I was pretty thrilled to be pregnant so quickly after I had an early miscarriage over the summer. I knew I wanted to give birth at home. I figured I was as low-risk at that point in my life as I was ever going to be – medically unremarkable, slightly overweight, but active and eating good whole foods. My mother went post dates and had cesarean births with me and my sister; I always sensed she felt like it was a loss or a shortcoming and I didn’t want that for my birth experience. I didn’t want unnecessary medical interventions. My partner and I had been living in our cozy 105 year old house for two years and I imagined other babies had been born there, ours should be too. We found some midwives we really liked and started having our appointments with them instead of the OBGYN.
All was really lovely and uneventful until I was about 30 weeks along, when I started feeling anxiety I could not explain. I thought I was getting nervous about going through labor. I suddenly worried that I would lose my baby, second guessing my decision to birth at home. I was getting a couple headaches a week now which I wrote off as work-related. I was annoyed at 31 weeks when at a dental cleaning the hygienist commented on my blood pressure (which was typically around 90/60) being slightly elevated. Same thing a few days later with the chiropractor, who wagged her finger at me and told me if I didn’t eat more protein I would develop preeclampsia and my vision of a beautiful home birth would go out the window. My midwives monitored me calmly but I think they were worried as well. One night I experienced what felt like the worst heartburn in the world. I googled preeclampsia and found HELLP syndrome and read the description of epigastric pain, but I was in complete denial and wrote off the horrible feeling under my sternum as a pulled muscle. Another night I left work early with a headache so intense that I vomited violently later in the evening. Swelling in my legs and feet did not go down overnight. It was during this period of time (I realized after DD was born) that I had the only two dreams I remember from my pregnancy, and both of them involved struggling against someone or something that intended harm toward me and/or my baby. In the first I was standing in a hallway wrestling an intangible black force that seemed like a cloud with many arms; in the second I was kidnapped, mugged and left stranded in the middle of a desert with no way to get home, despite having pleaded with my attackers that I was pregnant.
Thinking about this string of events in hindsight, the pattern seems so clear, but I was so focused on what I wanted birth to be and who I thought should be involved that I put the thought of a major complication like preeclampsia right out of mind. I was young and healthy and could do anything. I simply couldn't develop preeclampsia. Not me!
At my 33 week appointment my blood pressure had shot up to 150/100. My midwives did not think I looked good – my neck and face were now swollen - and they advised me to go to the hospital that night to get a blood panel done. We went home, ate dinner, and headed to the closest hospital, about a five minute drive from our house. I was monitored for a while as we waited for the results of the panel, and my blood pressure was now completely normal. I fully expected to go home to my own bed that night, but we were told we needed to stay for further monitoring. In a room. In the maternity ward. With a gown. The on-duty OB came to the room and peeked in on our baby via ultrasound. He did not have the gentlest manner but he did point out the baby’s hair and said baby looked “pretty good”. He explained that he didn’t trust preeclampsia (right of him) and that we might not leave the hospital pregnant. Utter shock. What?!? Then it was time to tuck in for the night. This was Monday. Before the nurse started me on the magnesium sulfate IV (affectionately referred to as “the mag”), I asked her what side effects I might expect from it. “Oh, maybe you’ll feel a little warm” was her response. She forgot “you’ll experience the next week in a dry, burning, stuffy haze and feel like an elephant is on your chest!” I can see why they don’t advertise that aspect of it. I got a steroid injection to help prepare baby’s lungs for breathing on the outside, just in case. Baby and I got to experience continuous fetal monitoring and blood pressure monitoring while we occupied our hospital bed that week. I had brought a knitting project but couldn’t really do that, or read, or watch tv or use the computer because the strain on my eyes was so terrible.
I was beside myself that I had taken such good care of myself and my baby during pregnancy and now here I was, hospitalized for the first time in my life. Sad and indignant, actually. I complained about the mag to all the nurses but they all blamed my feeling terrible on the preeclampsia (go figure). I began to try to let go of the idea of carrying this baby to term. My partner and I started talking to our baby about what might happen, letting her know that other people might be helping us take care of her for a while, and that she didn’t need to worry or be scared, just to focus on breathing, sucking, and swallowing. Our midwives visited us and sat with me while I cried. I was a swollen, blubbering mess – oh yes, I gained about ten pounds of water weight that week. I was comforted by their presence. They helped me set my focus on the fact that ready or not, my baby was coming and possibly very soon. We were all going to get to meet this person.
After monitoring my urine and blood for a couple of days, the doctors determined that the preeclampsia wasn’t going away on its own and that there was enough time to try for an induction and a vaginal birth, if I wanted one, and of course I did. In went the Cervadil and we waited for two days for my cervix to ripen, but my cervix apparently clung unwaveringly to its sole task at 33 ½ weeks and was having none of it. By Friday night I wondered if I was strong enough to endure an induction anyway. My entire body ached and I knew it wasn’t normal pregnancy discomfort. My neck, lymph nodes, and spine felt like they were on fire.
I was not really surprised when the next morning the OB came to inform me that a cesarean birth would be necessary. He said he didn't want to see me get any sicker. I started crying with relief - I was so weak and in so much pain. Also terrified of going to the operating room and having my baby so early. We asked when it would happen. Twenty minutes! They gave DP and I a few minutes to cry and get our act together. Today would be our baby's birthday.
I felt calmer by the time we got to the operating room. They gave me an epidural and started prepping me. I tried to focus on breathing. The OR had a beautiful big window with a view of downtown Minneapolis. It was a gorgeous spring day. I started joking with people in the room, making sure everyone had had their coffee that morning. They assured me that it was the best time of the day to have a c-section because everyone was fresh on shift and there to do what they loved. I felt I could let go and trust them. I noticed the lamp above the table was large and had dozens of twinkling bulbs. It was so pretty. I’m sure the drugs were helping me along at this point. DP was able to join me after a few minutes and then they started.
