Wednesday, June 26, 2019

Emmy's Birth Story and My Not-Death Story

This is Emmy's story of the night she was born, but it's also my story of the night I didn't die. I struggle with that phrasing - too dramatic? - but it is accurate to how I feel. And, technically, accurate to what happened too. I am still processing that night and learning how to incorporate it into my life story. Just sitting down to actually write the words feels monumental. I hope anyone who reads this will be kind and understand that this is a step in my process and it is for me. As such, it's super long. 

[Also, I should probably put a warning here that I didn't hold back on gory details and birth terms. Also, if you have experienced something similar, this might be triggering for you.]




This was the one time when I met Emmy for a moment after she was born and before the crazy started.

Emmy was born on Thursday December 13th, 2018, at 9:00 pm, one week past her due date. At my doctor's appointment that morning, I asked to have my membranes stripped (for the 2nd time), but I was also informed that my blood pressure had gone up again. I wasn't terribly concerned because that's happened with each of my pregnancies (and I was always fine) but my midwife sent me over to the hospital to be monitored and checked for pre-eclampsia. Everything was fine but since I was dilated to about a 4 with some good strong contractions, they gave me the option of being admitted. The contractions weren't very consistent so I decided I wanted to go home and labor there (if this was really labor). (Spoiler: It was.)

We drove to McDonald's to meet up with the kids and my wonderful mother-in-law (who had picked up the kids from school on very short notice, bless her) for dinner. While we were there, my contractions got closer together and after about 20 minutes, I was uncomfortable enough to ask Tim to take me home. As soon as we got home, my contractions went from every 5 ish minutes to every 2 minutes or less. I went straight into active labor and it was intense! I could feel the baby moving down and I actually felt a distinct pop which I realized later was my cervix dilating/losing my mucus plug. At first I tried to tell Tim that we should wait a little while and that it might not be the real thing (denial, much?), but we were back in the car headed to the hospital less than 30 minutes after getting home.

I had hoped to have a natural birth again but that jump into active labor caught me off guard and I couldn't find my calm to ride out the waves. Soon after getting to the hospital, I decided to get an epidural. As it turned out (another spoiler), it was the best decision I've ever made. It took a while to get it in because of how close together my contractions were, but once it took effect, I was able to breathe and calm down and get my bearings. My doula and dearest friend Natalie arrived, my mom arrived, Tim submitted his final project for the semester, we called the girls to say goodnight. We were still trying to wrap our heads around the fact that our baby was really about to be born!

The next time my midwife checked me, I was at an 8, so she broke my water to help things move along. There was meconium in it, which was a little scary, but the baby's heart rate was holding steady. Around 8:45 pm the midwife checked me and I was at a 10! It was time! On the next contraction, I pushed three or four times, waited a sec, and pushed her out the next contraction! It was maybe 12 minutes of pushing total - I was so surprised! The cord was wrapped tightly around Emmy's neck so my midwife had me stop pushing as soon as her head was free and it took a sec to get it off. I got to hold my beautiful, slimy baby for just a minute before they whisked her over to the respiratory therapist there in the room to suction her out. It took a few minutes but she started crying and was totally fine. She had lots of dark hair that had a lovely greenish meconium tint to it, but she was completely healthy. I laughed/cried in amazement as I tried to let it sink in that she was really there and I was really done!

Or so I thought. 

Once the baby was taken care of, we turned our attention to the delivery of the placenta. The problem was, it did not want to come out. My midwife worked with it and worked with it but it would not deliver for probably close to an hour. During that time, I had two great gushes of blood (one of which directly caught my poor midwife). Finally, FINALLY, the placenta came out and the midwife was able to stitch and clean me up (small 1st degree tear in the same place I tore with my other deliveries). The placenta looked intact so we thought that was the end of it. (Spoiler: It was not.)

Shortly after that, I had a rush of lightheadedness. I let everyone know that I might pass out and they thought it was because my legs were finally down on the bed instead of up in the stirrups. They gave me an oxygen mask and I tried to breathe and stay calm. Then the pain started. On the left side, where the epidural had been the slowest to reach, I had a ton of pain. I gave it an 8 on the pain scale, and I'm generally pretty conservative about my pain scale scores. I thought maybe it was postpartum contractions, but it didn't go away and only got worse. They gave me pain meds and it only barely took the edge off. This was our first clue something was wrong. 

