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Bye-Bye, Birth Plan: When Child Birth Turns Life-Threatening

I would like to take a minute to dedicate this article to the amazing nurses and hospital staff at St. Luke’s Birthing Center, as well as Dr. Orr and Dr. Pickering of OB GYN Specialists in Cedar Rapids.


My husband and I were married in July of 2010, and we didn’t see any reason to wait to start our family. I always knew that I wanted to have children. I never wanted a huge family, but I knew that I wanted the two or three. And girls, oh did I want girls! Fortunately, it only took around a month for us to conceive. Unfortunately, I soon found out that my body does not like being pregnant. I developed life-threatening conditions with both of my children, which in the end, led to infertility.

Our first daughter, Zoey, was conceived in early August and was due in late April. To put it kindly, this pregnancy was rough. I had terrible morning sickness, started to bloat and swell at an early stage, and at around ten weeks I started to grow to the point of looking at least five months pregnant. I was already in maternity clothes, and people questioned if I was carrying twins. I was uncomfortable. My urine started showing traces of protein, yet the levels weren’t high enough to worry my doctor; it was just something to monitor.

10 weeks pregnant with preeclampsia.

10 weeks pregnant with preeclampsia.

By my 3rd trimester I was more swollen and uncomfortable than I thought I could ever be. I was unrecognizable. I gained over 55 lbs, my ankles were incognito, my nose doubled in size, and my eyes became tiny slits in my face. I was a walking water balloon.

I thought, “If this is pregnancy, I hate it!”

It got so bad that my boss would urge, no, beg me to stop walking around and sit with my feet up. He must have been psychic, because I collapsed at work at around 38 weeks.  My legs went numb and gave out which caused me to fall to my knees. I called my doctor, and they did a 24 hour preeclampsia test. Sure enough I had extremely elevated levels of protein, and they wanted to induce me the next morning.

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5 months pregnant with preeclampsia

I went in around 7:00 am, and the doctor broke my water an hour later. I was in labor for over 17 hours and delivered after pushing for one hour. My body was exhausted and then, to make matters worse, I began having a minor hemorrhage. My uterus would not contract, and my placenta started to shred.  Luckily, my doctor was able to stop the bleeding, and I was able to rest.

Due to the fact that my preeclampsia was not diagnosed until much later in my pregnancy, I ended up getting eclampsia post-delivery. My blood pressure was still elevated, and I was having dizzy spells a week or so after leaving the hospital. I was instructed to take it easy and to prop up my feet until my blood pressure was back to normal. Thankfully, the eclampsia did not last long, and I recovered swiftly.

The complications that I had with my first caused me to be in no hurry to get pregnant again.

It took several years (four to be exact), several sessions of planning with my therapist, and many discussions with my husband until I felt that I was ready. In early February of 2014 we became pregnant with our second child. Once again I had extreme nausea from morning sickness which kept me bedridden for quite some time.

This time I switched to a smaller OB GYN practice (OB GYN Specialists of Cedar Rapids) and to a new physician as well. I was unhappy with the occasional apathetic qualities of my first physician and wanted things done differently. I decided to go to a practice that was attentive, personable, and willing to listen to all of my concerns.

Knowing my history, my new OB GYN did an early screening of preeclampsia that came back negative. They also did a few ultrasounds to check my uterus because of the complications I had with my first pregnancy. I felt more prepared and cared for this time around. However, in the middle of my 2nd trimester I started to show swelling again.

I was concerned. I did not want to go through what I did with my first.

At one of my check-ups there was a small amount of protein in my urine.  Instead of shrugging it off, my physician suggested a new diet plan that would cut out nearly all of my sodium intake. It wasn’t something that I necessarily had to do, but it was in my best interest and worth trying. I was willing to do anything to avoid what I went through before, so I agreed. On top of that, I decided to cut sugar out of my diet as well. It was more than I probably needed to do, but I wanted a healthier pregnancy for myself and for my child.

31 weeks

31 weeks with baby #2. Feeling great and healthy on my diet regimen.

Overall, this pregnancy was reasonably easier. I felt healthier than with my first. My blood pressure was great, I gained a reasonable amount of weight, the protein in my urine went away, and I had ankles! This pregnancy did go beyond the 40 week mark and even past 41 weeks.

At my last check up, with my feelings and wishes in mind, my doctor and I made a birthing plan to break my water. On October 15, 2015, I once again arrived to the birthing center at 7:00 am and the doctor broke my water about a half hour later. We waited…and waited…and waited. I wasn’t experiencing any contractions and was actually quite comfortable; minutes and hours went by.

My body wasn’t going into labor.

My doctor and I agreed that they would begin the laboring process by giving me Pitocin. I hated the experience I had with that drug during my first delivery four years earlier, but I was ready to meet my baby. I have an extremely low tolerance for pain so I requested an epidural before they started the IV of pitocin. I can honestly say that it was the easiest and painless laboring that I have ever experienced. MUCH different than my first. The Pitocin worked fairly quickly, and by 3:30 pm I started to feel pressure. I was fully dilated and ready to deliver. I pushed for about 15 minutes, and before we knew it she was here!

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Munroe and her big sister Zoey

A few minutes after I needed to push again in order to deliver my placenta. For some reason, he kept asking me to push and push some more. I was terribly uncomfortable, and he kept apologizing for the discomfort. I didn’t realize that something was wrong until the nurse came to grab our daughter from me. Everyone assured me that things were fine and that they were just trying to get my placenta out.

