Aligned Birth

Ep 159: Surrogacy Birth Story with Dr. Lotem

June 12, 2024 Dr. Shannon and Doula Rachael Episode 159
Ep 159: Surrogacy Birth Story with Dr. Lotem
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Aligned Birth
Ep 159: Surrogacy Birth Story with Dr. Lotem
Jun 12, 2024 Episode 159
Dr. Shannon and Doula Rachael

Dr. Lotem Schulke, a prenatal and pediatric chiropractor in the metro-Atlanta area joins us on the show today to share her surrogacy journey.  We talk about:

  • Her decision to become a surrogate
  • The entire process from finding an agency, the criteria for selecting intended parents, and the medical screening and legal clearance phases 
  • All of the medical phases involved from taking birth control pills and hormone medication to prepare her uterus for implantation to the process of embryo transfer and the challenges faced during pregnancy.
  • She shares her pregnancy journey, which involved hyperemesis gravidarum during the first trimester, hospitalizations due to severe dehydration,irritable uterus diagnosis, and prodromal labor starting at 28 weeks.
  •  Despite all the challenges, she shares her birth story, who was on her birth support team, the emotions in the birthing facility with the intended parents and she reflects on her postpartum journey.

Connect with Dr. Lotem

00:00

Embarking on the Surrogacy Journey: Dr. Lotem Schulke's Story

04:16

Finding the Right Agency and Intended Parents

10:50

The Lengthy Process of Medical Screening and Legal Clearance

23:11

Embryo Transfer Process

28:03

Dealing with a Miscarriage

32:51

The Emotional Journey of Being a Surrogate

37:52

Challenges and Complications During Pregnancy

42:48

Navigating Hyperemesis Gravidarum and Dehydration

43:26

Managing an Irritable Uterus and Prodromal Labor

45:19

Monitoring High Amniotic Fluid Levels

48:37

A Successful Induction and Birth

56:10

Recovering from a Cesarean Birth

59:07

The Emotional Journey of Being a Surrogate

Support the Show.

Want to show your support? Want to help us continue doing this important and impactful work: Support the Show (we greatly appreciate it!)

Don't miss new episodes: Join the Aligned Birth Community

Instagram: Aligned Birth

Email: alignedbirthpodcast@gmail.com

Find us online:
Sunrise Chiropractic and Wellness
North Atlanta Birth Services

Editing: Godfrey Sound
Music: "Freedom” by Roa

Disclaimer: The information shared, obtained, and discussed in this podcast is not intended as medical advice and should not be relied upon as a substitute for professional consultation with a qualified healthcare provider familiar with your individual medical needs. By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician for any medical issues that you may be having. This disclaimer includes all guests or contributors to the podcast.

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Show Notes Transcript

Dr. Lotem Schulke, a prenatal and pediatric chiropractor in the metro-Atlanta area joins us on the show today to share her surrogacy journey.  We talk about:

  • Her decision to become a surrogate
  • The entire process from finding an agency, the criteria for selecting intended parents, and the medical screening and legal clearance phases 
  • All of the medical phases involved from taking birth control pills and hormone medication to prepare her uterus for implantation to the process of embryo transfer and the challenges faced during pregnancy.
  • She shares her pregnancy journey, which involved hyperemesis gravidarum during the first trimester, hospitalizations due to severe dehydration,irritable uterus diagnosis, and prodromal labor starting at 28 weeks.
  •  Despite all the challenges, she shares her birth story, who was on her birth support team, the emotions in the birthing facility with the intended parents and she reflects on her postpartum journey.

Connect with Dr. Lotem

00:00

Embarking on the Surrogacy Journey: Dr. Lotem Schulke's Story

04:16

Finding the Right Agency and Intended Parents

10:50

The Lengthy Process of Medical Screening and Legal Clearance

23:11

Embryo Transfer Process

28:03

Dealing with a Miscarriage

32:51

The Emotional Journey of Being a Surrogate

37:52

Challenges and Complications During Pregnancy

42:48

Navigating Hyperemesis Gravidarum and Dehydration

43:26

Managing an Irritable Uterus and Prodromal Labor

45:19

Monitoring High Amniotic Fluid Levels

48:37

A Successful Induction and Birth

56:10

Recovering from a Cesarean Birth

59:07

The Emotional Journey of Being a Surrogate

Support the Show.

Want to show your support? Want to help us continue doing this important and impactful work: Support the Show (we greatly appreciate it!)

Don't miss new episodes: Join the Aligned Birth Community

Instagram: Aligned Birth

Email: alignedbirthpodcast@gmail.com

Find us online:
Sunrise Chiropractic and Wellness
North Atlanta Birth Services

Editing: Godfrey Sound
Music: "Freedom” by Roa

Disclaimer: The information shared, obtained, and discussed in this podcast is not intended as medical advice and should not be relied upon as a substitute for professional consultation with a qualified healthcare provider familiar with your individual medical needs. By listening to this podcast you agree not to use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician for any medical issues that you may be having. This disclaimer includes all guests or contributors to the podcast.

Dr. Shannon (00:03.177)
Hello, hello, you are listening to the Aligned Birth Podcast. I'm Dr. Shannon, I'm one of the hosts of the show and today's episode and birthy topic is going to be, I guess like all about surrogacy, but from one side of the surrogacy journey. So we have a guest on who was just recently a surrogate and went through the whole...

entire process and she's being open and honest and just willing to share her whole journey with us. And I'm friends with her on social media and I saw it come across and I was like, my God, I have to have her on the show because this is, it's just, it was a lot and it was like so many emotions and the images, just everything was beautiful. And so I really wanted her to be able to come on today and talk about how she decided on surrogacy, what the process is.

how she felt, labor and birth, like just everything that is kind of involved in it. So she is a fellow pediatric and prenatal chiropractor. So we have Dr. Lotham Schuelke on and she's a mom and a bonus mom to four girls. And so like I said, she just recently went through her beautiful surrogacy journey. She lives locally, Metro Atlanta area. She's gonna be opening up a boutique practice soon. So I'm so excited to see that journey for her. But...

Dr. Lotem Schulke (01:18.423)
you

Dr. Lotem Schulke (01:22.735)
I am so, so excited to be on today. Yay!

Dr. Shannon (01:27.242)
Welcome to the show today, Dr. Le Tem, how are you?

Dr. Shannon (01:35.081)
Ugh, I know. So, gosh, I don't even know where to start, because you had that beautiful post that you did, and it just kind of outlined everything. I was like, my gosh, this sounds amazing. So, I want to start with how you decided to embark on this surrogacy journey.

Dr. Lotem Schulke (01:57.328)
Yeah, it's definitely not for everybody. So I personally, just my own story is that I am divorced. I have one biological child. And I really, when I met my current husband, I didn't know if I was done experiencing that part of my life yet. I felt that there was more that I could give.

Dr. Shannon (02:00.393)
Yeah, yeah.

Dr. Lotem Schulke (02:25.52)
But he has three children and with my one, we have four together. And after a while of having four children, going from one to four is a really big jump. So having four children, we just, you know, together kind of decided that our family was complete and that we were done with our family, but there was still a part of me that just didn't know.

Dr. Shannon (02:26.025)
Mm -hmm.

Dr. Shannon (02:37.769)
Yes.

Dr. Lotem Schulke (02:53.297)
if I was done experiencing pregnancy. I didn't want my one pregnancy to kind of be my only experience, right? And so that's how I went in. And honestly, it was a pretty easy leap for me. My daughter's daycare teacher was a surrogate twice and she, yeah. And so...

Dr. Shannon (03:04.009)
Mm -hmm.

Dr. Shannon (03:16.617)
No way! Ha!

Dr. Lotem Schulke (03:19.633)
she was a really easy resource for me. It was kind of this like spark in the back of my mind, like, what about Sarah UC, you know? But to be able to have a really, like, hey, tell me about how I would get started, you know? With her, it made it super easy to actually achieve. So it went from this, like...

Dr. Shannon (03:22.185)
yeah.

Dr. Shannon (03:27.657)
-huh.

Dr. Shannon (03:37.769)
huh.

Dr. Lotem Schulke (03:45.521)
hypothetical thought to like, okay, how do we get the ball rolling and get this started?

Dr. Shannon (03:48.265)
yeah, like this is real life, because someone over here like did it multiple times, you know? And that's, yeah. I love how that works out though. How I feel like God provides that everyone's smile where it's like, you had that idea? Here's this resource for you. So, okay, so that idea was planted. Go from there. What is the process?

