An Unmedicated Birth, Ovarian Cyst and Breastfeeding Challenges

Abbey Gray, a speech-language pathologist, lactation counselor, and mother of two, shares her experience with a complex postpartum recovery. After navigating a typical pregnancy and labor during the COVID-19 pandemic, Abbey discovered an ovarian cyst five weeks postpartum. The cyst, a teratoma filled with hair, led to emergency surgery, the removal of her left ovary and fallopian tube, and significant challenges in her breastfeeding journey.

Unexpected Labor at 37 Weeks

Change was in the air when Abbey and her husband decided to try for a baby. She and her husband had recently relocated to Maine, hoping to start a family. "We thought this was a good time to grow our family, especially with COVID happening," she recalls.

Abbey with her family after her unmedicated birth and ovarian cyst

While experiencing common pregnancy symptoms like nausea and sciatica, Abbey focused on an unmedicated birth plan. Despite now living in Maine, Abbey decided that she wanted to deliver her baby at a hospital in Boston where she felt comfortable.

Abbey Gray's labor began unexpectedly at 37 weeks and two days, catching her and her husband off guard. "We were not prepared. I don’t think I had packed my hospital bag yet because we thought we had some extra time," she recalls. Waking up in the middle of the night feeling wetness, she initially wondered if she had wet herself. However, upon noticing a pink tinge on the sheets, she realized it was likely her water breaking.

Abbey describes the confusion many women feel about what happens when their water breaks. "I feel like there’s not a lot of knowledge out there about when your water breaks, what actually happens," she noted. After confirming with the on-call OB-GYN, they were advised to head to the hospital. Despite the unexpected situation, Abbey and her husband quickly prepared for the two-hour drive from Maine to Boston to deliver their baby.

"My husband likes to brag that he got there in, like, an hour," she jokes, noting the urgency of the situation.

Unmedicated Labor & Delivery

At the hospital, Abbey faced slow dilation and endured hours of labor, ultimately leaning on personal strategies to cope. "I did a lot of breathing, meditation, and listening to music," she recalls.

"I was pushing and projectile vomiting. It was so disgusting and terrible. I would do pushes, and at the end of each push, I would vomit."

Without a doula due to COVID-19 restrictions, Abbey relied on her preparation. "My guidance for pain management without medication was mostly coming from me doing my own research and trying to figure out what would help me in the moment."

As labor intensified, Abbey faced additional complications. "I had a really bad reflux throughout my entire pregnancy," she explains. During pushing, the reflux became unbearable. "I was pushing and projectile vomiting. It was so disgusting and terrible. I would do pushes, and at the end of each push, I would vomit."

Her husband and the medical team helped her get through the labor.

"My husband was a huge, huge support throughout the whole birth, labor, and delivery process. He was there the whole time, holding one or both of my legs along with the nurse," she shares. Music also played a role. "At one point, I started listening to Justin Bieber to get more energy."

Despite the intense pain—"My pain level was definitely at like a ten, the most pain I’ve ever felt"—Abbey found strength in meeting her baby. "Once the baby was born, you just are so engrossed in this new baby, in this new life, that it doesn’t really—at least for me, I didn’t really remember the pain," she reflects.

Breastfeeding Journey

Despite Abbey Gray's extensive training as a lactation counselor, her breastfeeding journey presented unexpected challenges. "Even though I had all the training, it just…when it's your own body, your own child, you just don't, you know, it's like you forget what you're doing," she shares.

Abbey's sone Caleb who was born at 37 weeks through an unmedicated birth

Initially, breastfeeding seemed to go well, with her son, Caleb, gaining weight and tracking well on his growth chart. "He was born at 37 weeks, and he was 8 pounds, five ounces. I’m glad he didn’t go to 40 weeks because he would have been massive," Abbey adds.

However, things took a turn when Abbey developed severe lower back pain about five weeks postpartum, which led her to urgent care. The pain, coupled with constipation and a prolapse, was debilitating. "I can't even, like, stand up. Moving from, like, standing to sitting was extremely painful," she recalls

Postpartum Discovery of the Ovarian Cyst

At urgent care, after a series of tests, a twisted ovarian cyst was discovered. "They did a CAT scan and a transvaginal ultrasound, and saw that there was a cyst on my ovary." The cyst's size and complications led to an urgent need for surgery. During this time, Abbey faced another challenge: she hadn't brought her pump and went from 10 a.m. to 8 p.m. without pumping. "In hindsight, I wish that I had brought my pump with me," she reflected.

"They found a teratoma that had twisted seven times."

Upon arrival at the hospital, she immediately requested a pump and was relieved to find hospital-grade equipment available. Thankfully, her parents were able to care for Caleb while Abbey and her husband managed the medical emergency. "We just kind of waited around, and then finally they said the O.R. was open," she recounted. The discovery of the cyst's torsion necessitated immediate surgery, marking a critical juncture in her postpartum experience.

Abbey before getting surgery to remove her teratoma ovarian cyst

"They found a teratoma that had twisted seven times," Abbey says. Teratomas are unique cysts that can contain various tissues, such as hair, teeth, or bone.

Abbey’s cyst had grown to the size of a grapefruit and was cutting off blood flow to her left ovary and fallopian tube, requiring their removal. "The doctor said they would try to save the ovary and tube, but if the blood flow was too compromised, they would have to remove them," she recalls. The surgery was performed laparoscopically, and fortunately, the cyst was benign.

Impact of Ovarian Cysts on Pregnancy

While Abbey’s cyst was discovered postpartum, ovarian cysts during pregnancy can vary in impact. Common types include functional cysts, dermoid cysts (like Abbey’s teratoma), and cystadenomas according to the Clevland Clinic. Most ovarian cysts during pregnancy are benign and may not interfere with pregnancy, though some, like large teratomas, might require monitoring or surgery if they cause pain or complications.

For questions about ovarian cysts and their impact on fertility, it's important to consult medical sources:

Can a cyst on an ovary prevent pregnancy? According to Mayo Clinic, most ovarian cysts do not prevent pregnancy. However, some, especially those associated with conditions like endometriosis or polycystic ovary syndrome (PCOS), might affect fertility.
Will an ovarian cyst prevent pregnancy? As noted by Cleveland Clinic, most ovarian cysts are functional and resolve on their own, having minimal impact on fertility. However, larger or more complex cysts may require treatment.

Breastfeeding Challenges and Solutions

The surgery significantly affected Abbey’s breastfeeding journey. "We had to figure out different breastfeeding positions because of the surgery incisions," she explains. Her milk supply diminished, leading her to supplement with donor milk. "Donor milk was a huge help for us," she emphasizes.

Caleb’s weight gain slowed, prompting consultations with lactation specialists. A posterior tongue tie was identified and corrected, enabling successful breastfeeding. "We did oral motor exercises, and two weeks later, he was back to breastfeeding well," Abbey says.

Practical Tips from Abbey’s Experience

For mothers facing similar challenges, Abbey recommends Dr. Brown’s bottles and stresses the importance of proper flange sizing for pumping. "Flange sizing is huge. It made a big difference in my output and comfort," she advises.

Abbey also notes the significance of choosing the right pump and accessories. "A sturdy primary pump is essential, and getting the right flange size made a huge difference," she advises. For mobility, she found the Willow Go wearable pump helpful.

To new parents, Abbey recommends taking a fluid approach. "Follow your gut, have a plan, but be flexible. Things will come up that you can’t anticipate. Reach out for support—whether it’s a doula, a lactation consultant, or family. You don’t have to do it alone."

To find out more about Abbey's work as a speech pathologist and certified lactation consultant, check out Gray Eat, Speak, Play.