This pregnancy seemed to be wrought with so many issues, I had worried something like this would happen, call it a mother's intuition. I measured 7 cms big throughout, had numerous infections (shingles, chronic ear infections which I've never had in my life, carpal tunnel, you name it) and preterm labor at 28 weeks followed by bed rest. It's like my immune system just tanked.
I went to my midwife appointment on Tuesday morning at 9:15am, Myles' heartbeat was 153 and he was moving around. It was the week of Thanksgiving and it was the first year I've ever had it at my house and my mom and stepdad came down to spend it with my B (my dear husband), S(my dear daughter), and I. Needless to say, Wednesday and Thursday were busy, and I didn't think too much about Myles. I was actually hoping all the excitement would put me into labor. I'd been anxiously awaiting Thanksgiving since the beginning of the pregnancy, and especially after the preterm labor and bedrest; reaching week 37 on Friday was so important to me. It felt like such a huge accomplishment to make it to term, I was so happy all that week.
It was probably thursday night when B and I sat down to watch a movie that I first thought that it seemed like it had a been a while since I felt him move. I assured myself he was fine, that I was so busy those last two days I just hadn't paid attention. When I woke up that Friday morning, I felt crampy, but nothing too unusual. I've had an 'irritable uterus' throughout the pregnancy and I was used to the uncomfortable BH contractions by now. The only eery part about that night was that for the first time in 6 months I slept for seven hours straight. I usually wake up at least 3 times, if not 5 or 6, so I was a little concerned that I had slept so soundly. I mentioned it to my sister that morning on the phone, and I took the uninterrupted night of sleep as more of a sign that perhaps labor was imminent, and not that something was wrong.
Starting about 1pm on Friday, I noticed my BH contractions were a lot closer than they have been over the last few weeks. I started tracking them and they were five to seven minutes apart. They weren't painful yet, however, so I didn't quite know what to do. I was 37 weeks on that day, so I thought that I should wait until I get a more clear indication that this was real labor. I've had so many false labor contractions before, I didn't want to call in for nothing now that I was finally term. I finally decided to call my midwife at 9pm that night, as the contractions had remained steady, they never strengthened. I mentioned the contractions and that I had been worried I hadn't felt him for a while and she sent me in for a non stress test just to be safe. I wasn't at all concerned about the movements, mostly because I've heard they slow down during labor. For the most part, I went to the hospital fully expecting to be back home that night.
I got to the hospital and immediately became very scared when they didn't find his heartbeat right away. They've never had trouble before. I was in shock and I was alone, I really thought this trip to the hospital would be nothing. It took an hour for someone with an ultrasound to come in but they wouldn't let me look at the screen so I watched the eyes of midwife and nurse. Needless to say, there was not a flicker of hope. B and S walked in right at that moment, and he looked into my eyes and knew; we just hugged and bawled. S was confused, she imagined her brother was 'broken' and suggested we use tape to fix him. We tried our best to explain it to her, but she didn't quite understand. We called my mom who was an hour away at her MIL's house (my stepdad's mom) and she came right away. My husband called the rest of the family as well.
I think one of the weirdest parts about this labor is that when I got there at 9pm, I was 6cm, 90% effaced. I couldn't believe I was over halfway dilated without experiencing any severe pain. Since my painless contractions were obviously doing what they needed to do, I decided to try to sleep and to wait out the labor naturally (no augmentation or amniotomy). I didn't sleep at all that night, I just cried alone in my bed and in the jacuzzi while B and S slept. It was peaceful, and I came to terms with what I must do. By 9am the next morning I made it to 7-8 centimeters still with very little pain. At this point I decided this was a gift and that I was going to continue with my peaceful natural labor and allow for family to arrive before I birthed my little Myles. These were happy moments in hindsight, my daughter took a bath with me in the jacuzzi, and we talked a lot about what was going to happen that day. We also sang and played and she kept my mind off of things. She was anxious for the birth (she has been for 9 months after all) even though she knew the baby wasn't going to get to come home with us.
At 2pm, I was 8-9 centimeters, fully effaced, and his head was 0 station (it had been floating before, my big bag of waters was doing all the dilating). Most of my family had arrived, and most importantly my sister was there to assist. The midwife broke my water and I went directly into transition, my pain was immediate. I got into the tub to do the water birth I had dreamed of. It gave me comfort that I got the birth I wanted even though I wouldn't get my baby. The contractions were right on top of each other, and the pressure was intense. I had my sister and daughter on one side of the tub and B on the other side with the midwife down by my feet. I held their hands through the contractions. B said his arm was sore afterwards. He was such a big help thoughout, getting me cold washcloths for my forehead between contractions and such, I felt like a boxer in between rounds and he was my corner man. S plugged her ears when I yelled, but she also helped with the washcloths, she was pretty funny. There were a few times where I said, 'I can't do this, it hurts too bad', but I did it. I birthed Myles at 3:04pm, yes, one hour later.