When the doctor held our baby up over the curtain I remember she appeared very grey and ancient, tiny and perfect. We had a girl. She was taken for evaluation and cleaning up, and soon she was screaming at the top of her lungs. I was so, so relieved to hear that sound because it meant she was breathing. Her apgar scores were 8 and 9. After hearing that I think I let myself just space out for a while. I got to hold her to my chest for a few minutes. I don't remember that well. She was so little, 4 lbs and 17” long. Soon DP went with the baby to the Special Care Nursery and I went to recovery to puke in a little cup and get instructed in breast pumping. My mom and midwives were going back and forth from the SCN to my room, showing me video and pictures of her. I remember begging the nurse for food and complaining that I hadn't even had breakfast and she just laughed at me. I think I dreamed up some weird things during those few hours because I have a memory of the nurse and I both pumping our breasts at the same time as she explained to me how to do it. Hmmmm. :)
The next days were pretty much a haze – sleeping and taking painkillers, finally getting to eat and drink, starting to feel better, and getting wheeled upstairs to visit DD in her isolette. It was quite humbling to be so sick and to see my baby hospitalized as well. She was totally perfect, just small and immature and not quite ready to feed the way a term baby would. The next few weeks could be a whole other post, but the short version is that I was discharged a few days later on bp medication with a hospital grade breast pump, and she was there for 21 days, first taking my milk from a dropper, then a NG tube, and finally we learned to breastfeed in the SCN. First baths, first books, first clothes, first naps on our chests all happened there in the hospital until finally she was discharged and we brought her home. It was the longest three week wait ever and I pretty much did nothing but pump, eat, sleep, and visit her. Joy mixed with such a sense of loss and bewilderment over how everything transpired. Our village kept us well supplied with phone calls, tupperwares full of homemade meals, full grocery bags from the co-op, and love. I don’t know how we would have managed to feed ourselves! I should add that the whole time I was in the hospital, DP brought me home cooked meals and he slept on the cot in my room every night. He was there with anything I needed, and I barely had to ask. Being that sick was horrific but also an amazing bonding experience. I don’t know if something like that will ever happen again. I am just grateful for the opportunity to have that.
DD is an alert, gorgeous, social, dimpled, tiny little shrimp of a 9 month old. I had so many fears that we would both be scarred from the trauma of her birth and her subsequent stay in the cold, drab SCN, but we are OK. She seems to have gotten over it much more efficiently than I have. J For a long time I was very conscious of how small she was and had difficulty not comparing her with other babies her age, but with time I have gotten over that. I still have twinges of sadness for not being able to carry her to term, never getting to experience labor or natural birth, not having my child be born into a warm home and taken to her parents’ bed to sleep that same night. I wonder why my body failed me and what having had severe preeclampsia / HELLP means for my future health or any future pregnancies. I know we are lucky to have made it as far as we did in the pregnancy and to have gotten away with seemingly no lasting damage to our health. I am very, very thankful that my baby had no problems related to her prematurity and that she went to the Special Care Nursery instead of the nearby NICU.
Our birth story is a far cry from what I expected and wanted, but I try to remember the good things about it because it is ours. I love being a mother and I want to celebrate the day I gave birth. I have been wanting to write this down for a long time and share it with this community. This is my first post here. Thank you for reading.
Thank you so much for sharing your story. It's good to read your experience of the symptoms and what you went through, and I would have been right there with you with intense relief to not have to go through labor, even though that was your heart's desire. You were so beat by that point. Have you read at all since whether a recurrence is very likely or not? I thought I'd read that it's most common in your first pregnancy with the father, but I hadn't researched it in any depth.
It's such a strange dance - losing the birth you wanted, but realizing you needed the birth you had for your health in that pregnancy. A grief to be had for many reasons. If you have more children, I have every confidence that you can achieve an VBAC. May you and another baby someday experience a calm, full term birth at home with all those moments you desire in the first few weeks, that you missed this time.
Congrats! I was there for my sister when she had pre-e and had to have a c-section. It was very scary.
I'm glad that you such a good outcome despite things not going how you would have hoped and planned.
Happily married Christian SAHM of 2 boys, DD1 , and DD2 July 2013
What a beautiful story of a rough, but ultimately wonderful time in your life. I felt similarly about my c-section, though I wasn't really physically exhausted, I was completely emotionally spent when I agreed to mine.
Thank you for your kind words everyone. Since I made this post, my mind has been chewing over this story less frequently than before. It's nice to have a break. :)
CookAMH, I'm not sure exactly what the likelihood of a recurrence would be as I've heard different things from different sources. I think that having had preeclampsia once already is the single greatest risk factor for getting it again. If I knew I could get the same outcome, I wouldn't have as much hesitation (and would be much better prepared for a 33 weeker in the hospital) but I'm not sure if I would want to risk going much earlier than that.
I have done a lot of reading at preeclampsia.org - very helpful and informative, but also kind of strikes fear in my heart when reading other mamas' stories of loss and continuing health problems that haven't gone away since delivery. Makes me really upset to think about how the doctor discharged me with reassurance that it was all over since my baby had been delivered, no more problems. They KNOW preeclampsia is related to higher incidence of CV disease, heart disease, hypertension, maybe autoimmune stuff.... and at the same time so much is not known. Maybe just a heads up would have been nice.
Happy , delayed/selective vaxxing, WOHM to DD1 4/10 , DD2 8/12 and partner/wife for thirteen years to SAHD DH.