Dr. Lotem Schulke (03:53.744)
Yeah, yeah, yeah, yeah.

Dr. Lotem Schulke (04:02.609)
Exactly. Yup. Yeah.

Dr. Shannon (04:15.689)
involved there and agencies and organizations because I know there's a lot of differences that can come from different agencies and organizations that you go through.

Dr. Lotem Schulke (04:15.92)
Yeah.

Dr. Lotem Schulke (04:25.554)
Yeah, and to be perfectly honest, there probably are. I've only been in contact with one, so I don't know the differences. I can only share from my perspective and my experience. But my daughter's daycare teacher is really, really good friends with the owner of a surrogacy agency. And so she connected me with her.

Dr. Shannon (04:34.057)
Mm -hmm.

Dr. Lotem Schulke (04:55.185)
And that was kind of the beginning of the conversation is that I got to speak with Dawn and she wanted to hear my story and get to know me as a human being and see who I was. And I just loved that approach because I felt like a human, right? I'm not just a uterus, I'm a human. And she made me feel.

Dr. Shannon (05:18.729)
Mm -hmm. -huh.

Dr. Lotem Schulke (05:25.009)
like I was the priority, like I was going to run the show, like quote unquote, right? And then I had the freedom to kind of express what I wanted in the process within some guidelines. And so the first, they kind of sent me some samples of what other surrogates do. And it was my first...

Dr. Shannon (05:32.425)
-huh.

Dr. Lotem Schulke (05:53.201)
time being a surrogate and so, you know, I didn't even know where to start. And so you kind of create a surrogacy profile. The surrogacy agency at first kind of works like a matchmaking agency, if you want to think about it that way, where I create a profile, I have pictures, I tell about my family life and, you know, my kids and whatever. And, you know, I kind of create this profile for myself.

Dr. Shannon (05:58.953)
Right.

Dr. Shannon (06:08.457)
Mm -hmm.

Dr. Lotem Schulke (06:23.025)
And then I have a preliminary surrogacy agreement, which talks about my base compensation. It talks about where, you know, what hospital I want to deliver at and what provide, you know, just specific things that I am requesting, some of them being.

Dr. Shannon (06:38.793)
Mm -hmm.

Dr. Shannon (06:45.289)
So you can kind of come in and say, this is what I would like for my birth experience. You two degree, okay.

Dr. Lotem Schulke (06:53.329)
To a degree, to a degree. So for instance, I mean, I chose my provider. But for instance, home birth isn't allowed in a in a in a surrogacy agreement. Through my agency, at least. So it has to be in a hospital.

Dr. Shannon (07:00.361)
Mm -hmm.

Dr. Shannon (07:10.633)
okay.

Dr. Shannon (07:15.049)
huh. Yeah.

Dr. Lotem Schulke (07:20.273)
you know, insurance is a factor in this. That's part of the, that's part of the surrogacy agreement too, is to, you know, mention what kind of insurance you have. And there's, there's a lot of components to it. So, so for me personally, it was really important that I have as near a home birth experience as possible. I attempted a home birth with my daughter.

Dr. Shannon (07:22.345)
Mm -hmm.

Dr. Shannon (07:34.377)
Yeah.

Dr. Lotem Schulke (07:50.001)
and had to eventually be transferred for delivery at the hospital. Her heart rate started decelerating. And so just for safety, we transferred and that was the best decision at that moment. So I really, really, really wanted a water birth. Really bad with my daughter and it didn't happen. And so I was like, okay, this is my chance, but obviously not in a home birth environment. So.

Dr. Shannon (07:58.857)
Okay.

Dr. Shannon (08:10.697)
Mm -hmm.

Dr. Shannon (08:19.721)
Right.

Dr. Lotem Schulke (08:19.985)
In Georgia, there's really only one hospital option that offers water births. So that was North Bolton Hospital. So that's the hospital that I chose. And I chose a provider that came ridiculously highly rated from every, ridiculously.

Dr. Shannon (08:36.905)
ridiculously highly, Ray. my gosh. I was gonna say, I want you to share whoever, like all the people on your support team as we go through, whatever you feel comfortable with. But yeah, when I saw who your support team was, I was like, dang, girl got it. Like, you did so good.

Dr. Lotem Schulke (08:45.905)
Yeah.

Dr. Lotem Schulke (08:49.713)
Yeah. Yeah. So I had Carson Reagan as my midwife. And she is just, I mean, like everything everybody says about her, it's not just like gushing. It's the truth. She's just one of the best humans I've ever known. And so it's pretty awesome. She's...

Dr. Shannon (08:58.409)
Mm -hmm.

Dr. Shannon (09:06.697)
It's the truth.

Dr. Lotem Schulke (09:15.921)
She's just the right kind of personality for birth. She tells you how it is, but she loves on you in the process. So yeah, I just, I really love that. So the cool thing for me too, which not everybody can do, I did her concierge services. I live about an hour away from the hospital and -

Dr. Shannon (09:18.761)
Aha. Mm -hmm.

Dr. Shannon (09:24.073)
Yes.

Dr. Shannon (09:40.393)
Mm -hmm.

Dr. Lotem Schulke (09:44.817)
and the Roswell, actually any location. I live about an hour away. And so that was actually something that I put into my surrogacy agreement. Like that first thing that anybody would have to see in order to work with me is that I want concierge midwifery care. And so that was the non -negotiable for me. That was something that I knew I wanted from the get -go, but...

Dr. Shannon (10:02.889)
Mm -hmm.

Dr. Lotem Schulke (10:10.993)
And, you know, as we kind of talk about the actual pregnancy experience, I'll tell you how it kind of played in, but it was extremely convenient for me because I live an hour away and I have four kids and I have, you know, schedules to balance and everything. And so, so that that was something that I did end up getting and it was amazing and worth every penny in my opinion. Yes.

Dr. Shannon (10:20.169)
Mm -hmm. Mm -hmm.

Dr. Shannon (10:33.097)
Yes. What's the timing process of you starting and making this profile and then being matched with a couple like or whoever, you know, wants to have the baby? Like what's how long is that process? Well, I mean, I know everybody's is different, but in your case,

Dr. Lotem Schulke (10:45.137)
Yeah.

Dr. Lotem Schulke (10:50.225)
Yeah, for me the turnaround time for like actually receiving family profiles was really quickly. And it was really quick and, but the actual selection process was not. So August of 22 is when I started and I just had the baby. So.

Dr. Shannon (10:58.921)
wow.

Dr. Shannon (11:07.817)
okay.

Dr. Shannon (11:15.849)
Wow, yeah.

Dr. Lotem Schulke (11:18.513)
So it's a really, really long process, the whole thing from start to finish. But yeah, as soon as your profile kind of gets accepted, then it's out there, right? And so I think, and I may be mistaken, but this was my perception is that Dawn herself, the owner, the agency that I went with, by the way, is called US Surrogacy. And they work a lot with international couples.

Dr. Shannon (11:30.985)
Mm -hmm.

Dr. Lotem Schulke (11:46.353)
The surrogates are all local from what I understand, but there's a lot of families that are international and domestic. So there's kind of that choice that you kind of have to make too. So I am Israeli and Jewish, and they have a lot of families in Israel that are looking to

Dr. Shannon (11:49.865)
Mm -hmm.

Dr. Shannon (12:03.273)
huh.

Dr. Shannon (12:12.297)
Mm -hmm.

Dr. Lotem Schulke (12:16.241)
to have surrogates and everything. surrogacy is not something that's accepted over there. and so that's where I kind of was headed at the beginning. because I speak Hebrew, I kind of figured that was like an obvious advantage for me. but, so it took about, I think we were in contact with four different families. it did three, three or four. Anyways, they,

Dr. Shannon (12:20.457)
Mm -hmm.

Mm -hmm.

Dr. Lotem Schulke (12:46.097)
It's complicated. They either want someone and then we get ghosted or yeah, it's just this back and forth. And we actually realized through the process and doing a lot of research that I couldn't be a surrogate for a Jewish family because I'm Jewish. The Jewish law is kind of...

Dr. Shannon (12:48.361)
Mm -hmm.

Dr. Shannon (12:54.729)
Huh.

Dr. Shannon (13:09.833)
wow.

