*Some of this is repeated from my post Pregnancy Scare. It has been edited and added to, though! This is still a work in progress, as I continue to remember things that I forgot in my drug induced haze.
On the night of Sunday, March 11, Dad and I were lying in bed. We had been talking about making a plan for when I went into labor, like who would take care of Whiskey and when we would call our families. We had been lying there watching my stomach roll from your movements. I got up to use the bathroom once more before going to sleep. I was not prepared for what happened next. I had had ZERO complications, no pain, absolutely no indication that anything was going on. But when I used the bathroom that night, the toilet was full of bright red blood. It went from zero to sixty in a matter of seconds. I went from no bleeding to bleeding so heavily with so many large clots that I was leaving puddles on the floor trying to get to my phone to call the doctor.
I called the emergency number for the doctor’s office at 10:29 pm and the answering service said I’d have a call back within 20 minutes. That phone call lasted 2 minutes. I still had my phone in my hand when Dr. Stephenson called back 10:33. He instructed me to get to the hospital as soon as possible. He said don’t pack a bag, do nothing but get in the car and get here. I was so scared that I couldn’t stop shivering, even once I got settled in my room at the hospital. Dad was scared, too, but he was very calm, which made me feel so much better. We each packed a quick bag, got Whiskey straight, and got in the truck. It was actually just beginning to snow when we pulled out of the driveway. The only thing really keeping me calm was the fact that you had been so active all night and were still moving around some. I knew that if we could just get there quickly, they could get you out if they needed to.
We got checked in and back to triage. Dr. Stephenson was there almost as soon as I got in bed. When they realized the amount of bleeding I was having, things started happening very quickly. I remember hearing Dr. Stephenson in the hall before he came in the room for the first time saying “If she’s bleeding that bad, we need to get a type and screen, CBC, get an IV running, everything.” Suddenly, there was the doctor, the care partner, two nurses, and the charge nurse.
Luckily, they found a strong heartbeat pretty quickly, which obviously eased some fears. Dr. Stephenson did an exam, but couldn’t see or tell much because of the amount of blood and large clots. He said that he did not believe I was dilated at all. He then did a quick ultrasound. Everything looked good there and he said that my fluid levels looked normal. He, at first, was concerned about placenta previa, but then he found my placenta high in the back. It was actually a large blood clot sitting on top of my cervix.
While they were starting an IV and drawing labs, I started feeling very light headed and seeing spots. They immediately turned me on my side and started me on full oxygen. After a few minutes, I felt started feeling better. The Amnisure that they collected during my exam was positive, however blood can cause a false positive, and there was definitely plenty of that.
I was transferred to labor and delivery, where I stayed hooked up to fetal heart rate and contraction monitors. They also measured my urine output and monitored it for clots. My pads were weighed regularly to determine how much blood I was losing.
Dr. Stephenson said that he expected me to stay at the hospital until I deliver. He said he was 80-95% sure I would have a baby within the week, most likely within the next 24-48 hours, but if not, they wanted to try to keep me pregnant until 37 weeks. That would mean in the hospital on bed rest for 4 weeks.
At midnight, I was given the first round of steroid shots to boost fetal lung maturity. Those shots HURT! I starting having contractions overnight. By 8:30 am, they were 2-3 minutes apart lasting for about 1 minute each. Later, they had spaced back out to about 5 minutes apart. Dr. Stephenson said around 1000 that he did not believe it was truly labor, but more just the blood irritating my uterus making it contract. He said again that he expected me to be here until I deliver. The first goal was to stay pregnant for the next 36 hours in order to be considered “steroid complete.” I had to get two shots, 24 hours apart, and then make it another 24 hours after the last shot for the steroids to work their magic on you.
Throughout the day, the bleeding slowed significantly and eventually the contractions stopped. I was on IV antibiotics every 6 hours. I got my next shot that night. Tuesday morning, the bleeding was really just when I stood or used the bathroom. I was moved to 1 West instead of labor and delivery. 1 West meant that I didn’t have to be hooked to monitors 24/7. I was disconnected from the heart rate monitors and from my IV.
Dr. Taft stopped by later in the evening and gave good news. He said he didn’t see any reason why I should have to stay until 37 weeks. He said if things continue to improve, he could foresee me going home at 34 weeks on bed rest, possibly even phasing back to normal! 34 weeks would be a pretty major milestone.