I began to feel weak and lightheaded. I remember saying that I felt like passing out.

My once very calm, joking, and sweet physician suddenly went into drill sergeant mode. He was stern and focused as he dictated to everyone where they needed to be. I then saw the hemorrhage kit. My stomach sank, and I instantly thought to myself, “This is it. I’m going to die.” I then faintly remember my husband telling me that he loved me over and over again. I remember asking for my parents. I remember seeing my nurse sitting on top of me pushing up and down on my stomach. I remember praying the Our Father. What I don’t remember is the pain. Thankfully I still had in the epidural so there was no pain. My body was attacking me.

At the time we didn’t know it, but I had developed placenta accreta: a condition where the placenta attaches itself to the uterine wall. While detaching it, I developed a life threatening hemorrhage. My blood pressure dropped all the way to 60/30, I lost over 2.5 liters of blood, and I was minutes away from a cardiac arrest. I had to have an emergency D and C in the room, a blood transfusion, the MET (medical emergency team) was called and were waiting outside my room with a crash cart, and in the end I ended up in surgery to finally stop the bleeding.

What started at 3:30 pm did not end until after midnight. During this time, my birthing team were rock stars. They were a dedicated medical staff and had performed at the top of their game. They were, and forever will be, the group of people that saved my life. I will always be forever grateful for them. I believe that God chose them to be in the hospital and in my room that day.

It is because of them that I am able to sit here and share my story with mothers in the Corridor area.
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2 weeks post delivery

So by now you’re probably thinking, “Why is this crazy woman telling me this? Is she trying to scare me?” No. Nor am I here to tell you what you should or need to do.  Everyone has their own birth plans, pregnancy wishes, and rules to follow.  There’s no “mom shaming” here. I am simply a woman and fellow mother offering advice to those that might face a similar situation. So here is my list to you if you may wish to follow it.

Advice to take from my experience:

  1. Know your doctors.  This is important.  Choose a practice that allows you to meet EVERY doctor in their practice. I can’t imagine going through what I did not knowing my doctor and having that connection prior to delivery.
  2. If you do not feel a connection with your birthing nurse, do NOT feel ashamed to ask for a new one. My nurse stayed with me well past her shift to ensure that I was safe and recovering well. I TRUSTED her. Because of this, we still keep in touch 🙂
  3. Choose a doctor that takes your thoughts and wishes into consideration. Bedside manner is KEY. My doctors and I made a birthing plan and recovery plan together. They asked what I wanted/needed and never forced a decision on me. This is something that I did not have with my first physician.
  4. Prepare an emergency plan in addition to a birth plan.  No one ever told me that this could ever be a possibility. I prepared for the health of my baby, but I didn’t prepare for the health of myself.  I know several moms that deliver at the hospital, at home, with doctors, with midwives.  It is CRUCIAL to have a plan in place of what you want your family, doctors, nurses to do in an emergency situation during pregnancy, labor, and/or delivery. As moms, we are frightened to think about the worst but by talking and researching we can be prepared.
  5. Know the facts.

What Are the Signs and Symptoms of Preeclampsia?                   

In addition to swelling, protein in the urine, and high blood  pressurepreeclampsia symptoms can include:

  • Rapid weight gain caused by a significant increase in bodily fluid
  • Abdominal pain
  • Severe headaches
  • Change in reflexes
  • Reduced urine or no urine output
  • Dizziness
  • Excessive vomiting and nausea
  • Vision changes

Drs. Mark and Donna Santillan at the UIHC specialize in this area. Listen to Mark Santillan’s latest interview on Iowa Public Radio and read about their latest advances in research.

 

Unfortunately placenta accreta goes undetected, but is more common in women who have experienced a C-Section. More information is available from the American Pregnancy Association.


 

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2 Responses to Bye-Bye, Birth Plan: When Child Birth Turns Life-Threatening

  1. Jessie Hanks August 29, 2016 at 7:41 am #

    I can relate to the absent birth plan. A month before I was due, I lost 6 lbs (I had only gained 12) and ended up in the hospital. I showed very little protein in my urine, so the doctors and nurses couldn’t figure out what was wrong with me. I was so sick and week that I couldn’t even sit up in bed by myself. After a whole day in the hospital and blood draws every hour, my room filled with about 15 medical staff. Apparently they were going to send me to a large hospital in St Louis ( I lived about 40 min away) and they decided I wouldn’t make it. I had 20 minutes, and I would be knocked out and under the knife. At that point, they had 2 minutes to get my baby out. I was diagnosed with “Sudden Onset Class I HELLP Syndrome”. Long story short, my baby was keeping my body alive for about a week before it became too much and they started losing me. A few of my organs began shutting down, and the only cure for HELLP Syndrome is delivery of the baby. I wasn’t conscious during the birth.. I never got to hear that first cry.. and I didn’t even get to see the baby until the next day, and at that point I had 4 IV lines coming out of me and I could barely move. I had to stay in a labor and delivery room for a week in case I took a turn for the worse… it was an awful experience. I know people think “That could never happen to me.. that’s too rare”. But, you should always be prepared.

    • Mary Swanson
      Mary Swanson August 29, 2016 at 7:54 am #

      Oh my goodness Jessie, I can only imagine! I’m so glad that you have recovered and are able to share your story as well. Thank you!

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