Monday, December 15, 2008

Ethan's Birth Story: December 15, 2008

Part 1: The Beginning…

On Monday, December 15th, I was feeling a bit yucky and decided to take a nice, warm shower at around 10:15 to try to feel better. Unfortunately, I didn’t end up feeling better, because halfway through my shower I noticed vivid red blood streaming down and swirling inside the tub. My heart dropped—more bleeding? Again?? And this time, it seemed worse, somehow—it just wouldn’t stop, and it was much scarier. We hurriedly called the Family Birthing Center and drove over to get checked out. To keep my mind busy, I was thinking of a few totally off-topic and trivial things—like, “Man, I didn’t get a chance to do my hair before we left home” and “The ground beef that just defrosted in the fridge will need to be cooked soon” and so on. We even sent Joel out to go pay a bill and drop off a check just a few minutes after I got admitted to the Birthing Center, which shows either how much denial we were in, or how much we were buying the doctor’s usual “this is a totally typical pregnancy!” spiel.

Once I got admitted, the nurses noticed that I was still bleeding quite a bit, and called my doctor to come check things out. He finally arrived at around 12:30 and did a pelvic exam. He could feel the cervix finally dilating, but also noticed that the placenta was covering the cervix—unless it was a large blood clot, of course. Oh, great! From bad to worse. He could also feel the baby’s head, but was concerned about the amount of blood I was losing and the fact that the placenta was apparently detaching (Placental Abruption). He felt that inducing labor and attempting a vaginal delivery could be dangerous, so he said he wanted to do a C-Section instead just to be safe. I agreed, so he looked at the nurse and asks “How soon can we get her in; is 1:30 okay?” At this point, by the way, it’s 1:00 p.m. The anesthesiologist wasn’t free until 2:00 p.m., so he agreed to wait until 2:00 for the surgery. Considering that it took them half an hour to get me prepped for surgery, I started to get a sense of urgency about this whole situation. That’s because, as I found out later, it was considered an emergency C-section.

I was so overwhelmed with how suddenly things were happening… and all while my husband is out paying bills! My brain felt incapable of processing what was going on. I called Joel and told him to hurry back, then made a few phone calls and sent some texts to update the “phone tree” and let everyone know what was going on. And then I cried. This was not part of the plan!

Plan or not, they prepped us for the C-section. I got a lovely blue cap for my hair, an IV (hey, this one didn’t blow a vein, at least!), and then they took me in for the epidural… yowza. They laid me down on a surgical bed with my arms angled out from my body, like a maternity crucifix, or something equally strange… The epidural let me have the sensations of pressure and movement without feeling pain, which was somewhat like getting dental work done while numbed up—uncomfortable, lots of pressure, thoughts of “Oh my god what are they digging for in there”, etc. And then, after what seemed like forever but was only 12 minutes later, I heard it—the sound of my baby boy, crying loud and clear. The tears started immediately, just knowing he was safe and sound and finally here with us… I was smiling and crying, and then crying while I was smiling, and then laughing and crying… what an overwhelming moment. I knew I would lose it when I heard his voice! Joel was there the whole time, comforting me and taking pictures and video when he could; he was much more involved than I’d expected. He even cut the cord, which I never thought would happen. I was so proud of him for stepping up and being a great support, right from the beginning. I knew he was going to be a great dad, but that he would be such an awesome partner in this adventure was an added blessing.

Part 2: Placental Abruption…

Just after the C-Section, I heard the doctor telling a nurse that it was definitely a placental abruption—a chronic abruption. The next morning, in a haze of pain and meds and lack of sleep, I asked him about it. He confirmed that the placental abruption appeared to have been happening for some time now. The placenta had apparently been tearing away from the uterus little by little; when that happens, it causes bleeding, sharp pains every so often, and even contractions. All of the symptoms, of course, that I’d been bringing up for the past month. Luckily, the placenta was very low in the uterus, and the abruption (tearing away) was taking place low enough to allow blood to slowly drain out rather than building up and causing even more tearing away, which could have lead to a sudden/critical abruption. If that had happened, the majority of the placenta tears away from the uterus and there is a markedly increased chance of hemorrhage and fetal/maternal death. So, all of the bleeding I’d been experiencing since mid-November *did* have a cause, and wasn’t really cervical bleeding or “normal” bleeding, as my doctor had been saying. Ah, vindication! But not really the way I wanted it.

When I got home from the hospital, I did some research about placental abruption. It’s pretty uncommon (less than 1% of births), and even mild/low grade abruptions are highly dangerous for mom and baby— fetal mortality rates are as high as 40%, and maternal mortality can be anywhere from 10-25%. When you “Google” abruptions, you are directed to blogs and comment boards all over the web where women write about losing their babies after an abruption… some of them happening at term (40 weeks) during a regular labor, others happening earlier in pregnancy. Knowing how close I was to losing this baby makes me feel 100 times as blessed to have this child with us today; he could so easily have not survived, and I wouldn’t be listening to him sigh in the bassinet right now. But this also makes me wonder if things could have happened a little differently if my doctor had been more aggressive or proactive when I started having problems with bleeding in mid-November. Instead, he was very laid-back and fairly dismissive of my concerns (“Oh, that’s normal in pregnancy… The bleeding is old blood, probably caused by cervical changes..” etc.). … It really bothers me to think that we were so close to losing this baby. We are just so very lucky to have our son here, healthy and happy and doing well.

Uterine Damage?

Anyway, after explaining how I was unlucky to have had an abruption but lucky to have that specific kind rather than the sudden abruption, the doctor then says “We also found some necrotic uterine tissue, which was strange… I didn’t expect that.” Not what I wanted to hear while laying back in a fog of pain pills and fatigue, trying to process the fact that (a) I have a newborn, (b) I had an abruption that luckily didn’t go bad, and (c) now my doctor is telling me I also had necrotic uterine tissue?? I was too in shock to ask him about it, and he left almost immediately after that anyway. The next day I brought it up, and he said that he excicsed the necrotic tissue and sent it in to Pathology for assessment. Now I’m worried about what this means in terms of future pregnancies… how could this affect my chances of carrying another child in a year or so? *sigh*

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