When he came out, they put him on my stomach and he was so beautiful and it was suddenly so quiet. He felt alive because he was so warm from my body and the warm water. He was slightly purple in color, especially his lips, but otherwise he was perfect, soft, and precious. I held him in the tub and kissed him and told him I missed him already so, so, much. My sister cried, my husband cut the chord, and my daughter stroked his head and back. S kept splashing water on him trying to get him to wake up. I held him there in the tub for about 10 minutes but eventually had to hand him off so I could get out of the tub to birth the placenta. This is where the problems began.
I got out of the tub and onto the birthing bed, it felt so good to get that baby out and I was ready to get the placenta out too. The midwife told me that placentas were a little slow sometimes with stillborns, so after 20 minutes, we still weren't worried too much that it hadn't come. I'd wait for a contraction I'd push, but all I would get was blood clots. At about 30 minutes, she lost the chord (they hang on to it, not to pull, but to make sure they can get it out in case of an emergency) and you could tell she was beginning to worry. She decided to call in the OB/perinatalogist because after a half an hour they worry about losing too much blood. During this time, my mother was holding Myles and I told the nurses to please find a private room where the rest of the family can see him while I deal with my stubborn placenta. At that point, I was losing more blood, and the midwife kept thinking she felt the placenta and that it was partly in the vagina and partly in the uterus and that it would come right out. She was wrong.
We waited for about 15 minutes on the perinatalogist, so the time was roughly 3:50pm. In the meantime, they gave me an IV and ordered some narcotics. At that point, I had labored completely naturally, and they knew I was going to need something as he was going to have to reach in side my uterus and pull out my placenta. If I had had an epidural, this wouldn't have been such a big deal, but I didn't so it would be as painful as birthing my son. When all was said and done, he had to reach inside my body into my uterus probably 3 or 4 times each time pulling out more pieces of my placenta. They were not coming out easily. They were using the ultrasound to guide them, and each time he reached I screamed as my midwife tried to tell me to breath, it was the most excruciating experience of my entire life. They had to hold me down, and the doctor kept ordering more and more narcotics everytime he had to go back in. He didn't want to do surgery, he wanted to give me time with Myles to grieve, and he kept thinking if he tried one more time we could be done and I could go on with mourning. Unfortunately, he couldn't get all the placenta, it was stuck, and I was done for physically and emotionally. I'm surprised I didn't pass out. They decided to put me under general anesthesia for a D&C. My hemoglobin before surgery was only a 7.6, I had already lost a lot of blood.
In the OR, they put me under general anasthesia and it was a welcome feeling after what I had been through. I found out later they had decided to use Ketamine due to the circumstances, a drug they don't generally use. Yay Ketamine, is all I can say. When they got inside, they just pulled out more pieces of my placenta, it's like it disentegrated. The perinatalogist said he's never seen anything like it (and he sees it all). They found what he described as a fibrous strand of tissue (4 or 5 inches long) that looked like a scar. He cut a piece off, this was also quite the anomaly, and it's at a lab now. All we know is that through all my troubles with this pregnancy that there had been nothing wrong with Myles at all (through the preterm labor and stillbirth) it was the placenta that was bad. We discussed placenta accreta, but we don't know for sure still. The ultrasounds had never given any indications of this, but there is only so much modern technology can do.
By the time surgery was over, my blood pressure dropped to 60/40, and I needed a transfusion as my hemoglobin was barely a 6. I woke up in recovery and began to feel very claustrophobic. I went from this natural childbirth to two IV's and millions of sensors and machines hooked to me. Luckily, they stabilized me and I didn't have to go to the ICU that night, although it took them quite awhile to get my blood pressure back to normal. I got back to my room at about 8pm and it was only the second time I got to see Myles' beautiful little body since I gave birth five hours earlier. So many things happened while I was gone, they did his foot and handprints, took photos, all of the aunts and uncles and grandparents got to see him. My midwife said it was my gift to them; that they got to spend so much time with him and say goodbye. The problems with my placenta had sadly stolen even those moments from me. When I got him back he was cold, but still so perfect. My daughter and I played with him for a while. She wanted him to hold her hand and wanted to swaddle him. She began to realize at this time I think that he wasn't going to wake up. I said goodbye to my baby boy, and tried to get some rest.
There were so many things I wanted to do with my little Myles. It seemed like with my daughter that I had wanted all those milestones to happen so quick that I didn't relish her infancy enough. I wasn't going to make that mistake with him. I was looking forward to cherishing every moment because I knew he would be my last baby. Mostly, I was just excited to fall in love again, just like I did with B and S. And I did fall in love again, as soon as I saw him, but that was it. It's been so hard to come back home, I'm gathering all his stuff up to give it to my best friend who is expecting in January. I just can't look at it. I wish this birth story had a happier ending, I wish this were all a dream, but I am thankful for the months he was in our lives and in my body. Now I wish I had cherished my pregnancy more, it seems like all I did was complain, but I would give anything to be pregnant again right now. I know though, that no matter what, my daughter will always be a big sister and I will always be a mother and B will always be a father to our son Myles, whether he is here with us today or not.
Monday, December 3, 2007
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