Dr. Lotem Schulke (13:10.161)
different where a baby born to me in the eyes of Jewish law would be my child and there's no way around that. So we decided to nix that idea after a few months of trying and start fresh. And so it was really eye -opening. Yeah. Yeah. So and how to do with my husband is also Jewish. And so.

Dr. Shannon (13:26.313)
Yes, this is fascinating. my gosh. All the little things that you learn. Yeah, you're like, what? Okay.

Dr. Shannon (13:38.793)
Okay.

Dr. Lotem Schulke (13:39.153)
It had to do with that too, it's very complicated. But anyway, the nitty gritty. But that's why it took so long to match with the families because we had an idea, like I had an idea of the type of family that I wanted to work with initially. And then we had to kind of start from scratch. Yeah. But then I got the profile for the family that I worked with and...

Dr. Shannon (13:42.409)
Yeah.

Dr. Shannon (13:48.297)
Yeah.

Dr. Shannon (13:54.345)
-huh.

You just switch gears. Yeah. Okay.

Dr. Shannon (14:08.137)
-huh.

Dr. Lotem Schulke (14:09.273)
they immediately just stood out to me. And there's a lot of it that's just heart and gut instinct and, you know, connection. And there's not a really great way to explain it. They seemed, I think the things that were important to me when selecting a family were that they seemed like they were in it together.

Dr. Shannon (14:18.857)
-huh.

Dr. Shannon (14:38.153)
Yes. Yeah. Mm hmm.

Dr. Lotem Schulke (14:39.097)
You know, that the connection between the two parents was important to me, but also that they had a good, like a good situation as far as family life, right? And, you know, I just wanted to make sure that the baby that I gave, you know what I mean, that I created was gonna go into a good situation that I felt good about, you know, with my gut.

Dr. Shannon (14:53.385)
Mm -hmm.

Dr. Shannon (15:03.049)
Mm -hmm.

Dr. Lotem Schulke (15:09.305)
and I got that. So, yeah.

Dr. Shannon (15:12.713)
Wow. Okay. So once you finally get and select that and get kind of matched it and lean into, okay, this is the couple that I want to work with. What is that next step then?

Dr. Lotem Schulke (15:28.427)
So as soon as I was like, yep, I wanna talk to these people, they sent them my profile. And if they also said, yep, we'd like to speak to her, then we connected. It was an hour long Zoom call. At that point, I had been assigned a case manager from the agency as well. And so the case manager, the owner of the agency, myself and the intended parents,

Dr. Shannon (15:40.457)
Okay.

Dr. Shannon (15:47.945)
huh.

Dr. Lotem Schulke (15:56.794)
got on this like an hour long Zoom conversation, the case manager kind of ran the show. You know, it's kind of awkward. It's people that you've never met before and you're trying to see like, we're gonna do this really kind of intimate thing together. And you kind of have to ask the hard questions from the beginning, right? So that's the conversation where we talked about, are they going to want to be in the birthing room while I'm delivering?

Dr. Shannon (16:05.417)
Mm -hmm. Yeah.

Dr. Shannon (16:14.313)
Yes!

Dr. Shannon (16:19.305)
huh.

Dr. Lotem Schulke (16:26.042)
I mean, like big, you know, big topics. But I don't remember the exact timeframe. They get, I think we each got like, I don't know, 24, 48 hours, something like that to say yay or nay after that conversation. And I immediately was like, yep, I'm good to go if they are. And I think they did the same thing. I think they talked for like 20 minutes and almost immediately.

Dr. Shannon (16:27.017)
wow, yeah.

Dr. Shannon (16:54.825)
They were like, yep.

Dr. Lotem Schulke (16:55.898)
almost immediately messaged the agency back and they were excited too. So they...

Dr. Shannon (17:06.633)
So now, okay, so you do that, you meet up, and now what's the next step?

Dr. Lotem Schulke (17:13.691)
Yeah, so I actually had to ask my husband because it's been such a long time. I think that the next step was they had me fly out to where their embryos were stored and that the fertility clinic where their embryos were was San Diego Fertility Center. So the...

Dr. Shannon (17:29.353)
Okay.

Dr. Lotem Schulke (17:39.995)
I think that the next step was that I flew out there and I had my medical screening done. So the IVF clinic kind of has their own guidelines as far as what you need to be. I think they took blood, they took my weight, they did an ultrasound if I recall. they did it, that's it. They did a saline sonohistogram. So they injected saline water.

Dr. Shannon (17:44.233)
Mm -hmm.

Okay.

Dr. Shannon (17:51.657)
yeah.

Dr. Lotem Schulke (18:07.707)
into my uterus just to make sure that there's no fibroids, there's no, you know, anything in there that would prevent a pregnancy from being successful. And based off of those things, I got cleared, so it's called medical clearance, and flew back. Yeah.

Dr. Shannon (18:11.529)
Mm -hmm.

Dr. Shannon (18:17.737)
Mm -hmm.

Dr. Shannon (18:24.137)
I have a random question. Just in what I've, we were chatting before the episode and I just, I have a friend that just went through surrogacy, but she's on the receiving end of the surrogacy baby. And one agency that she had looked at, like it, you didn't have, it could have been your first pregnancy. Like they did allow it to be like, you didn't have to have any children before, but was that different with this agency? Like, did you need to have had?

a child already or like have successfully birthed a child already.

Dr. Lotem Schulke (18:54.972)
Yeah, I don't know the answer to that because I felt like it was very tailored to me. The conversation that I had with the agency's owner wasn't about generalities, it was about me specifically. So there is a good possibility that that is an actual criteria, that you have to have proof that you've...

Dr. Shannon (19:01.705)
Okay. Okay.

Dr. Shannon (19:07.497)
Mmm. Mm -hmm.

Dr. Shannon (19:12.105)
Hmm, okay

Dr. Lotem Schulke (19:22.716)
successfully birthed a live child. Yeah.

Dr. Shannon (19:23.017)
Yeah, yeah. No, it just reminded me as you were going through like the medical screening of things. Okay.

Dr. Lotem Schulke (19:29.948)
Yeah, but I don't, yeah, I don't work off.

Dr. Shannon (19:32.329)
Okay. So you're in San Diego, you're doing the whole medical screening for, because it is going to be, you know, essentially the IVF, you know, like it is like, you know, it's that process too.

Dr. Lotem Schulke (19:36.796)
Yep.

Dr. Lotem Schulke (19:40.956)
It is, yep. It is for the first 12 weeks of the pregnancy, leading up to the pregnancy, and then the first 12 weeks of the pregnancy, you're considered an IVF patient. So yeah, I was, and that's another challenge, is having the fertility clinic not local and super -duper far away on the other side of the country was interesting. It was an interesting experience, but anyway.

Dr. Shannon (19:52.329)
Okay.

Dr. Shannon (19:57.385)
Mm -hmm. Mm -hmm. Mm -hmm.

Dr. Shannon (20:06.857)
Yeah.

Dr. Lotem Schulke (20:08.605)
Yeah, so I got medically cleared, we flew back, and then we started the legal clearance process. So the intended parents have an attorney, and then they hire a separate, different attorney for me. I obviously get final approval of whether or not I want to work with that attorney, but there are not very many. It's a very niche specialty for attorneys. And so, you know, you just...

Dr. Shannon (20:31.017)
Mm -hmm.

Dr. Lotem Schulke (20:38.429)
The intended parents basically built a legal contract. They sent it over to my attorney. We got to look over it. And that process was the longest process of all of it. You can imagine that, you know, yeah. So I think because by the time we got to the legal clearance process, I think it was probably like November -ish of 22.

Dr. Shannon (20:49.801)
wow. Yeah. Not surprised. Yeah.

Dr. Shannon (21:01.353)
Mm -hmm.

Dr. Lotem Schulke (21:03.037)
And so then we have Thanksgiving and Christmas and New Year's and everybody's closed and nobody's working. And so it probably took three or four months to come to a complete decision. And that's not really a time when I'm having conversations with the intended parents at all. I'm mostly communicating with my attorney and with the case manager that's over.

Dr. Shannon (21:04.937)
Mm -hmm.

Dr. Shannon (21:24.169)
Yeah.

Dr. Lotem Schulke (21:32.349)
were my case, but that's that's kind of where we went from there.

Dr. Shannon (21:33.833)
Yeah. Okay. So once all of that, all the legality and the attorney talk is done, then do you move into, okay, this is the conception phase, you know, and going from there? What was that like?

Dr. Lotem Schulke (21:47.23)
Yeah.

