- (yelling) Joe, I need you.
- That is terrifying.
Things that go through my head are,
could we be having a placental abruption?
Could she have a placenta previa?
It's everybody's favorite time of the month again.
I'm Mama Dr. Jones and OB/GYN and mom to four.
And today we're reacting to another episode
of TLC's famously entertaining show,
"I Didn't Know I Was Pregnant".
This one is a real rollercoaster,
but it has so many great learning points.
And I'm so excited for you to watch it.
If you're new here and you wanna be subscribed,
hit that subscribe button.
If you don't want to be subscribed, that's fine too.
Just watch a video.
I think you'll learn a lot and I think you will enjoy it.
(upbeat music)
(chuckles)
- [Narrator] 20 year old Amanda, has been dating Joe
for three years.
They've been in love since they met in high school.
- He's really fun.
We're talking about marriage but way down the line.
- For birth control, we use condoms.
- [Narrator] But Amanda thinks their chances
of getting pregnant are slim,
because she's always had irregular periods.
- Okay, so right out the gate,
we're talking about condom use and irregular periods.
Condom use is effective as a form of contraception,
if they're used every time and correctly.
They work about 98% of the time in that case.
That's still a 2% failure rate,
even when you're using them perfectly.
When we look at what we call typical use,
meaning how most people use condoms,
most people aren't using them perfectly.
They either put them on incorrectly or they fail to
use them in some instances.
And this drastically lowers the effectiveness rate.
On the side of irregular periods;
people who have irregular periods may have more trouble
trying to get pregnant because it's more difficult
to nail down exactly when they're ovulating.
However, if you're ovulating, which is usually signified
by the fact that you're having periods at all,
on a somewhat regular basis, even if it's not exactly
the same every single month, you still have a relatively
good likelihood of pregnancy.
So I would never rely on irregular periods
as a form of contraception.
But it doesn't sound like they were doing that.
- [Narrator] In March of 2010,
Amanda notices something strange.
She smoked for years, but now the smell
of cigarette smoke makes her nauseous.
- I just felt instantly like I was gonna throw up.
The scent of it was just terrible.
- So she's told us her first pregnancy symptom,
but honestly if you don't know you're pregnant
and you have irregular periods, I'm not surprised
she doesn't know she's pregnant at this point.
A food aversion or smell aversion is a super common
early pregnancy sign.
- [Narrator] In June, she notices another change.
She suddenly starts experiencing mood swings.
- I had Joe go get us chicken sandwiches,
and when he came back my chicken sandwich
didn't have cheese and I clarified that I wanted cheese.
Joe, I asked for cheese. I asked you to do one thing.
And I was having these crazy mood swings,
but I thought maybe I was just getting my period.
- [Narrator] But her period doesn't come in July or August.
Even though that's not unusual for her, Amanda decides
to play it safe and take a pregnancy test.
- [Joe] What does it say? - And when I took-
- I always say this in these videos, take a pregnancy test.
Good job, Amanda, you did the right thing.
But now I'm concerned about what went wrong here.
- It said that it was unreadable.
- What do you mean unreadable?
What does that mean?
We took two pregnancy tests
and they both came up inconclusive.
You followed instructions?
- Yeah. So I really just thought it was my hormones.
I thought they were all just out of whack.
- So it's pretty uncommon to get an unreadable
or like I can't tell you yes or no on a pregnancy test.
But when that happens, it's definitely a reason you need
to go into your doctor or advanced practice provider
and get a blood test.
That is a signal from the pregnancy test that they can't say
for sure you're not pregnant.
So I think in this situation, and I'm sure now looking back
on it she would say the same thing.
This should prompt you to investigate further,
not rely on that as meaning you're not pregnant.
- [Narrator] Later that summer on August 21st,
the couple takes a trip to visit Amanda's friend Brandy,
who lives in a nearby town.
They spend the day catching up.
- You're so cute.
- [Narrator] But that night, the visit takes
an unexpected turn.
- I have really bad chest pains.
Like an elephant was sitting on my chest.
I thought it was something with my heart.
Go get Brandy.