Dr. Whitley came by on Wednesday and confirmed what Dr. Taft said. She said she believes it was a partial abruption, possibly a chronic abruption, which happens slowly over time. If I continue with decreasing bleeding and no cramping/contractions, I could go home on bed rest at 34 weeks. If I stayed the same, with at least weekly office visits, and there were no changes at 36 weeks, I could potentially go back to 100% and just wait for him to come in his own. Which would obviously be AMAZING! And is way more than we were expecting several days ago! Everyone kept asking if I had had any pain, and I thought I hadn’t. Thinking back now though, for several weeks I had been having a dull, almost cramp like achy pain in my back right around my bottom rib on my right side, which is exactly where my placenta was located. At my last appointment, the midwife I saw said it was most likely just you pushing against me or possibly my gallbladder. Now, I believe it was the abruption happening.
On Wednesday night, I had an ultrasound. You looked good, and I had normal fluid levels, which is a pretty good indication that my water had, in fact, not broken. You were measuring 2406 grams, or 5 pounds 5 ounces. The ultrasound tech was one of the girls that trained Aunt Heather when she was in school. She wasn’t supposed to tell us anything or show us your picture, but since she knew Aunt Heather, she let us peek at you and told us that you were looking good! Frieda Tucker, one of the midwives, stopped by Thursday morning. She said much the same as Dr. Whitley and said that things are looking good. So, I was to just hang out, continue to take it easy, and hope for continued improvements.
I ended up being discharged on Saturday, March 17 with orders to take it easy for at least a week and we would see how things went. My bleeding had mostly stopped and everything looked normal with me and baby. All I wanted to do when we got home was take a shower in my own shower and sleep in my own bed. So that’s exactly what I did! On Sunday, we just had a lazy day. On Monday, March 19, dad went back to work. While we were in the hospital, several packages had been delivered with things that I had ordered for you that we hadn’t gotten at your baby shower the weekend before. I spent the morning trying to get all of that put away and finish getting things ready for you to come home. After lunch, I started having increased bleeding. I laid down and took nap to see if maybe I had just been doing too much. When I woke up, I was still bleeding. I called my doctor’s office, who scheduled a time for me to be seen in the morning since it was already late in the afternoon. That night, I woke up in the middle of the night with a pounding headache. I tried to go back to sleep, but couldn’t. I eventually took some of my prescription migraine medication, which still did nothing.
At that point, with how I was feeling, the increased bleeding, and the swelling (this was the first time in my whole pregnancy that I couldn’t wear my wedding rings because my fingers were too swollen), I was almost certain that it was my blood pressure. I knew for certain that if that was the case, I was going to be sent back to the hospital, and I was pretty sure they would send me back regardless. Sure enough, when I got to the office, my blood pressure was elevated (150/98). Dr. Avery came in the room and said “Well, you just bought yourself a one way ticket back to the hospital.” He wanted an ultrasound done before I went back over, though. Dad had gone to work, so I called him while I was waiting for the ultrasound and he got there just before they called me back. In the ultrasound, they saw that there was still a large clot above my cervix and in the uterine cavity. You were measuring around 5 pounds, though!
Dad and I went home and finished packing a bag. We got to the hospital and were admitted around 1245. Dr. Whitley met us in triage. She came in the room singing “guess who’s back, back again, shady’s back…” She planned to admit me to the antepartum unit but once she saw my blood pressures, which were now elevated in the “severe” range, she sent me to L&D. I got there around 1345. Dad went to get lunch, and brought back Tropical Smoothie. I had such a bad headache still and once I started eating the sandwich, I got so nauseous. I ended up getting sick and had to be given Zofran.
I started a 24 hour urine collection and stayed in L&D until 1300 on 3/21, when I was sent to 1West. The 24 hour urine showed elevated protein and my blood pressure continued to be elevated, confirming preeclampsia. Around 2000, when the nurse was checking my vitals, my BP was 161/83. She had me lay in the dark and relax for 15 minutes and checked it again, at which point it was 170/91. She then checked it manually and got 152/90. She paged Dr. Gay since the automated ones had been so high, and he told her to check it every 3 hours manually. Dad went home to try and get some sleep since he was planning to go to work the next day.
Dr. Gay ended up coming in around 2230. He said that he had been worried and decided it was safer for him to come lay eyes on me and make sure I was okay. He checked me and found that I was still closed, 20% effaced. He stayed in my room for quite a while checking my BP both with the automatic one and manually. They were 183/100, 163/96, and manually 176/99, and 172/88. Since they were staying in the severe range even manually now, and my hematocrit has been steadily dropping over the past few days, he felt it was time to induce me.
I called dad at home and told him he needed to get back. He was dead asleep when I called and said that he had to lay there for a minute to make sure he hadn’t dreamed it. When he got back he said that he felt like he was having a heart attack! He said they better not check his blood pressure because it was probably higher than mine had ever been!
