successful. All the cycles looked good and there were plenty of follicles. The doctor called it unexplained advanced maternal age unexplained infertility. Besides being older, it was a mystery why she wasn’t getting pregnant. Everything always looked good but got no results. It was taxing mentally and emotionally. Her clinic wouldn’t do an egg retrieval because of her age. Janice found an out-of-state clinic that would do it, but she felt like she was piecing her care together from different places which didn’t feel right. Since she already had five biological child, deciding to use donor eggs wasn’t hard for her. She said it’s hard to explain, but the decision was a spiritual process for her.

Her clinic had three different ways to find a donor: she could work with their two agencies for a fresh egg retrieval. They also had options with local donors for a fresh egg retrieval which had only three donor option available. The last option was a bank of frozen eggs. Her first choice was to go through the donor agencies and search the profiles. It was weird at first. She looked for a donor with her same physical attributes. There was one that she thought looked just liked her, but she ended up backing out after four months of waiting. Next, she wanted to look at the frozen egg options. The clinic had two more donor options from when she last asked. She looked at the new profiles, and the second one who she chose. The donor was a nurse and answered the questions just like Janice would have. Everything the donor wrote in her profile was so thoughtful and sweet. She sent the profile to her fiancé immediately. She talked with him that night to decide she was sure this was the one. She was confident she was going to have a baby using these donor eggs. They got six frozen eggs.

The clinic created three embryos using the donor eggs and Janice’s fiancé’s sperm: one Day 5 embryo and two more day 6 embryos for a total of three embryos. The first one was the most perfect grade embryo that you can have. Before her first transfer, she had a hysteroscopy to look for polyps and fibroids. Then they did a biopsy with a mock transfer to check for endometriosis. All that checked out and she was scheduled for her first transfer, but then she ovulated. The transfer was canceled. They recommended her to go on Lupron to stop ovulation for the next cycle. She took the Lupron, so the next cycle was not canceled. She had her first transfer with the perfectly graded embryo. She just knew this was it. Then she got the call that it didn’t work. She was just devastated but wanted to hear what the next steps would be. The clinic recommended doing the Emma Alice test which tested for inflammation and bacteria in the uterus. The results were no inflammation and no bad bacteria, but she had absolutely no good bacteria at all. She feels like she takes care of her body and has been taking probiotics for years. They recommended a quality probiotic but also with specific strains of bacteria. The probiotics that she had been taking didn’t have those in it. The next cycle she ovulated, so it was canceled. She took Lupron again to have her second transfer on November 22, 2022. Janice has taken so many pregnancy tests over the years, that she wanted to wait for the clinic to call with the results. Her clinic had her come in on Day 8 post transfer to test her HGC levels. Afterward the bloodwork, her and her fiancé decided to see a movie and eat pizza to help keep her mind off of it. If she wasn’t pregnant, she wanted a beer and the brewery was right there. She and her fiancé walked outside to take the call from the nurse during that chilly November day. Janice cried after she heard she was pregnant and her HGC level was over 100. It was exciting and the happiest moment.

I was more active at 46 than I was in my 20’s.

She continued taking pregnancy tests because she kept thinking it will go away if she doesn’t keep doing them. She was nervous the whole time wanting to make sure the pregnancy stuck. The first trimester was really good. She didn’t have morning sickness, but many food aversions. What replaced morning sickness was anxiety and worry. Mentally, she says she was a mess the whole first trimester. She’s a meat eater and loves eggs, but she couldn’t even smell either let alone eat an egg in the first trimester. She found meat repulsive, too. Sometimes she felt nauseous, but eating every two hours really helped with that. She agreed to have all of the high risk ultrasounds, but there wasn’t a lot of them. Advance maternal age was on her paperwork, but her doctor never called her that. At her first ultrasound at 18 weeks, the placenta was lying low which was normal at that time of the pregnancy. Everything looked great, except for that. In her third trimester, the placenta was still in the way. It had moved a little, but it was still in the way. The doctor discussed a c-section because of the placenta and her age. Janice wanted to wait to have one more ultrasound before scheduling a c-section. At 35 weeks it had moved out of the way. She was cleared for a vaginal birth. She recommends compression socks. She worked out throughout the pregnancy. She ran three times a week until she was put on activity restrictions because of the placenta. When they were lifted, she walked 2-3 times a week. She prepared for the baby by doing lots of yoga, and lots of meditation really helped. She watched a lot of birth videos but didn’t think she needed to take any classes. Looking back, she does wish she took a classes with her fiancé. Pregnancy at 46 was a lot the same as far as her health from her other pregnancies. She was obsessed with not getting gestational diabetes or hypertension. She bought blood glucose test strips and had a home blood pressure monitor. Her doctor allowed her do a natural test for gestational diabetes. She didn’t make her drink the sugar solution. She just made her have a certain amount of carbohydrates and she opted to not do the quick test but did the three-hour test instead which is more precise.

She didn’t do testing on the embryos because the egg donor was so young. They had the NIPT testing early in the pregnancy to test for genetic disorders but opted out of finding out the gender. She’s not into gender reveals but wanted to do something for the family. Her youngest daughter was the only one to know the sex of the baby from the ultrasound results. Her youngest daughter used flavored ice cream hidden under vanilla. It was taking forever and by the time Janice got her ice cream, she was digging into the soupy mix to find out she was having a boy. Janice really thought she was having a girl and even had a name picked out. Her youngest daughter agreed she liked the girl’s name she picked out, so she thought that was a give-away she was having a girl. She was so surprised to see the blue ice cream. She now has four boys, two girls. Robert also has four boys and two girls.