Yep. Yeah, so the first step was that the IVF clinic wanted to put me on birth control pills so that they could control my cycle basically remotely. So that's what we did. So I started, I think I did one full month of that. They wanted me to get a cycle and so I got my period and then we did another. So it was two months of tracking.

Dr. Shannon (22:00.601)
Yeah.

Dr. Lotem Schulke (22:19.646)
just to see how my body was going to respond. They were super happy with that. And at that point, at one point in there, they started me on an estrogen pill. And once that started, it basically built up the lining of my uterus. And so we would get a, we would go to a local fertility clinic here.

Dr. Shannon (22:19.721)
Mm -hmm.

Dr. Shannon (22:41.289)
Mm -hmm.

Dr. Lotem Schulke (22:47.519)
to get a baseline ultrasound and blood work so we know where we're starting from. And then there's a certain criteria that we had to meet. So the first criteria was that my uterine lining had to be, I think it was eight millimeters thick, if I recall correctly. And so after, so we get the baseline ultrasound and then after 10 days,

Dr. Shannon (22:54.217)
Mm -hmm.

Dr. Shannon (23:05.513)
Okay.

Dr. Lotem Schulke (23:11.967)
we do the follow -up ultrasound and they obviously time it to where you are in your cycle. And so the first go -around, I think I was at, gosh, I think I was at like nine millimeters or something. So I passed. And so at that point, then you start progesterone injections.

Dr. Shannon (23:17.929)
Mm -hmm.

Dr. Shannon (23:39.467)
Okay. Mm -hmm. Right, right. Yeah.

Dr. Lotem Schulke (23:39.967)
Or I did specifically. I don't know if everybody's exactly the same. I don't know how they decide the medications, but that's what I did. And so we do that for seven days and then we transfer seven days after. So, so, so it's sorry that was sounded confusing. So it's the, the, the lining ultrasound, once you get cleared for it, then you start injections that day and.

Dr. Shannon (23:52.809)
Wow, okay.

Dr. Lotem Schulke (24:09.632)
Seven days after that is when the transfer happens. So I went to San Diego and we transferred an embryo and it goes through genetic screenings and everything. The parents obviously are the ones that choose which embryo they want. They know all about it. They have conversations with the physician and everything. And so...

Dr. Shannon (24:12.041)
Okay.

Dr. Shannon (24:28.297)
Mm -hmm.

Dr. Lotem Schulke (24:37.216)
you know, I'm just there and it's a super cool experience to transfer, you know, an embryo. It's very like movie -esque sci -fi. So yeah, I just laid there and had an ultrasound on my belly constantly. The doctor, the fertility doctor put basically a catheter into my uterus and then...

Dr. Shannon (24:48.873)
Yeah, yeah.

Dr. Shannon (25:03.433)
Mm -hmm.

Dr. Lotem Schulke (25:05.568)
the embryologist comes out of like the freezer with a Petri dish and they're in the other room and they put a camera over it to make sure that the names are the same names so that we're not transferring somebody else's, you know, an embryos into me. And so then she comes over and I guess there's like a very short time from the thawing process, because all these embryos are frozen. From the thawing process, like,

Dr. Shannon (25:20.137)
Yeah.

Dr. Shannon (25:31.657)
Mm -hmm.

Dr. Lotem Schulke (25:33.633)
how long they can be exposed to the elements, right? And so they just like really, really quickly do this whole thing. So she comes in wearing what looks like a hazmat suit. It's like all white. She's completely covered with a Petri dish. And the fertility doctor basically like, it looks like this teeny tiny microscopic fork and picks up the embryo and you can see it under a mic. They're like, they have a microscope under this whole thing the whole time.

Dr. Shannon (25:37.033)
Mm -hmm.

Dr. Shannon (25:44.201)
Yes, yes.

Dr. Shannon (25:59.369)
huh.

Dr. Lotem Schulke (25:59.585)
And then he puts the embryo into the catheter and injects it into it. And you can actually see on the ultrasound, you can see the embryo moving into the cavity of the uterus. And then he gets it to where he wants it to be most optimally to attach and everything. And then they take the catheter out and you're done and you're pregnant. So.

Dr. Shannon (26:10.249)
of the uterus.

Dr. Shannon (26:16.041)
huh.

Dr. Shannon (26:20.457)
wow.

Dr. Lotem Schulke (26:23.553)
It's pretty cool, it's pretty quick, it's completely painless. There's no like, and there's nothing in there, you know, that hurts. And so you just, you kind of come out and you're like, my God, like now I have this baby inside me, right? And like, you kind of feel, yeah, you feel very protective immediately. So.

Dr. Shannon (26:31.529)
Yeah.

Dr. Shannon (26:35.497)
Okay, yeah, yeah.

I feel like that's a mental, yeah, like that. That's just mentally different. -huh, yes.

Dr. Lotem Schulke (26:50.049)
So yeah, so we basically from the fertility clinic, we got an Uber. I was on bed rest for 24 hours after that and flew home the next day. So.

Dr. Shannon (26:52.585)
Okay.

Okay. Okay. So you come home and then it's more of a tracking of like, okay, yes, your pregnancy tests are positive, right? And like, you know, it's still maintaining.

Dr. Lotem Schulke (27:07.874)
Yeah, I think it was 10 days after I would go get a blood work, like pregnancy blood work done. But, you know, I'm not a very patient person. So they told me basically that like two to three days after, you should already have a positive at -home pregnancy test. So I started, you know, I started doing that and it was like super duper duper faint.

Dr. Shannon (27:11.913)
Mm -hmm.

Dr. Shannon (27:16.201)
Mm -hmm. Mm -hmm.

Dr. Shannon (27:32.009)
Mm -hmm.

Dr. Lotem Schulke (27:36.802)
and all these things. So yeah, so they wanna track, sorry, it's five days and then seven days and then 10 days. It's like something, it's a very frequent blood test because they wanna see the HCG levels rise and they wanna see them rise at a very specific rate. So mine did, they rose and everything was fine. And...

Dr. Shannon (27:38.313)
Mm -hmm.

Dr. Shannon (27:46.121)
huh. Okay. Go up. Yeah.

Okay. Yep.

Dr. Lotem Schulke (28:03.202)
Long story short, with that one, sadly, at eight weeks, I started bleeding. The bleeding stopped eventually. They told me that unless I was filling up a whole pad in an hour, I didn't have to go into the ER. And so I wasn't bleeding that intensely. But yeah, it eventually stopped after a couple of days and I thought nothing of it. And so I went in for my initial...

Dr. Shannon (28:05.673)
Hahaha.

Dr. Shannon (28:15.177)
huh.

Dr. Shannon (28:19.305)
Yeah.

Dr. Lotem Schulke (28:31.811)
Pregnancy confirmation ultrasound, which is done for the surrogacy process, it was done in eight weeks. So I was seven weeks pregnant, it was the week before. And we saw that essentially I was pregnant. There was a yolk sac that had been created, but there was nothing inside the sac, the sac was empty.

Dr. Shannon (28:41.865)
Mm -hmm.

Dr. Shannon (28:55.785)
Mm -hmm.

Dr. Shannon (28:59.621)
Hmm... Hmm...

Dr. Lotem Schulke (28:59.651)
And I was like, how does that even happen? It just blew my mind. So it's apparently a condition called blighted ovum. It's one of the most, the IVF doctor told me it's one of the most common causes for a miscarriage. In fact, some women don't even know they're pregnant because it looks like a cycle. Like they don't even know they're pregnant and they have a blighted ovum. Anyway, so I did, I had a miscarriage and it was really sad. And I know I was like,

Dr. Shannon (29:05.961)
Mm -hmm.

Dr. Shannon (29:17.211)
Right.

Dr. Shannon (29:26.025)
Hmm.

Dr. Lotem Schulke (29:27.523)
what did I do wrong? And all these things go through your head, you know? And he basically told me that it was a genetic problem with the embryo itself and that they do genetic testing on the embryos, but they test for trisomy 23 and like Tay -Sachs and like all of these genetic disorders, but not necessarily, they can't.

Dr. Shannon (29:29.275)
Right.

Dr. Shannon (29:37.929)
Okay.

Dr. Shannon (29:48.329)
Mm -hmm.

Mm -hmm.

