Deborah Howell (Host): Throughout the journey to try to start a family, there can be many complications along the way, including high-risk pregnancies. I'm Deborah Howell, and our guest today is Kristen Tobin, a patient at Tri-State Perinatology. She'll be sharing her story with us about her particular journey to starting her own family. Welcome, Kristen.

Kristen Tobin: Thank you. Good morning Deborah and thank you for having me today to share my journey to motherhood.

Host: Oh, we couldn't be happier to have you. Can you start us off and tell us where your journey began?

Kristen Tobin: Yes. So I was diagnosed with Type 1 diabetes when I was 11 years old. So I've had it for the past, a little over 19 years. My husband and I got married three years ago as of yesterday.

Host: Oh, congratulations.

Kristen Tobin: Thank you, in the middle of the COVID-19 pandemic. At the time, I was working in healthcare as a nurse, going to graduate school, and just balancing life in general. And so my A1C ended up elevating at that time due to the stress. My OB saw me the week before we got married and decided that it would be best to refer me to Tri-State Perinatology since my husband and I were wanting to start our family shortly after being married.

He told me that if we were to get my A1C in a better control, it would be better for me and better for a future pregnancy. So I was referred to the office at Tri-State Perinatology and saw them June of 2020 for the first time. The first appointment, I remember all the different team members coming in to meet both myself and my husband and giving us the rundown of how things would look once we did acheive pregnancy.

The first time that I left the office, I left with the famous little blood sugar logs from them. Little did I know that I was going to be filling out a lot of those over the next three years. So we started seeing them every two weeks, just to gain a better A1C control. Cause at the time my A1C was, uh, little over eight when I first started seeing them. And they wanted it to be less than six and a half prior to giving us the all clear to try to start our family. We did achieve that in August of 2020, and were told that we could start moving forward.

Host: And how did you hear about Tri-State Perinatology?

Kristen Tobin: I heard about them from my OB. And then I also, I worked downstairs in the NICU at the Women's Hospital. So I've been aware of Tri-State Perinatology, but I didn't truly know everything they did until I became a patient in the office.

Host: Okay. And when were you referred?

Kristen Tobin: June of 2020.

Host: Okay. I want to back up just a second. How did you know that you were considered to be at high risk for pregnancy? And did you find out once you started to have your family, or did you kind of know before that?

Kristen Tobin: A little bit of both. I knew with my type 1, that there were going to be additional risk factors, additional potential complications. But I didn't know the true, kind of intensity of how the pregnancy was going to be considered high risk, until I started seeing the office.

Host: And what did the physicians do for you at Tri-State Perinatology?

Kristen Tobin: They did a lot for us. They always went above and beyond to care for both me and the baby. Any concerns that I had, whether it was from the blood sugar management, from what popped up during our weekly ultrasounds. They always took time to come and speak with me if I had any questions or concerns.

There was one day that Dr. Contreras, she was on a couple different times when I, I had concerns or worries, and she came and spoke with me and sat down and made sure that I felt better about the findings before she left. Dr. Staat did the same thing. I remember there was a day that my fluid levels were a little bit elevated in baby, and he came and talked to me and explained how we were going to move forward and, kind of what that meant for both me and the baby. So I just felt like each physician that I encountered, they just took the extra time to make sure that both I and my husband understood the findings, and just eased our mind, with any kind of concerns that we had along the way.

Host: That's so great that they really included your husband along the way because, um, it can be an isolating factor for the husband if he's not included.

Kristen Tobin: Yeah, they did a great job. And towards the end of the pregnancy, I, I was being seen weekly, from week 28 on, due to the extra fluid that baby had. And so my husband wasn't able to take off for each appointment that I had, at that point. And so then my, my mom was able to come to a couple of the appointments, my dad, and my sister-in-law, and they treated everyone who came into the office, they treated everyone really great, to make sure that they felt welcome and involved in the care as well.

Host: Oh, that's so great. And of course during COVID, none of that could have happened, right?

Kristen Tobin: Yes. Yeah. So we're really thankful that the restrictions have let up a little bit.

Host: How else did they help you with your journey?

Kristen Tobin: They helped me achieve a healthier A1C prior to pregnancy, and they helped me manage my blood sugars appropriately during the pregnancy. I was actually referred to Boston's in December of 2021, after we had tried for a little over a year. Um, and we were diagnosed with infertility. So, at that time, we were put on both the oral and injectable hormones. And it played a huge, a huge role with my blood sugars, making it very difficult to control. We ended up achieving pregnancy in March of 2022. But that pregnancy did end up in an early miscarriage. I just felt like through the infertility journey, through the miscarriage and through the hormone treatment, every member at Tri-State Perinatology that we encountered, they were there to support us, and to make sure that they were offering, like encouraging advice along the way while they were treating my blood sugars, and supporting me through that.