- I'm a certified nursing assistant.
- My chest hurts really bad.
- So when she said she had the chest pain,
the only thing I could think of was heart attack.
- So I told her, well, let's go to the hospital right now
and get you checked up.
- This is really concerning especially
in someone who is pregnant.
Of course you think about heart attack,
'cause that's a classic thing that people think
about when they hear, I feel like elephant
was sitting on my chest or something like that.
But I worry in that situation about someone having something
like a pulmonary embolism.
When you are pregnant you have an increased risk
of blood clots.
And anytime I have a patient come in complaining
of chest pain and shortness of breath,
of course, things like heart attack are on the table
to consider, but I am so much more worried
about blood clots.
So I am glad that they have decided, this is a reason
we need to go to the hospital
and that they're going right now.
- [Narrator] Joe rushes Amanda to the nearest hospital
where a doctor wants to x-ray her chest
after hearing her symptoms.
And he was like, before we do the x-ray
we have to make sure that you're not pregnant.
When he came back in he was like,
"so the test came back."
- You're definitely pregnant.
- What?
And I'm like, "Oh my God"
- He felt the stomach and he was like,
"Well, hon, you're like five months pregnant."
- I can't keep track of the timeline here,
but I'm glad that this ER doctor was being thorough.
Good on them.
And you can tell from them telling the story
how shocked they were.
But at a very minimum, at least they know right now
before she's in active labor, I guess.
Or maybe this is her first symptom of labor.
As far as the x-rays go, this is kind of a common thing
that people think that you can't get an x-ray
if you're pregnant.
And of course we wanna minimize radiation
as much as possible in pregnancy.
But if somebody has an indication to get a chest x-ray
during pregnancy, we can still do that safely.
We don't wanna be doing chest x-rays every single day.
And we'd like to avoid doing that really early in pregnancy,
if it's safe for the person who's pregnant to avoid that.
But at the end of the day a chest x-ray is a very low amount
of radiation and I still think,
if he thought that was indicated based on her symptoms
that we would probably want them to go ahead and do that.
But getting the pregnancy test first is super important.
The other things to consider in someone who's complaining
of chest pain and pregnancy is you wanna rule out anything
that's life-threatening, get an EKG,
get the oxygen saturation, check and make sure
they don't have a pulmonary embolism.
And you can do that in various ways.
But the first would be just checking vital signs
like oxygenation and heart rate.
And then if you rule out all of the big scary things
that are less common but need to be identified immediately,
another really common thing that people wake
up with chest pain, especially centralized chest pain
in the middle of the night while they're laying flat,
is GERD, Gastroesophageal Reflux.
And that is basically heartburn.
And it can feel, especially in pregnancy
like a little bit of chest pain.
Importantly, you wanna rule out other more concerning
things first, but that is something really common.
Reflux is more common in pregnancy because the little door
that kind of keeps the stomach acid in the stomach
and away from the esophagus gets a little bit more relaxed
with pregnancy due to estrogen levels being higher.
And the door just opens a little more easily.
Laying flat at night and eating large meals before
you lay down, increases that even more.
So this is a super common thing that happens in pregnancy.
- [Brandy] So it's a big surprise.
- We went back to Brandy's house and told her the good news.
- I'm pregnant.
- Oh My God, congratulations.
I was very surprised to hear Amanda
was five months pregnant.
She did not look pregnant at all.
You gonna be a mom.
- I know.
That night, I had laid down 'cause I still didn't feel well.
And then all of a sudden I felt myself bleeding.
(yelling) Joe, I need you.
I thought, "Oh my God," I think I'm having a miscarriage.
- That is terrifying.
And I think anybody's first thought
in that situation where they've just found out
they were pregnant that day and then they start bleeding,
is this is miscarriage.
Things that go through my head are,
could we potentially be a little further along?
And this is the start of some labor or cervical change.
Could we be having a placental abruption?
Could she have a placenta previa?
So placental abruption is where the placenta separates
from the side of the uterus and causes massive bleeding.
That is life-threatening to both the person
who is pregnant and to the baby.