Dr. Lotem Schulke (29:56.036)
The human genome is such an expansive thing that they can't possibly test for every single thing. So he thought it was probably some kind of issue that happened during the thawing process, that it just didn't go well and the rest is history, right? So I went through a miscarriage. It took about four months for my body to recoup from that.

Dr. Shannon (30:01.033)
We can't test for everything. Yeah.

Dr. Shannon (30:19.273)
Hmm.

Dr. Shannon (30:24.933)
You start over again. Wow. huh.

Dr. Lotem Schulke (30:25.028)
And then I started back at square one. So started over with birth control pills for a month or two. And then, yeah, so it was, you know, it was a long process. So we transferred, that first transfer was in March of 23. I found out that I was miscarrying in May of 23. And then that whole summer was basically just me.

Dr. Shannon (30:38.217)
It's emotional. Mm -hmm.

Dr. Lotem Schulke (30:55.044)
healing from that. And then we started the process over again and did another transfer in August of 23. It was August 10th of 23. So you just, you know, you kind of, anybody that's been through a miscarriage can identify with this. You just, you're kind of cautiously optimistic, but you're kind of not at the same time. You're kind of disconnected from it all at once.

Dr. Shannon (30:57.289)
Mm -hmm.

Dr. Shannon (31:06.633)
Okay.

Dr. Shannon (31:14.281)
Mm -hmm.

Mm -hmm.

Mm -hmm. Yeah.

Dr. Lotem Schulke (31:23.045)
And that was kind of my mindset. Like I was not gonna become so emotionally invested in it the second time because I was devastated the first time. You know, having a loss for yourself is hard enough, you know? But then having a loss for someone else and having to think about what it means to that family, you know, my body has to go through it, which is difficult, but like the loss for them is what I was hurting for the most, you know?

Dr. Shannon (31:31.017)
Yeah.

Dr. Shannon (31:36.265)
Yeah.

Mm -hmm.

Dr. Shannon (31:44.393)
Mm -hmm.

Dr. Shannon (31:52.138)
Mm -hmm. Ugh.

Dr. Lotem Schulke (31:53.029)
And luckily for me, I had the most supportive, incredible, intended parents. And so they just truly and genuinely cared about me and how I was processing the whole thing and my body was going through it. And they sent me this most gorgeous bouquet of flowers. But still, there's another layer on top of it when it's somebody else's. So.

Dr. Shannon (32:12.457)
Hmm.

Dr. Shannon (32:17.737)
yeah, definitely.

So how did this one go in August? Okay.

Dr. Lotem Schulke (32:21.893)
So we did, we transferred again. Yeah, we transferred again. This time around, my numbers were significantly higher than with the first pregnancy. So my lining was thicker. The HCG pregnancy hormone was like twice the number of the first one. And so again, cautiously optimistic. I'm like, okay, everything looks good on paper here, right?

Dr. Shannon (32:35.081)
wow.

Mm -hmm.

Dr. Lotem Schulke (32:51.43)
And I decide, yeah, so then at eight weeks, the pregnancy confirmation ultrasound where we're trying to get a heartbeat, that was super nerve wracking for me, because that was obviously a bad experience the last time. And so I kind of held my breath for that, but there was a little tiny gummy bear in there. That's what it looked like. So yeah, there was a little...

Dr. Shannon (33:04.649)
Yeah, definitely.

Dr. Shannon (33:13.801)
Yeah.

Dr. Lotem Schulke (33:18.822)
there was a baby this time and the heartbeat looked really, really good. And we saw the like where it implanted and everything and that looked fine. And I mean, couldn't have gotten better news. I was just so relieved at that point. So, so.

Dr. Shannon (33:31.913)
Wow. So now with, so did you have in your, I guess like your profile, like things that you wanted? Like I know you had mentioned, okay, well, we can't necessarily do a home birth, but I would like to do this water birth and try to make it as close to home birth as possible. So did you have anything else in there in that profile?

Dr. Lotem Schulke (33:50.149)
So the water birth.

Yeah, the water birth wasn't in there specifically. It was more the provider and the hospital. I also requested that my doula, I had my, my doula was booked. Like, I think the minute that I had my first daughter, I was like, okay, I'm booking, booking you for my second. Like, you know what I mean? It was four years previously. So, so yes, so my doula was also in there.

Dr. Shannon (33:57.801)
-huh.

Okay.

Dr. Shannon (34:04.713)
Yeah.

Hehehe.

Dr. Shannon (34:14.109)
Yes.

Aha. You knew who you wanted. Yes. Yes. Okay.

Dr. Lotem Schulke (34:23.238)
Yeah. But otherwise, not anything specific like that.

Dr. Shannon (34:28.617)
Okay. And how did pregnancy go? How did you feel, you know?

Dr. Lotem Schulke (34:35.143)
Yeah. I was, I was, I had a, I had a very, I guess in hindsight, I had a pretty easy pregnancy with my first, with my daughter. I think I probably had hyperemesis, with her. That, that was just, that was just not, not diagnosed. I was very, very, very sick my, my first trimester, but I remember at 14 weeks, it was, it just like,

Dr. Shannon (34:51.785)
gravity. Mm -hmm.

Dr. Shannon (34:59.241)
Hmm.

Dr. Lotem Schulke (35:03.143)
which was flipped and I was fine and everything was great after that. I had no nothing, nothing came up. Everything was great. This pregnancy was the complete opposite. And it just is a really good reminder for everybody that you can't compare pregnancies. Like the same person can be pregnant multiple times and they can be vastly different. So that's, that's what, you know, and I kind of looked at this whole thing.

Dr. Shannon (35:11.241)
Mm -hmm.

Dr. Shannon (35:20.073)
Mm -mm.

Dr. Shannon (35:29.289)
Yeah.

Dr. Lotem Schulke (35:32.168)
you know, being a doctor, I always am just very curious from the science perspective, right? And the child obviously was not genetically mine in any way. It was not my egg and the embryo had not, you know, not genetically mine at all. And so I was wondering, and it's an IVF pregnancy, so it was different than my first pregnancy. So I was wondering how...

Dr. Shannon (35:37.481)
Mm -hmm.

Dr. Shannon (35:46.281)
Mm -hmm.

Dr. Shannon (35:51.049)
Mm -hmm.

Dr. Lotem Schulke (35:55.048)
how it would differ, right? In what ways would it differ? I kind of figured it would, I just didn't know exactly how. And so it was one big science experiment, one big kind of question of how it would go. And it was quite the eye -opening experience. I immediately, so basically around the same time, so it was, I got the heartbeat confirmation ultrasound with this pregnancy at eight weeks, and then two days later.

Dr. Shannon (35:59.689)
Right.

Dr. Shannon (36:09.353)
It was, yeah.

Dr. Lotem Schulke (36:23.688)
Two days later, I started bleeding again. Naturally thought that I was losing the baby again. And I was like, how could it be? We saw a heartbeat two days ago. So I decided at this point, I was like, I'm going to the emergency room because I need to figure, I need to see if it's still there. So we went to the emergency room, baby's fine. I got diagnosed with a medium to large size. goodness, what are they called?

Dr. Shannon (36:28.905)
-huh.

Dr. Shannon (36:39.433)
Mm -hmm.

Dr. Lotem Schulke (36:54.569)
a subchondral hematoma or a hemorrhage. It was a hemorrhage at that point. And so come to find out, when I told the IVF clinic, I would just went to the ER and this is what I was diagnosed with. They were like, okay. So apparently it's unbelievably common with IVF. Like really, I don't wanna throw out a random stat, but I wanna say it's definitely over 50%.

Dr. Shannon (36:57.065)
okay, a hemorrhage, -huh.

Dr. Shannon (37:10.345)
Hahaha.

Dr. Shannon (37:15.945)
Okay.

Dr. Lotem Schulke (37:24.073)
almost everyone I've heard of that has IVF had one of these. So it's very scary. And there has to be a reason why, you know, IVF is more prone to one of those, but essentially it is not harmful to the baby, to the development of the baby in any way, and it heals itself within a couple of weeks. So they told me basically by...

Dr. Shannon (37:24.553)
Okay.

Dr. Shannon (37:30.217)
Hmm.

Dr. Shannon (37:39.433)
Mm -hmm.

Dr. Lotem Schulke (37:52.425)
12 weeks, it should stop. So I kind of had some light spotting after that until 12 weeks and at the 12 week mark, by the 12 week mark, it had stopped completely. So at that point you get pretty frequent ultrasounds too to make sure that the baby's growing and developing and everything looks okay at the beginning.