In the meantime, I started to feel worse in general. I had waves of lightheadedness, I was really cold, and I needed the oxygen mask. I felt terrible enough that I decided not to try to hold Emmy, and once she started to get hungry, I knew I wasn't up for trying to breastfeed. But she is the champion baby who took a bottle and drank all 30 mL of the substitute milk Tim got to feed her. (I want it noted that I am incredibly grateful for that milk and the nurses who took care of her that first night. I knew she was fine, and that helped me through the rest.)

I was also still bleeding, a lot. I couldn't see or feel it, thanks to the epidural that was still working, so I never realized how much until after everything happened. Apparently, my bleeding slowed down to a normal amount after the placenta delivered, but then started up again in waves. I was losing tons of blood. At one point, the nurses tried to draw blood from my arm and could literally squeeze only drops out. I needed a transfusion, but my midwife had left to go to another delivery (earlier when I seemed stable, not when things got dicey) so without someone in charge, things didn't happen very quickly. 

The nurses called in the backup doctor, but that took time, and even once I started receiving a transfusion (before he got there), I still felt horrible. Tim asked the nurses how long it would take for the transfusion to help and they said, "Well, she's losing blood about as fast as we can get it in her, so, not yet." 

The timeline of events is very fuzzy in my memory, because while in my head I was conscious and awake, in reality I became less and less cognizant of what was happening as I lost more and more blood. I was very focused on breathing through the pain, keeping calm, and using my voice to let people know what I was feeling and what I needed. I never really believed my life was in danger but I recognized that things were not going well. At one point, I told Tim that I didn't want to die, not because I thought it was a real possibility, but more as a "just so we're clear..." statement. Tim assured me I wouldn't die, but when he looked up and none of the nurses would make eye contact with him, he realized that it might have been a lie and that my life was in very real danger. 

I was fading in and out and trying to sleep (it was around 2 am, after all) when the backup doctor arrived along with what seemed to me to be a ton of people. Everything got loud and crazy all at once. The doctor started asking me questions to assess my coherence. The on-call anesthesiologist placed another IV (I believe I was up to four at that point, two in each arm) to get another bag of blood going but he couldn't take the time to be gentle and I ended up yelling, "What are you doing???" at him. I had taken off my glasses at some point so I couldn't really see anyone and couldn't really open my eyes anyway, so it was all just noise and chaos to me.

With the doctor there, we finally had a guess what was wrong - I had an inverted uterus, which means that my uterus had turned inside out. (Didn't know that could happen, right??) As he told Tim, he couldn't tell for sure from the initial physical assessment if that was the problem, and I would need to go to the hospital's OR to find out for sure. If he could, he'd try to correct the inversion but if they couldn't fix it quickly, I'd need an emergency hysterectomy. "Our focus right now is on saving her life," he said. 

When Tim came over to tell me what was happening, I realized he was crying. "Are you okay?" I asked, because I still didn't fully understand that I was the one not okay. He told me they were taking me to the OR. I asked if he could come with me, and he said no. I asked if Natalie (who was still there, bless her forever) could come with me, and he said no. "So I have to go alone?" I asked. He couldn't answer. 

The nurses and anesthesiologist rushed me through the hospital to the OR. (Side note: I was awake enough to think it felt like a movie to be wheeled through the hospital like that, so when we got the the OR doors and they slowed down to maneuver the bed in, I quipped, "Well this is very dramatic." No one appreciated that I still had a sense of humor but they should have!) They got me moved to the OR table and started prepping. My arms had to be out to the sides and my feet were up in candy cane stirrups. My throat was completely dry after hours of oxygen masks and I begged for some water but was told no. I was also in so much pain that I begged to be put under completely and was told no. (My epidural had gotten a boost but I could still feel the one spot that had worn off.) I was lying so flat that I couldn't breathe very well, but the oxygen mask they put on me made it even harder to breathe and I started to panic. (Thankfully they switched to a different type of mask.) 

It was 3:00 am, six hours after Emmy was born. I found out later from my medical records that they guessed I had already lost more than three liters (3,000 mL) of blood at that point (blood loss for a normal vaginal delivery is around 500 mL, blood loss for a c-section is around 1,000 mL). 

The doctor had pulled another on-call doctor from going into a c-section to come to the OR, and it turned out to be a very, very good thing. This second doctor had smaller hands (apparently) so he was able to manually reach in and push my uterus back into place. 

This was the worst moment for me. The pain was excruciating. Having your uterus pushed back into place with one hand on the inside and one hand on the outside is even more painful than it sounds. My one comfort was the nurse who held my hand and kept patting my arm, and I will be forever grateful to her for doing that. I couldn't find the deep breathing calm that had helped me for hours, and my attempts at low labor sounds turned into panicked "This hurts this hurts this hurts" cries. I couldn't thrash, I couldn't move, and I couldn't manage the pain. 