The nurse came in and started putting everything on my bed to move me to L&D. Once there, I was started on Magnesium and Pitocin at 0017. The magnesium was to control my blood pressure. The nurse told me that it would make me feel like I had the flu. It definitely did. I felt horrible! Eventually, I had a headache and body aches and I was sweating even though dad was about to freeze.
All I was allowed to have was ice chips. I was eating them like crazy! The contractions were getting stronger and stronger. I was having some mild back labor also. None of it was terrible though! I just felt like I couldn’t get comfortable.
Dr. Gay came to check me at 0840. I was 4 cm dilated, 90% effaced, and -1. He manually removed the clot above my cervix. He then said that he was holding baby’s head in his hand! It was extremely painful! He told me that when he came back next time he was going to break my water. When he left, the nurse asked if I wanted an epidural before he came back! I said “Yes please!” At 1130, Dr. O’Rourke, the anesthesiologist, came in to start my epidural. I got the first “test” dose of medicine at 1141, and the second full dose at 1144. Shortly after, at 1150, Dr. Gay came in to check me. I was 5cm, 90%, and -1. He said he was hoping that I would be a little farther along.
Dad decided then to go to the cafeteria to get lunch for himself since he did not eat breakfast. While he was gone, a little after 1230, Dr. Gay came back in. He said that he had been sitting at the nurse’s station watching my monitors. At 1216, there had been a subtle decrease in beat to beat reactivity on the fetal heart rate monitor. At 1230 and 1233, the monitor showed decelerations. He told me that he had been consulting with Dr. Eden, a high risk maternal fetal specialist, and that they agreed an emergency cesarean was necessary at that point.
He was obviously very concerned because things started happening very quickly to get me prepped. I called at dad at 1242 to tell him to get back and he didn’t answer. I was starting to panic when he walked in the door. He was in shock when he came in to see all of the people and commotion in my room.
The anesthesiologist evaluated me and determined that he could use my epidural to give me the rest of the medicine needed for the C-section. He said that what he was about to give me was 10x times stronger than my epidural. He gave me one dose in my room. We were then waiting for the nurses to print consent forms. Dr. Gay came back in to see what the holdup was. When he found out we were waiting on forms, he looked at me and said “Are you okay with me doing a C-section on you right now?” I said yes and he said “Ok, good enough, we don’t have time for anything else, let’s roll.” They immediately started pushing me out the door. That was at 1250.
I got the second dose of medicine as we were rolling down the hallway. We got in the OR and they moved me to the operating table. There were so many people rushing around trying to get me and the room prepped. Dr. Gay made the first incision before the drapes were even hung. There was a nurse on the phone yelling at someone because the NICU team hadn’t arrived. She was saying “There is a 34 weeker being born RIGHT NOW and no one is here yet! Someone needs to get here NOW!” It was only a minute later that they came running in. Dad was still in L&D getting his scrubs on. He said he just heard people yelling that experienced nurses were needed in OR 2 STAT.
I started to be sick while Dr. Gay was operating. I think it was from nerves mostly. At that point everything was such a blur. I remember hearing them saying that my water had broken. There was an anesthesiologist resident standing by my head. She kept talking to me, trying to keep me calm. She said “Do you hear that sound?! That’s your baby crying!” Then I heard a nurse saying “He’s peeing!” You were born almost 6 weeks early at 1259 pm on March 22, 2018, only 9 minutes after I left my room. Dr. Gay held you up very quickly over the drapes. I heard someone saying “Someone needs to go get dad.” I remember thinking that they better have a chair ready for him or else he was going to be on the floor. I may have told someone that, but I can’t remember for sure! Dad said that a nurse came to get him and told him not to worry with the rest of his OR outfit, just to come on because the baby was out already! He came in and saw you for a minute before they took you away. Dad said that when he walked in, the first thing he saw was the doctor pick up something round and purple and shove it back inside me!
He came and sat by my head. I was still getting sick and had to be put on oxygen, but I felt so much better with him there with me. At some point, Dr. Gay asked about your name. When I told him, he said “Well, no one will ever mistake you guys as being from the north, will they!?” The nurses were commenting on how I didn’t have any stretch marks and my stomach already looked flat like I was never even pregnant. Even though you were so early and a tiny little thing, Dr. Gay described you as “vigorous” when you were born! That makes sense, because that’s how you were the whole time you were inside me! You weighed 5 pounds, 7.5 ounces and were 18.5 inches long. Your APGAR scores were 9 and 9. You had some difficulty breathing right at first, so they started you on an infant CPAP. However, the NICU nurses said you pulled it off and were breathing fine without it, so they didn’t put it back on you! You only had it on for less than 12 hours. Dad went to the NICU to see you while I went to recovery. He came back and showed me pictures and said that you were doing great! Your doctor there was Dr. Peeden. It killed me not to be able to see you for the first 24 hours of your life, but I was too sick to be able to go. My blood pressure was up to 200 something over 190 and they were worried about me having a stroke. My doctors had even consulted with a cardiologist. You were not alone though! Dad went down often, and my parents, my sister, Aunt Carol, Dad’s parents, and several others all went to see you while I couldn’t. Every time a nurse or doctor came in to check me and asked how I was, the only thing I told them was that I still hadn’t seen my baby. I was at least able to call and talk to your nurse and hear for myself that you were okay.