Dr. Shannon (38:03.753)
Wow. Okay.

Dr. Shannon (38:10.472)
Mm -hmm.

Dr. Lotem Schulke (38:16.425)
And so we could see that the hematoma was shrinking as we went. And by 12 weeks, you couldn't see it anymore on ultrasound, so it was gone. But that's, yeah, that was my first bump in the road.

Dr. Shannon (38:26.793)
well good. Okay. Yes, I know. Okay, so take us through the rest of the pregnancy or up to birth kind of like where, you know, wherever you're at in there.

Dr. Lotem Schulke (38:36.906)
Yeah.

Dr. Lotem Schulke (38:42.058)
Yeah, so 12 weeks, okay. Then...

I wanna make sure that I'm not missing anything. The pregnancy had a lot of hospital visits in it. Unfortunately, I think the next thing that happened at 14 weeks, when I was 14 weeks pregnant, I lost my dad. It was the hardest thing that I've ever had to go through. And it just...

Dr. Shannon (39:16.617)
Mm -hmm.

Dr. Lotem Schulke (39:18.986)
It just stinks because when you're pregnant life doesn't just stop, you know? And,

Dr. Shannon (39:23.337)
Mm -hmm.

Dr. Shannon (39:27.305)
I'm so sorry. I know that's a lot.

Dr. Lotem Schulke (39:28.17)
Yeah, it was unexpected. My dad was only 58. And so it was an emotionally taxing experience. And I felt really guilty that I had to go through that pregnant. And honestly, there's just nothing that you can do. Life just happens. And so you just got to roll with the punches. And so...

Dr. Shannon (39:39.081)
Mm -hmm.

Dr. Shannon (39:48.265)
Mm -hmm.

Dr. Lotem Schulke (39:55.083)
Yeah, that was, I went through that at 14 weeks, then four, yep, four weeks after, three weeks after? Anyway, somewhere around there, three to four weeks after my dad passed, I was re -rendered. And I was like, why? The universe is trying to tell me something. But my daughter was in the car, it was, it was...

Dr. Shannon (40:11.177)
gosh. Yeah. I know.

Dr. Lotem Schulke (40:23.723)
you know, it was a scary experience. And so obviously I went to the hospital to get checked out and baby was okay from the get -go. That was the first thing they did was check his heart, you know, for a heartbeat. And so, so yeah, he was, he was fine and tolerated it okay. I was in a lot of pain. But as far as the pregnancy was concerned, everything was, everything was okay.

Dr. Shannon (40:24.809)
It was an ordeal.

Dr. Shannon (40:38.153)
Mm -hmm.

Dr. Shannon (40:44.745)
Hmm.

Dr. Lotem Schulke (40:52.139)
you know, I started some pretty rigorous chiropractic care after that. And at that point, actually, I started going to see a pelvic floor PT because obviously with relaxin in your system and going through a car accident, I was uncomfortable, to say the least, especially related to the pregnancy.

Dr. Shannon (40:55.913)
Yeah.

Dr. Shannon (41:13.129)
Mm -hmm. Mm -hmm.

Dr. Lotem Schulke (41:16.907)
So I went to see Brandy Freeman is right next to, she's like super close to my house and she's ridiculously amazing.

Dr. Shannon (41:26.217)
yeah, yeah, yeah. We have her on the show. She's good. Good people. Aww.

Dr. Lotem Schulke (41:30.444)
Yeah, so I started seeing her and she, I mean, helped me tremendously post -car accident and prepping my body throughout pregnancy and prepping it for delivery. So that was awesome. Yeah, then I also went through, so that was, if you're counting, that was the second hospital visit.

Dr. Shannon (41:44.233)
Mm -hmm.

Dr. Shannon (41:59.817)
huh.

Dr. Lotem Schulke (42:00.012)
Then at 28 weeks, we had an event, like a family get together kind of thing at our house and come to find out everybody that came to my house that weekend, everybody got like this nasty stomach bug. And literally, I mean, everybody, people were dropping like flies and I was like, what is happening? What is this thing? And me, my husband, my daughter didn't get it. And I'm like,

Dr. Shannon (42:18.121)
no.

Dr. Shannon (42:29.129)
wow.

Dr. Lotem Schulke (42:29.548)
we're just the lucky ones. Well, I mean like a week later, everybody was already better and a week later, it's the middle of the night, my husband works at the time that he worked the night shift, so he's gone, so I'm by myself and I start vomiting and I'm like, great. I thought vomiting in the first trimester was bad. Vomiting in the third trimester, completely, way worse. It's just horrible.

Dr. Shannon (42:43.657)
Hmm.

Dr. Shannon (42:48.137)
No.

Dr. Shannon (42:52.509)
Yeah.

Dr. Lotem Schulke (42:56.621)
vomiting over a baby, like a huge baby. It's just, I like, God, it was horrible. Anyway, I got so sick that I, I couldn't hold the phone up to call my husband to come home. But anyway, he made it, he took me to the hospital. On the way to the hospital, I started having contractions at 28 weeks and I was like,

Dr. Shannon (42:57.897)
Yeah, like.

Dr. Shannon (43:13.289)
Mmm... Mm -hmm.

Dr. Shannon (43:23.433)
yeah.

Dr. Lotem Schulke (43:26.285)
that was not good. So super, super lethargic. So I got to the hospital, they gave me, you know, anti -nausea medication, and then they started me on an IV bolus. And thank God for that, because two bags of IV later, the contractions did end up stopping. So it was just dehydration. Yeah. And so,

Dr. Shannon (43:28.009)
Mm -hmm.

Dr. Shannon (43:43.401)
Yeah.

Dr. Shannon (43:47.337)
Just that dehydration. Yeah. gosh.

Dr. Lotem Schulke (43:53.709)
I was able to go home, they sent me home, I was fine. But man, that was not fun. Not fun. And then unfortunately, from that point forward, starting at 28 weeks, I basically have an irritable uterus. So because my uterus started contracting at 28 weeks, it kind of just continued contracting at 28 weeks. So...

Dr. Shannon (43:59.081)
That's intense. Yeah.

Dr. Shannon (44:17.929)
huh.

Okay.

Dr. Lotem Schulke (44:23.022)
pretty much starting at 5 p every single night from that point on, I had prodromal labor. So it would start off with like Braxton Hicks type contractions, you know, where the belly just kind of tightens up and I can still do everything. And then after a couple hours of that, it would turn into real contractions. And then, you know, I'd have to get in the bath to kind of calm them down. And...

Dr. Shannon (44:40.937)
Mm -hmm.

Dr. Lotem Schulke (44:49.774)
Sometimes they would calm down and sometimes they wouldn't calm down and we're just praying that this baby doesn't come soon. But yeah, that was that. That's what I missed. At 20 weeks during my anatomy scan ultrasound, the baby looked perfect. He was, I think, just about the 50th percentile for everything. So very average. And...

Dr. Shannon (44:54.377)
Yeah, super early. Yeah.

Dr. Shannon (45:10.921)
Mm -hmm.

Dr. Lotem Schulke (45:19.343)
I was happy about that. He was doing well. The only thing that we found on that was that I had something called a circumvallate placenta, which basically come to find out what that is, is the edges of the placenta kind of roll up. So they're no longer attached to the lining of the uterus. And there have been...

Dr. Shannon (45:20.809)
Mm -hmm.

Dr. Shannon (45:30.953)
Okay.

Dr. Shannon (45:43.657)
Hmm.

Dr. Lotem Schulke (45:46.607)
studies done on it. One was in 2014, which showed that there's an increase in preterm labor. There's an increased chance of intrauterine growth restriction and, you know, just lots of issues from there. The subsequent research study from 2018 showed that that is actually not true.

Dr. Shannon (46:04.297)
Yeah.

Dr. Lotem Schulke (46:13.103)
accurate, that there's no statistical significance. So there's differing data on it. So because there isn't a consensus, we decided from that point on, from 20 weeks on, that I would have more frequent ultrasounds, growth ultrasounds, to monitor his growth. So every four weeks I had a growth ultrasound, which...

Dr. Shannon (46:16.681)
okay.

Mm -hmm.

Dr. Shannon (46:33.514)
Right. Okay.

Dr. Lotem Schulke (46:42.031)
You know, there's pros and cons to everything. I mean, it was nice and reassuring to see that everything was working well, but you know, it's still a lot of ultrasounds. So, yeah. So, yeah, so he always was perfectly fine. Yeah, yeah, yeah. So he was growing perfectly fine. Obviously, if he wasn't, if we saw a growth issue, then we would start with...