Host: I can't imagine you trying to handle all of that on your own without a team behind you.

Kristen Tobin: They were great and not only offered support to me from a professional standpoint, but some of them shared personal experiences as well that made me know that I wasn't, I wasn't walking the the journey alone, that they also had their family in the end. And so I knew that there was still a hope for us to have our one day baby.

Host: Yeah. So overall, your experience at Tri-State Perinatology was a, a good one.

Kristen Tobin: Yes, it was wonderful. Dr. Fitzpatrick. There was one night that I ended up, my insulin pump had kind of malfunctioned on me, and I ended up with ketones, which could be dangerous for both me or the baby if I didn't treat them appropriately. And so I, I called after hours that night, and Dr. Fitzpatrick was the one who called me back and he just made a really great game plan for that evening, to how to treat at home, when to go in. And he just kept emphasizing if I were to go in, to make sure that I called him, and let him know so that he could call ahead to the OB ED and let them know exactly what he wanted them to do for me, um, to keep myself and the baby safe.

I was actually seen in the office the next day, so I felt a little, little silly calling, calling after hours. And, when I woke up the next morning, actually, one of the nurses, had called me that morning. I missed a phone call from her. So I called her back and she, she's like, I know you're coming in for your appointment here, in a like an hour and a half or so. She's like, but I just wanted to make sure that you were feeling okay this morning. I wanted to see how your night went. So it just, they just always took the extra step to make sure that we were truly cared for and that we, we were doing good.

Host: I can actually hear the support in your voice that was surrounding you during this incredible time in your life. How are you feeling now?

Kristen Tobin: I'm really excited to finally be a mom. It's been a dream of mine for quite some time, and there's, there's really no better feeling in the world. And people kept telling me this along the way. They're like, once you hold that baby, they're like, that's, that'll be the best feeling in the world.

Um, but they, were right. Once they put him in my arms, especially waiting for him, after the loss, there's just, it's, you know, it's a feeling that you really, truly can't describe. I am just so thankful to everyone at Tri-State Perinatology for everything they did for myself, for my little baby boy Axel, before, during, and like after the pregnancy. I ended up developing preeclampsia, so we, we delivered at 36 and six. And so, being a NICU nurse, I knew that being a late preterm baby, it kind of increased our risk factors for like potential NICU time and, I knew that the complications of me with having the preeclampsia, it could be dangerous for both of us.

My ob Dr. Scorlokis, he really kind of calmed my fears and made me feel very comfortable going into the delivery room. And actually Dr. Cooper came, to help deliver the baby as well. So it was in that moment that I knew as I was getting ready to have like the spinal and the medications.

I had been kinda stressed that day, like just trying to figure out how everything was going to work out and how the baby was going to be, be born and transition. But once I saw, both Dr. Scorlokis and Dr. Cooper come in, I just knew that both the baby and myself would be in good hands and that we'd be, we'd be managed appropriately. So that made me feel better to see both of them in the delivery room.

Host: I can only imagine. Um, well, congratulations, your baby boy, Axel and, and your husband, what's his name?

Kristen Tobin: Uh, sorry, Marshall.

Host: To all three of you. Such a heartwarming story, Kristen. Thank you so, so much for being with us today to talk about your journey to parenthood. I'm sure you have some parental duties to attend to right now.

Kristen Tobin: He, he is asleep for the moment, but yes, I, I, uh, put my husband on the duty. I said, uh, you make sure that he, if he starts crying, that we get him to be nice and quiet.

Host: Well, you know, on this particular podcast, that would be a blessing to hear today. We thank you so much for being here today.

Kristen Tobin: Thank you.

Host: And that wraps up this episode of the podcast series from Deaconess, the Women's Hospital, A Place for All Your Life. For more information about Tri-State Perinatology at the Women's Hospital, you can visit www.deaconess.com/theWomen'shospital/services/pregnancycare/high-riskpregnancy or call 812-842-4550.

Please remember to subscribe, rate, and review this podcast and all the other Deaconess Women Hospital podcasts. For more health tips and updates, follow us on your social channels. I'm Deborah Howell. Thanks for listening and have yourself a great day.