I finally turned inward and cried out to my Heavenly Father in my mind, "I CANNOT do this. You HAVE to help me." And then I "cast my mind" toward Jesus and felt, for just a moment, a kinship. I don't know how else to describe it. It was just this wordless feeling that we were the only two people in the world to know exactly what this pain felt like. And though I didn't put it into words like this until later, it was the knowledge that he had suffered that pain alone so that I didn't have to. 

Immediately after that, though it was gradual, my panic was replaced with peace. It was not the assurance that I would be okay, but it was the reassurance that I was not alone. And I saw, in my mind's eye, that the room was full of people in white, and I knew that people who loved me on the other side of the veil were with me too. The pain did not go away but my panic did, so much that I was able to breathe deeply and focus myself to get through it.  

All of that happened within just a few minutes, although it felt much much longer. The doctor was able to get my uterus back into place, remove all the placenta pieces left in there, and re-stitch up my tear. I knew the minute my uterus was restored because the excruciating pain stopped immediately.

I was stable, but there was quite a bit of care left. I received shots in both arms and they did a blood draw from my earlobe (not my finger because it wouldn't have been accurate). With each new thing, someone warned me that it might hurt and each time I just took a deep breath and said, "Okay, I'm ready." And compared to the pain I had been in, it was no problem. I started asking for information and felt (unsurprisingly) more awake than I had been for hours. My very first thought once it was over was to send someone to tell Tim I was okay. They told me they would but not yet, so about five-ish minutes later I asked again. I wanted to make sure he knew I was alright.

They moved me to a post-op recovery room for an hour. (I asked again if Tim could be there with me, and again they said no. Jeesh.) I was finally coherent enough to ask questions and chat with the nurses, even though I was completely exhausted. (Funny side note: At one point I asked what time it was and when they told me 4:30 am, I said, "Well no wonder I'm so tired!" Still didn't connect that I was tired because I'd just lost a ton of blood.) I ended up receiving a total of 4 units of blood and 1 or 2 units of plasma, plus bags and bags of pitocin (like 7 altogether). The doctors said no food or liquids until the morning, but my throat was completely parched. I needed a drink so badly, so one of the nurses got permission to give me water on a little sponge. I drank a whole cup of water that way, with that sweet nurse sponging it to me one tiny bit at a time. I'm still humbled to remember her service to me - it meant more than she will probably ever know.

Finally, FINALLY, they wheeled me back to my room, which the housecleaning staff should have won an award for cleaning what appeared to be a murder scene back to a pristine hospital room. I was so glad to see Tim, though not as glad as he was to see me since he had a much better grasp on the situation than I did. Natalie stayed with him and kept him from falling apart while I was gone, something we can never thank her enough for. She sponged me another cup of water while the nurses got me set up (one of my IVs came out!), and I finally got to sleep for a little bit before the shift change in the morning. 

There is one last piece of the story: I still hadn't held Emmy and was extremely anxious to do so. After I got to eat breakfast (almost 5 hours post OR), I tried to sleep again but I couldn't relax and settle enough to do it. So around 8:30 or so, I asked my nurse to bring in Emmy so I could finally meet her. 

When the nurse brought her in, she was so quiet I thought she was asleep, but in fact, she'd just had gunk (including more meconium) pumped out of her stomach and was wide awake but totally chill. The nurse handed her to me, I got her undressed for skin-to-skin, held her up to my chest, and just wept. I had waited 12 hours to hold my precious baby and I will never, ever forget that moment when I finally did. The nurse got us settled and then gave us some privacy. I snuggled Emmy and marveled at her, and she quickly fell asleep against me. Before long, I was struggling to stay awake myself and called the nurse to take her again. After that, I was finally able to sleep.

The process of recovering from that experience emotionally is ongoing, for both me and Tim, but I am fully recovered physically. I can even have more babies if I want, though we're not ready to face that yet. If you are still reading, bless you. This was very much more for me than for anyone else. I am still grappling with understanding what happened and have researched and learned a ton about uterine inversion, if anyone wants to know more. 

I am also still tremendously and eternally grateful to be alive, grateful for blood and plasma donors, grateful for competent doctors and nurses, and grateful for all the people who helped us out during my extended recovery. Grateful for my Savior, who walked through that experience with me. Grateful for eternal families on both sides of the veil. 

And grateful for my body. I never felt like my life was in danger because my body carried me through that experience. It sounds odd but I really felt like we were a team, my body and I. Even when I was not totally conscious, my body stepped up and was strong for me. She was amazing, IS amazing, and I am so grateful.