Dr. Shannon (46:44.457)
Right.

Dr. Shannon (46:52.361)
It's still a lot. Yeah, it's still a lot of ultrasounds.

Dr. Shannon (46:59.433)
And then you dealt with the prodromal labor or the issues. -huh. Okay. Okay, good.

Dr. Lotem Schulke (47:11.344)
bi -weekly, so twice a week monitoring, we never had to go that route. So he was perfectly fine. The only thing with that is that we did discover at the 34 week ultrasound that I had high, like a lot of water. So I, the regular, the normal range is five to 25, and I don't know what the units of measurements are, but it's five to 25, and I was at 21.

Dr. Shannon (47:12.681)
Mm -hmm.

Dr. Shannon (47:28.553)
Mm -hmm.

Dr. Lotem Schulke (47:38.959)
which is a lot of fluid. So we wanted to wait until, sorry, that was a 32 week ultrasound. So we wanted to wait until a 36 week ultrasound to see if the water continued to rise or if it stayed the same or if it dropped down. And it stayed the same. And so I wasn't diagnosed with anything at that time. It was just on the high end of normal, basically. But it is my theory. It is nobody else's theory. Nobody has confirmed this. It is my theory alone.

Dr. Shannon (47:41.161)
Okay.

Dr. Shannon (47:53.929)
Okay.

Dr. Lotem Schulke (48:08.463)
that the super high fluid levels were caused probably from the placental issue to begin with. And that is what kept my body from actually going into labor. Starting around 38 weeks, I was actually going into labor. So there was a Friday, it was a Thursday evening at like 11 o 'clock and I was having very, very, very consistent.

Dr. Shannon (48:16.169)
Hmm.

Dr. Shannon (48:25.001)
Yeah.

Dr. Shannon (48:29.257)
Okay.

Dr. Lotem Schulke (48:37.999)
contractions, we went into the hospital, I came in at midnight and was monitored until 8 a I was having contractions every five minutes that were lasting a minute and a half to two minutes each. I mean, very strong, like very consistent contractions, right? With no cervical change whatsoever. So they, yeah. So they sent me home. I know, I was at three centimeters and 50 % of phased, so.

Dr. Shannon (48:50.889)
Mm -hmm. Yeah.

Dr. Shannon (48:56.201)
Huh. Ugh. That's the worst. Okay.

Dr. Shannon (49:07.017)
Okay.

Dr. Lotem Schulke (49:07.247)
And that's kind of where I stayed. So sent me home fully expecting for my body to go into labor that weekend. I didn't. Then Tuesday rolled around and started having contractions again. This time we went into the office to make sure that this actually was labor because I'm not trusting my body at this point. It's kind of like the boy who cried wolf, right? So.

Dr. Shannon (49:30.409)
Yeah, yeah.

Dr. Lotem Schulke (49:33.263)
We went into the office, Carson checked me, and this time she couldn't even feel ahead anymore. She was like, I don't know what happened here. Let's send you straight back to an ultrasound. Back in the ultrasound, so this is literally at 38 weeks, we found out that the baby flipped transverse. And I was devastated, devastated, because there go all of my plans, right?

Dr. Shannon (49:52.553)
Ugh.

Yeah.

Mm -hmm.

Dr. Lotem Schulke (50:00.815)
transverse if we can't get him out of it means an automatic c -section and so I I was not I was not ready for it I did not want that I was I was I wanted my water birth so bad and so Carson was basically like okay do all the things like you know what to do go home and do all the things and so I got adjusted that day I I mean I was doing inversions like a madwoman actually I went to go see my the the

Dr. Shannon (50:06.953)
Mm -hmm. Mm -hmm.

Dr. Shannon (50:12.201)
Mm -hmm.

Dr. Shannon (50:18.057)
Yeah, you know what to do. huh.

Dr. Shannon (50:27.145)
Mm -hmm.

Dr. Lotem Schulke (50:29.871)
Brandy the pelvic floor PT that day too. We did like it was 72 hours of just a very intensive intentional speaking to the baby, talking it into existence, please flip, please flip, you know, and not knowing. So I got adjusted every single day, multiple times a day if I could.

Dr. Shannon (50:30.569)
Mm -hmm. Mm -hmm.

Dr. Shannon (50:46.601)
Mm -hmm.

Dr. Lotem Schulke (50:54.927)
and I was doing spinning babies, lots of inversions, lots of side -lying releases, anything that I could possibly do to get this baby to flip back head down. So we had a scheduled induction date for that Saturday. So it was Tuesday that I had this. So I had...

Dr. Shannon (51:02.697)
Mm -hmm.

Dr. Shannon (51:11.145)
my gosh, so what happened?

Dr. Lotem Schulke (51:22.383)
up until Saturday to figure it out, basically. So the reason, by the way, that we did a scheduled induction at 39 weeks, it was for multiple reasons. First being that it's an IVF pregnancy and really they're comfortable at delivering at 39 weeks for an IVF pregnancy. They really don't want it to go past that usually. But also it made it much more convenient for figuring out childcare, for having the parents come in.

Dr. Shannon (51:24.133)
I'm sorry.

Dr. Shannon (51:50.921)
Mm -hmm.

Dr. Lotem Schulke (51:51.087)
They're not local and so they're not international. They are domestic, but still coordinating with them. Yeah. So the parents, after that initial time I went to the hospital and was contracting pretty steadily, the parents decided to accelerate their plans to come in. And so they came in early, just in case I went into labor early. And...

Dr. Shannon (51:58.153)
There were lots of outside, yeah, those outside factors.

Dr. Shannon (52:13.289)
Mm -hmm.

Dr. Lotem Schulke (52:17.811)
It was definitely nice having them here. We got to connect a lot more and, you know, it was great. But I didn't go into labor. So then anyway, that Friday, the Friday before the induction, we already had a C -section scheduled for the following Wednesday and we had the induction on the books. And so we needed to decide at that appointment which way we were going to go.

Dr. Shannon (52:29.409)
you

Dr. Shannon (52:34.089)
Mm -hmm.

Dr. Shannon (52:43.177)
What are you gonna do?

Dr. Lotem Schulke (52:44.692)
And yeah, and we went in, the first thing we did was the ultrasound and we're all holding our breaths and the parents are in the room, my husband's in the room, everybody's in there and we're just like all holding hands and the baby went head down. And so we were all crying and it was just the best thing ever. And so we're back to no more C -section, we're back to our plans. And...

Dr. Shannon (52:59.369)
wow.

Yes.

Dr. Shannon (53:11.433)
Are your plans of the induction okay?

Dr. Lotem Schulke (53:14.708)
Yeah, so we, I just, I asked Carson to strip my membranes at that point. I was like, the parents are here, let's get the show on the road, right? So she did, she stripped my membranes and I had pretty much an hour afterwards. I started contracting pretty regularly. I thought I was probably gonna go into labor that night and they kind of fizzled out. So I attempted to get some sleep that night. It's very, very difficult. I was,

Dr. Shannon (53:21.161)
Mm -hmm.

Mm -hmm.

Dr. Shannon (53:42.185)
Mm -hmm.

Dr. Lotem Schulke (53:44.596)
very cognizant of his movements and I was like, please stay head down, please stay head down the whole night, you know? And so we woke up in the morning and went in for the induction just the way that we had planned. So yeah, so we went in to the induction. We...

Dr. Shannon (53:48.649)
-huh.

Dr. Shannon (54:00.777)
Okay.

Dr. Lotem Schulke (54:09.557)
The first thing we did was a confirmation ultrasound to make sure that he was still head down. Yeah, so that was good. He was fine, still head down. And then we started on a really low dose pitocin. I was already five centimeters dilated and 50 % effaced at that point. So I had done half the work already and not even in labor yet. So that was cool.

Dr. Shannon (54:14.203)
Yeah, still head down.

Dr. Shannon (54:25.033)
Mm -hmm.

Dr. Shannon (54:31.177)
Okay, yeah, yeah.

Dr. Lotem Schulke (54:37.845)
Yeah, and so we started at, the Pitocin started at two and we went up by two every 30 minutes. And so it was a really comfortable induction. I was like dancing and having fun and like my birth team is just like family and we were just hanging out the entire time. It was a really awesome birth.