Finally, on Friday, 3/23, my blood pressure had gone down enough that I was allowed to get out of bed. They told me that if I could take a shower with no problems, I would be allowed to go see you. I was determined. I made it through the shower and removing my bandages. When I got out, they told me I was being moved from L&D to 1West. And after I got there, I would be free to go see you. As soon as we got to the room, the nurse there checked me really quickly. Then dad pushed me in my wheelchair down to the NICU.
You were so tiny lying in your incubator. I was so unsure of what to do, or what I was even allowed to do. The nurse asked if I would like to hold you. Of course I said yes! We had one of the best daytime nurses starting Saturday. Her name was Jamie and she was truly amazing. She helped us and taught us so much. Our night nurse for most of our stay was Hayes Bryant. I actually knew her from high school! I was able to try and breastfeed you on Friday. I was warned that you may not be able to because of your size, but you latched on perfectly the first time. The nurses and lactation consultants were amazed. You were still getting IV fluids so we were able to take our time to learn and not worry about you not being fed. We had to go back and forth between the NICU and my room for me to be monitored and get my medications, but we always made sure to be back to feed you every three hours.
On Sunday, 3/25, a lot happened! You were weaned off of IV fluids. We had to check your glucose before every feeding to make sure it was staying where it needed to. Your fluids were cut in half and then stopped all together. The same day, your bilirubin had become elevated (12.2) so you were started on double phototherapy. Your bilirubin was down to 7.7 by the next morning and you were taken off of phototherapy on 3/26. Your IV was removed that day and you were moved to a big boy bassinet instead of the incubator, too!
At one point, they mentioned the possibility of starting a feeding tube to make sure you were getting enough because you were losing too much weight. You were down to 4 pounds and 13 ounces, which meant you had lost 10 ounces since birth. I think that was the hardest day for me. I already felt like I had failed with you having to be born so early, and now I was failing at giving you enough food, too. Thankfully, it never came to that. That night, when they weighed you, you hadn’t lost anything. By the next night, you had started gaining. They said you had to show that you were gaining for at least two nights before they would consider sending us home. It was almost like you heard them every time they said that something was wrong, and you took it as a challenge. Every day they mentioned a problem, you fixed it yourself by the next day. You were so incredibly strong and continually amazed everyone taking care of you.
On 3/27, you were moved to an isolation room to free up space for others. Our nurse there was Mrs. Edie. She had been a NICU nurse for a very long time, and she taught us a lot as well. The isolation room was nice because we got an actual room to ourselves instead of just a pod with a curtain. It was big and had two comfortable chairs with footrests instead of just one and a stool! You got orders for a 30mL minimum at each feeding because they were worried that you hadn’t taken in very much or had very many wet diapers the night before, so we would nurse for 20 minutes then give you a bottle of breast milk. You also had gotten orders to have 2 bottles of EnfaCare, a high calorie preemie formula, a day. Dr. Peeden and the residents were concerned that you were getting dehydrated. We were so hoping to be able to go home on 3/28, but they were still concerned about you being dehydrated. They ran a Complete Metabolic Panel on you and your Sodium was on the higher end of normal. One of the residents came and spoke to us and we decided that it was better to be safe and keep you there one more day to be sure. You did have your car seat test and hearing test on 3/28, though, and passed both perfectly, which meant we were one step closer to going home.
On 3/29, you were moved back to a regular NICU pod. Dad had just left to go get us lunch when they came in and said we were going home! I called him and told him to forget lunch and come back! It took a little while to get all of your orders put in and your follow up visits scheduled, but we were finally discharged that afternoon. It took two nurses rolling up blankets and putting them around you to get you secure in your car seat because you were so tiny! It was such a relief to have you home with us, but it was terrifying at the same time. We no longer had the safety net of nurses watching out for us.
“I feared because it was too early, I cried because it was too soon, yet I underestimated the strength in one as small as you.” That quote is perfect, but I couldn’t even think it without tearing up. I still can’t. We were prepared for a long NICU stay and a whole list of possible problems, yet you proved everyone wrong. You continue to amaze us every day with your strength and determination. Mom and Dad love you, baby boy.