When she graduated from the fertility clinic, the clinic wanted to know what doctor to transfer the records to. She didn’t want to use any of the large practices they recommended because she wanted care with the least intervention. She used her family practice that has one OBGYN in the office. A few months in, she wanted to have the baby at a birthing center because it would be a good middle ground between a home birth and the hospital. They went to orientation and got their packets and did the tour. The birth center called later to tell her they couldn’t take her as a patient because it was a new practice and the risk factors. A month later, she decided to pursue a home birth. She got in touch with one of the midwives she briefly saw with her pregnancy at 29 with the twins. The midwife wasn’t doing many births any more but wanted to take Janice on. The plan was a home birth with the doctor as back-up. Luckily, she had a great doctor that was open to idea.

She started labor with her midwife at 39 weeks by taking homeopathic packets to help her body get ready for birth. She wanted to do the least invasive thing to tell her body she was ready. Her doctor didn’t want to induce her just because of her age. Janice told her she was willing to go to 42 weeks. If she hasn’t had the baby, she will do an induction then. She just knew she was going to have this baby before 42 weeks. At 41 week, she took castor oil. It didn’t work. She could have taken more, but she had diarrhea for about 11 hours afterwards. It was awful. She never had any problems going into labor with her other kids. She started exercising and jogging again to help start labor, too. Every night she would go to bed thinking that she would be in labor during the night, but wake up feeling normal. Her doctor recommended having fetal heart monitoring. She had to go back 2 or 3 times because they thought they saw something. It was nothing. At 42 weeks, 3 days she had her induction scheduled. Janice had a leap procedure fifteen years ago where they removed precancerous cells on her cervix. They went in and scraped and lasered off all the bad cells. There was a lot of scar tissue that prevented her from going into labor on her own.

Janice was admitted to the hospital for the induction at 42 weeks, 3 days. Her midwife came to the hospital as her Doula. She didn’t want to get Pitocin right away. Instead, she had the catheter balloon to physically open the cervix. It’s supposed to fall out when the dilation is 4 centimeters. After almost 12 hours, she was only three centimeters dilated. Not much was happening and it wasn’t coming out. She felt like she was in labor while it was in. Once it was out, the labor went away. She didn’t sleep that night because the monitors were so uncomfortable. There was a tub in her room that she could labor in but not birth in. She used the tub to relax and sleep. She wanted the monitors off so she could sleep. The nurse finally agreed and got a few hours of rest. That day, the plan was to start Pitocin. She started the Pitocin at 11:00 am and she bounced on the ball. Her friend came to visit and offered her gluten free Oreos. Still nothing. They had to get another order to go up on the Pitocin. She was losing quite a bit of blood and tissue which was more than the ‘bloody show’ all because of her cervix. Her cervix was completely unresponsive because there was so much scar tissue. Her body had lots of scar tissue to get rid of before her cervix could dilate. Her labor didn’t start until the Pitocin was up to 28 units. Janice was excited to see her baby soon. The labor was the most intense labor she has ever experienced. The ultrasound showed her baby turned posterior which caused painful back labor. She got to 7 centimeters. She was passing out from the pain and screamed with every contraction. She couldn’t relax and was throwing up. Janice was against having an epidural at first, but the midwife suggested it. She got scared at the end and wasn’t sure she could do it. She labored for a few more hours, and then gave into an epidural. She was only numb on one side, so they gave her more. After that, all she felt was pressure and no pain. She was so tired, she fell asleep. The doctor woke her up an hour later to tell her she was 10 centimeters dilated. The room was full of people, including the NICU staff in case they were needed for the baby. The nurses guided her the whole time. One of her friends recorded the birth even though she wasn’t allowed. Janice pushed for 30-40 minutes. It was one of the happiest moments of her life.

Skin to skin and delayed cord clamping were important to her, but she was loosing more blood than the doctor wanted to see. The cord was cut after it stopped pulsating. The doctors spoke to her about the possibility of a hemorrhage. They couldn’t figure out where the blood was coming from. She ended up in the OR just to be under the lights. He baby nursed until then and was only away from him for about an hour. It wasn’t bad enough to receive a transfusion, but they needed to find out where she was hemorrhaging from. They stitched up her cervix. The doctor described her cervix as tattered and was in rough shape. She’s never been so exhausted in all of her life. She couldn’t save the cord but she saved the placenta. Janice saved all of the placentas with all of her children, except for the second. For the placenta at 46, she decided to do placenta prints with it. We kept it in a cooler on some ice and didn’t really get around to it for a couple of weeks.

It took Janice longer to recovery at 46 than in her 20’s. She was sore for two weeks from all the different positions she was in during labor which made it hard to do things. She felt like a failure at first for not giving birth naturally. It was a traumatic birth experience for her. She doesn’t remember worrying about her other babies as much as she did this time postpartum. She had breastfeeding challenges which she was not prepared for. He had tongue and lip tie. She never had any problems with her other children. It was pretty rough in the beginning. She could tell her latch wasn’t good. It was painful to nurse. Janice supplemented with donor milk in the hospital and still is today.

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