Dr. Shannon (54:50.281)
Mm -hmm.

Dr. Lotem Schulke (55:03.413)
labor experience the contractions started, I could feel them, they still weren't very bad. And it literally got to the point where we maxed out on Pitocin and I'm still barely feeling the contractions, barely, barely feeling them. And I like, we just, you know, I don't, we don't know what to do from that point. The contractions are strong, like on the monitor, they are, they are off the chart strong, but I am, I'm like hanging out, you know?

Dr. Shannon (55:09.353)
Mm -hmm.

Dr. Shannon (55:17.321)
Wow.

Dr. Shannon (55:25.417)
Strong, yeah.

Dr. Shannon (55:32.233)
Mm -hmm.

Dr. Lotem Schulke (55:32.469)
So at that point, we decided to have me rest. So I did, I slept for 45 minutes.

in, in a very specific position to try and get him to descend, he's still pretty, pretty high up. He's not engaged in my pelvis yet. and, and so we were trying to get him to come down. He was having trouble making it around my pubic bone. So I got into a lot of very uncomfortable positions. so I w I woke up, with a, with a pretty strong contraction. went to the bathroom, lost my mucus plug and,

Dr. Shannon (55:41.993)
Hehehehe.

Dr. Shannon (55:46.921)
Okay.

Dr. Shannon (55:59.817)
Mm -hmm.

Dr. Shannon (56:10.025)
Okay.

Dr. Lotem Schulke (56:11.606)
And at that point, we attempted to do all those different positions. So he did end up getting into a better position to where Carson felt that it was probably the best option at that point to break my water.

Dr. Shannon (56:27.369)
Mm -hmm.

Dr. Lotem Schulke (56:29.174)
And when she broke my water, we found out that there was meconium in there. And so that unfortunately disqualified me from having a water birth. I kind of knew the entire time that my birth plan was open. I was kind of open to whatever happens happens. Cause you know, I know you have to be, you know? But I knew that I had two routes that I wanted to go. I either was going to get my water birth or I was going to get an epidural. I was not going to just.

Dr. Shannon (56:36.809)
The water birth, yeah.

Dr. Shannon (56:45.993)
Mm -hmm. You have to be. Yeah.

Dr. Shannon (56:57.161)
Yeah.

Dr. Lotem Schulke (56:58.679)
to just go without, you know, without something to help me along. And so at that point when she was like, yeah, but there's meconium in here. And I was like, well, you know, I was like, all right, well, let's bring on the epidural because here we go. Right. And so she called the anesthesiologist and

Dr. Shannon (57:02.121)
Mm -hmm.

Dr. Shannon (57:09.705)
Mm -hmm.

Dr. Shannon (57:14.153)
Yeah, here we go. Yeah.

Dr. Shannon (57:28.329)
Hmm.

Dr. Lotem Schulke (57:38.846)
like all the way at max. They were horrendous and coming every 30 seconds and yeah so I labored like that for an hour waiting for the waiting for the anesthesiologist to get in. He I was at 7.

Dr. Shannon (57:44.105)
Hmm.

Dr. Lotem Schulke (58:29.056)
his heart rate kept dipping pretty low.

Dr. Shannon (58:32.177)
Sorry, it keeps... I'm hoping the audio still goes because it keeps going out on my end so I can't hear what you're saying but then I know you're still talking so I apologize for that. I'm gonna see if it's still working but the audio is going in and out.

Dr. Lotem Schulke (59:02.643)
it's just the way he had to be born and I'm okay with it. Yeah. So that's my story. Is that your story?

Dr. Shannon (59:07.081)
Yeah.

Dr. Shannon (59:11.529)
That's your story. I know so many emotions.

Dr. Lotem Schulke (59:17.971)
It was. Luckily, we called the C -section before it became an emergency C -section because in an emergency situation, they don't allow anybody in there. They just kind of get the baby out and do their thing. But my husband was able to be at my side. My doula slash photographer extro...

Dr. Shannon (59:29.705)
Mm -hmm.

Dr. Shannon (01:00:05.609)
There you go. Sorry, it was cutting out again. I'm hoping that that came through. Yeah, because I had lots of, lots of, so sorry if I was quiet. I was lots of sections where I couldn't hear anything that you were saying. And so, but I'm hoping it came through on the recording end because it tells me that it is. But gosh, that sounds like a lot of emotions. I hope you mentioned Megan's name as well too, Megan Hall, because we had her on the show. So yes, because she's the doula and photographer.

Dr. Lotem Schulke (01:00:28.671)
I did. yes. Megan Hall was my amazing doula and photographer extraordinaire. She's magic.

Dr. Shannon (01:00:35.017)
And so good. Yes. golly, that's a lot. I mean, like the whole journey is a lot to process. And then how, if you want to speak just a bit to, to that, your postpartum, you know,

Dr. Lotem Schulke (01:00:50.846)
Yeah, I find myself really lucky and kind of in awe of women who have to have a c -section and then take care of a baby on top of it. The recovery from a c -section is not easy for me personally. It's taken a lot longer and I've had to be way more patient with my body than I had anticipated. It's been challenging.

Dr. Shannon (01:01:03.721)
Mm -hmm.

Dr. Shannon (01:01:13.897)
Yeah.

Dr. Lotem Schulke (01:01:20.319)
But again, I count myself lucky because I don't have to take care of a baby in the process.

Dr. Shannon (01:01:28.809)
but that's still lots of emotions with that.

Dr. Lotem Schulke (01:01:40.9)
I went into it, right? Knowing that it wasn't my baby, knowing what I was doing this for, knowing that it was theirs. I have, I mean, it's more pride than anything else. Like I'm proud of my body, I'm proud of the decisions we made and my birth team and my husband and my support and...

Like I'm in awe of the entire experience. It's an honor to be able to give a family a child when they can't otherwise have one. It's just, there's emotions, you know, for that, but not any like sadness or, you know, anything like that. Yeah.

Dr. Shannon (01:02:16.297)
Mm -hmm.

Dr. Shannon (01:02:31.209)
Yeah, yeah, it's like that different set of emotions that go with it. Yeah, and what you know, a beautiful gift even if right at the end it was you had all the things come in as far as like, I want the water birth and we won't be able to do that. And now it's like, well, now we're going to have Caesarian. It's like, okay, here we are, you know, it's you it's you've got to process that as well too, which...

Dr. Lotem Schulke (01:02:35.587)
Yeah.

Dr. Lotem Schulke (01:02:45.891)
Nope.

Dr. Shannon (01:03:00.713)
And I know that the cesarean recovery is definitely different. A lot of that cesarean recovery is different too when you have not necessarily pushed for a while, but when you've gone through those labor portions as well too. So that impacts that recovery I know as well. So, well, thank you so much for sharing your story.

Dr. Lotem Schulke (01:03:15.991)
Sure. Yeah.

Dr. Lotem Schulke (01:03:22.775)
Yeah.

Dr. Lotem Schulke (01:03:28.055)
my gosh, absolutely. I think the most frequent question that I get after I share my story is, well, do you want to do it again? And my answer, I think at this point is no. I think the process, I don't regret any of it, obviously, and I am so.

Dr. Shannon (01:03:29.769)
I mean, it's beautiful.

Dr. Shannon (01:03:41.609)
Yeah.

Dr. Lotem Schulke (01:03:52.278)
in awe that I was able to do all of that, but it is such a long process. And yeah, I think one and done for me. I think that chapter, I think I'm very content emotionally with saying that chapter of my life has closed now. And yeah, so at this point, the answer is no.

Dr. Shannon (01:03:57.993)
Mm -hmm.

Dr. Shannon (01:04:03.337)
Yeah.

Dr. Shannon (01:04:14.633)
Yeah, you're like, give me some time. But yeah, no, I appreciate you coming and sharing that story and all the pieces, parts that went into it. I loved hearing about your birth support team that you had on there and just the whole thing. And what a beautiful gift though. I don't know. I have chills, just chills from you kind of sharing that. Yeah.

Dr. Lotem Schulke (01:04:17.557)
Yeah.

Dr. Lotem Schulke (01:04:38.581)
Well, thank you. Yeah.

Dr. Shannon (01:04:39.689)
You're welcome. Thanks so much for being on the show. Yeah, and I greatly, greatly appreciate it.

Dr. Lotem Schulke (01:04:43.189)
Of course.

Dr. Lotem Schulke (01:04:47.926)
Awesome. It was my honor.