And a placenta previa is where the placenta overlays
the cervix and it can cause massive bleeding as well.
And that can be very dangerous as well.
And then we also want to consider
maybe she's not quite as far along as they said,
and it is a miscarriage.
Although notably, she doesn't mention
that they did an ultrasound or any kind of dating.
So I'm not sure how far along she actually is.
But we don't call it miscarriage after 20 weeks.
Miscarriages happen up until 20,
after that it's either extremely premature delivery
or stillbirth or fetal death, things like that.
- That we were having a baby and now she's sitting
in a puddle of blood.
I had no idea if we were gonna lose the baby
or if she was gonna die or what was gonna happen.
- The blood was so intense. I was very, very scared.
- That would be terrifying.
Can you imagine, I mean, just hearing them talk about it,
you can tell they're still traumatized by this.
I mean, you just find out that you're pregnant
and you're trying to celebrate that and be happy about that.
Or you're trying to come to terms with that and adjust
to that because it wasn't something you were planning,
and now all of a sudden you're having massive bleeding.
You don't know why, you don't know if it means
that you are in danger, the baby's in danger, what have you?
That would be absolutely terrifying.
- I do not handle blood at all.
And I was like, "Brandy, could you take her to the hospital?
'Cause I don't think I could make it there,
'cause I already feel like I'm about to throw up
and pass out and just faint."
- [Brandy] I was very, very scared.
- This is terrifying, but while the partner is explaining
how he doesn't deal well with blood,
it reminds me of when I was about 23 weeks pregnant
with our youngest and I was cutting an avocado
and the knife went through the avocado, into my finger.
I severed a digital nerve and my finger
and I ended up having surgery as a whole thing.
But my husband does not deal well with blood or injuries.
And even though it wasn't super bloody, I was like,
I put the rag on it and I was like,
I need you to take me to the clinic to get this stitched up.
I definitely need stitches.
And he was like, "Okay, I can do that, but don't show me.
Don't like, make me look at it.
And if it's bleeding, just keep it covered up."
(Dr. Jones laughing)
So I feel that and I feel sorry
for her that he had to let her go with her friend,
but I'm sure there's people watching
this who would judge that, and like, I get it.
Some people just cannot handle that.
And on top of that being terrified.
Like the friend if she deals better with blood
is probably the best person to take her to the hospital.
- They did a pelvic exam and they also did an ultrasound.
- [Doctor] Hang in there for me. Hang in there.
(Amanda sobs loudly)
(heartbeat whooshing)
We have a heartbeat.
- What?
- That heartbeat is way too slow.
And I don't know if they're about to say
the baby's heartbeat was low
and they need to do something about it.
Or if that was just bad editing and research on their part.
But that heart rate is like 85, and normal for a fetus
at that gestational age or really any gestational age
is at least over 120.
- [Narrator] Doctors determined that Amanda's bleeding
is caused by a life-threatening condition
involving her unborn child called placenta previa.
- Yes, this is an emergency.
So I don't know if they've now decided
that she's further along than they thought.
But if they are in planning to deliver the baby
she's got to be over five months or 20 weeks,
because there would need to be a discussion about the fact
that if she was only 20 weeks, the baby's not going to live.
So this is life-threatening.
Placenta previa is where like we discussed,
the placenta sits over the top of the cervix.
If you go into labor with placenta previa there,
obviously the placenta is covering the cervix.
The baby's head is here. You can't deliver a baby like that.
Because if the placenta comes out first
the baby will swiftly bleed to death.
This is extremely dangerous.
It's dangerous for her,
but it's also extremely dangerous for the baby.
So massive bleeding in someone who has placenta previa
is almost always an indication for an emergency C-section.
And placenta previa is always a reason
to avoid vaginal delivery.
- [Narrator] Amanda is prepped for an emergency C-section.
She's worried because earlier in the day,
doctors told her she's only five months pregnant.
- I'm getting ahead of myself.
- I was really concerned for the baby's life,
because I didn't know if the baby's lungs were developed
or how big the baby was.
(dramatic music)
- [Narrator] Doctors rush Amanda into the operating room,
where she delivers a tiny baby girl.
They believe is four months premature.
- So she delivered the baby by C-section
and they say four months premature.
So that would be somewhere
in the range of like 25 or 26 weeks.
This is still extremely premature and very, very dangerous,
but is way better than 20 weeks because this baby
actually does have a chance to survive.
So I will be interested in seeing the outcome.
And I'm also terrified for both the baby and for her,
because this is dangerous.
Obviously, we know she lives, she's telling her story,
but this is a very scary situation
for me as an obstetrician.
Thinking about being in the shoes of those people
and trying to make these decisions so quickly
with not knowing exactly how far
along she is and all of those things.
And it happens, I have cared for situations
exactly like this, this is very realistic.
- [Narrator] After arriving at the hospital,
Joe waits with Brandy for news about Amanda and their baby.
- It was terrible. It was the worst feeling ever.
I might've lost my baby. I could've lost my girlfriend.
I could've lost both of them.
- [Narrator] After what seems like hours,
a nurse tells Joe and Brandy that Amanda is okay,
and that she has given birth to a very small baby girl
who they had to rush to the intensive care unit for tests.
- She was so tiny.
- They were just gonna do a whole bunch of tests on her,
make sure that she's breathing okay.
- That first picture they just showed,
she's definitely not right at 25 weeks.
That must have been after she'd been in the NICU
for a while and at that point she's only on some room air.
And I suspect that this baby at the time of delivery
likely needed a little bit more breathing support
than just the little oxygen prongs.
So I think they're showing some pictures
as she got a little bit bigger,
which is good because now I'm encouraged
that maybe she's gonna do well.
It makes me very nervous though.
- [Narrator] Over the next two hours, doctors determined
that the surprise baby was actually born
just two months premature.
And she has no major complications.
Since she was born underweight
at just two pounds, 10 ounces,
doctors insert a feeding tube to ensure she gains weight.
And when Amanda wakes up from surgery,
she recovers so quickly that doctors allow
her to hold her new daughter that same day.
- It was unbelievable, I couldn't believe
that this little tiny thing just came out of me.
- That is crazy.
So it wasn't that those pictures were actually
after she'd been in there a while,
they were wrong about the dating.
So she was only two months early,
but she was little around two pounds.
So they can decide the gestational age based
on some tests that they do on the baby.
It has to do with kind of the state of their skin,
their reflexes, their flexibility, things like this.
And so they can guess the gestational age based on that.
A common thing that happens in people
with undiagnosed pregnancies is they have babies
who are underweight or what we call small
for gestational age.
And it sounds like they suspect
that that's what happened here as well.
So I'm so glad to see that she recovered quickly.
That baby actually did very well,
but this could have gone very differently.
And you know, it seems like most
of these "I Didn't Know I Was Pregnant" episodes
have good outcomes, but I do appreciate them.
At least showing one that ended with an emergency C-section
at an early gestational age and a long NICU stay,
because that is something that happens
with an increased frequency in undiagnosed pregnancy.
- [Narrator] The baby, they named Isabella Rose,
must remain in the hospital for a month,
giving Amanda time to wonder how she could've missed
the signs that she was seven and a half months pregnant.
- The two birth control tests we did take
they both came up inconclusive.
We should have took more, but we didn't.
- [Narrator] Today, Isabella is a healthy five month old.
- Amanda and Isabella are both healthy and full of life.
- Isabella wakes up in the morning with a smile on her face.
She goes to bed with a smile on her face.
She's always happy, she is the perfect baby
that anyone can have.
- That was so sweet.
And that sweet little bald baby just makes me like,
Oh my gosh, my babies were all bald.
And I just have a special place in my heart for bald babies.
But I'm so glad that Isabella and Amanda
are both doing well.
I hope you learned something in this video today.
If you're new here and you wanna be subscribed
we would love to have you.
Be kind to yourself, to each other, to me,
in the comments be kind and I will see you next time.
And if you wanna go watch another
"I Didn't Know I Was Pregnant" reaction video,
I will link a playlist, one over there somewhere. Bye.